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Charge Type Price  
Service Code CPT 73701 RT,TC
Hospital Charge Code 1241046
Hospital Revenue Code 350
Min. Negotiated Rate $1,283.04
Max. Negotiated Rate $2,770.20
Rate for Payer: Aetna Commercial $2,770.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,507.76
Rate for Payer: Cash Price $874.80
Rate for Payer: Cash Price $874.80
Rate for Payer: Cigna Commercial $2,770.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,458.00
Rate for Payer: Dean Health DHI/DHP/ASO $1,749.60
Rate for Payer: Health EOS Commercial $2,653.56
Rate for Payer: Multiplan Commercial $2,332.80
Rate for Payer: Preferred Network Access Commercial $2,770.20
Rate for Payer: Quartz Beloit One Network $1,283.04
Rate for Payer: Quartz Commercial $1,662.12
Rate for Payer: The Alliance Commercial $1,458.00
Rate for Payer: WEA Trust Commercial $1,603.80
Rate for Payer: WPS Commercial $2,159.88
Service Code CPT 73700 LT,TC
Hospital Charge Code 1241048
Hospital Revenue Code 350
Min. Negotiated Rate $1,116.28
Max. Negotiated Rate $2,410.15
Rate for Payer: Aetna Commercial $2,410.15
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,181.82
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cigna Commercial $2,410.15
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,268.50
Rate for Payer: Dean Health DHI/DHP/ASO $1,522.20
Rate for Payer: Health EOS Commercial $2,308.67
Rate for Payer: Multiplan Commercial $2,029.60
Rate for Payer: Preferred Network Access Commercial $2,410.15
Rate for Payer: Quartz Beloit One Network $1,116.28
Rate for Payer: Quartz Commercial $1,446.09
Rate for Payer: The Alliance Commercial $1,268.50
Rate for Payer: WEA Trust Commercial $1,395.35
Rate for Payer: WPS Commercial $1,879.16
Service Code CPT 73700
Hospital Charge Code 629850
Min. Negotiated Rate $129.71
Max. Negotiated Rate $4,912.45
Rate for Payer: Aetna Commercial $4,912.45
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,447.06
Rate for Payer: Aetna Managed Medicare $129.71
Rate for Payer: Anthem Medicare Advantage $129.71
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $129.71
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $129.71
Rate for Payer: Cash Price $1,551.30
Rate for Payer: Cash Price $1,551.30
Rate for Payer: Cigna Commercial $4,912.45
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $2,585.50
Rate for Payer: Dean Health DHI/DHP/ASO $129.71
Rate for Payer: Health EOS Commercial $4,705.61
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $475.77
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $475.77
Rate for Payer: Independent Care Health Plan Medicare $129.71
Rate for Payer: Multiplan Commercial $4,136.80
Rate for Payer: Preferred Network Access Commercial $4,912.45
Rate for Payer: Quartz Beloit One Network $2,275.24
Rate for Payer: Quartz Commercial $2,947.47
Rate for Payer: Quartz Medicare Advantage $129.71
Rate for Payer: The Alliance Commercial $492.90
Rate for Payer: United Healthcare Medicare Advantage $129.71
Rate for Payer: WEA Trust Commercial $2,844.05
Rate for Payer: WPS Commercial $648.55
Service Code CPT 73700 LT,TC
Hospital Charge Code 1241048
Hospital Revenue Code 350
Min. Negotiated Rate $710.36
Max. Negotiated Rate $10,148.00
Rate for Payer: Aetna Commercial $2,283.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,181.82
Rate for Payer: Aetna Managed Medicare $710.36
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 $1,344.61
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cigna Commercial $2,334.04
Rate for Payer: Health EOS Commercial $2,257.93
Rate for Payer: HFN Commercial $2,334.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,902.75
Rate for Payer: Multiplan Commercial $2,029.60
Rate for Payer: NAPHCARE Commercial $1,522.20
Rate for Payer: Preferred Network Access Commercial $2,334.04
Rate for Payer: Quartz Beloit One Network $1,243.13
Rate for Payer: Quartz Commercial $1,649.05
Rate for Payer: Quartz Medicare Advantage $1,522.20
Rate for Payer: The Alliance Commercial $10,148.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $1,395.35
Rate for Payer: WPS Commercial $1,879.16
Service Code CPT 73700
Hospital Charge Code 629850
Min. Negotiated Rate $21.68
Max. Negotiated Rate $4,757.32
Rate for Payer: Aetna Commercial $4,653.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,447.06
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,361.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,585.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,482.08
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,740.63
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $1,551.30
Rate for Payer: Cash Price $1,551.30
Rate for Payer: Cigna Commercial $4,757.32
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $4,602.19
Rate for Payer: HFN Commercial $4,757.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $4,136.80
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $4,757.32
Rate for Payer: Quartz Beloit One Network $2,533.79
Rate for Payer: Quartz Commercial $3,361.15
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $21.68
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $2,844.05
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $3,830.16
Service Code CPT 73700
Hospital Charge Code 629850
Min. Negotiated Rate $2,533.79
Max. Negotiated Rate $4,757.32
Rate for Payer: Aetna Commercial $4,653.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,740.63
Rate for Payer: Cash Price $1,551.30
Rate for Payer: Cigna Commercial $4,757.32
Rate for Payer: Health EOS Commercial $4,602.19
Rate for Payer: HFN Commercial $4,757.32
Rate for Payer: Multiplan Commercial $4,136.80
Rate for Payer: NAPHCARE Commercial $3,102.60
Rate for Payer: Preferred Network Access Commercial $4,757.32
Rate for Payer: Quartz Beloit One Network $2,533.79
Rate for Payer: Quartz Commercial $3,102.60
Rate for Payer: WEA Trust Commercial $2,844.05
Rate for Payer: WPS Commercial $3,830.16
Service Code CPT 73700 LT,TC
Hospital Charge Code 1241048
Hospital Revenue Code 350
Min. Negotiated Rate $1,243.13
Max. Negotiated Rate $2,334.04
Rate for Payer: Aetna Commercial $2,283.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,344.61
Rate for Payer: Cash Price $761.10
Rate for Payer: Cigna Commercial $2,334.04
Rate for Payer: Health EOS Commercial $2,257.93
Rate for Payer: HFN Commercial $2,334.04
Rate for Payer: Multiplan Commercial $2,029.60
Rate for Payer: NAPHCARE Commercial $1,522.20
Rate for Payer: Preferred Network Access Commercial $2,334.04
Rate for Payer: Quartz Beloit One Network $1,243.13
Rate for Payer: Quartz Commercial $1,522.20
Rate for Payer: WEA Trust Commercial $1,395.35
Rate for Payer: WPS Commercial $1,879.16
Service Code CPT 73700
Hospital Charge Code 629852
Min. Negotiated Rate $129.71
Max. Negotiated Rate $2,455.75
Rate for Payer: Aetna Commercial $2,455.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,223.10
Rate for Payer: Aetna Managed Medicare $129.71
Rate for Payer: Anthem Medicare Advantage $129.71
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $129.71
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $129.71
Rate for Payer: Cash Price $775.50
Rate for Payer: Cash Price $775.50
Rate for Payer: Cigna Commercial $2,455.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,292.50
Rate for Payer: Dean Health DHI/DHP/ASO $129.71
Rate for Payer: Health EOS Commercial $2,352.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $475.77
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $475.77
Rate for Payer: Independent Care Health Plan Medicare $129.71
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: Preferred Network Access Commercial $2,455.75
Rate for Payer: Quartz Beloit One Network $1,137.40
Rate for Payer: Quartz Commercial $1,473.45
Rate for Payer: Quartz Medicare Advantage $129.71
Rate for Payer: The Alliance Commercial $492.90
Rate for Payer: United Healthcare Medicare Advantage $129.71
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: WPS Commercial $648.55
Service Code CPT 73700 LT,TC
Hospital Charge Code 1241050
Hospital Revenue Code 350
Min. Negotiated Rate $1,233.76
Max. Negotiated Rate $2,663.80
Rate for Payer: Aetna Commercial $2,663.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,411.44
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cigna Commercial $2,663.80
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,402.00
Rate for Payer: Dean Health DHI/DHP/ASO $1,682.40
Rate for Payer: Health EOS Commercial $2,551.64
Rate for Payer: Multiplan Commercial $2,243.20
Rate for Payer: Preferred Network Access Commercial $2,663.80
Rate for Payer: Quartz Beloit One Network $1,233.76
Rate for Payer: Quartz Commercial $1,598.28
Rate for Payer: The Alliance Commercial $1,402.00
Rate for Payer: WEA Trust Commercial $1,542.20
Rate for Payer: WPS Commercial $2,076.92
Service Code CPT 73700 LT,TC
Hospital Charge Code 1241050
Hospital Revenue Code 350
Min. Negotiated Rate $785.12
Max. Negotiated Rate $11,216.00
Rate for Payer: Aetna Commercial $2,523.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,411.44
Rate for Payer: Aetna Managed Medicare $785.12
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 $1,486.12
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cigna Commercial $2,579.68
Rate for Payer: Health EOS Commercial $2,495.56
Rate for Payer: HFN Commercial $2,579.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,103.00
Rate for Payer: Multiplan Commercial $2,243.20
Rate for Payer: NAPHCARE Commercial $1,682.40
Rate for Payer: Preferred Network Access Commercial $2,579.68
Rate for Payer: Quartz Beloit One Network $1,373.96
Rate for Payer: Quartz Commercial $1,822.60
Rate for Payer: Quartz Medicare Advantage $1,682.40
Rate for Payer: The Alliance Commercial $11,216.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $1,542.20
Rate for Payer: WPS Commercial $2,076.92
Service Code CPT 73700 LT,TC
Hospital Charge Code 1241050
Hospital Revenue Code 350
Min. Negotiated Rate $1,373.96
Max. Negotiated Rate $2,579.68
Rate for Payer: Aetna Commercial $2,523.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,486.12
Rate for Payer: Cash Price $841.20
Rate for Payer: Cigna Commercial $2,579.68
Rate for Payer: Health EOS Commercial $2,495.56
Rate for Payer: HFN Commercial $2,579.68
Rate for Payer: Multiplan Commercial $2,243.20
Rate for Payer: NAPHCARE Commercial $1,682.40
Rate for Payer: Preferred Network Access Commercial $2,579.68
Rate for Payer: Quartz Beloit One Network $1,373.96
Rate for Payer: Quartz Commercial $1,682.40
Rate for Payer: WEA Trust Commercial $1,542.20
Rate for Payer: WPS Commercial $2,076.92
Service Code CPT 73700
Hospital Charge Code 629852
Min. Negotiated Rate $21.68
Max. Negotiated Rate $2,378.20
Rate for Payer: Aetna Commercial $2,326.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,223.10
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,680.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,292.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,240.80
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,370.05
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $775.50
Rate for Payer: Cash Price $775.50
Rate for Payer: Cigna Commercial $2,378.20
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $2,300.65
Rate for Payer: HFN Commercial $2,378.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $2,378.20
Rate for Payer: Quartz Beloit One Network $1,266.65
Rate for Payer: Quartz Commercial $1,680.25
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $21.68
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $1,914.71
Service Code CPT 73700
Hospital Charge Code 629852
Min. Negotiated Rate $1,266.65
Max. Negotiated Rate $2,378.20
Rate for Payer: Aetna Commercial $2,326.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,370.05
Rate for Payer: Cash Price $775.50
Rate for Payer: Cigna Commercial $2,378.20
Rate for Payer: Health EOS Commercial $2,300.65
Rate for Payer: HFN Commercial $2,378.20
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: NAPHCARE Commercial $1,551.00
Rate for Payer: Preferred Network Access Commercial $2,378.20
Rate for Payer: Quartz Beloit One Network $1,266.65
Rate for Payer: Quartz Commercial $1,551.00
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: WPS Commercial $1,914.71
Service Code CPT 73700 RT,TC
Hospital Charge Code 1241052
Hospital Revenue Code 350
Min. Negotiated Rate $785.12
Max. Negotiated Rate $11,216.00
Rate for Payer: Aetna Commercial $2,523.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,411.44
Rate for Payer: Aetna Managed Medicare $785.12
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 $1,486.12
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cigna Commercial $2,579.68
Rate for Payer: Health EOS Commercial $2,495.56
Rate for Payer: HFN Commercial $2,579.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,103.00
Rate for Payer: Multiplan Commercial $2,243.20
Rate for Payer: NAPHCARE Commercial $1,682.40
Rate for Payer: Preferred Network Access Commercial $2,579.68
Rate for Payer: Quartz Beloit One Network $1,373.96
Rate for Payer: Quartz Commercial $1,822.60
Rate for Payer: Quartz Medicare Advantage $1,682.40
Rate for Payer: The Alliance Commercial $11,216.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $1,542.20
Rate for Payer: WPS Commercial $2,076.92
Service Code CPT 73700
Hospital Charge Code 629854
Min. Negotiated Rate $21.68
Max. Negotiated Rate $2,378.20
Rate for Payer: Aetna Commercial $2,326.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,223.10
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,680.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,292.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,240.80
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,370.05
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $775.50
Rate for Payer: Cash Price $775.50
Rate for Payer: Cigna Commercial $2,378.20
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $2,300.65
Rate for Payer: HFN Commercial $2,378.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $2,378.20
Rate for Payer: Quartz Beloit One Network $1,266.65
Rate for Payer: Quartz Commercial $1,680.25
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $21.68
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $1,914.71
Service Code CPT 73700 TC,RT
Hospital Charge Code 2980070
Hospital Revenue Code 350
Min. Negotiated Rate $1,116.28
Max. Negotiated Rate $2,410.15
Rate for Payer: Aetna Commercial $2,410.15
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,181.82
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cigna Commercial $2,410.15
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,268.50
Rate for Payer: Dean Health DHI/DHP/ASO $1,522.20
Rate for Payer: Health EOS Commercial $2,308.67
Rate for Payer: Multiplan Commercial $2,029.60
Rate for Payer: Preferred Network Access Commercial $2,410.15
Rate for Payer: Quartz Beloit One Network $1,116.28
Rate for Payer: Quartz Commercial $1,446.09
Rate for Payer: The Alliance Commercial $1,268.50
Rate for Payer: WEA Trust Commercial $1,395.35
Rate for Payer: WPS Commercial $1,879.16
Service Code CPT 73700 TC,RT
Hospital Charge Code 2980070
Hospital Revenue Code 350
Min. Negotiated Rate $710.36
Max. Negotiated Rate $10,148.00
Rate for Payer: Aetna Commercial $2,283.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,181.82
Rate for Payer: Aetna Managed Medicare $710.36
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 $1,344.61
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cash Price $761.10
Rate for Payer: Cigna Commercial $2,334.04
Rate for Payer: Health EOS Commercial $2,257.93
Rate for Payer: HFN Commercial $2,334.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,902.75
Rate for Payer: Multiplan Commercial $2,029.60
Rate for Payer: NAPHCARE Commercial $1,522.20
Rate for Payer: Preferred Network Access Commercial $2,334.04
Rate for Payer: Quartz Beloit One Network $1,243.13
Rate for Payer: Quartz Commercial $1,649.05
Rate for Payer: Quartz Medicare Advantage $1,522.20
Rate for Payer: The Alliance Commercial $10,148.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $1,395.35
Rate for Payer: WPS Commercial $1,879.16
Service Code CPT 73700
Hospital Charge Code 629854
Min. Negotiated Rate $129.71
Max. Negotiated Rate $2,455.75
Rate for Payer: Aetna Commercial $2,455.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,223.10
Rate for Payer: Aetna Managed Medicare $129.71
Rate for Payer: Anthem Medicare Advantage $129.71
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $129.71
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $129.71
Rate for Payer: Cash Price $775.50
Rate for Payer: Cash Price $775.50
Rate for Payer: Cigna Commercial $2,455.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,292.50
Rate for Payer: Dean Health DHI/DHP/ASO $129.71
Rate for Payer: Health EOS Commercial $2,352.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $475.77
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $475.77
Rate for Payer: Independent Care Health Plan Medicare $129.71
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: Preferred Network Access Commercial $2,455.75
Rate for Payer: Quartz Beloit One Network $1,137.40
Rate for Payer: Quartz Commercial $1,473.45
Rate for Payer: Quartz Medicare Advantage $129.71
Rate for Payer: The Alliance Commercial $492.90
Rate for Payer: United Healthcare Medicare Advantage $129.71
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: WPS Commercial $648.55
Service Code CPT 73700
Hospital Charge Code 629854
Min. Negotiated Rate $1,266.65
Max. Negotiated Rate $2,378.20
Rate for Payer: Aetna Commercial $2,326.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,370.05
Rate for Payer: Cash Price $775.50
Rate for Payer: Cigna Commercial $2,378.20
Rate for Payer: Health EOS Commercial $2,300.65
Rate for Payer: HFN Commercial $2,378.20
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: NAPHCARE Commercial $1,551.00
Rate for Payer: Preferred Network Access Commercial $2,378.20
Rate for Payer: Quartz Beloit One Network $1,266.65
Rate for Payer: Quartz Commercial $1,551.00
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: WPS Commercial $1,914.71
Service Code CPT 73700 TC,RT
Hospital Charge Code 2980070
Hospital Revenue Code 350
Min. Negotiated Rate $1,243.13
Max. Negotiated Rate $2,334.04
Rate for Payer: Aetna Commercial $2,283.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,344.61
Rate for Payer: Cash Price $761.10
Rate for Payer: Cigna Commercial $2,334.04
Rate for Payer: Health EOS Commercial $2,257.93
Rate for Payer: HFN Commercial $2,334.04
Rate for Payer: Multiplan Commercial $2,029.60
Rate for Payer: NAPHCARE Commercial $1,522.20
Rate for Payer: Preferred Network Access Commercial $2,334.04
Rate for Payer: Quartz Beloit One Network $1,243.13
Rate for Payer: Quartz Commercial $1,522.20
Rate for Payer: WEA Trust Commercial $1,395.35
Rate for Payer: WPS Commercial $1,879.16
Service Code CPT 73700 RT,TC
Hospital Charge Code 1241052
Hospital Revenue Code 350
Min. Negotiated Rate $1,233.76
Max. Negotiated Rate $2,663.80
Rate for Payer: Aetna Commercial $2,663.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,411.44
Rate for Payer: Cash Price $841.20
Rate for Payer: Cash Price $841.20
Rate for Payer: Cigna Commercial $2,663.80
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,402.00
Rate for Payer: Dean Health DHI/DHP/ASO $1,682.40
Rate for Payer: Health EOS Commercial $2,551.64
Rate for Payer: Multiplan Commercial $2,243.20
Rate for Payer: Preferred Network Access Commercial $2,663.80
Rate for Payer: Quartz Beloit One Network $1,233.76
Rate for Payer: Quartz Commercial $1,598.28
Rate for Payer: The Alliance Commercial $1,402.00
Rate for Payer: WEA Trust Commercial $1,542.20
Rate for Payer: WPS Commercial $2,076.92
Service Code CPT 73700 RT,TC
Hospital Charge Code 1241052
Hospital Revenue Code 350
Min. Negotiated Rate $1,373.96
Max. Negotiated Rate $2,579.68
Rate for Payer: Aetna Commercial $2,523.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,486.12
Rate for Payer: Cash Price $841.20
Rate for Payer: Cigna Commercial $2,579.68
Rate for Payer: Health EOS Commercial $2,495.56
Rate for Payer: HFN Commercial $2,579.68
Rate for Payer: Multiplan Commercial $2,243.20
Rate for Payer: NAPHCARE Commercial $1,682.40
Rate for Payer: Preferred Network Access Commercial $2,579.68
Rate for Payer: Quartz Beloit One Network $1,373.96
Rate for Payer: Quartz Commercial $1,682.40
Rate for Payer: WEA Trust Commercial $1,542.20
Rate for Payer: WPS Commercial $2,076.92
Service Code CPT 73702
Hospital Charge Code 629838
Min. Negotiated Rate $181.60
Max. Negotiated Rate $7,074.80
Rate for Payer: Aetna Commercial $6,921.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,613.40
Rate for Payer: Aetna Managed Medicare $181.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,998.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,845.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,691.20
Rate for Payer: Anthem Medicare Advantage $181.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,075.70
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 $2,307.00
Rate for Payer: Cash Price $2,307.00
Rate for Payer: Cigna Commercial $7,074.80
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 $6,844.10
Rate for Payer: HFN Commercial $7,074.80
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 $6,152.00
Rate for Payer: NAPHCARE Commercial $272.40
Rate for Payer: Preferred Network Access Commercial $7,074.80
Rate for Payer: Quartz Beloit One Network $3,768.10
Rate for Payer: Quartz Commercial $4,998.50
Rate for Payer: Quartz Medicare Advantage $181.60
Rate for Payer: The Alliance Commercial $286.40
Rate for Payer: United Healthcare Medicare Advantage $181.60
Rate for Payer: WEA Trust Commercial $4,229.50
Rate for Payer: Wellcare Medicare $181.60
Rate for Payer: WPS Commercial $5,695.98
Service Code CPT 73702
Hospital Charge Code 629838
Min. Negotiated Rate $195.75
Max. Negotiated Rate $7,305.50
Rate for Payer: Aetna Commercial $7,305.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,613.40
Rate for Payer: Aetna Managed Medicare $195.75
Rate for Payer: Anthem Medicare Advantage $195.75
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $195.75
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $195.75
Rate for Payer: Cash Price $2,307.00
Rate for Payer: Cash Price $2,307.00
Rate for Payer: Cigna Commercial $7,305.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3,845.00
Rate for Payer: Dean Health DHI/DHP/ASO $195.75
Rate for Payer: Health EOS Commercial $6,997.90
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $718.67
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $718.67
Rate for Payer: Independent Care Health Plan Medicare $195.75
Rate for Payer: Multiplan Commercial $6,152.00
Rate for Payer: Preferred Network Access Commercial $7,305.50
Rate for Payer: Quartz Beloit One Network $3,383.60
Rate for Payer: Quartz Commercial $4,383.30
Rate for Payer: Quartz Medicare Advantage $195.75
Rate for Payer: The Alliance Commercial $743.85
Rate for Payer: United Healthcare Medicare Advantage $195.75
Rate for Payer: WEA Trust Commercial $4,229.50
Rate for Payer: WPS Commercial $978.75
Service Code CPT 73702 LT,TC
Hospital Charge Code 1241036
Hospital Revenue Code 350
Min. Negotiated Rate $1,848.77
Max. Negotiated Rate $3,471.16
Rate for Payer: Aetna Commercial $3,395.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,999.69
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cigna Commercial $3,471.16
Rate for Payer: Health EOS Commercial $3,357.97
Rate for Payer: HFN Commercial $3,471.16
Rate for Payer: Multiplan Commercial $3,018.40
Rate for Payer: NAPHCARE Commercial $2,263.80
Rate for Payer: Preferred Network Access Commercial $3,471.16
Rate for Payer: Quartz Beloit One Network $1,848.77
Rate for Payer: Quartz Commercial $2,263.80
Rate for Payer: WEA Trust Commercial $2,075.15
Rate for Payer: WPS Commercial $2,794.66