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Service Code CPT 74178 TC
Hospital Charge Code 1240803
Hospital Revenue Code 350
Min. Negotiated Rate $251.64
Max. Negotiated Rate $7,160.15
Rate for Payer: Aetna Commercial $7,160.15
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,481.82
Rate for Payer: Aetna Managed Medicare $251.64
Rate for Payer: Anthem Medicare Advantage $251.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $251.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $251.64
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cigna Commercial $7,160.15
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,768.50
Rate for Payer: Dean Health DHI/DHP/ASO $251.64
Rate for Payer: Health EOS Commercial $6,858.67
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $935.91
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $935.91
Rate for Payer: Independent Care Health Plan Medicare $251.64
Rate for Payer: Multiplan Commercial $6,029.60
Rate for Payer: Preferred Network Access Commercial $7,160.15
Rate for Payer: Quartz Beloit One Network $3,316.28
Rate for Payer: Quartz Commercial $4,296.09
Rate for Payer: Quartz Medicare Advantage $251.64
Rate for Payer: The Alliance Commercial $956.23
Rate for Payer: United Healthcare Medicare Advantage $251.64
Rate for Payer: WEA Trust Commercial $4,145.35
Rate for Payer: WPS Commercial $1,258.20
Service Code CPT 74177 TC
Hospital Charge Code 5551882
Hospital Revenue Code 350
Min. Negotiated Rate $3,307.50
Max. Negotiated Rate $6,210.00
Rate for Payer: Aetna Commercial $6,075.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,577.50
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cigna Commercial $6,210.00
Rate for Payer: Health EOS Commercial $6,007.50
Rate for Payer: HFN Commercial $6,210.00
Rate for Payer: Multiplan Commercial $5,400.00
Rate for Payer: NAPHCARE Commercial $4,050.00
Rate for Payer: Preferred Network Access Commercial $6,210.00
Rate for Payer: Quartz Beloit One Network $3,307.50
Rate for Payer: Quartz Commercial $4,050.00
Rate for Payer: WEA Trust Commercial $3,712.50
Rate for Payer: WPS Commercial $4,999.72
Service Code CPT 74177 TC
Hospital Charge Code 5551882
Hospital Revenue Code 350
Min. Negotiated Rate $222.99
Max. Negotiated Rate $6,412.50
Rate for Payer: Aetna Commercial $6,412.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,805.00
Rate for Payer: Aetna Managed Medicare $222.99
Rate for Payer: Anthem Medicare Advantage $222.99
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $222.99
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $222.99
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cigna Commercial $6,412.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,375.00
Rate for Payer: Dean Health DHI/DHP/ASO $222.99
Rate for Payer: Health EOS Commercial $6,142.50
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $828.00
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $828.00
Rate for Payer: Independent Care Health Plan Medicare $222.99
Rate for Payer: Multiplan Commercial $5,400.00
Rate for Payer: Preferred Network Access Commercial $6,412.50
Rate for Payer: Quartz Beloit One Network $2,970.00
Rate for Payer: Quartz Commercial $3,847.50
Rate for Payer: Quartz Medicare Advantage $222.99
Rate for Payer: The Alliance Commercial $847.36
Rate for Payer: United Healthcare Medicare Advantage $222.99
Rate for Payer: WEA Trust Commercial $3,712.50
Rate for Payer: WPS Commercial $1,114.95
Service Code CPT 74177 TC
Hospital Charge Code 5551882
Hospital Revenue Code 350
Min. Negotiated Rate $1,560.93
Max. Negotiated Rate $27,000.00
Rate for Payer: Aetna Commercial $6,075.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,805.00
Rate for Payer: Aetna Managed Medicare $1,890.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,205.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,586.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,454.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,577.50
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cash Price $2,025.00
Rate for Payer: Cigna Commercial $6,210.00
Rate for Payer: Health EOS Commercial $6,007.50
Rate for Payer: HFN Commercial $6,210.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,062.50
Rate for Payer: Multiplan Commercial $5,400.00
Rate for Payer: NAPHCARE Commercial $4,050.00
Rate for Payer: Preferred Network Access Commercial $6,210.00
Rate for Payer: Quartz Beloit One Network $3,307.50
Rate for Payer: Quartz Commercial $4,387.50
Rate for Payer: Quartz Medicare Advantage $4,050.00
Rate for Payer: The Alliance Commercial $27,000.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $3,712.50
Rate for Payer: WPS Commercial $1,560.93
Service Code CPT 74176 TC
Hospital Charge Code 5551885
Hospital Revenue Code 350
Min. Negotiated Rate $720.37
Max. Negotiated Rate $23,844.00
Rate for Payer: Aetna Commercial $5,364.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,126.46
Rate for Payer: Aetna Managed Medicare $1,669.08
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,205.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,586.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,454.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,159.33
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cigna Commercial $5,484.12
Rate for Payer: Health EOS Commercial $5,305.29
Rate for Payer: HFN Commercial $5,484.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,470.75
Rate for Payer: Multiplan Commercial $4,768.80
Rate for Payer: NAPHCARE Commercial $3,576.60
Rate for Payer: Preferred Network Access Commercial $5,484.12
Rate for Payer: Quartz Beloit One Network $2,920.89
Rate for Payer: Quartz Commercial $3,874.65
Rate for Payer: Quartz Medicare Advantage $3,576.60
Rate for Payer: The Alliance Commercial $23,844.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $3,278.55
Rate for Payer: WPS Commercial $720.37
Service Code CPT 74176 TC
Hospital Charge Code 5551885
Hospital Revenue Code 350
Min. Negotiated Rate $2,920.89
Max. Negotiated Rate $5,484.12
Rate for Payer: Aetna Commercial $5,364.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,159.33
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cigna Commercial $5,484.12
Rate for Payer: Health EOS Commercial $5,305.29
Rate for Payer: HFN Commercial $5,484.12
Rate for Payer: Multiplan Commercial $4,768.80
Rate for Payer: NAPHCARE Commercial $3,576.60
Rate for Payer: Preferred Network Access Commercial $5,484.12
Rate for Payer: Quartz Beloit One Network $2,920.89
Rate for Payer: Quartz Commercial $3,576.60
Rate for Payer: WEA Trust Commercial $3,278.55
Rate for Payer: WPS Commercial $4,415.31
Service Code CPT 74176 TC
Hospital Charge Code 5551885
Hospital Revenue Code 350
Min. Negotiated Rate $102.91
Max. Negotiated Rate $5,662.95
Rate for Payer: Aetna Commercial $5,662.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,126.46
Rate for Payer: Aetna Managed Medicare $102.91
Rate for Payer: Anthem Medicare Advantage $102.91
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $102.91
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $102.91
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cash Price $1,788.30
Rate for Payer: Cigna Commercial $5,662.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $2,980.50
Rate for Payer: Dean Health DHI/DHP/ASO $102.91
Rate for Payer: Health EOS Commercial $5,424.51
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $380.96
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $380.96
Rate for Payer: Independent Care Health Plan Medicare $102.91
Rate for Payer: Multiplan Commercial $4,768.80
Rate for Payer: Preferred Network Access Commercial $5,662.95
Rate for Payer: Quartz Beloit One Network $2,622.84
Rate for Payer: Quartz Commercial $3,397.77
Rate for Payer: Quartz Medicare Advantage $102.91
Rate for Payer: The Alliance Commercial $391.06
Rate for Payer: United Healthcare Medicare Advantage $102.91
Rate for Payer: WEA Trust Commercial $3,278.55
Rate for Payer: WPS Commercial $514.55
Service Code CPT 74170 TC
Hospital Charge Code 5724130
Hospital Revenue Code 350
Min. Negotiated Rate $1,268.40
Max. Negotiated Rate $18,120.00
Rate for Payer: Aetna Commercial $4,077.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,895.80
Rate for Payer: Aetna Managed Medicare $1,268.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,205.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,586.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,454.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,400.90
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cigna Commercial $4,167.60
Rate for Payer: Health EOS Commercial $4,031.70
Rate for Payer: HFN Commercial $4,167.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,397.50
Rate for Payer: Multiplan Commercial $3,624.00
Rate for Payer: NAPHCARE Commercial $2,718.00
Rate for Payer: Preferred Network Access Commercial $4,167.60
Rate for Payer: Quartz Beloit One Network $2,219.70
Rate for Payer: Quartz Commercial $2,944.50
Rate for Payer: Quartz Medicare Advantage $2,718.00
Rate for Payer: The Alliance Commercial $18,120.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $2,491.50
Rate for Payer: WPS Commercial $1,403.15
Service Code CPT 74170 TC
Hospital Charge Code 5724130
Hospital Revenue Code 350
Min. Negotiated Rate $2,219.70
Max. Negotiated Rate $4,167.60
Rate for Payer: Aetna Commercial $4,077.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,400.90
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cigna Commercial $4,167.60
Rate for Payer: Health EOS Commercial $4,031.70
Rate for Payer: HFN Commercial $4,167.60
Rate for Payer: Multiplan Commercial $3,624.00
Rate for Payer: NAPHCARE Commercial $2,718.00
Rate for Payer: Preferred Network Access Commercial $4,167.60
Rate for Payer: Quartz Beloit One Network $2,219.70
Rate for Payer: Quartz Commercial $2,718.00
Rate for Payer: WEA Trust Commercial $2,491.50
Rate for Payer: WPS Commercial $3,355.37
Service Code CPT 74170 TC
Hospital Charge Code 5724130
Hospital Revenue Code 350
Min. Negotiated Rate $200.45
Max. Negotiated Rate $4,303.50
Rate for Payer: Aetna Commercial $4,303.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,895.80
Rate for Payer: Aetna Managed Medicare $200.45
Rate for Payer: Anthem Medicare Advantage $200.45
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $200.45
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $200.45
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cash Price $1,359.00
Rate for Payer: Cigna Commercial $4,303.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $2,265.00
Rate for Payer: Dean Health DHI/DHP/ASO $200.45
Rate for Payer: Health EOS Commercial $4,122.30
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $737.52
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $737.52
Rate for Payer: Independent Care Health Plan Medicare $200.45
Rate for Payer: Multiplan Commercial $3,624.00
Rate for Payer: Preferred Network Access Commercial $4,303.50
Rate for Payer: Quartz Beloit One Network $1,993.20
Rate for Payer: Quartz Commercial $2,582.10
Rate for Payer: Quartz Medicare Advantage $200.45
Rate for Payer: The Alliance Commercial $761.71
Rate for Payer: United Healthcare Medicare Advantage $200.45
Rate for Payer: WEA Trust Commercial $2,491.50
Rate for Payer: WPS Commercial $1,002.25
Service Code CPT 74178 TC
Hospital Charge Code 5724133
Hospital Revenue Code 350
Min. Negotiated Rate $3,693.13
Max. Negotiated Rate $6,934.04
Rate for Payer: Aetna Commercial $6,783.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,994.61
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cigna Commercial $6,934.04
Rate for Payer: Health EOS Commercial $6,707.93
Rate for Payer: HFN Commercial $6,934.04
Rate for Payer: Multiplan Commercial $6,029.60
Rate for Payer: NAPHCARE Commercial $4,522.20
Rate for Payer: Preferred Network Access Commercial $6,934.04
Rate for Payer: Quartz Beloit One Network $3,693.13
Rate for Payer: Quartz Commercial $4,522.20
Rate for Payer: WEA Trust Commercial $4,145.35
Rate for Payer: WPS Commercial $5,582.66
Service Code CPT 74178 TC
Hospital Charge Code 5724133
Hospital Revenue Code 350
Min. Negotiated Rate $251.64
Max. Negotiated Rate $7,160.15
Rate for Payer: Aetna Commercial $7,160.15
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,481.82
Rate for Payer: Aetna Managed Medicare $251.64
Rate for Payer: Anthem Medicare Advantage $251.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $251.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $251.64
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cigna Commercial $7,160.15
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,768.50
Rate for Payer: Dean Health DHI/DHP/ASO $251.64
Rate for Payer: Health EOS Commercial $6,858.67
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $935.91
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $935.91
Rate for Payer: Independent Care Health Plan Medicare $251.64
Rate for Payer: Multiplan Commercial $6,029.60
Rate for Payer: Preferred Network Access Commercial $7,160.15
Rate for Payer: Quartz Beloit One Network $3,316.28
Rate for Payer: Quartz Commercial $4,296.09
Rate for Payer: Quartz Medicare Advantage $251.64
Rate for Payer: The Alliance Commercial $956.23
Rate for Payer: United Healthcare Medicare Advantage $251.64
Rate for Payer: WEA Trust Commercial $4,145.35
Rate for Payer: WPS Commercial $1,258.20
Service Code CPT 74178 TC
Hospital Charge Code 5724133
Hospital Revenue Code 350
Min. Negotiated Rate $1,761.48
Max. Negotiated Rate $30,148.00
Rate for Payer: Aetna Commercial $6,783.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,481.82
Rate for Payer: Aetna Managed Medicare $2,110.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,205.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,586.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,454.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,994.61
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cash Price $2,261.10
Rate for Payer: Cigna Commercial $6,934.04
Rate for Payer: Health EOS Commercial $6,707.93
Rate for Payer: HFN Commercial $6,934.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,652.75
Rate for Payer: Multiplan Commercial $6,029.60
Rate for Payer: NAPHCARE Commercial $4,522.20
Rate for Payer: Preferred Network Access Commercial $6,934.04
Rate for Payer: Quartz Beloit One Network $3,693.13
Rate for Payer: Quartz Commercial $4,899.05
Rate for Payer: Quartz Medicare Advantage $4,522.20
Rate for Payer: The Alliance Commercial $30,148.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $4,145.35
Rate for Payer: WPS Commercial $1,761.48
Service Code CPT 75635
Hospital Charge Code 625588
Min. Negotiated Rate $3,329.55
Max. Negotiated Rate $6,251.40
Rate for Payer: Aetna Commercial $6,115.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,601.35
Rate for Payer: Cash Price $2,038.50
Rate for Payer: Cigna Commercial $6,251.40
Rate for Payer: Health EOS Commercial $6,047.55
Rate for Payer: HFN Commercial $6,251.40
Rate for Payer: Multiplan Commercial $5,436.00
Rate for Payer: NAPHCARE Commercial $4,077.00
Rate for Payer: Preferred Network Access Commercial $6,251.40
Rate for Payer: Quartz Beloit One Network $3,329.55
Rate for Payer: Quartz Commercial $4,077.00
Rate for Payer: WEA Trust Commercial $3,737.25
Rate for Payer: WPS Commercial $5,033.06
Service Code CPT 75635 TC
Hospital Charge Code 1240819
Hospital Revenue Code 350
Min. Negotiated Rate $301.75
Max. Negotiated Rate $6,475.20
Rate for Payer: Aetna Commercial $6,475.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,861.76
Rate for Payer: Aetna Managed Medicare $301.75
Rate for Payer: Anthem Medicare Advantage $301.75
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $301.75
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $301.75
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cigna Commercial $6,475.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,408.00
Rate for Payer: Dean Health DHI/DHP/ASO $301.75
Rate for Payer: Health EOS Commercial $6,202.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,115.34
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,115.34
Rate for Payer: Independent Care Health Plan Medicare $301.75
Rate for Payer: Multiplan Commercial $5,452.80
Rate for Payer: Preferred Network Access Commercial $6,475.20
Rate for Payer: Quartz Beloit One Network $2,999.04
Rate for Payer: Quartz Commercial $3,885.12
Rate for Payer: Quartz Medicare Advantage $301.75
Rate for Payer: The Alliance Commercial $1,146.65
Rate for Payer: United Healthcare Medicare Advantage $301.75
Rate for Payer: WEA Trust Commercial $3,748.80
Rate for Payer: WPS Commercial $1,508.75
Service Code CPT 75635 TC
Hospital Charge Code 1240819
Hospital Revenue Code 350
Min. Negotiated Rate $3,339.84
Max. Negotiated Rate $6,270.72
Rate for Payer: Aetna Commercial $6,134.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,612.48
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cigna Commercial $6,270.72
Rate for Payer: Health EOS Commercial $6,066.24
Rate for Payer: HFN Commercial $6,270.72
Rate for Payer: Multiplan Commercial $5,452.80
Rate for Payer: NAPHCARE Commercial $4,089.60
Rate for Payer: Preferred Network Access Commercial $6,270.72
Rate for Payer: Quartz Beloit One Network $3,339.84
Rate for Payer: Quartz Commercial $4,089.60
Rate for Payer: WEA Trust Commercial $3,748.80
Rate for Payer: WPS Commercial $5,048.61
Service Code CPT 75635
Hospital Charge Code 625588
Min. Negotiated Rate $7.28
Max. Negotiated Rate $6,251.40
Rate for Payer: Health EOS Commercial $6,047.55
Rate for Payer: Aetna Commercial $6,115.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,843.70
Rate for Payer: Aetna Managed Medicare $181.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,416.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,397.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,261.60
Rate for Payer: Anthem Medicare Advantage $181.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,601.35
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $181.60
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $181.60
Rate for Payer: Cash Price $2,038.50
Rate for Payer: Cash Price $2,038.50
Rate for Payer: Cigna Commercial $6,251.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $181.60
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $181.60
Rate for Payer: HFN Commercial $6,251.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $675.55
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $181.60
Rate for Payer: Independent Care Health Plan Medicare $181.60
Rate for Payer: Managed Health Services Medicare Advantage $181.60
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $181.60
Rate for Payer: Multiplan Commercial $5,436.00
Rate for Payer: NAPHCARE Commercial $272.40
Rate for Payer: Preferred Network Access Commercial $6,251.40
Rate for Payer: Quartz Beloit One Network $3,329.55
Rate for Payer: Quartz Commercial $4,416.75
Rate for Payer: Quartz Medicare Advantage $181.60
Rate for Payer: The Alliance Commercial $7.28
Rate for Payer: United Healthcare Medicare Advantage $181.60
Rate for Payer: WEA Trust Commercial $3,737.25
Rate for Payer: Wellcare Medicare $181.60
Rate for Payer: WPS Commercial $5,033.06
Service Code CPT 75635
Hospital Charge Code 625588
Min. Negotiated Rate $410.43
Max. Negotiated Rate $6,455.25
Rate for Payer: Aetna Commercial $6,455.25
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,843.70
Rate for Payer: Aetna Managed Medicare $410.43
Rate for Payer: Anthem Medicare Advantage $410.43
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $410.43
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $410.43
Rate for Payer: Cash Price $2,038.50
Rate for Payer: Cash Price $2,038.50
Rate for Payer: Cigna Commercial $6,455.25
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,397.50
Rate for Payer: Dean Health DHI/DHP/ASO $410.43
Rate for Payer: Health EOS Commercial $6,183.45
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,510.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,510.84
Rate for Payer: Independent Care Health Plan Medicare $410.43
Rate for Payer: Multiplan Commercial $5,436.00
Rate for Payer: Preferred Network Access Commercial $6,455.25
Rate for Payer: Quartz Beloit One Network $2,989.80
Rate for Payer: Quartz Commercial $3,873.15
Rate for Payer: Quartz Medicare Advantage $410.43
Rate for Payer: The Alliance Commercial $1,559.63
Rate for Payer: United Healthcare Medicare Advantage $410.43
Rate for Payer: WEA Trust Commercial $3,737.25
Rate for Payer: WPS Commercial $2,052.15
Service Code CPT 75635 TC
Hospital Charge Code 1240819
Hospital Revenue Code 350
Min. Negotiated Rate $1,908.48
Max. Negotiated Rate $27,264.00
Rate for Payer: Aetna Commercial $6,134.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,861.76
Rate for Payer: Aetna Managed Medicare $1,908.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,205.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,586.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,454.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,612.48
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cash Price $2,044.80
Rate for Payer: Cigna Commercial $6,270.72
Rate for Payer: Health EOS Commercial $6,066.24
Rate for Payer: HFN Commercial $6,270.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,112.00
Rate for Payer: Multiplan Commercial $5,452.80
Rate for Payer: NAPHCARE Commercial $4,089.60
Rate for Payer: Preferred Network Access Commercial $6,270.72
Rate for Payer: Quartz Beloit One Network $3,339.84
Rate for Payer: Quartz Commercial $4,430.40
Rate for Payer: Quartz Medicare Advantage $4,089.60
Rate for Payer: The Alliance Commercial $27,264.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $3,748.80
Rate for Payer: WPS Commercial $2,112.25
Service Code CPT 74175 TC
Hospital Charge Code 1240821
Hospital Revenue Code 350
Min. Negotiated Rate $2,733.71
Max. Negotiated Rate $5,132.68
Rate for Payer: Aetna Commercial $5,021.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,956.87
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cigna Commercial $5,132.68
Rate for Payer: Health EOS Commercial $4,965.31
Rate for Payer: HFN Commercial $5,132.68
Rate for Payer: Multiplan Commercial $4,463.20
Rate for Payer: NAPHCARE Commercial $3,347.40
Rate for Payer: Preferred Network Access Commercial $5,132.68
Rate for Payer: Quartz Beloit One Network $2,733.71
Rate for Payer: Quartz Commercial $3,347.40
Rate for Payer: WEA Trust Commercial $3,068.45
Rate for Payer: WPS Commercial $4,132.37
Service Code CPT 74175 TC
Hospital Charge Code 1240821
Hospital Revenue Code 350
Min. Negotiated Rate $1,562.12
Max. Negotiated Rate $22,316.00
Rate for Payer: Aetna Commercial $5,021.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,797.94
Rate for Payer: Aetna Managed Medicare $1,562.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,205.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,586.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,454.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,956.87
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cigna Commercial $5,132.68
Rate for Payer: Health EOS Commercial $4,965.31
Rate for Payer: HFN Commercial $5,132.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,184.25
Rate for Payer: Multiplan Commercial $4,463.20
Rate for Payer: NAPHCARE Commercial $3,347.40
Rate for Payer: Preferred Network Access Commercial $5,132.68
Rate for Payer: Quartz Beloit One Network $2,733.71
Rate for Payer: Quartz Commercial $3,626.35
Rate for Payer: Quartz Medicare Advantage $3,347.40
Rate for Payer: The Alliance Commercial $22,316.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $3,068.45
Rate for Payer: WPS Commercial $1,571.43
Service Code CPT 74175
Hospital Charge Code 625596
Min. Negotiated Rate $307.83
Max. Negotiated Rate $7,286.50
Rate for Payer: Aetna Commercial $7,286.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,596.20
Rate for Payer: Aetna Managed Medicare $307.83
Rate for Payer: Anthem Medicare Advantage $307.83
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $307.83
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $307.83
Rate for Payer: Cash Price $2,301.00
Rate for Payer: Cash Price $2,301.00
Rate for Payer: Cigna Commercial $7,286.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,835.00
Rate for Payer: Dean Health DHI/DHP/ASO $307.83
Rate for Payer: Health EOS Commercial $6,979.70
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,119.29
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,119.29
Rate for Payer: Independent Care Health Plan Medicare $307.83
Rate for Payer: Multiplan Commercial $6,136.00
Rate for Payer: Preferred Network Access Commercial $7,286.50
Rate for Payer: Quartz Beloit One Network $3,374.80
Rate for Payer: Quartz Commercial $4,371.90
Rate for Payer: Quartz Medicare Advantage $307.83
Rate for Payer: The Alliance Commercial $1,169.75
Rate for Payer: United Healthcare Medicare Advantage $307.83
Rate for Payer: WEA Trust Commercial $4,218.50
Rate for Payer: WPS Commercial $1,539.15
Service Code CPT 74175 TC
Hospital Charge Code 1240821
Hospital Revenue Code 350
Min. Negotiated Rate $224.49
Max. Negotiated Rate $5,300.05
Rate for Payer: Aetna Commercial $5,300.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,797.94
Rate for Payer: Aetna Managed Medicare $224.49
Rate for Payer: Anthem Medicare Advantage $224.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $224.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $224.49
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cash Price $1,673.70
Rate for Payer: Cigna Commercial $5,300.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $2,789.50
Rate for Payer: Dean Health DHI/DHP/ASO $224.49
Rate for Payer: Health EOS Commercial $5,076.89
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $817.58
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $817.58
Rate for Payer: Independent Care Health Plan Medicare $224.49
Rate for Payer: Multiplan Commercial $4,463.20
Rate for Payer: Preferred Network Access Commercial $5,300.05
Rate for Payer: Quartz Beloit One Network $2,454.76
Rate for Payer: Quartz Commercial $3,180.03
Rate for Payer: Quartz Medicare Advantage $224.49
Rate for Payer: The Alliance Commercial $853.06
Rate for Payer: United Healthcare Medicare Advantage $224.49
Rate for Payer: WEA Trust Commercial $3,068.45
Rate for Payer: WPS Commercial $1,122.45
Service Code CPT 74175
Hospital Charge Code 625596
Min. Negotiated Rate $181.60
Max. Negotiated Rate $7,642.76
Rate for Payer: Aetna Commercial $6,903.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,596.20
Rate for Payer: Aetna Managed Medicare $181.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,985.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,835.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,681.60
Rate for Payer: Anthem Medicare Advantage $181.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,065.10
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $181.60
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $181.60
Rate for Payer: Cash Price $2,301.00
Rate for Payer: Cash Price $2,301.00
Rate for Payer: Cigna Commercial $7,056.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $181.60
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $181.60
Rate for Payer: Health EOS Commercial $6,826.30
Rate for Payer: HFN Commercial $7,056.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $675.55
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $181.60
Rate for Payer: Independent Care Health Plan Medicare $181.60
Rate for Payer: Managed Health Services Medicare Advantage $181.60
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $181.60
Rate for Payer: Multiplan Commercial $6,136.00
Rate for Payer: NAPHCARE Commercial $272.40
Rate for Payer: Preferred Network Access Commercial $7,056.40
Rate for Payer: Quartz Beloit One Network $3,758.30
Rate for Payer: Quartz Commercial $4,985.50
Rate for Payer: Quartz Medicare Advantage $181.60
Rate for Payer: The Alliance Commercial $7,642.76
Rate for Payer: United Healthcare Medicare Advantage $181.60
Rate for Payer: WEA Trust Commercial $4,218.50
Rate for Payer: Wellcare Medicare $181.60
Rate for Payer: WPS Commercial $5,681.17
Service Code CPT 74175
Hospital Charge Code 625596
Min. Negotiated Rate $3,758.30
Max. Negotiated Rate $7,056.40
Rate for Payer: Aetna Commercial $6,903.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,065.10
Rate for Payer: Cash Price $2,301.00
Rate for Payer: Cigna Commercial $7,056.40
Rate for Payer: Health EOS Commercial $6,826.30
Rate for Payer: HFN Commercial $7,056.40
Rate for Payer: Multiplan Commercial $6,136.00
Rate for Payer: NAPHCARE Commercial $4,602.00
Rate for Payer: Preferred Network Access Commercial $7,056.40
Rate for Payer: Quartz Beloit One Network $3,758.30
Rate for Payer: Quartz Commercial $4,602.00
Rate for Payer: WEA Trust Commercial $4,218.50
Rate for Payer: WPS Commercial $5,681.17