Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS Q4081
Hospital Charge Code 3697519
Hospital Revenue Code 635
Min. Negotiated Rate $1.09
Max. Negotiated Rate $124.00
Rate for Payer: Aetna Commercial $27.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26.66
Rate for Payer: Aetna Managed Medicare $8.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $14.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16.43
Rate for Payer: Cash Price $9.30
Rate for Payer: Cash Price $9.30
Rate for Payer: Cigna Commercial $28.52
Rate for Payer: Dean Health DHI/DHP/ASO $1.09
Rate for Payer: Health EOS Commercial $27.59
Rate for Payer: HFN Commercial $28.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $23.25
Rate for Payer: Multiplan Commercial $24.80
Rate for Payer: NAPHCARE Commercial $18.60
Rate for Payer: Preferred Network Access Commercial $28.52
Rate for Payer: Quartz Beloit One Network $15.19
Rate for Payer: Quartz Commercial $20.15
Rate for Payer: Quartz Medicare Advantage $18.60
Rate for Payer: The Alliance Commercial $124.00
Rate for Payer: WEA Trust Commercial $17.05
Rate for Payer: WPS Commercial $2.07
Service Code HCPCS Q4081
Hospital Charge Code 3697519
Hospital Revenue Code 635
Min. Negotiated Rate $0.83
Max. Negotiated Rate $29.45
Rate for Payer: Aetna Commercial $29.45
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26.66
Rate for Payer: Cash Price $9.30
Rate for Payer: Cash Price $9.30
Rate for Payer: Cigna Commercial $29.45
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $15.50
Rate for Payer: Dean Health DHI/DHP/ASO $0.83
Rate for Payer: Health EOS Commercial $28.21
Rate for Payer: HFN Commercial $29.45
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3.00
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3.00
Rate for Payer: Multiplan Commercial $24.80
Rate for Payer: Preferred Network Access Commercial $29.45
Rate for Payer: Quartz Beloit One Network $13.64
Rate for Payer: Quartz Commercial $17.67
Rate for Payer: The Alliance Commercial $15.50
Rate for Payer: WEA Trust Commercial $17.05
Rate for Payer: WPS Commercial $2.07
Service Code HCPCS Q4081
Hospital Charge Code 3697519
Hospital Revenue Code 635
Min. Negotiated Rate $15.19
Max. Negotiated Rate $28.52
Rate for Payer: Aetna Commercial $27.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16.43
Rate for Payer: Cash Price $9.30
Rate for Payer: Cigna Commercial $28.52
Rate for Payer: Health EOS Commercial $27.59
Rate for Payer: HFN Commercial $28.52
Rate for Payer: Multiplan Commercial $24.80
Rate for Payer: NAPHCARE Commercial $18.60
Rate for Payer: Preferred Network Access Commercial $28.52
Rate for Payer: Quartz Beloit One Network $15.19
Rate for Payer: Quartz Commercial $18.60
Rate for Payer: WEA Trust Commercial $17.05
Rate for Payer: WPS Commercial $22.96
Service Code HCPCS J0885
Hospital Charge Code 3697520
Hospital Revenue Code 636
Min. Negotiated Rate $8.27
Max. Negotiated Rate $29.45
Rate for Payer: Aetna Commercial $29.45
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26.66
Rate for Payer: Cash Price $9.30
Rate for Payer: Cash Price $9.30
Rate for Payer: Cigna Commercial $29.45
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $8.27
Rate for Payer: Dean Health DHI/DHP/ASO $8.27
Rate for Payer: Health EOS Commercial $28.21
Rate for Payer: HFN Commercial $29.45
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $12.47
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $12.47
Rate for Payer: Multiplan Commercial $24.80
Rate for Payer: Preferred Network Access Commercial $29.45
Rate for Payer: Quartz Beloit One Network $13.64
Rate for Payer: Quartz Commercial $17.67
Rate for Payer: The Alliance Commercial $15.50
Rate for Payer: United Healthcare Medicaid $8.27
Rate for Payer: WEA Trust Commercial $17.05
Rate for Payer: WPS Commercial $20.68
Service Code HCPCS J0885
Hospital Charge Code 3697520
Hospital Revenue Code 636
Min. Negotiated Rate $15.19
Max. Negotiated Rate $28.52
Rate for Payer: Aetna Commercial $27.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16.43
Rate for Payer: Cash Price $9.30
Rate for Payer: Cigna Commercial $28.52
Rate for Payer: Health EOS Commercial $27.59
Rate for Payer: HFN Commercial $28.52
Rate for Payer: Multiplan Commercial $24.80
Rate for Payer: NAPHCARE Commercial $18.60
Rate for Payer: Preferred Network Access Commercial $28.52
Rate for Payer: Quartz Beloit One Network $15.19
Rate for Payer: Quartz Commercial $18.60
Rate for Payer: WEA Trust Commercial $17.05
Rate for Payer: WPS Commercial $22.96
Service Code HCPCS J0885
Hospital Charge Code 3697520
Hospital Revenue Code 636
Min. Negotiated Rate $8.89
Max. Negotiated Rate $35.54
Rate for Payer: Aetna Commercial $27.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26.66
Rate for Payer: Aetna Managed Medicare $8.89
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $14.88
Rate for Payer: Anthem Medicare Advantage $8.89
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16.43
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $8.89
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $8.89
Rate for Payer: Cash Price $9.30
Rate for Payer: Cash Price $9.30
Rate for Payer: Cigna Commercial $28.52
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $8.89
Rate for Payer: Dean Health DHI/DHP/ASO $10.95
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $8.89
Rate for Payer: Health EOS Commercial $27.59
Rate for Payer: HFN Commercial $28.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $33.06
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $8.89
Rate for Payer: Independent Care Health Plan Medicare $8.89
Rate for Payer: Managed Health Services Medicare Advantage $8.89
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $8.89
Rate for Payer: Multiplan Commercial $24.80
Rate for Payer: NAPHCARE Commercial $13.33
Rate for Payer: Preferred Network Access Commercial $28.52
Rate for Payer: Quartz Beloit One Network $15.19
Rate for Payer: Quartz Commercial $20.15
Rate for Payer: Quartz Medicare Advantage $8.89
Rate for Payer: The Alliance Commercial $35.54
Rate for Payer: United Healthcare Medicare Advantage $8.89
Rate for Payer: WEA Trust Commercial $17.05
Rate for Payer: Wellcare Medicare $8.89
Rate for Payer: WPS Commercial $20.68
Service Code HCPCS Q4081
Hospital Charge Code 6219845
Hospital Revenue Code 636
Min. Negotiated Rate $1.09
Max. Negotiated Rate $28.00
Rate for Payer: Aetna Commercial $6.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6.02
Rate for Payer: Aetna Managed Medicare $1.96
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3.71
Rate for Payer: Cash Price $2.10
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.44
Rate for Payer: Dean Health DHI/DHP/ASO $1.09
Rate for Payer: Health EOS Commercial $6.23
Rate for Payer: HFN Commercial $6.44
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5.25
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: NAPHCARE Commercial $4.20
Rate for Payer: Preferred Network Access Commercial $6.44
Rate for Payer: Quartz Beloit One Network $3.43
Rate for Payer: Quartz Commercial $4.55
Rate for Payer: Quartz Medicare Advantage $4.20
Rate for Payer: The Alliance Commercial $28.00
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $2.07
Service Code HCPCS Q4081
Hospital Charge Code 6219845
Hospital Revenue Code 636
Min. Negotiated Rate $3.43
Max. Negotiated Rate $6.44
Rate for Payer: Aetna Commercial $6.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6.02
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3.71
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.44
Rate for Payer: Health EOS Commercial $6.23
Rate for Payer: HFN Commercial $6.44
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: NAPHCARE Commercial $4.20
Rate for Payer: Preferred Network Access Commercial $6.44
Rate for Payer: Quartz Beloit One Network $3.43
Rate for Payer: Quartz Commercial $4.20
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $5.18
Service Code HCPCS Q4081
Hospital Charge Code 6219846
Hospital Revenue Code 636
Min. Negotiated Rate $3.43
Max. Negotiated Rate $6.44
Rate for Payer: Aetna Commercial $6.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6.02
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3.71
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.44
Rate for Payer: Health EOS Commercial $6.23
Rate for Payer: HFN Commercial $6.44
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: NAPHCARE Commercial $4.20
Rate for Payer: Preferred Network Access Commercial $6.44
Rate for Payer: Quartz Beloit One Network $3.43
Rate for Payer: Quartz Commercial $4.20
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $5.18
Service Code HCPCS Q4081
Hospital Charge Code 6219846
Hospital Revenue Code 636
Min. Negotiated Rate $1.09
Max. Negotiated Rate $28.00
Rate for Payer: Aetna Commercial $6.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6.02
Rate for Payer: Aetna Managed Medicare $1.96
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3.71
Rate for Payer: Cash Price $2.10
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.44
Rate for Payer: Dean Health DHI/DHP/ASO $1.09
Rate for Payer: Health EOS Commercial $6.23
Rate for Payer: HFN Commercial $6.44
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5.25
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: NAPHCARE Commercial $4.20
Rate for Payer: Preferred Network Access Commercial $6.44
Rate for Payer: Quartz Beloit One Network $3.43
Rate for Payer: Quartz Commercial $4.55
Rate for Payer: Quartz Medicare Advantage $4.20
Rate for Payer: The Alliance Commercial $28.00
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $2.07
Hospital Charge Code 3005579
Hospital Revenue Code 270
Min. Negotiated Rate $2.45
Max. Negotiated Rate $4.60
Rate for Payer: Aetna Commercial $4.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2.65
Rate for Payer: Cash Price $1.50
Rate for Payer: Cigna Commercial $4.60
Rate for Payer: Health EOS Commercial $4.45
Rate for Payer: HFN Commercial $4.60
Rate for Payer: Multiplan Commercial $4.00
Rate for Payer: NAPHCARE Commercial $3.00
Rate for Payer: Preferred Network Access Commercial $4.60
Rate for Payer: Quartz Beloit One Network $2.45
Rate for Payer: Quartz Commercial $3.00
Rate for Payer: WEA Trust Commercial $2.75
Rate for Payer: WPS Commercial $3.70
Hospital Charge Code 3005579
Hospital Revenue Code 270
Min. Negotiated Rate $1.40
Max. Negotiated Rate $20.00
Rate for Payer: Aetna Commercial $4.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4.30
Rate for Payer: Aetna Managed Medicare $1.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2.65
Rate for Payer: Cash Price $1.50
Rate for Payer: Cigna Commercial $4.60
Rate for Payer: Dean Health DHI/DHP/ASO $2.80
Rate for Payer: Health EOS Commercial $4.45
Rate for Payer: HFN Commercial $4.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3.75
Rate for Payer: Multiplan Commercial $4.00
Rate for Payer: NAPHCARE Commercial $3.00
Rate for Payer: Preferred Network Access Commercial $4.60
Rate for Payer: Quartz Beloit One Network $2.45
Rate for Payer: Quartz Commercial $3.25
Rate for Payer: Quartz Medicare Advantage $3.00
Rate for Payer: The Alliance Commercial $20.00
Rate for Payer: WEA Trust Commercial $2.75
Rate for Payer: WPS Commercial $3.70
Hospital Charge Code 3026463
Hospital Revenue Code 270
Min. Negotiated Rate $2.45
Max. Negotiated Rate $4.60
Rate for Payer: Aetna Commercial $4.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2.65
Rate for Payer: Cash Price $1.50
Rate for Payer: Cigna Commercial $4.60
Rate for Payer: Health EOS Commercial $4.45
Rate for Payer: HFN Commercial $4.60
Rate for Payer: Multiplan Commercial $4.00
Rate for Payer: NAPHCARE Commercial $3.00
Rate for Payer: Preferred Network Access Commercial $4.60
Rate for Payer: Quartz Beloit One Network $2.45
Rate for Payer: Quartz Commercial $3.00
Rate for Payer: WEA Trust Commercial $2.75
Rate for Payer: WPS Commercial $3.70
Hospital Charge Code 3026463
Hospital Revenue Code 270
Min. Negotiated Rate $1.40
Max. Negotiated Rate $20.00
Rate for Payer: Aetna Commercial $4.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4.30
Rate for Payer: Aetna Managed Medicare $1.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2.65
Rate for Payer: Cash Price $1.50
Rate for Payer: Cigna Commercial $4.60
Rate for Payer: Dean Health DHI/DHP/ASO $2.80
Rate for Payer: Health EOS Commercial $4.45
Rate for Payer: HFN Commercial $4.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3.75
Rate for Payer: Multiplan Commercial $4.00
Rate for Payer: NAPHCARE Commercial $3.00
Rate for Payer: Preferred Network Access Commercial $4.60
Rate for Payer: Quartz Beloit One Network $2.45
Rate for Payer: Quartz Commercial $3.25
Rate for Payer: Quartz Medicare Advantage $3.00
Rate for Payer: The Alliance Commercial $20.00
Rate for Payer: WEA Trust Commercial $2.75
Rate for Payer: WPS Commercial $3.70
Service Code CPT 93603
Hospital Charge Code 4125700
Hospital Revenue Code 481
Min. Negotiated Rate $554.68
Max. Negotiated Rate $1,041.44
Rate for Payer: Aetna Commercial $1,018.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $973.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $599.96
Rate for Payer: Cash Price $339.60
Rate for Payer: Cigna Commercial $1,041.44
Rate for Payer: Health EOS Commercial $1,007.48
Rate for Payer: HFN Commercial $1,041.44
Rate for Payer: Multiplan Commercial $905.60
Rate for Payer: NAPHCARE Commercial $679.20
Rate for Payer: Preferred Network Access Commercial $1,041.44
Rate for Payer: Quartz Beloit One Network $554.68
Rate for Payer: Quartz Commercial $679.20
Rate for Payer: WEA Trust Commercial $622.60
Rate for Payer: WPS Commercial $838.47
Service Code CPT 93603
Hospital Charge Code 4125700
Hospital Revenue Code 481
Min. Negotiated Rate $554.68
Max. Negotiated Rate $29,139.00
Rate for Payer: Aetna Commercial $1,018.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $973.52
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 $599.96
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 $339.60
Rate for Payer: Cash Price $339.60
Rate for Payer: Cash Price $339.60
Rate for Payer: Cigna Commercial $1,041.44
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,176.34
Rate for Payer: Dean Health DHI/DHP/ASO $633.47
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,176.34
Rate for Payer: Health EOS Commercial $1,007.48
Rate for Payer: HFN Commercial $1,041.44
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 $905.60
Rate for Payer: NAPHCARE Commercial $1,764.51
Rate for Payer: Preferred Network Access Commercial $1,041.44
Rate for Payer: Quartz Beloit One Network $554.68
Rate for Payer: Quartz Commercial $735.80
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 $622.60
Rate for Payer: Wellcare Medicare $1,176.34
Rate for Payer: WPS Commercial $838.47
Service Code CPT 86663
Hospital Charge Code 5176624
Hospital Revenue Code 300
Min. Negotiated Rate $13.12
Max. Negotiated Rate $74.52
Rate for Payer: Aetna Commercial $72.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $69.66
Rate for Payer: Aetna Managed Medicare $13.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $49.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $22.96
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $21.78
Rate for Payer: Anthem Medicaid $13.56
Rate for Payer: Anthem Medicare Advantage $13.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $42.93
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $13.12
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $13.12
Rate for Payer: Cash Price $24.30
Rate for Payer: Cash Price $24.30
Rate for Payer: Cigna Commercial $74.52
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $13.12
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $13.56
Rate for Payer: Dean Health DHI/DHP/ASO $45.33
Rate for Payer: Dean Health Medicaid $13.56
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $13.12
Rate for Payer: Health EOS Commercial $72.09
Rate for Payer: HFN Commercial $74.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $48.81
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $13.12
Rate for Payer: Independent Care Health Plan Medicaid $13.56
Rate for Payer: Independent Care Health Plan Medicare $13.12
Rate for Payer: Managed Health Services Medicaid $14.10
Rate for Payer: Managed Health Services Medicare Advantage $13.12
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $13.12
Rate for Payer: Multiplan Commercial $64.80
Rate for Payer: NAPHCARE Commercial $19.68
Rate for Payer: Preferred Network Access Commercial $74.52
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $13.56
Rate for Payer: Quartz Beloit One Network $39.69
Rate for Payer: Quartz Commercial $52.65
Rate for Payer: Quartz Medicare Advantage $13.12
Rate for Payer: The Alliance Commercial $52.48
Rate for Payer: United Healthcare Medicaid $13.56
Rate for Payer: United Healthcare Medicare Advantage $13.12
Rate for Payer: United Healthcare PPO $60.75
Rate for Payer: WEA Trust Commercial $44.55
Rate for Payer: Wellcare Medicare $13.12
Rate for Payer: WMAP Medicaid $13.56
Rate for Payer: WPS Commercial $60.00
Service Code CPT 86663
Hospital Charge Code 5176624
Hospital Revenue Code 300
Min. Negotiated Rate $39.69
Max. Negotiated Rate $74.52
Rate for Payer: Aetna Commercial $72.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $69.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $42.93
Rate for Payer: Cash Price $24.30
Rate for Payer: Cigna Commercial $74.52
Rate for Payer: Health EOS Commercial $72.09
Rate for Payer: HFN Commercial $74.52
Rate for Payer: Multiplan Commercial $64.80
Rate for Payer: NAPHCARE Commercial $48.60
Rate for Payer: Preferred Network Access Commercial $74.52
Rate for Payer: Quartz Beloit One Network $39.69
Rate for Payer: Quartz Commercial $48.60
Rate for Payer: WEA Trust Commercial $44.55
Rate for Payer: WPS Commercial $60.00
Service Code CPT 86663
Hospital Charge Code 5176624
Hospital Revenue Code 300
Min. Negotiated Rate $35.64
Max. Negotiated Rate $76.95
Rate for Payer: Aetna Commercial $76.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $69.66
Rate for Payer: Cash Price $24.30
Rate for Payer: Cash Price $24.30
Rate for Payer: Cigna Commercial $76.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $40.50
Rate for Payer: Dean Health DHI/DHP/ASO $48.60
Rate for Payer: Health EOS Commercial $73.71
Rate for Payer: HFN Commercial $76.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $46.31
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $46.31
Rate for Payer: Multiplan Commercial $64.80
Rate for Payer: Preferred Network Access Commercial $76.95
Rate for Payer: Quartz Beloit One Network $35.64
Rate for Payer: Quartz Commercial $46.17
Rate for Payer: The Alliance Commercial $40.50
Rate for Payer: WEA Trust Commercial $44.55
Rate for Payer: WPS Commercial $60.00
Service Code CPT 86664
Hospital Charge Code 977935
Hospital Revenue Code 300
Min. Negotiated Rate $131.32
Max. Negotiated Rate $246.56
Rate for Payer: Aetna Commercial $241.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $230.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.04
Rate for Payer: Cash Price $80.40
Rate for Payer: Cigna Commercial $246.56
Rate for Payer: Health EOS Commercial $238.52
Rate for Payer: HFN Commercial $246.56
Rate for Payer: Multiplan Commercial $214.40
Rate for Payer: NAPHCARE Commercial $160.80
Rate for Payer: Preferred Network Access Commercial $246.56
Rate for Payer: Quartz Beloit One Network $131.32
Rate for Payer: Quartz Commercial $160.80
Rate for Payer: WEA Trust Commercial $147.40
Rate for Payer: WPS Commercial $198.51
Service Code CPT 86664
Hospital Charge Code 977935
Hospital Revenue Code 300
Min. Negotiated Rate $53.97
Max. Negotiated Rate $254.60
Rate for Payer: Aetna Commercial $254.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $230.48
Rate for Payer: Cash Price $80.40
Rate for Payer: Cash Price $80.40
Rate for Payer: Cigna Commercial $254.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $134.00
Rate for Payer: Dean Health DHI/DHP/ASO $160.80
Rate for Payer: Health EOS Commercial $243.88
Rate for Payer: HFN Commercial $254.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $53.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $53.97
Rate for Payer: Multiplan Commercial $214.40
Rate for Payer: Preferred Network Access Commercial $254.60
Rate for Payer: Quartz Beloit One Network $117.92
Rate for Payer: Quartz Commercial $152.76
Rate for Payer: The Alliance Commercial $134.00
Rate for Payer: WEA Trust Commercial $147.40
Rate for Payer: WPS Commercial $198.51
Service Code CPT 86664
Hospital Charge Code 977935
Hospital Revenue Code 300
Min. Negotiated Rate $15.29
Max. Negotiated Rate $246.56
Rate for Payer: Aetna Commercial $241.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $230.48
Rate for Payer: Aetna Managed Medicare $15.29
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $57.34
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $26.76
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $25.38
Rate for Payer: Anthem Medicaid $15.80
Rate for Payer: Anthem Medicare Advantage $15.29
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.04
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $15.29
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $15.29
Rate for Payer: Cash Price $80.40
Rate for Payer: Cash Price $80.40
Rate for Payer: Cigna Commercial $246.56
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $15.29
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $15.80
Rate for Payer: Dean Health DHI/DHP/ASO $149.97
Rate for Payer: Dean Health Medicaid $15.80
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $15.29
Rate for Payer: Health EOS Commercial $238.52
Rate for Payer: HFN Commercial $246.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $56.88
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $15.29
Rate for Payer: Independent Care Health Plan Medicaid $15.80
Rate for Payer: Independent Care Health Plan Medicare $15.29
Rate for Payer: Managed Health Services Medicaid $16.43
Rate for Payer: Managed Health Services Medicare Advantage $15.29
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $15.29
Rate for Payer: Multiplan Commercial $214.40
Rate for Payer: NAPHCARE Commercial $22.94
Rate for Payer: Preferred Network Access Commercial $246.56
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $15.80
Rate for Payer: Quartz Beloit One Network $131.32
Rate for Payer: Quartz Commercial $174.20
Rate for Payer: Quartz Medicare Advantage $15.29
Rate for Payer: The Alliance Commercial $61.16
Rate for Payer: United Healthcare Medicaid $15.80
Rate for Payer: United Healthcare Medicare Advantage $15.29
Rate for Payer: United Healthcare PPO $201.00
Rate for Payer: WEA Trust Commercial $147.40
Rate for Payer: Wellcare Medicare $15.29
Rate for Payer: WMAP Medicaid $15.80
Rate for Payer: WPS Commercial $198.51
Service Code CPT 86665
Hospital Charge Code 5569256
Hospital Revenue Code 300
Min. Negotiated Rate $32.34
Max. Negotiated Rate $60.72
Rate for Payer: Aetna Commercial $59.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $56.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $34.98
Rate for Payer: Cash Price $19.80
Rate for Payer: Cigna Commercial $60.72
Rate for Payer: Health EOS Commercial $58.74
Rate for Payer: HFN Commercial $60.72
Rate for Payer: Multiplan Commercial $52.80
Rate for Payer: NAPHCARE Commercial $39.60
Rate for Payer: Preferred Network Access Commercial $60.72
Rate for Payer: Quartz Beloit One Network $32.34
Rate for Payer: Quartz Commercial $39.60
Rate for Payer: WEA Trust Commercial $36.30
Rate for Payer: WPS Commercial $48.89
Service Code CPT 86665
Hospital Charge Code 5569256
Hospital Revenue Code 300
Min. Negotiated Rate $18.14
Max. Negotiated Rate $72.56
Rate for Payer: Aetna Commercial $59.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $56.76
Rate for Payer: Aetna Managed Medicare $18.14
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $68.02
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $31.74
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $30.11
Rate for Payer: Anthem Medicaid $18.74
Rate for Payer: Anthem Medicare Advantage $18.14
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $34.98
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $18.14
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $18.14
Rate for Payer: Cash Price $19.80
Rate for Payer: Cash Price $19.80
Rate for Payer: Cigna Commercial $60.72
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $18.14
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $18.74
Rate for Payer: Dean Health DHI/DHP/ASO $36.93
Rate for Payer: Dean Health Medicaid $18.74
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $18.14
Rate for Payer: Health EOS Commercial $58.74
Rate for Payer: HFN Commercial $60.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $67.48
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $18.14
Rate for Payer: Independent Care Health Plan Medicaid $18.74
Rate for Payer: Independent Care Health Plan Medicare $18.14
Rate for Payer: Managed Health Services Medicaid $19.49
Rate for Payer: Managed Health Services Medicare Advantage $18.14
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $18.14
Rate for Payer: Multiplan Commercial $52.80
Rate for Payer: NAPHCARE Commercial $27.21
Rate for Payer: Preferred Network Access Commercial $60.72
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $18.74
Rate for Payer: Quartz Beloit One Network $32.34
Rate for Payer: Quartz Commercial $42.90
Rate for Payer: Quartz Medicare Advantage $18.14
Rate for Payer: The Alliance Commercial $72.56
Rate for Payer: United Healthcare Medicaid $18.74
Rate for Payer: United Healthcare Medicare Advantage $18.14
Rate for Payer: United Healthcare PPO $49.50
Rate for Payer: WEA Trust Commercial $36.30
Rate for Payer: Wellcare Medicare $18.14
Rate for Payer: WMAP Medicaid $18.74
Rate for Payer: WPS Commercial $48.89
Service Code CPT 86665
Hospital Charge Code 5569256
Hospital Revenue Code 300
Min. Negotiated Rate $29.04
Max. Negotiated Rate $64.03
Rate for Payer: Aetna Commercial $62.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $56.76
Rate for Payer: Cash Price $19.80
Rate for Payer: Cash Price $19.80
Rate for Payer: Cigna Commercial $62.70
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $33.00
Rate for Payer: Dean Health DHI/DHP/ASO $39.60
Rate for Payer: Health EOS Commercial $60.06
Rate for Payer: HFN Commercial $62.70
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $64.03
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $64.03
Rate for Payer: Multiplan Commercial $52.80
Rate for Payer: Preferred Network Access Commercial $62.70
Rate for Payer: Quartz Beloit One Network $29.04
Rate for Payer: Quartz Commercial $37.62
Rate for Payer: The Alliance Commercial $33.00
Rate for Payer: WEA Trust Commercial $36.30
Rate for Payer: WPS Commercial $48.89