Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Hospital Charge Code 5459195
Hospital Revenue Code 272
Min. Negotiated Rate $511.56
Max. Negotiated Rate $960.48
Rate for Payer: Aetna Commercial $939.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $897.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $553.32
Rate for Payer: Cash Price $313.20
Rate for Payer: Cigna Commercial $960.48
Rate for Payer: Health EOS Commercial $929.16
Rate for Payer: HFN Commercial $960.48
Rate for Payer: Multiplan Commercial $835.20
Rate for Payer: NAPHCARE Commercial $626.40
Rate for Payer: Preferred Network Access Commercial $960.48
Rate for Payer: Quartz Beloit One Network $511.56
Rate for Payer: Quartz Commercial $626.40
Rate for Payer: WEA Trust Commercial $574.20
Rate for Payer: WPS Commercial $773.29
Hospital Charge Code 5459194
Hospital Revenue Code 272
Min. Negotiated Rate $292.32
Max. Negotiated Rate $4,176.00
Rate for Payer: Aetna Commercial $939.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $897.84
Rate for Payer: Aetna Managed Medicare $292.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $678.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $522.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $501.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $553.32
Rate for Payer: Cash Price $313.20
Rate for Payer: Cigna Commercial $960.48
Rate for Payer: Dean Health DHI/DHP/ASO $584.22
Rate for Payer: Health EOS Commercial $929.16
Rate for Payer: HFN Commercial $960.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $783.00
Rate for Payer: Multiplan Commercial $835.20
Rate for Payer: NAPHCARE Commercial $626.40
Rate for Payer: Preferred Network Access Commercial $960.48
Rate for Payer: Quartz Beloit One Network $511.56
Rate for Payer: Quartz Commercial $678.60
Rate for Payer: Quartz Medicare Advantage $626.40
Rate for Payer: The Alliance Commercial $4,176.00
Rate for Payer: WEA Trust Commercial $574.20
Rate for Payer: WPS Commercial $773.29
Hospital Charge Code 5459194
Hospital Revenue Code 272
Min. Negotiated Rate $511.56
Max. Negotiated Rate $960.48
Rate for Payer: Aetna Commercial $939.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $897.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $553.32
Rate for Payer: Cash Price $313.20
Rate for Payer: Cigna Commercial $960.48
Rate for Payer: Health EOS Commercial $929.16
Rate for Payer: HFN Commercial $960.48
Rate for Payer: Multiplan Commercial $835.20
Rate for Payer: NAPHCARE Commercial $626.40
Rate for Payer: Preferred Network Access Commercial $960.48
Rate for Payer: Quartz Beloit One Network $511.56
Rate for Payer: Quartz Commercial $626.40
Rate for Payer: WEA Trust Commercial $574.20
Rate for Payer: WPS Commercial $773.29
Hospital Charge Code 5521013
Hospital Revenue Code 272
Min. Negotiated Rate $431.20
Max. Negotiated Rate $809.60
Rate for Payer: Aetna Commercial $792.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $756.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $466.40
Rate for Payer: Cash Price $264.00
Rate for Payer: Cigna Commercial $809.60
Rate for Payer: Health EOS Commercial $783.20
Rate for Payer: HFN Commercial $809.60
Rate for Payer: Multiplan Commercial $704.00
Rate for Payer: NAPHCARE Commercial $528.00
Rate for Payer: Preferred Network Access Commercial $809.60
Rate for Payer: Quartz Beloit One Network $431.20
Rate for Payer: Quartz Commercial $528.00
Rate for Payer: WEA Trust Commercial $484.00
Rate for Payer: WPS Commercial $651.82
Hospital Charge Code 5521013
Hospital Revenue Code 272
Min. Negotiated Rate $246.40
Max. Negotiated Rate $3,520.00
Rate for Payer: Aetna Commercial $792.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $756.80
Rate for Payer: Aetna Managed Medicare $246.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $572.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $440.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $422.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $466.40
Rate for Payer: Cash Price $264.00
Rate for Payer: Cigna Commercial $809.60
Rate for Payer: Dean Health DHI/DHP/ASO $492.45
Rate for Payer: Health EOS Commercial $783.20
Rate for Payer: HFN Commercial $809.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $660.00
Rate for Payer: Multiplan Commercial $704.00
Rate for Payer: NAPHCARE Commercial $528.00
Rate for Payer: Preferred Network Access Commercial $809.60
Rate for Payer: Quartz Beloit One Network $431.20
Rate for Payer: Quartz Commercial $572.00
Rate for Payer: Quartz Medicare Advantage $528.00
Rate for Payer: The Alliance Commercial $3,520.00
Rate for Payer: WEA Trust Commercial $484.00
Rate for Payer: WPS Commercial $651.82
Hospital Charge Code 6190962
Hospital Revenue Code 272
Min. Negotiated Rate $350.35
Max. Negotiated Rate $657.80
Rate for Payer: Aetna Commercial $643.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $614.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $378.95
Rate for Payer: Cash Price $214.50
Rate for Payer: Cigna Commercial $657.80
Rate for Payer: Health EOS Commercial $636.35
Rate for Payer: HFN Commercial $657.80
Rate for Payer: Multiplan Commercial $572.00
Rate for Payer: NAPHCARE Commercial $429.00
Rate for Payer: Preferred Network Access Commercial $657.80
Rate for Payer: Quartz Beloit One Network $350.35
Rate for Payer: Quartz Commercial $429.00
Rate for Payer: WEA Trust Commercial $393.25
Rate for Payer: WPS Commercial $529.60
Hospital Charge Code 6190962
Hospital Revenue Code 272
Min. Negotiated Rate $200.20
Max. Negotiated Rate $2,860.00
Rate for Payer: Aetna Commercial $643.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $614.90
Rate for Payer: Aetna Managed Medicare $200.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $464.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $357.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $343.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $378.95
Rate for Payer: Cash Price $214.50
Rate for Payer: Cigna Commercial $657.80
Rate for Payer: Dean Health DHI/DHP/ASO $400.11
Rate for Payer: Health EOS Commercial $636.35
Rate for Payer: HFN Commercial $657.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $536.25
Rate for Payer: Multiplan Commercial $572.00
Rate for Payer: NAPHCARE Commercial $429.00
Rate for Payer: Preferred Network Access Commercial $657.80
Rate for Payer: Quartz Beloit One Network $350.35
Rate for Payer: Quartz Commercial $464.75
Rate for Payer: Quartz Medicare Advantage $429.00
Rate for Payer: The Alliance Commercial $2,860.00
Rate for Payer: WEA Trust Commercial $393.25
Rate for Payer: WPS Commercial $529.60
Hospital Charge Code 2965978
Hospital Revenue Code 272
Min. Negotiated Rate $754.11
Max. Negotiated Rate $1,415.88
Rate for Payer: Aetna Commercial $1,385.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,323.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $815.67
Rate for Payer: Cash Price $461.70
Rate for Payer: Cigna Commercial $1,415.88
Rate for Payer: Health EOS Commercial $1,369.71
Rate for Payer: HFN Commercial $1,415.88
Rate for Payer: Multiplan Commercial $1,231.20
Rate for Payer: NAPHCARE Commercial $923.40
Rate for Payer: Preferred Network Access Commercial $1,415.88
Rate for Payer: Quartz Beloit One Network $754.11
Rate for Payer: Quartz Commercial $923.40
Rate for Payer: WEA Trust Commercial $846.45
Rate for Payer: WPS Commercial $1,139.94
Hospital Charge Code 2965978
Hospital Revenue Code 272
Min. Negotiated Rate $430.92
Max. Negotiated Rate $6,156.00
Rate for Payer: Aetna Commercial $1,385.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,323.54
Rate for Payer: Aetna Managed Medicare $430.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,000.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $769.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $738.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $815.67
Rate for Payer: Cash Price $461.70
Rate for Payer: Cigna Commercial $1,415.88
Rate for Payer: Dean Health DHI/DHP/ASO $861.22
Rate for Payer: Health EOS Commercial $1,369.71
Rate for Payer: HFN Commercial $1,415.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,154.25
Rate for Payer: Multiplan Commercial $1,231.20
Rate for Payer: NAPHCARE Commercial $923.40
Rate for Payer: Preferred Network Access Commercial $1,415.88
Rate for Payer: Quartz Beloit One Network $754.11
Rate for Payer: Quartz Commercial $1,000.35
Rate for Payer: Quartz Medicare Advantage $923.40
Rate for Payer: The Alliance Commercial $6,156.00
Rate for Payer: WEA Trust Commercial $846.45
Rate for Payer: WPS Commercial $1,139.94
Hospital Charge Code 2964874
Hospital Revenue Code 272
Min. Negotiated Rate $186.20
Max. Negotiated Rate $2,660.00
Rate for Payer: Aetna Commercial $598.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $571.90
Rate for Payer: Aetna Managed Medicare $186.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $432.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $332.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $319.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $352.45
Rate for Payer: Cash Price $199.50
Rate for Payer: Cigna Commercial $611.80
Rate for Payer: Dean Health DHI/DHP/ASO $372.13
Rate for Payer: Health EOS Commercial $591.85
Rate for Payer: HFN Commercial $611.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $498.75
Rate for Payer: Multiplan Commercial $532.00
Rate for Payer: NAPHCARE Commercial $399.00
Rate for Payer: Preferred Network Access Commercial $611.80
Rate for Payer: Quartz Beloit One Network $325.85
Rate for Payer: Quartz Commercial $432.25
Rate for Payer: Quartz Medicare Advantage $399.00
Rate for Payer: The Alliance Commercial $2,660.00
Rate for Payer: WEA Trust Commercial $365.75
Rate for Payer: WPS Commercial $492.57
Hospital Charge Code 2964874
Hospital Revenue Code 272
Min. Negotiated Rate $325.85
Max. Negotiated Rate $611.80
Rate for Payer: Aetna Commercial $598.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $571.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $352.45
Rate for Payer: Cash Price $199.50
Rate for Payer: Cigna Commercial $611.80
Rate for Payer: Health EOS Commercial $591.85
Rate for Payer: HFN Commercial $611.80
Rate for Payer: Multiplan Commercial $532.00
Rate for Payer: NAPHCARE Commercial $399.00
Rate for Payer: Preferred Network Access Commercial $611.80
Rate for Payer: Quartz Beloit One Network $325.85
Rate for Payer: Quartz Commercial $399.00
Rate for Payer: WEA Trust Commercial $365.75
Rate for Payer: WPS Commercial $492.57
Service Code HCPCS A4649
Hospital Charge Code 2966153
Hospital Revenue Code 278
Min. Negotiated Rate $1,742.72
Max. Negotiated Rate $24,896.00
Rate for Payer: Aetna Commercial $5,601.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,352.64
Rate for Payer: Aetna Managed Medicare $1,742.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,045.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,112.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,987.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,298.72
Rate for Payer: Cash Price $1,867.20
Rate for Payer: Cigna Commercial $5,726.08
Rate for Payer: Dean Health DHI/DHP/ASO $3,482.95
Rate for Payer: Health EOS Commercial $5,539.36
Rate for Payer: HFN Commercial $5,726.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,668.00
Rate for Payer: Multiplan Commercial $4,979.20
Rate for Payer: NAPHCARE Commercial $3,734.40
Rate for Payer: Preferred Network Access Commercial $5,726.08
Rate for Payer: Quartz Beloit One Network $3,049.76
Rate for Payer: Quartz Commercial $4,045.60
Rate for Payer: Quartz Medicare Advantage $3,734.40
Rate for Payer: The Alliance Commercial $24,896.00
Rate for Payer: WEA Trust Commercial $3,423.20
Rate for Payer: WPS Commercial $4,610.12
Service Code HCPCS A4649
Hospital Charge Code 2966153
Hospital Revenue Code 278
Min. Negotiated Rate $3,049.76
Max. Negotiated Rate $5,726.08
Rate for Payer: Aetna Commercial $5,601.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,352.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,298.72
Rate for Payer: Cash Price $1,867.20
Rate for Payer: Cigna Commercial $5,726.08
Rate for Payer: Health EOS Commercial $5,539.36
Rate for Payer: HFN Commercial $5,726.08
Rate for Payer: Multiplan Commercial $4,979.20
Rate for Payer: NAPHCARE Commercial $3,734.40
Rate for Payer: Preferred Network Access Commercial $5,726.08
Rate for Payer: Quartz Beloit One Network $3,049.76
Rate for Payer: Quartz Commercial $3,734.40
Rate for Payer: WEA Trust Commercial $3,423.20
Rate for Payer: WPS Commercial $4,610.12
Hospital Charge Code 4519117
Hospital Revenue Code 272
Min. Negotiated Rate $413.07
Max. Negotiated Rate $775.56
Rate for Payer: Aetna Commercial $758.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $724.98
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $446.79
Rate for Payer: Cash Price $252.90
Rate for Payer: Cigna Commercial $775.56
Rate for Payer: Health EOS Commercial $750.27
Rate for Payer: HFN Commercial $775.56
Rate for Payer: Multiplan Commercial $674.40
Rate for Payer: NAPHCARE Commercial $505.80
Rate for Payer: Preferred Network Access Commercial $775.56
Rate for Payer: Quartz Beloit One Network $413.07
Rate for Payer: Quartz Commercial $505.80
Rate for Payer: WEA Trust Commercial $463.65
Rate for Payer: WPS Commercial $624.41
Hospital Charge Code 4519117
Hospital Revenue Code 272
Min. Negotiated Rate $236.04
Max. Negotiated Rate $3,372.00
Rate for Payer: Aetna Commercial $758.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $724.98
Rate for Payer: Aetna Managed Medicare $236.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $547.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $421.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $404.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $446.79
Rate for Payer: Cash Price $252.90
Rate for Payer: Cigna Commercial $775.56
Rate for Payer: Dean Health DHI/DHP/ASO $471.74
Rate for Payer: Health EOS Commercial $750.27
Rate for Payer: HFN Commercial $775.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $632.25
Rate for Payer: Multiplan Commercial $674.40
Rate for Payer: NAPHCARE Commercial $505.80
Rate for Payer: Preferred Network Access Commercial $775.56
Rate for Payer: Quartz Beloit One Network $413.07
Rate for Payer: Quartz Commercial $547.95
Rate for Payer: Quartz Medicare Advantage $505.80
Rate for Payer: The Alliance Commercial $3,372.00
Rate for Payer: WEA Trust Commercial $463.65
Rate for Payer: WPS Commercial $624.41
Hospital Charge Code 2965526
Hospital Revenue Code 272
Min. Negotiated Rate $42.84
Max. Negotiated Rate $612.00
Rate for Payer: Aetna Commercial $137.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $131.58
Rate for Payer: Aetna Managed Medicare $42.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $99.45
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $76.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $73.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $81.09
Rate for Payer: Cash Price $45.90
Rate for Payer: Cigna Commercial $140.76
Rate for Payer: Dean Health DHI/DHP/ASO $85.62
Rate for Payer: Health EOS Commercial $136.17
Rate for Payer: HFN Commercial $140.76
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $114.75
Rate for Payer: Multiplan Commercial $122.40
Rate for Payer: NAPHCARE Commercial $91.80
Rate for Payer: Preferred Network Access Commercial $140.76
Rate for Payer: Quartz Beloit One Network $74.97
Rate for Payer: Quartz Commercial $99.45
Rate for Payer: Quartz Medicare Advantage $91.80
Rate for Payer: The Alliance Commercial $612.00
Rate for Payer: WEA Trust Commercial $84.15
Rate for Payer: WPS Commercial $113.33
Hospital Charge Code 2965526
Hospital Revenue Code 272
Min. Negotiated Rate $74.97
Max. Negotiated Rate $140.76
Rate for Payer: Aetna Commercial $137.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $131.58
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $81.09
Rate for Payer: Cash Price $45.90
Rate for Payer: Cigna Commercial $140.76
Rate for Payer: Health EOS Commercial $136.17
Rate for Payer: HFN Commercial $140.76
Rate for Payer: Multiplan Commercial $122.40
Rate for Payer: NAPHCARE Commercial $91.80
Rate for Payer: Preferred Network Access Commercial $140.76
Rate for Payer: Quartz Beloit One Network $74.97
Rate for Payer: Quartz Commercial $91.80
Rate for Payer: WEA Trust Commercial $84.15
Rate for Payer: WPS Commercial $113.33
Hospital Charge Code 4518781
Hospital Revenue Code 272
Min. Negotiated Rate $265.09
Max. Negotiated Rate $497.72
Rate for Payer: Aetna Commercial $486.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $465.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $286.73
Rate for Payer: Cash Price $162.30
Rate for Payer: Cigna Commercial $497.72
Rate for Payer: Health EOS Commercial $481.49
Rate for Payer: HFN Commercial $497.72
Rate for Payer: Multiplan Commercial $432.80
Rate for Payer: NAPHCARE Commercial $324.60
Rate for Payer: Preferred Network Access Commercial $497.72
Rate for Payer: Quartz Beloit One Network $265.09
Rate for Payer: Quartz Commercial $324.60
Rate for Payer: WEA Trust Commercial $297.55
Rate for Payer: WPS Commercial $400.72
Hospital Charge Code 4518781
Hospital Revenue Code 272
Min. Negotiated Rate $151.48
Max. Negotiated Rate $2,164.00
Rate for Payer: Aetna Commercial $486.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $465.26
Rate for Payer: Aetna Managed Medicare $151.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $351.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $270.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $259.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $286.73
Rate for Payer: Cash Price $162.30
Rate for Payer: Cigna Commercial $497.72
Rate for Payer: Dean Health DHI/DHP/ASO $302.74
Rate for Payer: Health EOS Commercial $481.49
Rate for Payer: HFN Commercial $497.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $405.75
Rate for Payer: Multiplan Commercial $432.80
Rate for Payer: NAPHCARE Commercial $324.60
Rate for Payer: Preferred Network Access Commercial $497.72
Rate for Payer: Quartz Beloit One Network $265.09
Rate for Payer: Quartz Commercial $351.65
Rate for Payer: Quartz Medicare Advantage $324.60
Rate for Payer: The Alliance Commercial $2,164.00
Rate for Payer: WEA Trust Commercial $297.55
Rate for Payer: WPS Commercial $400.72
Hospital Charge Code 5563609
Hospital Revenue Code 272
Min. Negotiated Rate $652.40
Max. Negotiated Rate $9,320.00
Rate for Payer: Aetna Commercial $2,097.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,003.80
Rate for Payer: Aetna Managed Medicare $652.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,514.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,165.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,118.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,234.90
Rate for Payer: Cash Price $699.00
Rate for Payer: Cigna Commercial $2,143.60
Rate for Payer: Dean Health DHI/DHP/ASO $1,303.87
Rate for Payer: Health EOS Commercial $2,073.70
Rate for Payer: HFN Commercial $2,143.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,747.50
Rate for Payer: Multiplan Commercial $1,864.00
Rate for Payer: NAPHCARE Commercial $1,398.00
Rate for Payer: Preferred Network Access Commercial $2,143.60
Rate for Payer: Quartz Beloit One Network $1,141.70
Rate for Payer: Quartz Commercial $1,514.50
Rate for Payer: Quartz Medicare Advantage $1,398.00
Rate for Payer: The Alliance Commercial $9,320.00
Rate for Payer: WEA Trust Commercial $1,281.50
Rate for Payer: WPS Commercial $1,725.83
Hospital Charge Code 5563609
Hospital Revenue Code 272
Min. Negotiated Rate $1,141.70
Max. Negotiated Rate $2,143.60
Rate for Payer: Aetna Commercial $2,097.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,003.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,234.90
Rate for Payer: Cash Price $699.00
Rate for Payer: Cigna Commercial $2,143.60
Rate for Payer: Health EOS Commercial $2,073.70
Rate for Payer: HFN Commercial $2,143.60
Rate for Payer: Multiplan Commercial $1,864.00
Rate for Payer: NAPHCARE Commercial $1,398.00
Rate for Payer: Preferred Network Access Commercial $2,143.60
Rate for Payer: Quartz Beloit One Network $1,141.70
Rate for Payer: Quartz Commercial $1,398.00
Rate for Payer: WEA Trust Commercial $1,281.50
Rate for Payer: WPS Commercial $1,725.83
Hospital Charge Code 5349393
Hospital Revenue Code 272
Min. Negotiated Rate $879.20
Max. Negotiated Rate $12,560.00
Rate for Payer: Aetna Commercial $2,826.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,700.40
Rate for Payer: Aetna Managed Medicare $879.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,041.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,570.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,507.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,664.20
Rate for Payer: Cash Price $942.00
Rate for Payer: Cigna Commercial $2,888.80
Rate for Payer: Dean Health DHI/DHP/ASO $1,757.14
Rate for Payer: Health EOS Commercial $2,794.60
Rate for Payer: HFN Commercial $2,888.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,355.00
Rate for Payer: Multiplan Commercial $2,512.00
Rate for Payer: NAPHCARE Commercial $1,884.00
Rate for Payer: Preferred Network Access Commercial $2,888.80
Rate for Payer: Quartz Beloit One Network $1,538.60
Rate for Payer: Quartz Commercial $2,041.00
Rate for Payer: Quartz Medicare Advantage $1,884.00
Rate for Payer: The Alliance Commercial $12,560.00
Rate for Payer: WEA Trust Commercial $1,727.00
Rate for Payer: WPS Commercial $2,325.80
Hospital Charge Code 5349393
Hospital Revenue Code 272
Min. Negotiated Rate $1,538.60
Max. Negotiated Rate $2,888.80
Rate for Payer: Aetna Commercial $2,826.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,700.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,664.20
Rate for Payer: Cash Price $942.00
Rate for Payer: Cigna Commercial $2,888.80
Rate for Payer: Health EOS Commercial $2,794.60
Rate for Payer: HFN Commercial $2,888.80
Rate for Payer: Multiplan Commercial $2,512.00
Rate for Payer: NAPHCARE Commercial $1,884.00
Rate for Payer: Preferred Network Access Commercial $2,888.80
Rate for Payer: Quartz Beloit One Network $1,538.60
Rate for Payer: Quartz Commercial $1,884.00
Rate for Payer: WEA Trust Commercial $1,727.00
Rate for Payer: WPS Commercial $2,325.80
Hospital Charge Code 5659737
Hospital Revenue Code 272
Min. Negotiated Rate $465.92
Max. Negotiated Rate $6,656.00
Rate for Payer: Aetna Commercial $1,497.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,431.04
Rate for Payer: Aetna Managed Medicare $465.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,081.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $832.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $798.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $881.92
Rate for Payer: Cash Price $499.20
Rate for Payer: Cigna Commercial $1,530.88
Rate for Payer: Dean Health DHI/DHP/ASO $931.17
Rate for Payer: Health EOS Commercial $1,480.96
Rate for Payer: HFN Commercial $1,530.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,248.00
Rate for Payer: Multiplan Commercial $1,331.20
Rate for Payer: NAPHCARE Commercial $998.40
Rate for Payer: Preferred Network Access Commercial $1,530.88
Rate for Payer: Quartz Beloit One Network $815.36
Rate for Payer: Quartz Commercial $1,081.60
Rate for Payer: Quartz Medicare Advantage $998.40
Rate for Payer: The Alliance Commercial $6,656.00
Rate for Payer: WEA Trust Commercial $915.20
Rate for Payer: WPS Commercial $1,232.52
Hospital Charge Code 5659737
Hospital Revenue Code 272
Min. Negotiated Rate $815.36
Max. Negotiated Rate $1,530.88
Rate for Payer: Aetna Commercial $1,497.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,431.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $881.92
Rate for Payer: Cash Price $499.20
Rate for Payer: Cigna Commercial $1,530.88
Rate for Payer: Health EOS Commercial $1,480.96
Rate for Payer: HFN Commercial $1,530.88
Rate for Payer: Multiplan Commercial $1,331.20
Rate for Payer: NAPHCARE Commercial $998.40
Rate for Payer: Preferred Network Access Commercial $1,530.88
Rate for Payer: Quartz Beloit One Network $815.36
Rate for Payer: Quartz Commercial $998.40
Rate for Payer: WEA Trust Commercial $915.20
Rate for Payer: WPS Commercial $1,232.52