Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code CPT 86665
Hospital Charge Code 1039079
Hospital Revenue Code 300
Min. Negotiated Rate $129.85
Max. Negotiated Rate $243.80
Rate for Payer: Aetna Commercial $238.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $140.45
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $243.80
Rate for Payer: Health EOS Commercial $235.85
Rate for Payer: HFN Commercial $243.80
Rate for Payer: Multiplan Commercial $212.00
Rate for Payer: NAPHCARE Commercial $159.00
Rate for Payer: Preferred Network Access Commercial $243.80
Rate for Payer: Quartz Beloit One Network $129.85
Rate for Payer: Quartz Commercial $159.00
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 1039079
Hospital Revenue Code 300
Min. Negotiated Rate $64.03
Max. Negotiated Rate $251.75
Rate for Payer: Aetna Commercial $251.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
Rate for Payer: Cash Price $79.50
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $251.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $132.50
Rate for Payer: Dean Health DHI/DHP/ASO $159.00
Rate for Payer: Health EOS Commercial $241.15
Rate for Payer: HFN Commercial $251.75
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 $212.00
Rate for Payer: Preferred Network Access Commercial $251.75
Rate for Payer: Quartz Beloit One Network $116.60
Rate for Payer: Quartz Commercial $151.05
Rate for Payer: The Alliance Commercial $132.50
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 1039079
Hospital Revenue Code 300
Min. Negotiated Rate $18.14
Max. Negotiated Rate $243.80
Rate for Payer: Aetna Commercial $238.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
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 $140.45
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 $79.50
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $243.80
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 $148.29
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 $235.85
Rate for Payer: HFN Commercial $243.80
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 $212.00
Rate for Payer: NAPHCARE Commercial $27.21
Rate for Payer: Preferred Network Access Commercial $243.80
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $18.74
Rate for Payer: Quartz Beloit One Network $129.85
Rate for Payer: Quartz Commercial $172.25
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 $198.75
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: Wellcare Medicare $18.14
Rate for Payer: WMAP Medicaid $18.74
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 1039080
Hospital Revenue Code 300
Min. Negotiated Rate $18.14
Max. Negotiated Rate $243.80
Rate for Payer: Aetna Commercial $238.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
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 $140.45
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 $79.50
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $243.80
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 $148.29
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 $235.85
Rate for Payer: HFN Commercial $243.80
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 $212.00
Rate for Payer: NAPHCARE Commercial $27.21
Rate for Payer: Preferred Network Access Commercial $243.80
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $18.74
Rate for Payer: Quartz Beloit One Network $129.85
Rate for Payer: Quartz Commercial $172.25
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 $198.75
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: Wellcare Medicare $18.14
Rate for Payer: WMAP Medicaid $18.74
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 1039080
Hospital Revenue Code 300
Min. Negotiated Rate $129.85
Max. Negotiated Rate $243.80
Rate for Payer: Aetna Commercial $238.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $140.45
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $243.80
Rate for Payer: Health EOS Commercial $235.85
Rate for Payer: HFN Commercial $243.80
Rate for Payer: Multiplan Commercial $212.00
Rate for Payer: NAPHCARE Commercial $159.00
Rate for Payer: Preferred Network Access Commercial $243.80
Rate for Payer: Quartz Beloit One Network $129.85
Rate for Payer: Quartz Commercial $159.00
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 1039080
Hospital Revenue Code 300
Min. Negotiated Rate $64.03
Max. Negotiated Rate $251.75
Rate for Payer: Aetna Commercial $251.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
Rate for Payer: Cash Price $79.50
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $251.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $132.50
Rate for Payer: Dean Health DHI/DHP/ASO $159.00
Rate for Payer: Health EOS Commercial $241.15
Rate for Payer: HFN Commercial $251.75
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 $212.00
Rate for Payer: Preferred Network Access Commercial $251.75
Rate for Payer: Quartz Beloit One Network $116.60
Rate for Payer: Quartz Commercial $151.05
Rate for Payer: The Alliance Commercial $132.50
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 2942898
Hospital Revenue Code 300
Min. Negotiated Rate $18.14
Max. Negotiated Rate $187.68
Rate for Payer: Aetna Commercial $183.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $175.44
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 $108.12
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 $61.20
Rate for Payer: Cash Price $61.20
Rate for Payer: Cigna Commercial $187.68
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 $114.16
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 $181.56
Rate for Payer: HFN Commercial $187.68
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 $163.20
Rate for Payer: NAPHCARE Commercial $27.21
Rate for Payer: Preferred Network Access Commercial $187.68
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $18.74
Rate for Payer: Quartz Beloit One Network $99.96
Rate for Payer: Quartz Commercial $132.60
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 $153.00
Rate for Payer: WEA Trust Commercial $112.20
Rate for Payer: Wellcare Medicare $18.14
Rate for Payer: WMAP Medicaid $18.74
Rate for Payer: WPS Commercial $151.10
Service Code CPT 86665
Hospital Charge Code 2942898
Hospital Revenue Code 300
Min. Negotiated Rate $64.03
Max. Negotiated Rate $193.80
Rate for Payer: Aetna Commercial $193.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $175.44
Rate for Payer: Cash Price $61.20
Rate for Payer: Cash Price $61.20
Rate for Payer: Cigna Commercial $193.80
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $102.00
Rate for Payer: Dean Health DHI/DHP/ASO $122.40
Rate for Payer: Health EOS Commercial $185.64
Rate for Payer: HFN Commercial $193.80
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 $163.20
Rate for Payer: Preferred Network Access Commercial $193.80
Rate for Payer: Quartz Beloit One Network $89.76
Rate for Payer: Quartz Commercial $116.28
Rate for Payer: The Alliance Commercial $102.00
Rate for Payer: WEA Trust Commercial $112.20
Rate for Payer: WPS Commercial $151.10
Service Code CPT 86665
Hospital Charge Code 2942898
Hospital Revenue Code 300
Min. Negotiated Rate $99.96
Max. Negotiated Rate $187.68
Rate for Payer: Aetna Commercial $183.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $175.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $108.12
Rate for Payer: Cash Price $61.20
Rate for Payer: Cigna Commercial $187.68
Rate for Payer: Health EOS Commercial $181.56
Rate for Payer: HFN Commercial $187.68
Rate for Payer: Multiplan Commercial $163.20
Rate for Payer: NAPHCARE Commercial $122.40
Rate for Payer: Preferred Network Access Commercial $187.68
Rate for Payer: Quartz Beloit One Network $99.96
Rate for Payer: Quartz Commercial $122.40
Rate for Payer: WEA Trust Commercial $112.20
Rate for Payer: WPS Commercial $151.10
Service Code CPT 87798
Hospital Charge Code 1039074
Hospital Revenue Code 300
Min. Negotiated Rate $233.73
Max. Negotiated Rate $438.84
Rate for Payer: Aetna Commercial $429.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $410.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $252.81
Rate for Payer: Cash Price $143.10
Rate for Payer: Cigna Commercial $438.84
Rate for Payer: Health EOS Commercial $424.53
Rate for Payer: HFN Commercial $438.84
Rate for Payer: Multiplan Commercial $381.60
Rate for Payer: NAPHCARE Commercial $286.20
Rate for Payer: Preferred Network Access Commercial $438.84
Rate for Payer: Quartz Beloit One Network $233.73
Rate for Payer: Quartz Commercial $286.20
Rate for Payer: WEA Trust Commercial $262.35
Rate for Payer: WPS Commercial $353.31
Service Code CPT 87798
Hospital Charge Code 1039074
Hospital Revenue Code 300
Min. Negotiated Rate $123.87
Max. Negotiated Rate $453.15
Rate for Payer: Aetna Commercial $453.15
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $410.22
Rate for Payer: Cash Price $143.10
Rate for Payer: Cash Price $143.10
Rate for Payer: Cigna Commercial $453.15
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $238.50
Rate for Payer: Dean Health DHI/DHP/ASO $286.20
Rate for Payer: Health EOS Commercial $434.07
Rate for Payer: HFN Commercial $453.15
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $123.87
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $123.87
Rate for Payer: Multiplan Commercial $381.60
Rate for Payer: Preferred Network Access Commercial $453.15
Rate for Payer: Quartz Beloit One Network $209.88
Rate for Payer: Quartz Commercial $271.89
Rate for Payer: The Alliance Commercial $238.50
Rate for Payer: WEA Trust Commercial $262.35
Rate for Payer: WPS Commercial $353.31
Service Code CPT 87798
Hospital Charge Code 1039074
Hospital Revenue Code 300
Min. Negotiated Rate $35.09
Max. Negotiated Rate $438.84
Rate for Payer: Aetna Commercial $429.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $410.22
Rate for Payer: Aetna Managed Medicare $35.09
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $131.59
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $61.41
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $58.25
Rate for Payer: Anthem Medicaid $36.26
Rate for Payer: Anthem Medicare Advantage $35.09
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $252.81
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $35.09
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $35.09
Rate for Payer: Cash Price $143.10
Rate for Payer: Cash Price $143.10
Rate for Payer: Cigna Commercial $438.84
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $35.09
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $36.26
Rate for Payer: Dean Health DHI/DHP/ASO $266.93
Rate for Payer: Dean Health Medicaid $36.26
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $35.09
Rate for Payer: Health EOS Commercial $424.53
Rate for Payer: HFN Commercial $438.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $130.53
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $35.09
Rate for Payer: Independent Care Health Plan Medicaid $36.26
Rate for Payer: Independent Care Health Plan Medicare $35.09
Rate for Payer: Managed Health Services Medicaid $37.71
Rate for Payer: Managed Health Services Medicare Advantage $35.09
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $35.09
Rate for Payer: Multiplan Commercial $381.60
Rate for Payer: NAPHCARE Commercial $52.64
Rate for Payer: Preferred Network Access Commercial $438.84
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $36.26
Rate for Payer: Quartz Beloit One Network $233.73
Rate for Payer: Quartz Commercial $310.05
Rate for Payer: Quartz Medicare Advantage $35.09
Rate for Payer: The Alliance Commercial $140.36
Rate for Payer: United Healthcare Medicaid $36.26
Rate for Payer: United Healthcare Medicare Advantage $35.09
Rate for Payer: United Healthcare PPO $357.75
Rate for Payer: WEA Trust Commercial $262.35
Rate for Payer: Wellcare Medicare $35.09
Rate for Payer: WMAP Medicaid $36.26
Rate for Payer: WPS Commercial $353.31
Service Code CPT 87799
Hospital Charge Code 1039067
Hospital Revenue Code 300
Min. Negotiated Rate $208.25
Max. Negotiated Rate $391.00
Rate for Payer: Aetna Commercial $382.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $365.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $225.25
Rate for Payer: Cash Price $127.50
Rate for Payer: Cigna Commercial $391.00
Rate for Payer: Health EOS Commercial $378.25
Rate for Payer: HFN Commercial $391.00
Rate for Payer: Multiplan Commercial $340.00
Rate for Payer: NAPHCARE Commercial $255.00
Rate for Payer: Preferred Network Access Commercial $391.00
Rate for Payer: Quartz Beloit One Network $208.25
Rate for Payer: Quartz Commercial $255.00
Rate for Payer: WEA Trust Commercial $233.75
Rate for Payer: WPS Commercial $314.80
Service Code CPT 87799
Hospital Charge Code 1039067
Hospital Revenue Code 300
Min. Negotiated Rate $42.84
Max. Negotiated Rate $391.00
Rate for Payer: Aetna Commercial $382.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $365.50
Rate for Payer: Aetna Managed Medicare $42.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $160.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $74.97
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $71.11
Rate for Payer: Anthem Medicaid $44.27
Rate for Payer: Anthem Medicare Advantage $42.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $225.25
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $42.84
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $42.84
Rate for Payer: Cash Price $127.50
Rate for Payer: Cash Price $127.50
Rate for Payer: Cigna Commercial $391.00
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $42.84
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $44.27
Rate for Payer: Dean Health DHI/DHP/ASO $237.83
Rate for Payer: Dean Health Medicaid $44.27
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $42.84
Rate for Payer: Health EOS Commercial $378.25
Rate for Payer: HFN Commercial $391.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $159.36
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $42.84
Rate for Payer: Independent Care Health Plan Medicaid $44.27
Rate for Payer: Independent Care Health Plan Medicare $42.84
Rate for Payer: Managed Health Services Medicaid $46.04
Rate for Payer: Managed Health Services Medicare Advantage $42.84
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $42.84
Rate for Payer: Multiplan Commercial $340.00
Rate for Payer: NAPHCARE Commercial $64.26
Rate for Payer: Preferred Network Access Commercial $391.00
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $44.27
Rate for Payer: Quartz Beloit One Network $208.25
Rate for Payer: Quartz Commercial $276.25
Rate for Payer: Quartz Medicare Advantage $42.84
Rate for Payer: The Alliance Commercial $171.36
Rate for Payer: United Healthcare Medicaid $44.27
Rate for Payer: United Healthcare Medicare Advantage $42.84
Rate for Payer: United Healthcare PPO $318.75
Rate for Payer: WEA Trust Commercial $233.75
Rate for Payer: Wellcare Medicare $42.84
Rate for Payer: WMAP Medicaid $44.27
Rate for Payer: WPS Commercial $314.80
Service Code CPT 87799
Hospital Charge Code 1039067
Hospital Revenue Code 300
Min. Negotiated Rate $151.23
Max. Negotiated Rate $403.75
Rate for Payer: Aetna Commercial $403.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $365.50
Rate for Payer: Cash Price $127.50
Rate for Payer: Cash Price $127.50
Rate for Payer: Cigna Commercial $403.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $212.50
Rate for Payer: Dean Health DHI/DHP/ASO $255.00
Rate for Payer: Health EOS Commercial $386.75
Rate for Payer: HFN Commercial $403.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $151.23
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $151.23
Rate for Payer: Multiplan Commercial $340.00
Rate for Payer: Preferred Network Access Commercial $403.75
Rate for Payer: Quartz Beloit One Network $187.00
Rate for Payer: Quartz Commercial $242.25
Rate for Payer: The Alliance Commercial $212.50
Rate for Payer: WEA Trust Commercial $233.75
Rate for Payer: WPS Commercial $314.80
Service Code CPT 86664
Hospital Charge Code 2942899
Hospital Revenue Code 300
Min. Negotiated Rate $15.29
Max. Negotiated Rate $173.88
Rate for Payer: Aetna Commercial $170.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $162.54
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 $100.17
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 $56.70
Rate for Payer: Cash Price $56.70
Rate for Payer: Cigna Commercial $173.88
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 $105.76
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 $168.21
Rate for Payer: HFN Commercial $173.88
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 $151.20
Rate for Payer: NAPHCARE Commercial $22.94
Rate for Payer: Preferred Network Access Commercial $173.88
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $15.80
Rate for Payer: Quartz Beloit One Network $92.61
Rate for Payer: Quartz Commercial $122.85
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 $141.75
Rate for Payer: WEA Trust Commercial $103.95
Rate for Payer: Wellcare Medicare $15.29
Rate for Payer: WMAP Medicaid $15.80
Rate for Payer: WPS Commercial $139.99
Service Code CPT 86664
Hospital Charge Code 2942899
Hospital Revenue Code 300
Min. Negotiated Rate $53.97
Max. Negotiated Rate $179.55
Rate for Payer: Aetna Commercial $179.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $162.54
Rate for Payer: Cash Price $56.70
Rate for Payer: Cash Price $56.70
Rate for Payer: Cigna Commercial $179.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $94.50
Rate for Payer: Dean Health DHI/DHP/ASO $113.40
Rate for Payer: Health EOS Commercial $171.99
Rate for Payer: HFN Commercial $179.55
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 $151.20
Rate for Payer: Preferred Network Access Commercial $179.55
Rate for Payer: Quartz Beloit One Network $83.16
Rate for Payer: Quartz Commercial $107.73
Rate for Payer: The Alliance Commercial $94.50
Rate for Payer: WEA Trust Commercial $103.95
Rate for Payer: WPS Commercial $139.99
Service Code CPT 86664
Hospital Charge Code 2942899
Hospital Revenue Code 300
Min. Negotiated Rate $92.61
Max. Negotiated Rate $173.88
Rate for Payer: Aetna Commercial $170.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $162.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $100.17
Rate for Payer: Cash Price $56.70
Rate for Payer: Cigna Commercial $173.88
Rate for Payer: Health EOS Commercial $168.21
Rate for Payer: HFN Commercial $173.88
Rate for Payer: Multiplan Commercial $151.20
Rate for Payer: NAPHCARE Commercial $113.40
Rate for Payer: Preferred Network Access Commercial $173.88
Rate for Payer: Quartz Beloit One Network $92.61
Rate for Payer: Quartz Commercial $113.40
Rate for Payer: WEA Trust Commercial $103.95
Rate for Payer: WPS Commercial $139.99
Service Code CPT 86665
Hospital Charge Code 978116
Hospital Revenue Code 300
Min. Negotiated Rate $64.03
Max. Negotiated Rate $251.75
Rate for Payer: Aetna Commercial $251.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
Rate for Payer: Cash Price $79.50
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $251.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $132.50
Rate for Payer: Dean Health DHI/DHP/ASO $159.00
Rate for Payer: Health EOS Commercial $241.15
Rate for Payer: HFN Commercial $251.75
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 $212.00
Rate for Payer: Preferred Network Access Commercial $251.75
Rate for Payer: Quartz Beloit One Network $116.60
Rate for Payer: Quartz Commercial $151.05
Rate for Payer: The Alliance Commercial $132.50
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 978116
Hospital Revenue Code 300
Min. Negotiated Rate $18.14
Max. Negotiated Rate $243.80
Rate for Payer: Aetna Commercial $238.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
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 $140.45
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 $79.50
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $243.80
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 $148.29
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 $235.85
Rate for Payer: HFN Commercial $243.80
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 $212.00
Rate for Payer: NAPHCARE Commercial $27.21
Rate for Payer: Preferred Network Access Commercial $243.80
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $18.74
Rate for Payer: Quartz Beloit One Network $129.85
Rate for Payer: Quartz Commercial $172.25
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 $198.75
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: Wellcare Medicare $18.14
Rate for Payer: WMAP Medicaid $18.74
Rate for Payer: WPS Commercial $196.29
Service Code CPT 86665
Hospital Charge Code 978116
Hospital Revenue Code 300
Min. Negotiated Rate $129.85
Max. Negotiated Rate $243.80
Rate for Payer: Aetna Commercial $238.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $140.45
Rate for Payer: Cash Price $79.50
Rate for Payer: Cigna Commercial $243.80
Rate for Payer: Health EOS Commercial $235.85
Rate for Payer: HFN Commercial $243.80
Rate for Payer: Multiplan Commercial $212.00
Rate for Payer: NAPHCARE Commercial $159.00
Rate for Payer: Preferred Network Access Commercial $243.80
Rate for Payer: Quartz Beloit One Network $129.85
Rate for Payer: Quartz Commercial $159.00
Rate for Payer: WEA Trust Commercial $145.75
Rate for Payer: WPS Commercial $196.29
Service Code CPT 93623
Hospital Charge Code 3052510
Hospital Revenue Code 481
Min. Negotiated Rate $317.24
Max. Negotiated Rate $29,139.00
Rate for Payer: Aetna Commercial $1,019.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $974.38
Rate for Payer: Aetna Managed Medicare $317.24
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: Blue Cross Blue Shield of Illinois Blue Cross PPO $600.49
Rate for Payer: Cash Price $339.90
Rate for Payer: Cash Price $339.90
Rate for Payer: Cigna Commercial $1,042.36
Rate for Payer: Dean Health DHI/DHP/ASO $634.03
Rate for Payer: Health EOS Commercial $1,008.37
Rate for Payer: HFN Commercial $1,042.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $849.75
Rate for Payer: Multiplan Commercial $906.40
Rate for Payer: NAPHCARE Commercial $679.80
Rate for Payer: Preferred Network Access Commercial $1,042.36
Rate for Payer: Quartz Beloit One Network $555.17
Rate for Payer: Quartz Commercial $736.45
Rate for Payer: Quartz Medicare Advantage $679.80
Rate for Payer: The Alliance Commercial $4,532.00
Rate for Payer: WEA Trust Commercial $623.15
Rate for Payer: WPS Commercial $839.21
Service Code CPT 93623
Hospital Charge Code 3052510
Hospital Revenue Code 481
Min. Negotiated Rate $555.17
Max. Negotiated Rate $1,042.36
Rate for Payer: Aetna Commercial $1,019.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $974.38
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $600.49
Rate for Payer: Cash Price $339.90
Rate for Payer: Cigna Commercial $1,042.36
Rate for Payer: Health EOS Commercial $1,008.37
Rate for Payer: HFN Commercial $1,042.36
Rate for Payer: Multiplan Commercial $906.40
Rate for Payer: NAPHCARE Commercial $679.80
Rate for Payer: Preferred Network Access Commercial $1,042.36
Rate for Payer: Quartz Beloit One Network $555.17
Rate for Payer: Quartz Commercial $679.80
Rate for Payer: WEA Trust Commercial $623.15
Rate for Payer: WPS Commercial $839.21
Service Code CPT 93653
Hospital Charge Code 3052516
Hospital Revenue Code 481
Min. Negotiated Rate $3,902.36
Max. Negotiated Rate $93,900.28
Rate for Payer: Aetna Commercial $7,167.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,849.04
Rate for Payer: Aetna Managed Medicare $23,475.07
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 $23,475.07
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,220.92
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $23,475.07
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $23,475.07
Rate for Payer: Cash Price $2,389.20
Rate for Payer: Cash Price $2,389.20
Rate for Payer: Cash Price $2,389.20
Rate for Payer: Cigna Commercial $7,326.88
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $23,475.07
Rate for Payer: Dean Health DHI/DHP/ASO $4,456.65
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $23,475.07
Rate for Payer: Health EOS Commercial $7,087.96
Rate for Payer: HFN Commercial $7,326.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $87,327.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $23,475.07
Rate for Payer: Independent Care Health Plan Medicare $23,475.07
Rate for Payer: Managed Health Services Medicare Advantage $23,475.07
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $23,475.07
Rate for Payer: Multiplan Commercial $6,371.20
Rate for Payer: NAPHCARE Commercial $35,212.60
Rate for Payer: Preferred Network Access Commercial $7,326.88
Rate for Payer: Quartz Beloit One Network $3,902.36
Rate for Payer: Quartz Commercial $5,176.60
Rate for Payer: Quartz Medicare Advantage $23,475.07
Rate for Payer: The Alliance Commercial $93,900.28
Rate for Payer: United Healthcare Medicare Advantage $23,475.07
Rate for Payer: United Healthcare PPO $11,078.00
Rate for Payer: WEA Trust Commercial $4,380.20
Rate for Payer: Wellcare Medicare $23,475.07
Rate for Payer: WPS Commercial $5,898.93
Service Code CPT 93653
Hospital Charge Code 3052516
Hospital Revenue Code 481
Min. Negotiated Rate $3,902.36
Max. Negotiated Rate $7,326.88
Rate for Payer: Aetna Commercial $7,167.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,849.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,220.92
Rate for Payer: Cash Price $2,389.20
Rate for Payer: Cigna Commercial $7,326.88
Rate for Payer: Health EOS Commercial $7,087.96
Rate for Payer: HFN Commercial $7,326.88
Rate for Payer: Multiplan Commercial $6,371.20
Rate for Payer: NAPHCARE Commercial $4,778.40
Rate for Payer: Preferred Network Access Commercial $7,326.88
Rate for Payer: Quartz Beloit One Network $3,902.36
Rate for Payer: Quartz Commercial $4,778.40
Rate for Payer: WEA Trust Commercial $4,380.20
Rate for Payer: WPS Commercial $5,898.93