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Hospital Charge Code 2960018
Hospital Revenue Code 370
Min. Negotiated Rate $139.65
Max. Negotiated Rate $262.20
Rate for Payer: Aetna Commercial $256.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $245.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $151.05
Rate for Payer: Cash Price $85.50
Rate for Payer: Cigna Commercial $262.20
Rate for Payer: Health EOS Commercial $253.65
Rate for Payer: HFN Commercial $262.20
Rate for Payer: Multiplan Commercial $228.00
Rate for Payer: NAPHCARE Commercial $171.00
Rate for Payer: Preferred Network Access Commercial $262.20
Rate for Payer: Quartz Beloit One Network $139.65
Rate for Payer: Quartz Commercial $171.00
Rate for Payer: WEA Trust Commercial $156.75
Rate for Payer: WPS Commercial $211.10
Hospital Charge Code 2960018
Hospital Revenue Code 370
Min. Negotiated Rate $79.80
Max. Negotiated Rate $1,140.00
Rate for Payer: Aetna Commercial $256.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $245.10
Rate for Payer: Aetna Managed Medicare $79.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $185.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $142.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $136.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $151.05
Rate for Payer: Cash Price $85.50
Rate for Payer: Cigna Commercial $262.20
Rate for Payer: Dean Health DHI/DHP/ASO $159.49
Rate for Payer: Health EOS Commercial $253.65
Rate for Payer: HFN Commercial $262.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $213.75
Rate for Payer: Multiplan Commercial $228.00
Rate for Payer: NAPHCARE Commercial $171.00
Rate for Payer: Preferred Network Access Commercial $262.20
Rate for Payer: Quartz Beloit One Network $139.65
Rate for Payer: Quartz Commercial $185.25
Rate for Payer: Quartz Medicare Advantage $171.00
Rate for Payer: The Alliance Commercial $1,140.00
Rate for Payer: WEA Trust Commercial $156.75
Rate for Payer: WPS Commercial $211.10
Hospital Charge Code 2959922
Hospital Revenue Code 360
Min. Negotiated Rate $587.72
Max. Negotiated Rate $8,396.00
Rate for Payer: Aetna Commercial $1,889.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,805.14
Rate for Payer: Aetna Managed Medicare $587.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,364.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,049.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,007.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,112.47
Rate for Payer: Cash Price $629.70
Rate for Payer: Cigna Commercial $1,931.08
Rate for Payer: Dean Health DHI/DHP/ASO $1,174.60
Rate for Payer: Health EOS Commercial $1,868.11
Rate for Payer: HFN Commercial $1,931.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,574.25
Rate for Payer: Multiplan Commercial $1,679.20
Rate for Payer: NAPHCARE Commercial $1,259.40
Rate for Payer: Preferred Network Access Commercial $1,931.08
Rate for Payer: Quartz Beloit One Network $1,028.51
Rate for Payer: Quartz Commercial $1,364.35
Rate for Payer: Quartz Medicare Advantage $1,259.40
Rate for Payer: The Alliance Commercial $8,396.00
Rate for Payer: WEA Trust Commercial $1,154.45
Rate for Payer: WPS Commercial $1,554.73
Hospital Charge Code 2959922
Hospital Revenue Code 360
Min. Negotiated Rate $1,028.51
Max. Negotiated Rate $1,931.08
Rate for Payer: Aetna Commercial $1,889.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,805.14
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,112.47
Rate for Payer: Cash Price $629.70
Rate for Payer: Cigna Commercial $1,931.08
Rate for Payer: Health EOS Commercial $1,868.11
Rate for Payer: HFN Commercial $1,931.08
Rate for Payer: Multiplan Commercial $1,679.20
Rate for Payer: NAPHCARE Commercial $1,259.40
Rate for Payer: Preferred Network Access Commercial $1,931.08
Rate for Payer: Quartz Beloit One Network $1,028.51
Rate for Payer: Quartz Commercial $1,259.40
Rate for Payer: WEA Trust Commercial $1,154.45
Rate for Payer: WPS Commercial $1,554.73
Hospital Charge Code 5262679
Hospital Revenue Code 360
Min. Negotiated Rate $1,217.65
Max. Negotiated Rate $2,286.20
Rate for Payer: Aetna Commercial $2,236.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,137.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,317.05
Rate for Payer: Cash Price $745.50
Rate for Payer: Cigna Commercial $2,286.20
Rate for Payer: Health EOS Commercial $2,211.65
Rate for Payer: HFN Commercial $2,286.20
Rate for Payer: Multiplan Commercial $1,988.00
Rate for Payer: NAPHCARE Commercial $1,491.00
Rate for Payer: Preferred Network Access Commercial $2,286.20
Rate for Payer: Quartz Beloit One Network $1,217.65
Rate for Payer: Quartz Commercial $1,491.00
Rate for Payer: WEA Trust Commercial $1,366.75
Rate for Payer: WPS Commercial $1,840.64
Hospital Charge Code 5262679
Hospital Revenue Code 360
Min. Negotiated Rate $695.80
Max. Negotiated Rate $9,940.00
Rate for Payer: Aetna Commercial $2,236.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,137.10
Rate for Payer: Aetna Managed Medicare $695.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,615.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,242.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,192.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,317.05
Rate for Payer: Cash Price $745.50
Rate for Payer: Cigna Commercial $2,286.20
Rate for Payer: Dean Health DHI/DHP/ASO $1,390.61
Rate for Payer: Health EOS Commercial $2,211.65
Rate for Payer: HFN Commercial $2,286.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,863.75
Rate for Payer: Multiplan Commercial $1,988.00
Rate for Payer: NAPHCARE Commercial $1,491.00
Rate for Payer: Preferred Network Access Commercial $2,286.20
Rate for Payer: Quartz Beloit One Network $1,217.65
Rate for Payer: Quartz Commercial $1,615.25
Rate for Payer: Quartz Medicare Advantage $1,491.00
Rate for Payer: The Alliance Commercial $9,940.00
Rate for Payer: WEA Trust Commercial $1,366.75
Rate for Payer: WPS Commercial $1,840.64
Hospital Charge Code 4882606
Hospital Revenue Code 360
Min. Negotiated Rate $1,222.55
Max. Negotiated Rate $2,295.40
Rate for Payer: Aetna Commercial $2,245.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,145.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,322.35
Rate for Payer: Cash Price $748.50
Rate for Payer: Cigna Commercial $2,295.40
Rate for Payer: Health EOS Commercial $2,220.55
Rate for Payer: HFN Commercial $2,295.40
Rate for Payer: Multiplan Commercial $1,996.00
Rate for Payer: NAPHCARE Commercial $1,497.00
Rate for Payer: Preferred Network Access Commercial $2,295.40
Rate for Payer: Quartz Beloit One Network $1,222.55
Rate for Payer: Quartz Commercial $1,497.00
Rate for Payer: WEA Trust Commercial $1,372.25
Rate for Payer: WPS Commercial $1,848.05
Hospital Charge Code 4882606
Hospital Revenue Code 360
Min. Negotiated Rate $698.60
Max. Negotiated Rate $9,980.00
Rate for Payer: Aetna Commercial $2,245.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,145.70
Rate for Payer: Aetna Managed Medicare $698.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,621.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,247.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,197.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,322.35
Rate for Payer: Cash Price $748.50
Rate for Payer: Cigna Commercial $2,295.40
Rate for Payer: Dean Health DHI/DHP/ASO $1,396.20
Rate for Payer: Health EOS Commercial $2,220.55
Rate for Payer: HFN Commercial $2,295.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,871.25
Rate for Payer: Multiplan Commercial $1,996.00
Rate for Payer: NAPHCARE Commercial $1,497.00
Rate for Payer: Preferred Network Access Commercial $2,295.40
Rate for Payer: Quartz Beloit One Network $1,222.55
Rate for Payer: Quartz Commercial $1,621.75
Rate for Payer: Quartz Medicare Advantage $1,497.00
Rate for Payer: The Alliance Commercial $9,980.00
Rate for Payer: WEA Trust Commercial $1,372.25
Rate for Payer: WPS Commercial $1,848.05
Hospital Charge Code 5262680
Hospital Revenue Code 360
Min. Negotiated Rate $243.60
Max. Negotiated Rate $3,480.00
Rate for Payer: Aetna Commercial $783.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $748.20
Rate for Payer: Aetna Managed Medicare $243.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $565.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $435.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $417.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $461.10
Rate for Payer: Cash Price $261.00
Rate for Payer: Cigna Commercial $800.40
Rate for Payer: Dean Health DHI/DHP/ASO $486.85
Rate for Payer: Health EOS Commercial $774.30
Rate for Payer: HFN Commercial $800.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $652.50
Rate for Payer: Multiplan Commercial $696.00
Rate for Payer: NAPHCARE Commercial $522.00
Rate for Payer: Preferred Network Access Commercial $800.40
Rate for Payer: Quartz Beloit One Network $426.30
Rate for Payer: Quartz Commercial $565.50
Rate for Payer: Quartz Medicare Advantage $522.00
Rate for Payer: The Alliance Commercial $3,480.00
Rate for Payer: WEA Trust Commercial $478.50
Rate for Payer: WPS Commercial $644.41
Hospital Charge Code 5262680
Hospital Revenue Code 360
Min. Negotiated Rate $426.30
Max. Negotiated Rate $800.40
Rate for Payer: Aetna Commercial $783.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $748.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $461.10
Rate for Payer: Cash Price $261.00
Rate for Payer: Cigna Commercial $800.40
Rate for Payer: Health EOS Commercial $774.30
Rate for Payer: HFN Commercial $800.40
Rate for Payer: Multiplan Commercial $696.00
Rate for Payer: NAPHCARE Commercial $522.00
Rate for Payer: Preferred Network Access Commercial $800.40
Rate for Payer: Quartz Beloit One Network $426.30
Rate for Payer: Quartz Commercial $522.00
Rate for Payer: WEA Trust Commercial $478.50
Rate for Payer: WPS Commercial $644.41
Hospital Charge Code 2960564
Hospital Revenue Code 360
Min. Negotiated Rate $526.75
Max. Negotiated Rate $989.00
Rate for Payer: Aetna Commercial $967.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $924.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $569.75
Rate for Payer: Cash Price $322.50
Rate for Payer: Cigna Commercial $989.00
Rate for Payer: Health EOS Commercial $956.75
Rate for Payer: HFN Commercial $989.00
Rate for Payer: Multiplan Commercial $860.00
Rate for Payer: NAPHCARE Commercial $645.00
Rate for Payer: Preferred Network Access Commercial $989.00
Rate for Payer: Quartz Beloit One Network $526.75
Rate for Payer: Quartz Commercial $645.00
Rate for Payer: WEA Trust Commercial $591.25
Rate for Payer: WPS Commercial $796.25
Hospital Charge Code 2960564
Hospital Revenue Code 360
Min. Negotiated Rate $301.00
Max. Negotiated Rate $4,300.00
Rate for Payer: Aetna Commercial $967.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $924.50
Rate for Payer: Aetna Managed Medicare $301.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $698.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $537.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $516.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $569.75
Rate for Payer: Cash Price $322.50
Rate for Payer: Cigna Commercial $989.00
Rate for Payer: Dean Health DHI/DHP/ASO $601.57
Rate for Payer: Health EOS Commercial $956.75
Rate for Payer: HFN Commercial $989.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $806.25
Rate for Payer: Multiplan Commercial $860.00
Rate for Payer: NAPHCARE Commercial $645.00
Rate for Payer: Preferred Network Access Commercial $989.00
Rate for Payer: Quartz Beloit One Network $526.75
Rate for Payer: Quartz Commercial $698.75
Rate for Payer: Quartz Medicare Advantage $645.00
Rate for Payer: The Alliance Commercial $4,300.00
Rate for Payer: WEA Trust Commercial $591.25
Rate for Payer: WPS Commercial $796.25
Hospital Charge Code 2960524
Hospital Revenue Code 360
Min. Negotiated Rate $142.59
Max. Negotiated Rate $267.72
Rate for Payer: Aetna Commercial $261.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $250.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $154.23
Rate for Payer: Cash Price $87.30
Rate for Payer: Cigna Commercial $267.72
Rate for Payer: Health EOS Commercial $258.99
Rate for Payer: HFN Commercial $267.72
Rate for Payer: Multiplan Commercial $232.80
Rate for Payer: NAPHCARE Commercial $174.60
Rate for Payer: Preferred Network Access Commercial $267.72
Rate for Payer: Quartz Beloit One Network $142.59
Rate for Payer: Quartz Commercial $174.60
Rate for Payer: WEA Trust Commercial $160.05
Rate for Payer: WPS Commercial $215.54
Hospital Charge Code 2960524
Hospital Revenue Code 360
Min. Negotiated Rate $81.48
Max. Negotiated Rate $1,164.00
Rate for Payer: Aetna Commercial $261.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $250.26
Rate for Payer: Aetna Managed Medicare $81.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $189.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $145.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $139.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $154.23
Rate for Payer: Cash Price $87.30
Rate for Payer: Cigna Commercial $267.72
Rate for Payer: Dean Health DHI/DHP/ASO $162.84
Rate for Payer: Health EOS Commercial $258.99
Rate for Payer: HFN Commercial $267.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $218.25
Rate for Payer: Multiplan Commercial $232.80
Rate for Payer: NAPHCARE Commercial $174.60
Rate for Payer: Preferred Network Access Commercial $267.72
Rate for Payer: Quartz Beloit One Network $142.59
Rate for Payer: Quartz Commercial $189.15
Rate for Payer: Quartz Medicare Advantage $174.60
Rate for Payer: The Alliance Commercial $1,164.00
Rate for Payer: WEA Trust Commercial $160.05
Rate for Payer: WPS Commercial $215.54
Hospital Charge Code 4519584
Hospital Revenue Code 271
Min. Negotiated Rate $817.32
Max. Negotiated Rate $1,534.56
Rate for Payer: Aetna Commercial $1,501.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,434.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $884.04
Rate for Payer: Cash Price $500.40
Rate for Payer: Cigna Commercial $1,534.56
Rate for Payer: Health EOS Commercial $1,484.52
Rate for Payer: HFN Commercial $1,534.56
Rate for Payer: Multiplan Commercial $1,334.40
Rate for Payer: NAPHCARE Commercial $1,000.80
Rate for Payer: Preferred Network Access Commercial $1,534.56
Rate for Payer: Quartz Beloit One Network $817.32
Rate for Payer: Quartz Commercial $1,000.80
Rate for Payer: WEA Trust Commercial $917.40
Rate for Payer: WPS Commercial $1,235.49
Hospital Charge Code 4519584
Hospital Revenue Code 271
Min. Negotiated Rate $467.04
Max. Negotiated Rate $6,672.00
Rate for Payer: Aetna Commercial $1,501.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,434.48
Rate for Payer: Aetna Managed Medicare $467.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,084.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $834.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $800.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $884.04
Rate for Payer: Cash Price $500.40
Rate for Payer: Cigna Commercial $1,534.56
Rate for Payer: Dean Health DHI/DHP/ASO $933.41
Rate for Payer: Health EOS Commercial $1,484.52
Rate for Payer: HFN Commercial $1,534.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,251.00
Rate for Payer: Multiplan Commercial $1,334.40
Rate for Payer: NAPHCARE Commercial $1,000.80
Rate for Payer: Preferred Network Access Commercial $1,534.56
Rate for Payer: Quartz Beloit One Network $817.32
Rate for Payer: Quartz Commercial $1,084.20
Rate for Payer: Quartz Medicare Advantage $1,000.80
Rate for Payer: The Alliance Commercial $6,672.00
Rate for Payer: WEA Trust Commercial $917.40
Rate for Payer: WPS Commercial $1,235.49
Hospital Charge Code 3003916
Hospital Revenue Code 370
Min. Negotiated Rate $516.46
Max. Negotiated Rate $969.68
Rate for Payer: Aetna Commercial $948.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $906.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $558.62
Rate for Payer: Cash Price $316.20
Rate for Payer: Cigna Commercial $969.68
Rate for Payer: Health EOS Commercial $938.06
Rate for Payer: HFN Commercial $969.68
Rate for Payer: Multiplan Commercial $843.20
Rate for Payer: NAPHCARE Commercial $632.40
Rate for Payer: Preferred Network Access Commercial $969.68
Rate for Payer: Quartz Beloit One Network $516.46
Rate for Payer: Quartz Commercial $632.40
Rate for Payer: WEA Trust Commercial $579.70
Rate for Payer: WPS Commercial $780.70
Hospital Charge Code 3003916
Hospital Revenue Code 370
Min. Negotiated Rate $295.12
Max. Negotiated Rate $4,216.00
Rate for Payer: Aetna Commercial $948.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $906.44
Rate for Payer: Aetna Managed Medicare $295.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $685.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $527.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $505.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $558.62
Rate for Payer: Cash Price $316.20
Rate for Payer: Cigna Commercial $969.68
Rate for Payer: Dean Health DHI/DHP/ASO $589.82
Rate for Payer: Health EOS Commercial $938.06
Rate for Payer: HFN Commercial $969.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $790.50
Rate for Payer: Multiplan Commercial $843.20
Rate for Payer: NAPHCARE Commercial $632.40
Rate for Payer: Preferred Network Access Commercial $969.68
Rate for Payer: Quartz Beloit One Network $516.46
Rate for Payer: Quartz Commercial $685.10
Rate for Payer: Quartz Medicare Advantage $632.40
Rate for Payer: The Alliance Commercial $4,216.00
Rate for Payer: WEA Trust Commercial $579.70
Rate for Payer: WPS Commercial $780.70
Service Code HCPCS Q4186
Hospital Charge Code 5571280
Hospital Revenue Code 636
Min. Negotiated Rate $153.45
Max. Negotiated Rate $824.60
Rate for Payer: Aetna Commercial $824.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $746.48
Rate for Payer: Cash Price $260.40
Rate for Payer: Cash Price $260.40
Rate for Payer: Cigna Commercial $824.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $160.02
Rate for Payer: Dean Health DHI/DHP/ASO $153.45
Rate for Payer: Health EOS Commercial $789.88
Rate for Payer: HFN Commercial $824.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $543.37
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $543.37
Rate for Payer: Multiplan Commercial $694.40
Rate for Payer: Preferred Network Access Commercial $824.60
Rate for Payer: Quartz Beloit One Network $381.92
Rate for Payer: Quartz Commercial $494.76
Rate for Payer: The Alliance Commercial $434.00
Rate for Payer: United Healthcare Medicaid $160.02
Rate for Payer: WEA Trust Commercial $477.40
Rate for Payer: WPS Commercial $383.63
Service Code HCPCS Q4186
Hospital Charge Code 5571280
Hospital Revenue Code 636
Min. Negotiated Rate $203.02
Max. Negotiated Rate $3,472.00
Rate for Payer: Aetna Commercial $781.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $746.48
Rate for Payer: Aetna Managed Medicare $243.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $564.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $434.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $416.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $460.04
Rate for Payer: Cash Price $260.40
Rate for Payer: Cash Price $260.40
Rate for Payer: Cigna Commercial $798.56
Rate for Payer: Dean Health DHI/DHP/ASO $203.02
Rate for Payer: Health EOS Commercial $772.52
Rate for Payer: HFN Commercial $798.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $651.00
Rate for Payer: Multiplan Commercial $694.40
Rate for Payer: NAPHCARE Commercial $520.80
Rate for Payer: Preferred Network Access Commercial $798.56
Rate for Payer: Quartz Beloit One Network $425.32
Rate for Payer: Quartz Commercial $564.20
Rate for Payer: Quartz Medicare Advantage $520.80
Rate for Payer: The Alliance Commercial $3,472.00
Rate for Payer: WEA Trust Commercial $477.40
Rate for Payer: WPS Commercial $383.63
Service Code HCPCS Q4186
Hospital Charge Code 5571280
Hospital Revenue Code 636
Min. Negotiated Rate $425.32
Max. Negotiated Rate $798.56
Rate for Payer: Aetna Commercial $781.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $746.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $460.04
Rate for Payer: Cash Price $260.40
Rate for Payer: Cigna Commercial $798.56
Rate for Payer: Health EOS Commercial $772.52
Rate for Payer: HFN Commercial $798.56
Rate for Payer: Multiplan Commercial $694.40
Rate for Payer: NAPHCARE Commercial $520.80
Rate for Payer: Preferred Network Access Commercial $798.56
Rate for Payer: Quartz Beloit One Network $425.32
Rate for Payer: Quartz Commercial $520.80
Rate for Payer: WEA Trust Commercial $477.40
Rate for Payer: WPS Commercial $642.93
Service Code CPT 93618
Hospital Charge Code 3052506
Hospital Revenue Code 481
Min. Negotiated Rate $1,176.34
Max. Negotiated Rate $29,139.00
Rate for Payer: Aetna Commercial $16,214.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $15,493.76
Rate for Payer: Aetna Managed Medicare $1,176.34
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $29,139.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $26,420.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $25,100.00
Rate for Payer: Anthem Medicare Advantage $1,176.34
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $9,548.48
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,176.34
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,176.34
Rate for Payer: Cash Price $5,404.80
Rate for Payer: Cash Price $5,404.80
Rate for Payer: Cash Price $5,404.80
Rate for Payer: Cigna Commercial $16,574.72
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,176.34
Rate for Payer: Dean Health DHI/DHP/ASO $10,081.75
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,176.34
Rate for Payer: Health EOS Commercial $16,034.24
Rate for Payer: HFN Commercial $16,574.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,375.98
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,176.34
Rate for Payer: Independent Care Health Plan Medicare $1,176.34
Rate for Payer: Managed Health Services Medicare Advantage $1,176.34
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,176.34
Rate for Payer: Multiplan Commercial $14,412.80
Rate for Payer: NAPHCARE Commercial $1,764.51
Rate for Payer: Preferred Network Access Commercial $16,574.72
Rate for Payer: Quartz Beloit One Network $8,827.84
Rate for Payer: Quartz Commercial $11,710.40
Rate for Payer: Quartz Medicare Advantage $1,176.34
Rate for Payer: The Alliance Commercial $4,705.36
Rate for Payer: United Healthcare Medicare Advantage $1,176.34
Rate for Payer: WEA Trust Commercial $9,908.80
Rate for Payer: Wellcare Medicare $1,176.34
Rate for Payer: WPS Commercial $13,344.45
Service Code CPT 93618
Hospital Charge Code 3052506
Hospital Revenue Code 481
Min. Negotiated Rate $8,827.84
Max. Negotiated Rate $16,574.72
Rate for Payer: Aetna Commercial $16,214.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $15,493.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $9,548.48
Rate for Payer: Cash Price $5,404.80
Rate for Payer: Cigna Commercial $16,574.72
Rate for Payer: Health EOS Commercial $16,034.24
Rate for Payer: HFN Commercial $16,574.72
Rate for Payer: Multiplan Commercial $14,412.80
Rate for Payer: NAPHCARE Commercial $10,809.60
Rate for Payer: Preferred Network Access Commercial $16,574.72
Rate for Payer: Quartz Beloit One Network $8,827.84
Rate for Payer: Quartz Commercial $10,809.60
Rate for Payer: WEA Trust Commercial $9,908.80
Rate for Payer: WPS Commercial $13,344.45
Service Code HCPCS J0171
Hospital Charge Code 2974934
Hospital Revenue Code 636
Min. Negotiated Rate $1.07
Max. Negotiated Rate $92.00
Rate for Payer: Aetna Commercial $20.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19.78
Rate for Payer: Aetna Managed Medicare $6.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $14.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $11.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $11.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12.19
Rate for Payer: Cash Price $6.90
Rate for Payer: Cash Price $6.90
Rate for Payer: Cigna Commercial $21.16
Rate for Payer: Dean Health DHI/DHP/ASO $1.07
Rate for Payer: Health EOS Commercial $20.47
Rate for Payer: HFN Commercial $21.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $17.25
Rate for Payer: Multiplan Commercial $18.40
Rate for Payer: NAPHCARE Commercial $13.80
Rate for Payer: Preferred Network Access Commercial $21.16
Rate for Payer: Quartz Beloit One Network $11.27
Rate for Payer: Quartz Commercial $14.95
Rate for Payer: Quartz Medicare Advantage $13.80
Rate for Payer: The Alliance Commercial $92.00
Rate for Payer: WEA Trust Commercial $12.65
Rate for Payer: WPS Commercial $2.03
Service Code HCPCS J0171
Hospital Charge Code 2974934
Hospital Revenue Code 636
Min. Negotiated Rate $11.27
Max. Negotiated Rate $21.16
Rate for Payer: Aetna Commercial $20.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12.19
Rate for Payer: Cash Price $6.90
Rate for Payer: Cigna Commercial $21.16
Rate for Payer: Health EOS Commercial $20.47
Rate for Payer: HFN Commercial $21.16
Rate for Payer: Multiplan Commercial $18.40
Rate for Payer: NAPHCARE Commercial $13.80
Rate for Payer: Preferred Network Access Commercial $21.16
Rate for Payer: Quartz Beloit One Network $11.27
Rate for Payer: Quartz Commercial $13.80
Rate for Payer: WEA Trust Commercial $12.65
Rate for Payer: WPS Commercial $17.04