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Charge Type Price  
Service Code CPT 73702
Hospital Charge Code 629864
Min. Negotiated Rate $181.60
Max. Negotiated Rate $3,537.40
Rate for Payer: Aetna Commercial $3,460.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,306.70
Rate for Payer: Aetna Managed Medicare $181.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,499.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,922.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,845.60
Rate for Payer: Anthem Medicare Advantage $181.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,037.85
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 $1,153.50
Rate for Payer: Cash Price $1,153.50
Rate for Payer: Cigna Commercial $3,537.40
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 $3,422.05
Rate for Payer: HFN Commercial $3,537.40
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 $3,076.00
Rate for Payer: NAPHCARE Commercial $272.40
Rate for Payer: Preferred Network Access Commercial $3,537.40
Rate for Payer: Quartz Beloit One Network $1,884.05
Rate for Payer: Quartz Commercial $2,499.25
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 $2,114.75
Rate for Payer: Wellcare Medicare $181.60
Rate for Payer: WPS Commercial $2,847.99
Service Code CPT 73702 TC,RT
Hospital Charge Code 2980085
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
Service Code CPT 73702 RT,TC
Hospital Charge Code 1241060
Hospital Revenue Code 350
Min. Negotiated Rate $1,660.12
Max. Negotiated Rate $3,584.35
Rate for Payer: Aetna Commercial $3,584.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,244.78
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cigna Commercial $3,584.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,886.50
Rate for Payer: Dean Health DHI/DHP/ASO $2,263.80
Rate for Payer: Health EOS Commercial $3,433.43
Rate for Payer: Multiplan Commercial $3,018.40
Rate for Payer: Preferred Network Access Commercial $3,584.35
Rate for Payer: Quartz Beloit One Network $1,660.12
Rate for Payer: Quartz Commercial $2,150.61
Rate for Payer: The Alliance Commercial $1,886.50
Rate for Payer: WEA Trust Commercial $2,075.15
Rate for Payer: WPS Commercial $2,794.66
Service Code CPT 73702
Hospital Charge Code 629864
Min. Negotiated Rate $1,884.05
Max. Negotiated Rate $3,537.40
Rate for Payer: Aetna Commercial $3,460.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,037.85
Rate for Payer: Cash Price $1,153.50
Rate for Payer: Cigna Commercial $3,537.40
Rate for Payer: Health EOS Commercial $3,422.05
Rate for Payer: HFN Commercial $3,537.40
Rate for Payer: Multiplan Commercial $3,076.00
Rate for Payer: NAPHCARE Commercial $2,307.00
Rate for Payer: Preferred Network Access Commercial $3,537.40
Rate for Payer: Quartz Beloit One Network $1,884.05
Rate for Payer: Quartz Commercial $2,307.00
Rate for Payer: WEA Trust Commercial $2,114.75
Rate for Payer: WPS Commercial $2,847.99
Service Code CPT 73702 TC,RT
Hospital Charge Code 2980085
Hospital Revenue Code 350
Min. Negotiated Rate $1,056.44
Max. Negotiated Rate $15,092.00
Rate for Payer: Aetna Commercial $3,395.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,244.78
Rate for Payer: Aetna Managed Medicare $1,056.44
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 $1,999.69
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cash Price $1,131.90
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: Humana Commercial/EPO/HMO/POS/PPO $2,829.75
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 $2,452.45
Rate for Payer: Quartz Medicare Advantage $2,263.80
Rate for Payer: The Alliance Commercial $15,092.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $2,075.15
Rate for Payer: WPS Commercial $2,794.66
Service Code CPT 73702 RT,TC
Hospital Charge Code 1241060
Hospital Revenue Code 350
Min. Negotiated Rate $1,056.44
Max. Negotiated Rate $15,092.00
Rate for Payer: Aetna Commercial $3,395.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,244.78
Rate for Payer: Aetna Managed Medicare $1,056.44
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 $1,999.69
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cash Price $1,131.90
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: Humana Commercial/EPO/HMO/POS/PPO $2,829.75
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 $2,452.45
Rate for Payer: Quartz Medicare Advantage $2,263.80
Rate for Payer: The Alliance Commercial $15,092.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $2,075.15
Rate for Payer: WPS Commercial $2,794.66
Service Code CPT 73702 TC,RT
Hospital Charge Code 2980085
Hospital Revenue Code 350
Min. Negotiated Rate $1,660.12
Max. Negotiated Rate $3,584.35
Rate for Payer: Aetna Commercial $3,584.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,244.78
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cash Price $1,131.90
Rate for Payer: Cigna Commercial $3,584.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,886.50
Rate for Payer: Dean Health DHI/DHP/ASO $2,263.80
Rate for Payer: Health EOS Commercial $3,433.43
Rate for Payer: Multiplan Commercial $3,018.40
Rate for Payer: Preferred Network Access Commercial $3,584.35
Rate for Payer: Quartz Beloit One Network $1,660.12
Rate for Payer: Quartz Commercial $2,150.61
Rate for Payer: The Alliance Commercial $1,886.50
Rate for Payer: WEA Trust Commercial $2,075.15
Rate for Payer: WPS Commercial $2,794.66
Service Code CPT 73702 RT,TC
Hospital Charge Code 1241060
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
Service Code CPT 73702
Hospital Charge Code 629864
Min. Negotiated Rate $195.75
Max. Negotiated Rate $3,652.75
Rate for Payer: Aetna Commercial $3,652.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,306.70
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 $1,153.50
Rate for Payer: Cash Price $1,153.50
Rate for Payer: Cigna Commercial $3,652.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,922.50
Rate for Payer: Dean Health DHI/DHP/ASO $195.75
Rate for Payer: Health EOS Commercial $3,498.95
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 $3,076.00
Rate for Payer: Preferred Network Access Commercial $3,652.75
Rate for Payer: Quartz Beloit One Network $1,691.80
Rate for Payer: Quartz Commercial $2,191.65
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 $2,114.75
Rate for Payer: WPS Commercial $978.75
Service Code CPT 73201
Hospital Charge Code 629892
Min. Negotiated Rate $202.41
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 $202.41
Rate for Payer: Anthem Medicare Advantage $202.41
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $202.41
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $202.41
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 $202.41
Rate for Payer: Health EOS Commercial $4,705.61
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.22
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $754.22
Rate for Payer: Independent Care Health Plan Medicare $202.41
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 $202.41
Rate for Payer: The Alliance Commercial $769.16
Rate for Payer: United Healthcare Medicare Advantage $202.41
Rate for Payer: WEA Trust Commercial $2,844.05
Rate for Payer: WPS Commercial $1,012.05
Service Code CPT 73201 TC,LT
Hospital Charge Code 1241080
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 73201
Hospital Charge Code 629892
Min. Negotiated Rate $380.12
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 $380.12
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 $380.12
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 $380.12
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $380.12
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 $380.12
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $380.12
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 $1,414.05
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $380.12
Rate for Payer: Independent Care Health Plan Medicare $380.12
Rate for Payer: Managed Health Services Medicare Advantage $380.12
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $380.12
Rate for Payer: Multiplan Commercial $4,136.80
Rate for Payer: NAPHCARE Commercial $570.18
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 $380.12
Rate for Payer: The Alliance Commercial $1,897.76
Rate for Payer: United Healthcare Medicare Advantage $380.12
Rate for Payer: WEA Trust Commercial $2,844.05
Rate for Payer: Wellcare Medicare $380.12
Rate for Payer: WPS Commercial $3,830.16
Service Code CPT 73201 TC,LT
Hospital Charge Code 1241080
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 73201
Hospital Charge Code 629892
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 73201 TC,LT
Hospital Charge Code 1241080
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 73201 LT,TC
Hospital Charge Code 1241082
Hospital Revenue Code 350
Min. Negotiated Rate $1,290.17
Max. Negotiated Rate $2,422.36
Rate for Payer: Aetna Commercial $2,369.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,395.49
Rate for Payer: Cash Price $789.90
Rate for Payer: Cigna Commercial $2,422.36
Rate for Payer: Health EOS Commercial $2,343.37
Rate for Payer: HFN Commercial $2,422.36
Rate for Payer: Multiplan Commercial $2,106.40
Rate for Payer: NAPHCARE Commercial $1,579.80
Rate for Payer: Preferred Network Access Commercial $2,422.36
Rate for Payer: Quartz Beloit One Network $1,290.17
Rate for Payer: Quartz Commercial $1,579.80
Rate for Payer: WEA Trust Commercial $1,448.15
Rate for Payer: WPS Commercial $1,950.26
Service Code CPT 73201
Hospital Charge Code 629894
Min. Negotiated Rate $202.41
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 $202.41
Rate for Payer: Anthem Medicare Advantage $202.41
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $202.41
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $202.41
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 $202.41
Rate for Payer: Health EOS Commercial $2,352.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.22
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $754.22
Rate for Payer: Independent Care Health Plan Medicare $202.41
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 $202.41
Rate for Payer: The Alliance Commercial $769.16
Rate for Payer: United Healthcare Medicare Advantage $202.41
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: WPS Commercial $1,012.05
Service Code CPT 73201
Hospital Charge Code 629894
Min. Negotiated Rate $380.12
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 $380.12
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 $380.12
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 $380.12
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $380.12
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 $380.12
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $380.12
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 $1,414.05
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $380.12
Rate for Payer: Independent Care Health Plan Medicare $380.12
Rate for Payer: Managed Health Services Medicare Advantage $380.12
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $380.12
Rate for Payer: Multiplan Commercial $2,068.00
Rate for Payer: NAPHCARE Commercial $570.18
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 $380.12
Rate for Payer: The Alliance Commercial $1,897.76
Rate for Payer: United Healthcare Medicare Advantage $380.12
Rate for Payer: WEA Trust Commercial $1,421.75
Rate for Payer: Wellcare Medicare $380.12
Rate for Payer: WPS Commercial $1,914.71
Service Code CPT 73201 LT,TC
Hospital Charge Code 1241082
Hospital Revenue Code 350
Min. Negotiated Rate $1,158.52
Max. Negotiated Rate $2,501.35
Rate for Payer: Aetna Commercial $2,501.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,264.38
Rate for Payer: Cash Price $789.90
Rate for Payer: Cash Price $789.90
Rate for Payer: Cigna Commercial $2,501.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,316.50
Rate for Payer: Dean Health DHI/DHP/ASO $1,579.80
Rate for Payer: Health EOS Commercial $2,396.03
Rate for Payer: Multiplan Commercial $2,106.40
Rate for Payer: Preferred Network Access Commercial $2,501.35
Rate for Payer: Quartz Beloit One Network $1,158.52
Rate for Payer: Quartz Commercial $1,500.81
Rate for Payer: The Alliance Commercial $1,316.50
Rate for Payer: WEA Trust Commercial $1,448.15
Rate for Payer: WPS Commercial $1,950.26
Service Code CPT 73201
Hospital Charge Code 629894
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 73201 LT,TC
Hospital Charge Code 1241082
Hospital Revenue Code 350
Min. Negotiated Rate $737.24
Max. Negotiated Rate $10,532.00
Rate for Payer: Aetna Commercial $2,369.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,264.38
Rate for Payer: Aetna Managed Medicare $737.24
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 $1,395.49
Rate for Payer: Cash Price $789.90
Rate for Payer: Cash Price $789.90
Rate for Payer: Cash Price $789.90
Rate for Payer: Cash Price $789.90
Rate for Payer: Cigna Commercial $2,422.36
Rate for Payer: Health EOS Commercial $2,343.37
Rate for Payer: HFN Commercial $2,422.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,974.75
Rate for Payer: Multiplan Commercial $2,106.40
Rate for Payer: NAPHCARE Commercial $1,579.80
Rate for Payer: Preferred Network Access Commercial $2,422.36
Rate for Payer: Quartz Beloit One Network $1,290.17
Rate for Payer: Quartz Commercial $1,711.45
Rate for Payer: Quartz Medicare Advantage $1,579.80
Rate for Payer: The Alliance Commercial $10,532.00
Rate for Payer: United Healthcare PPO $2,065.00
Rate for Payer: WEA Trust Commercial $1,448.15
Rate for Payer: WPS Commercial $1,950.26
Service Code CPT 73201 RT,TC
Hospital Charge Code 1241084
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 73201
Hospital Charge Code 629898
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 73201 TC,RT
Hospital Charge Code 2980013
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 73201 TC,RT
Hospital Charge Code 2980013
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