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All Charges

Charge Type Price  
Service Code HCPCS C1760
Hospital Charge Code 3613524
Hospital Revenue Code 278
Min. Negotiated Rate $1,421.49
Max. Negotiated Rate $2,668.92
Rate for Payer: Aetna Commercial $2,610.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,537.53
Rate for Payer: Cash Price $870.30
Rate for Payer: Cigna Commercial $2,668.92
Rate for Payer: Health EOS Commercial $2,581.89
Rate for Payer: HFN Commercial $2,668.92
Rate for Payer: Multiplan Commercial $2,320.80
Rate for Payer: NAPHCARE Commercial $1,740.60
Rate for Payer: Preferred Network Access Commercial $2,668.92
Rate for Payer: Quartz Beloit One Network $1,421.49
Rate for Payer: Quartz Commercial $1,740.60
Rate for Payer: WEA Trust Commercial $1,595.55
Rate for Payer: WPS Commercial $2,148.77