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Charge Type Price  
Service Code CPT 44401
Hospital Charge Code 4494710
Hospital Revenue Code 750
Min. Negotiated Rate $1,166.39
Max. Negotiated Rate $21,990.36
Rate for Payer: Aetna Commercial $4,402.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,207.12
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,592.76
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cigna Commercial $4,500.64
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Health EOS Commercial $4,353.88
Rate for Payer: HFN Commercial $4,500.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: Multiplan Commercial $3,913.60
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Preferred Network Access Commercial $4,500.64
Rate for Payer: Quartz Beloit One Network $2,397.08
Rate for Payer: Quartz Commercial $3,179.80
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $21,990.36
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: WEA Trust Commercial $2,690.60
Rate for Payer: Wellcare Medicare $1,166.39
Rate for Payer: WPS Commercial $3,623.50
Service Code CPT 44401
Hospital Charge Code 4494710
Hospital Revenue Code 750
Min. Negotiated Rate $2,397.08
Max. Negotiated Rate $4,500.64
Rate for Payer: Aetna Commercial $4,402.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,592.76
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cigna Commercial $4,500.64
Rate for Payer: Health EOS Commercial $4,353.88
Rate for Payer: HFN Commercial $4,500.64
Rate for Payer: Multiplan Commercial $3,913.60
Rate for Payer: NAPHCARE Commercial $2,935.20
Rate for Payer: Preferred Network Access Commercial $4,500.64
Rate for Payer: Quartz Beloit One Network $2,397.08
Rate for Payer: Quartz Commercial $2,935.20
Rate for Payer: WEA Trust Commercial $2,690.60
Rate for Payer: WPS Commercial $3,623.50
Service Code CPT 44405
Hospital Charge Code 4494712
Hospital Revenue Code 750
Min. Negotiated Rate $2,534.77
Max. Negotiated Rate $4,759.16
Rate for Payer: Aetna Commercial $4,655.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,741.69
Rate for Payer: Cash Price $1,551.90
Rate for Payer: Cigna Commercial $4,759.16
Rate for Payer: Health EOS Commercial $4,603.97
Rate for Payer: HFN Commercial $4,759.16
Rate for Payer: Multiplan Commercial $4,138.40
Rate for Payer: NAPHCARE Commercial $3,103.80
Rate for Payer: Preferred Network Access Commercial $4,759.16
Rate for Payer: Quartz Beloit One Network $2,534.77
Rate for Payer: Quartz Commercial $3,103.80
Rate for Payer: WEA Trust Commercial $2,845.15
Rate for Payer: WPS Commercial $3,831.64
Service Code CPT 44405
Hospital Charge Code 4494712
Hospital Revenue Code 750
Min. Negotiated Rate $1,166.39
Max. Negotiated Rate $28,833.64
Rate for Payer: Aetna Commercial $4,655.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,448.78
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,741.69
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cash Price $1,551.90
Rate for Payer: Cash Price $1,551.90
Rate for Payer: Cash Price $1,551.90
Rate for Payer: Cigna Commercial $4,759.16
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Health EOS Commercial $4,603.97
Rate for Payer: HFN Commercial $4,759.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: Multiplan Commercial $4,138.40
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Preferred Network Access Commercial $4,759.16
Rate for Payer: Quartz Beloit One Network $2,534.77
Rate for Payer: Quartz Commercial $3,362.45
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $28,833.64
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: WEA Trust Commercial $2,845.15
Rate for Payer: Wellcare Medicare $1,166.39
Rate for Payer: WPS Commercial $3,831.64
Service Code CPT 44389
Hospital Revenue Code 750
Min. Negotiated Rate $1,166.39
Max. Negotiated Rate $13,185.36
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $13,185.36
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,166.39
Service Code CPT 44408
Hospital Charge Code 4494713
Hospital Revenue Code 750
Min. Negotiated Rate $903.36
Max. Negotiated Rate $39,231.04
Rate for Payer: Aetna Commercial $1,753.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,675.28
Rate for Payer: Aetna Managed Medicare $903.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,914.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,297.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,183.00
Rate for Payer: Anthem Medicare Advantage $903.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,032.44
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $903.36
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $903.36
Rate for Payer: Cash Price $584.40
Rate for Payer: Cash Price $584.40
Rate for Payer: Cash Price $584.40
Rate for Payer: Cigna Commercial $1,792.16
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $903.36
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $903.36
Rate for Payer: Health EOS Commercial $1,733.72
Rate for Payer: HFN Commercial $1,792.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,360.50
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $903.36
Rate for Payer: Independent Care Health Plan Medicare $903.36
Rate for Payer: Managed Health Services Medicare Advantage $903.36
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $903.36
Rate for Payer: Multiplan Commercial $1,558.40
Rate for Payer: NAPHCARE Commercial $1,355.04
Rate for Payer: Preferred Network Access Commercial $1,792.16
Rate for Payer: Quartz Beloit One Network $954.52
Rate for Payer: Quartz Commercial $1,266.20
Rate for Payer: Quartz Medicare Advantage $903.36
Rate for Payer: The Alliance Commercial $39,231.04
Rate for Payer: United Healthcare Medicare Advantage $903.36
Rate for Payer: United Healthcare PPO $2,257.00
Rate for Payer: WEA Trust Commercial $1,071.40
Rate for Payer: Wellcare Medicare $903.36
Rate for Payer: WPS Commercial $1,442.88
Service Code CPT 44408
Hospital Charge Code 4494713
Hospital Revenue Code 750
Min. Negotiated Rate $954.52
Max. Negotiated Rate $1,792.16
Rate for Payer: Aetna Commercial $1,753.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,032.44
Rate for Payer: Cash Price $584.40
Rate for Payer: Cigna Commercial $1,792.16
Rate for Payer: Health EOS Commercial $1,733.72
Rate for Payer: HFN Commercial $1,792.16
Rate for Payer: Multiplan Commercial $1,558.40
Rate for Payer: NAPHCARE Commercial $1,168.80
Rate for Payer: Preferred Network Access Commercial $1,792.16
Rate for Payer: Quartz Beloit One Network $954.52
Rate for Payer: Quartz Commercial $1,168.80
Rate for Payer: WEA Trust Commercial $1,071.40
Rate for Payer: WPS Commercial $1,442.88
Service Code CPT 44394
Hospital Revenue Code 750
Min. Negotiated Rate $1,166.39
Max. Negotiated Rate $21,990.36
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $21,990.36
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,166.39
Service Code CPT 44402
Hospital Charge Code 4494711
Hospital Revenue Code 750
Min. Negotiated Rate $2,238.81
Max. Negotiated Rate $21,990.36
Rate for Payer: Aetna Commercial $4,112.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,929.34
Rate for Payer: Aetna Managed Medicare $5,633.17
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,238.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $10,914.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,367.00
Rate for Payer: Anthem Medicare Advantage $5,633.17
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,421.57
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $5,633.17
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $5,633.17
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cigna Commercial $4,203.48
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $5,633.17
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $5,633.17
Rate for Payer: Health EOS Commercial $4,066.41
Rate for Payer: HFN Commercial $4,203.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $20,955.39
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $5,633.17
Rate for Payer: Independent Care Health Plan Medicare $5,633.17
Rate for Payer: Managed Health Services Medicare Advantage $5,633.17
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $5,633.17
Rate for Payer: Multiplan Commercial $3,655.20
Rate for Payer: NAPHCARE Commercial $8,449.76
Rate for Payer: Preferred Network Access Commercial $4,203.48
Rate for Payer: Quartz Beloit One Network $2,238.81
Rate for Payer: Quartz Commercial $2,969.85
Rate for Payer: Quartz Medicare Advantage $5,633.17
Rate for Payer: The Alliance Commercial $21,990.36
Rate for Payer: United Healthcare Medicare Advantage $5,633.17
Rate for Payer: United Healthcare PPO $4,240.00
Rate for Payer: WEA Trust Commercial $2,512.95
Rate for Payer: Wellcare Medicare $5,633.17
Rate for Payer: WPS Commercial $3,384.26
Service Code CPT 44402
Hospital Charge Code 4494711
Hospital Revenue Code 750
Min. Negotiated Rate $2,238.81
Max. Negotiated Rate $4,203.48
Rate for Payer: Aetna Commercial $4,112.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,421.57
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cigna Commercial $4,203.48
Rate for Payer: Health EOS Commercial $4,066.41
Rate for Payer: HFN Commercial $4,203.48
Rate for Payer: Multiplan Commercial $3,655.20
Rate for Payer: NAPHCARE Commercial $2,741.40
Rate for Payer: Preferred Network Access Commercial $4,203.48
Rate for Payer: Quartz Beloit One Network $2,238.81
Rate for Payer: Quartz Commercial $2,741.40
Rate for Payer: WEA Trust Commercial $2,512.95
Rate for Payer: WPS Commercial $3,384.26
Service Code CPT 44404
Hospital Charge Code 5544706
Hospital Revenue Code 510
Min. Negotiated Rate $796.32
Max. Negotiated Rate $28,833.64
Rate for Payer: Aetna Commercial $1,493.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,426.74
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,078.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $829.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $796.32
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $879.27
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cash Price $497.70
Rate for Payer: Cash Price $497.70
Rate for Payer: Cigna Commercial $1,526.28
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Health EOS Commercial $1,476.51
Rate for Payer: HFN Commercial $1,526.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: Multiplan Commercial $1,327.20
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Preferred Network Access Commercial $1,526.28
Rate for Payer: Quartz Beloit One Network $812.91
Rate for Payer: Quartz Commercial $1,078.35
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $28,833.64
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: WEA Trust Commercial $912.45
Rate for Payer: Wellcare Medicare $1,166.39
Rate for Payer: WPS Commercial $1,228.82
Service Code CPT 44404
Hospital Charge Code 5544706
Hospital Revenue Code 510
Min. Negotiated Rate $812.91
Max. Negotiated Rate $1,526.28
Rate for Payer: Aetna Commercial $1,493.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $879.27
Rate for Payer: Cash Price $497.70
Rate for Payer: Cigna Commercial $1,526.28
Rate for Payer: Health EOS Commercial $1,476.51
Rate for Payer: HFN Commercial $1,526.28
Rate for Payer: Multiplan Commercial $1,327.20
Rate for Payer: NAPHCARE Commercial $995.40
Rate for Payer: Preferred Network Access Commercial $1,526.28
Rate for Payer: Quartz Beloit One Network $812.91
Rate for Payer: Quartz Commercial $995.40
Rate for Payer: WEA Trust Commercial $912.45
Rate for Payer: WPS Commercial $1,228.82
Service Code CPT 45388
Hospital Charge Code 4494705
Hospital Revenue Code 750
Min. Negotiated Rate $1,166.39
Max. Negotiated Rate $13,185.36
Rate for Payer: Aetna Commercial $4,402.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,207.12
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,592.76
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cigna Commercial $4,500.64
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Health EOS Commercial $4,353.88
Rate for Payer: HFN Commercial $4,500.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: Multiplan Commercial $3,913.60
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Preferred Network Access Commercial $4,500.64
Rate for Payer: Quartz Beloit One Network $2,397.08
Rate for Payer: Quartz Commercial $3,179.80
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $13,185.36
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: WEA Trust Commercial $2,690.60
Rate for Payer: Wellcare Medicare $1,166.39
Rate for Payer: WPS Commercial $3,623.50
Service Code CPT 45388
Hospital Charge Code 4494705
Hospital Revenue Code 750
Min. Negotiated Rate $2,397.08
Max. Negotiated Rate $4,500.64
Rate for Payer: Aetna Commercial $4,402.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,592.76
Rate for Payer: Cash Price $1,467.60
Rate for Payer: Cigna Commercial $4,500.64
Rate for Payer: Health EOS Commercial $4,353.88
Rate for Payer: HFN Commercial $4,500.64
Rate for Payer: Multiplan Commercial $3,913.60
Rate for Payer: NAPHCARE Commercial $2,935.20
Rate for Payer: Preferred Network Access Commercial $4,500.64
Rate for Payer: Quartz Beloit One Network $2,397.08
Rate for Payer: Quartz Commercial $2,935.20
Rate for Payer: WEA Trust Commercial $2,690.60
Rate for Payer: WPS Commercial $3,623.50
Service Code CPT 45398
Hospital Charge Code 4494704
Hospital Revenue Code 750
Min. Negotiated Rate $2,985.08
Max. Negotiated Rate $5,604.64
Rate for Payer: Aetna Commercial $5,482.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,228.76
Rate for Payer: Cash Price $1,827.60
Rate for Payer: Cigna Commercial $5,604.64
Rate for Payer: Health EOS Commercial $5,421.88
Rate for Payer: HFN Commercial $5,604.64
Rate for Payer: Multiplan Commercial $4,873.60
Rate for Payer: NAPHCARE Commercial $3,655.20
Rate for Payer: Preferred Network Access Commercial $5,604.64
Rate for Payer: Quartz Beloit One Network $2,985.08
Rate for Payer: Quartz Commercial $3,655.20
Rate for Payer: WEA Trust Commercial $3,350.60
Rate for Payer: WPS Commercial $4,512.34
Service Code CPT 45398
Hospital Charge Code 4494704
Hospital Revenue Code 750
Min. Negotiated Rate $1,166.39
Max. Negotiated Rate $35,109.64
Rate for Payer: Aetna Commercial $5,482.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,239.12
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,228.76
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cash Price $1,827.60
Rate for Payer: Cash Price $1,827.60
Rate for Payer: Cash Price $1,827.60
Rate for Payer: Cigna Commercial $5,604.64
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Health EOS Commercial $5,421.88
Rate for Payer: HFN Commercial $5,604.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: Multiplan Commercial $4,873.60
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Preferred Network Access Commercial $5,604.64
Rate for Payer: Quartz Beloit One Network $2,985.08
Rate for Payer: Quartz Commercial $3,959.80
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $35,109.64
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: WEA Trust Commercial $3,350.60
Rate for Payer: Wellcare Medicare $1,166.39
Rate for Payer: WPS Commercial $4,512.34
Hospital Charge Code 2960553
Hospital Revenue Code 750
Min. Negotiated Rate $3,364.34
Max. Negotiated Rate $6,316.72
Rate for Payer: Aetna Commercial $6,179.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,638.98
Rate for Payer: Cash Price $2,059.80
Rate for Payer: Cigna Commercial $6,316.72
Rate for Payer: Health EOS Commercial $6,110.74
Rate for Payer: HFN Commercial $6,316.72
Rate for Payer: Multiplan Commercial $5,492.80
Rate for Payer: NAPHCARE Commercial $4,119.60
Rate for Payer: Preferred Network Access Commercial $6,316.72
Rate for Payer: Quartz Beloit One Network $3,364.34
Rate for Payer: Quartz Commercial $4,119.60
Rate for Payer: WEA Trust Commercial $3,776.30
Rate for Payer: WPS Commercial $5,085.65
Hospital Charge Code 2960553
Hospital Revenue Code 750
Min. Negotiated Rate $1,922.48
Max. Negotiated Rate $27,464.00
Rate for Payer: Aetna Commercial $6,179.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,904.76
Rate for Payer: Aetna Managed Medicare $1,922.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,462.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,433.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,295.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,638.98
Rate for Payer: Cash Price $2,059.80
Rate for Payer: Cigna Commercial $6,316.72
Rate for Payer: Dean Health DHI/DHP/ASO $3,842.21
Rate for Payer: Health EOS Commercial $6,110.74
Rate for Payer: HFN Commercial $6,316.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,149.50
Rate for Payer: Multiplan Commercial $5,492.80
Rate for Payer: NAPHCARE Commercial $4,119.60
Rate for Payer: Preferred Network Access Commercial $6,316.72
Rate for Payer: Quartz Beloit One Network $3,364.34
Rate for Payer: Quartz Commercial $4,462.90
Rate for Payer: Quartz Medicare Advantage $4,119.60
Rate for Payer: The Alliance Commercial $27,464.00
Rate for Payer: WEA Trust Commercial $3,776.30
Rate for Payer: WPS Commercial $5,085.65
Service Code CPT 45393
Hospital Charge Code 4494706
Hospital Revenue Code 750
Min. Negotiated Rate $954.52
Max. Negotiated Rate $35,109.64
Rate for Payer: Aetna Commercial $1,753.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,675.28
Rate for Payer: Aetna Managed Medicare $1,166.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,032.44
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,166.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,166.39
Rate for Payer: Cash Price $584.40
Rate for Payer: Cash Price $584.40
Rate for Payer: Cash Price $584.40
Rate for Payer: Cigna Commercial $1,792.16
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,166.39
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,166.39
Rate for Payer: Health EOS Commercial $1,733.72
Rate for Payer: HFN Commercial $1,792.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,338.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,166.39
Rate for Payer: Independent Care Health Plan Medicare $1,166.39
Rate for Payer: Managed Health Services Medicare Advantage $1,166.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,166.39
Rate for Payer: Multiplan Commercial $1,558.40
Rate for Payer: NAPHCARE Commercial $1,749.58
Rate for Payer: Preferred Network Access Commercial $1,792.16
Rate for Payer: Quartz Beloit One Network $954.52
Rate for Payer: Quartz Commercial $1,266.20
Rate for Payer: Quartz Medicare Advantage $1,166.39
Rate for Payer: The Alliance Commercial $35,109.64
Rate for Payer: United Healthcare Medicare Advantage $1,166.39
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: WEA Trust Commercial $1,071.40
Rate for Payer: Wellcare Medicare $1,166.39
Rate for Payer: WPS Commercial $1,442.88
Service Code CPT 45393
Hospital Charge Code 4494706
Hospital Revenue Code 750
Min. Negotiated Rate $954.52
Max. Negotiated Rate $1,792.16
Rate for Payer: Aetna Commercial $1,753.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,032.44
Rate for Payer: Cash Price $584.40
Rate for Payer: Cigna Commercial $1,792.16
Rate for Payer: Health EOS Commercial $1,733.72
Rate for Payer: HFN Commercial $1,792.16
Rate for Payer: Multiplan Commercial $1,558.40
Rate for Payer: NAPHCARE Commercial $1,168.80
Rate for Payer: Preferred Network Access Commercial $1,792.16
Rate for Payer: Quartz Beloit One Network $954.52
Rate for Payer: Quartz Commercial $1,168.80
Rate for Payer: WEA Trust Commercial $1,071.40
Rate for Payer: WPS Commercial $1,442.88
Hospital Charge Code 2960554
Hospital Revenue Code 750
Min. Negotiated Rate $2,017.40
Max. Negotiated Rate $28,820.00
Rate for Payer: Aetna Commercial $6,484.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,196.30
Rate for Payer: Aetna Managed Medicare $2,017.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,683.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,602.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,458.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,818.65
Rate for Payer: Cash Price $2,161.50
Rate for Payer: Cigna Commercial $6,628.60
Rate for Payer: Dean Health DHI/DHP/ASO $4,031.92
Rate for Payer: Health EOS Commercial $6,412.45
Rate for Payer: HFN Commercial $6,628.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,403.75
Rate for Payer: Multiplan Commercial $5,764.00
Rate for Payer: NAPHCARE Commercial $4,323.00
Rate for Payer: Preferred Network Access Commercial $6,628.60
Rate for Payer: Quartz Beloit One Network $3,530.45
Rate for Payer: Quartz Commercial $4,683.25
Rate for Payer: Quartz Medicare Advantage $4,323.00
Rate for Payer: The Alliance Commercial $28,820.00
Rate for Payer: WEA Trust Commercial $3,962.75
Rate for Payer: WPS Commercial $5,336.74
Hospital Charge Code 2960554
Hospital Revenue Code 750
Min. Negotiated Rate $3,530.45
Max. Negotiated Rate $6,628.60
Rate for Payer: Aetna Commercial $6,484.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,818.65
Rate for Payer: Cash Price $2,161.50
Rate for Payer: Cigna Commercial $6,628.60
Rate for Payer: Health EOS Commercial $6,412.45
Rate for Payer: HFN Commercial $6,628.60
Rate for Payer: Multiplan Commercial $5,764.00
Rate for Payer: NAPHCARE Commercial $4,323.00
Rate for Payer: Preferred Network Access Commercial $6,628.60
Rate for Payer: Quartz Beloit One Network $3,530.45
Rate for Payer: Quartz Commercial $4,323.00
Rate for Payer: WEA Trust Commercial $3,962.75
Rate for Payer: WPS Commercial $5,336.74
Hospital Charge Code 2960555
Hospital Revenue Code 750
Min. Negotiated Rate $3,538.29
Max. Negotiated Rate $6,643.32
Rate for Payer: Aetna Commercial $6,498.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,827.13
Rate for Payer: Cash Price $2,166.30
Rate for Payer: Cigna Commercial $6,643.32
Rate for Payer: Health EOS Commercial $6,426.69
Rate for Payer: HFN Commercial $6,643.32
Rate for Payer: Multiplan Commercial $5,776.80
Rate for Payer: NAPHCARE Commercial $4,332.60
Rate for Payer: Preferred Network Access Commercial $6,643.32
Rate for Payer: Quartz Beloit One Network $3,538.29
Rate for Payer: Quartz Commercial $4,332.60
Rate for Payer: WEA Trust Commercial $3,971.55
Rate for Payer: WPS Commercial $5,348.59
Hospital Charge Code 2960555
Hospital Revenue Code 750
Min. Negotiated Rate $2,021.88
Max. Negotiated Rate $28,884.00
Rate for Payer: Aetna Commercial $6,498.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,210.06
Rate for Payer: Aetna Managed Medicare $2,021.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,693.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,610.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,466.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,827.13
Rate for Payer: Cash Price $2,166.30
Rate for Payer: Cigna Commercial $6,643.32
Rate for Payer: Dean Health DHI/DHP/ASO $4,040.87
Rate for Payer: Health EOS Commercial $6,426.69
Rate for Payer: HFN Commercial $6,643.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,415.75
Rate for Payer: Multiplan Commercial $5,776.80
Rate for Payer: NAPHCARE Commercial $4,332.60
Rate for Payer: Preferred Network Access Commercial $6,643.32
Rate for Payer: Quartz Beloit One Network $3,538.29
Rate for Payer: Quartz Commercial $4,693.65
Rate for Payer: Quartz Medicare Advantage $4,332.60
Rate for Payer: The Alliance Commercial $28,884.00
Rate for Payer: WEA Trust Commercial $3,971.55
Rate for Payer: WPS Commercial $5,348.59
Service Code CPT 45389
Hospital Charge Code 4494708
Hospital Revenue Code 750
Min. Negotiated Rate $2,238.81
Max. Negotiated Rate $21,990.36
Rate for Payer: Aetna Commercial $4,112.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,929.34
Rate for Payer: Aetna Managed Medicare $5,633.17
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,238.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $10,914.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,367.00
Rate for Payer: Anthem Medicare Advantage $5,633.17
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,421.57
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $5,633.17
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $5,633.17
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cash Price $1,370.70
Rate for Payer: Cigna Commercial $4,203.48
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $5,633.17
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $5,633.17
Rate for Payer: Health EOS Commercial $4,066.41
Rate for Payer: HFN Commercial $4,203.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $20,955.39
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $5,633.17
Rate for Payer: Independent Care Health Plan Medicare $5,633.17
Rate for Payer: Managed Health Services Medicare Advantage $5,633.17
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $5,633.17
Rate for Payer: Multiplan Commercial $3,655.20
Rate for Payer: NAPHCARE Commercial $8,449.76
Rate for Payer: Preferred Network Access Commercial $4,203.48
Rate for Payer: Quartz Beloit One Network $2,238.81
Rate for Payer: Quartz Commercial $2,969.85
Rate for Payer: Quartz Medicare Advantage $5,633.17
Rate for Payer: The Alliance Commercial $21,990.36
Rate for Payer: United Healthcare Medicare Advantage $5,633.17
Rate for Payer: United Healthcare PPO $4,240.00
Rate for Payer: WEA Trust Commercial $2,512.95
Rate for Payer: Wellcare Medicare $5,633.17
Rate for Payer: WPS Commercial $3,384.26