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Service Code CPT 93654
Hospital Charge Code 3052517
Hospital Revenue Code 481
Min. Negotiated Rate $5,207.23
Max. Negotiated Rate $9,776.84
Rate for Payer: Aetna Commercial $9,564.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,139.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,632.31
Rate for Payer: Cash Price $3,188.10
Rate for Payer: Cigna Commercial $9,776.84
Rate for Payer: Health EOS Commercial $9,458.03
Rate for Payer: HFN Commercial $9,776.84
Rate for Payer: Multiplan Commercial $8,501.60
Rate for Payer: NAPHCARE Commercial $6,376.20
Rate for Payer: Preferred Network Access Commercial $9,776.84
Rate for Payer: Quartz Beloit One Network $5,207.23
Rate for Payer: Quartz Commercial $6,376.20
Rate for Payer: WEA Trust Commercial $5,844.85
Rate for Payer: WPS Commercial $7,871.42
Service Code CPT 93654
Hospital Charge Code 3052517
Hospital Revenue Code 481
Min. Negotiated Rate $5,207.23
Max. Negotiated Rate $93,900.28
Rate for Payer: Aetna Commercial $9,564.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,139.22
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 $5,632.31
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 $3,188.10
Rate for Payer: Cash Price $3,188.10
Rate for Payer: Cash Price $3,188.10
Rate for Payer: Cigna Commercial $9,776.84
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $23,475.07
Rate for Payer: Dean Health DHI/DHP/ASO $5,946.87
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $23,475.07
Rate for Payer: Health EOS Commercial $9,458.03
Rate for Payer: HFN Commercial $9,776.84
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 $8,501.60
Rate for Payer: NAPHCARE Commercial $35,212.60
Rate for Payer: Preferred Network Access Commercial $9,776.84
Rate for Payer: Quartz Beloit One Network $5,207.23
Rate for Payer: Quartz Commercial $6,907.55
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 $5,844.85
Rate for Payer: Wellcare Medicare $23,475.07
Rate for Payer: WPS Commercial $7,871.42
Service Code CPT 93621
Hospital Charge Code 4125519
Hospital Revenue Code 481
Min. Negotiated Rate $375.48
Max. Negotiated Rate $29,139.00
Rate for Payer: Aetna Commercial $1,206.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,153.26
Rate for Payer: Aetna Managed Medicare $375.48
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 $710.73
Rate for Payer: Cash Price $402.30
Rate for Payer: Cash Price $402.30
Rate for Payer: Cigna Commercial $1,233.72
Rate for Payer: Dean Health DHI/DHP/ASO $750.42
Rate for Payer: Health EOS Commercial $1,193.49
Rate for Payer: HFN Commercial $1,233.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,005.75
Rate for Payer: Multiplan Commercial $1,072.80
Rate for Payer: NAPHCARE Commercial $804.60
Rate for Payer: Preferred Network Access Commercial $1,233.72
Rate for Payer: Quartz Beloit One Network $657.09
Rate for Payer: Quartz Commercial $871.65
Rate for Payer: Quartz Medicare Advantage $804.60
Rate for Payer: The Alliance Commercial $5,364.00
Rate for Payer: WEA Trust Commercial $737.55
Rate for Payer: WPS Commercial $993.28
Service Code CPT 93621
Hospital Charge Code 4125519
Hospital Revenue Code 481
Min. Negotiated Rate $657.09
Max. Negotiated Rate $1,233.72
Rate for Payer: Aetna Commercial $1,206.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,153.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $710.73
Rate for Payer: Cash Price $402.30
Rate for Payer: Cigna Commercial $1,233.72
Rate for Payer: Health EOS Commercial $1,193.49
Rate for Payer: HFN Commercial $1,233.72
Rate for Payer: Multiplan Commercial $1,072.80
Rate for Payer: NAPHCARE Commercial $804.60
Rate for Payer: Preferred Network Access Commercial $1,233.72
Rate for Payer: Quartz Beloit One Network $657.09
Rate for Payer: Quartz Commercial $804.60
Rate for Payer: WEA Trust Commercial $737.55
Rate for Payer: WPS Commercial $993.28
Service Code CPT 93656
Hospital Charge Code 5464771
Hospital Revenue Code 481
Min. Negotiated Rate $7,580.30
Max. Negotiated Rate $93,900.28
Rate for Payer: Aetna Commercial $13,923.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,304.20
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 $8,199.10
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 $4,641.00
Rate for Payer: Cash Price $4,641.00
Rate for Payer: Cash Price $4,641.00
Rate for Payer: Cigna Commercial $14,232.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $23,475.07
Rate for Payer: Dean Health DHI/DHP/ASO $8,657.01
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $23,475.07
Rate for Payer: Health EOS Commercial $13,768.30
Rate for Payer: HFN Commercial $14,232.40
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 $12,376.00
Rate for Payer: NAPHCARE Commercial $35,212.60
Rate for Payer: Preferred Network Access Commercial $14,232.40
Rate for Payer: Quartz Beloit One Network $7,580.30
Rate for Payer: Quartz Commercial $10,055.50
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 $8,508.50
Rate for Payer: Wellcare Medicare $23,475.07
Rate for Payer: WPS Commercial $11,458.63
Service Code CPT 93656
Hospital Charge Code 5464771
Hospital Revenue Code 481
Min. Negotiated Rate $7,580.30
Max. Negotiated Rate $14,232.40
Rate for Payer: Aetna Commercial $13,923.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,304.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,199.10
Rate for Payer: Cash Price $4,641.00
Rate for Payer: Cigna Commercial $14,232.40
Rate for Payer: Health EOS Commercial $13,768.30
Rate for Payer: HFN Commercial $14,232.40
Rate for Payer: Multiplan Commercial $12,376.00
Rate for Payer: NAPHCARE Commercial $9,282.00
Rate for Payer: Preferred Network Access Commercial $14,232.40
Rate for Payer: Quartz Beloit One Network $7,580.30
Rate for Payer: Quartz Commercial $9,282.00
Rate for Payer: WEA Trust Commercial $8,508.50
Rate for Payer: WPS Commercial $11,458.63
Service Code HCPCS J9055
Hospital Charge Code 2958945
Hospital Revenue Code 636
Min. Negotiated Rate $73.49
Max. Negotiated Rate $235.60
Rate for Payer: Aetna Commercial $235.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $213.28
Rate for Payer: Cash Price $74.40
Rate for Payer: Cash Price $74.40
Rate for Payer: Cigna Commercial $235.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $73.49
Rate for Payer: Dean Health DHI/DHP/ASO $73.49
Rate for Payer: Health EOS Commercial $225.68
Rate for Payer: HFN Commercial $235.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $95.15
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $95.15
Rate for Payer: Multiplan Commercial $198.40
Rate for Payer: Preferred Network Access Commercial $235.60
Rate for Payer: Quartz Beloit One Network $109.12
Rate for Payer: Quartz Commercial $141.36
Rate for Payer: The Alliance Commercial $124.00
Rate for Payer: United Healthcare Medicaid $73.49
Rate for Payer: WEA Trust Commercial $136.40
Rate for Payer: WPS Commercial $183.72
Service Code HCPCS J9055
Hospital Charge Code 2958945
Hospital Revenue Code 636
Min. Negotiated Rate $73.72
Max. Negotiated Rate $294.88
Rate for Payer: Aetna Commercial $223.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $213.28
Rate for Payer: Aetna Managed Medicare $73.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $161.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $124.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $119.04
Rate for Payer: Anthem Medicare Advantage $73.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $131.44
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $73.72
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $73.72
Rate for Payer: Cash Price $74.40
Rate for Payer: Cash Price $74.40
Rate for Payer: Cigna Commercial $228.16
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $73.72
Rate for Payer: Dean Health DHI/DHP/ASO $97.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $73.72
Rate for Payer: Health EOS Commercial $220.72
Rate for Payer: HFN Commercial $228.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $274.24
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $73.72
Rate for Payer: Independent Care Health Plan Medicare $73.72
Rate for Payer: Managed Health Services Medicare Advantage $73.72
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $73.72
Rate for Payer: Multiplan Commercial $198.40
Rate for Payer: NAPHCARE Commercial $110.58
Rate for Payer: Preferred Network Access Commercial $228.16
Rate for Payer: Quartz Beloit One Network $121.52
Rate for Payer: Quartz Commercial $161.20
Rate for Payer: Quartz Medicare Advantage $73.72
Rate for Payer: The Alliance Commercial $294.88
Rate for Payer: United Healthcare Medicare Advantage $73.72
Rate for Payer: WEA Trust Commercial $136.40
Rate for Payer: Wellcare Medicare $73.72
Rate for Payer: WPS Commercial $183.72
Service Code HCPCS J9055
Hospital Charge Code 2958945
Hospital Revenue Code 636
Min. Negotiated Rate $121.52
Max. Negotiated Rate $228.16
Rate for Payer: Aetna Commercial $223.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $213.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $131.44
Rate for Payer: Cash Price $74.40
Rate for Payer: Cigna Commercial $228.16
Rate for Payer: Health EOS Commercial $220.72
Rate for Payer: HFN Commercial $228.16
Rate for Payer: Multiplan Commercial $198.40
Rate for Payer: NAPHCARE Commercial $148.80
Rate for Payer: Preferred Network Access Commercial $228.16
Rate for Payer: Quartz Beloit One Network $121.52
Rate for Payer: Quartz Commercial $148.80
Rate for Payer: WEA Trust Commercial $136.40
Rate for Payer: WPS Commercial $183.69
Service Code HCPCS J1335
Hospital Charge Code 2974935
Hospital Revenue Code 636
Min. Negotiated Rate $15.74
Max. Negotiated Rate $4,636.00
Rate for Payer: Aetna Commercial $1,043.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $996.74
Rate for Payer: Aetna Managed Medicare $324.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $753.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $579.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $556.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $614.27
Rate for Payer: Cash Price $347.70
Rate for Payer: Cash Price $347.70
Rate for Payer: Cigna Commercial $1,066.28
Rate for Payer: Dean Health DHI/DHP/ASO $15.74
Rate for Payer: Health EOS Commercial $1,031.51
Rate for Payer: HFN Commercial $1,066.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $869.25
Rate for Payer: Multiplan Commercial $927.20
Rate for Payer: NAPHCARE Commercial $695.40
Rate for Payer: Preferred Network Access Commercial $1,066.28
Rate for Payer: Quartz Beloit One Network $567.91
Rate for Payer: Quartz Commercial $753.35
Rate for Payer: Quartz Medicare Advantage $695.40
Rate for Payer: The Alliance Commercial $4,636.00
Rate for Payer: WEA Trust Commercial $637.45
Rate for Payer: WPS Commercial $29.74
Service Code HCPCS J1335
Hospital Charge Code 2974935
Hospital Revenue Code 636
Min. Negotiated Rate $567.91
Max. Negotiated Rate $1,066.28
Rate for Payer: Aetna Commercial $1,043.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $996.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $614.27
Rate for Payer: Cash Price $347.70
Rate for Payer: Cigna Commercial $1,066.28
Rate for Payer: Health EOS Commercial $1,031.51
Rate for Payer: HFN Commercial $1,066.28
Rate for Payer: Multiplan Commercial $927.20
Rate for Payer: NAPHCARE Commercial $695.40
Rate for Payer: Preferred Network Access Commercial $1,066.28
Rate for Payer: Quartz Beloit One Network $567.91
Rate for Payer: Quartz Commercial $695.40
Rate for Payer: WEA Trust Commercial $637.45
Rate for Payer: WPS Commercial $858.47
Service Code CPT 82820
Hospital Charge Code 3135500
Hospital Revenue Code 300
Min. Negotiated Rate $1,856.61
Max. Negotiated Rate $3,485.88
Rate for Payer: Aetna Commercial $3,410.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,258.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,008.17
Rate for Payer: Cash Price $1,136.70
Rate for Payer: Cigna Commercial $3,485.88
Rate for Payer: Health EOS Commercial $3,372.21
Rate for Payer: HFN Commercial $3,485.88
Rate for Payer: Multiplan Commercial $3,031.20
Rate for Payer: NAPHCARE Commercial $2,273.40
Rate for Payer: Preferred Network Access Commercial $3,485.88
Rate for Payer: Quartz Beloit One Network $1,856.61
Rate for Payer: Quartz Commercial $2,273.40
Rate for Payer: WEA Trust Commercial $2,083.95
Rate for Payer: WPS Commercial $2,806.51
Service Code CPT 82820
Hospital Charge Code 3135500
Hospital Revenue Code 300
Min. Negotiated Rate $13.34
Max. Negotiated Rate $3,485.88
Rate for Payer: Aetna Commercial $3,410.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,258.54
Rate for Payer: Aetna Managed Medicare $13.34
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $50.02
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $23.34
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $22.14
Rate for Payer: Anthem Medicaid $13.78
Rate for Payer: Anthem Medicare Advantage $13.34
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,008.17
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $13.34
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $13.34
Rate for Payer: Cash Price $1,136.70
Rate for Payer: Cash Price $1,136.70
Rate for Payer: Cigna Commercial $3,485.88
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $13.34
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $13.78
Rate for Payer: Dean Health DHI/DHP/ASO $2,120.32
Rate for Payer: Dean Health Medicaid $13.78
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $13.34
Rate for Payer: Health EOS Commercial $3,372.21
Rate for Payer: HFN Commercial $3,485.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $49.62
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $13.34
Rate for Payer: Independent Care Health Plan Medicaid $13.78
Rate for Payer: Independent Care Health Plan Medicare $13.34
Rate for Payer: Managed Health Services Medicaid $14.33
Rate for Payer: Managed Health Services Medicare Advantage $13.34
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $13.34
Rate for Payer: Multiplan Commercial $3,031.20
Rate for Payer: NAPHCARE Commercial $20.01
Rate for Payer: Preferred Network Access Commercial $3,485.88
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $13.78
Rate for Payer: Quartz Beloit One Network $1,856.61
Rate for Payer: Quartz Commercial $2,462.85
Rate for Payer: Quartz Medicare Advantage $13.34
Rate for Payer: The Alliance Commercial $53.36
Rate for Payer: United Healthcare Medicaid $13.78
Rate for Payer: United Healthcare Medicare Advantage $13.34
Rate for Payer: United Healthcare PPO $2,841.75
Rate for Payer: WEA Trust Commercial $2,083.95
Rate for Payer: Wellcare Medicare $13.34
Rate for Payer: WMAP Medicaid $13.78
Rate for Payer: WPS Commercial $2,806.51
Service Code CPT 82820
Hospital Charge Code 3135500
Hospital Revenue Code 300
Min. Negotiated Rate $47.09
Max. Negotiated Rate $3,599.55
Rate for Payer: Aetna Commercial $3,599.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,258.54
Rate for Payer: Cash Price $1,136.70
Rate for Payer: Cash Price $1,136.70
Rate for Payer: Cigna Commercial $3,599.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,894.50
Rate for Payer: Dean Health DHI/DHP/ASO $2,273.40
Rate for Payer: Health EOS Commercial $3,447.99
Rate for Payer: HFN Commercial $3,599.55
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $47.09
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $47.09
Rate for Payer: Multiplan Commercial $3,031.20
Rate for Payer: Preferred Network Access Commercial $3,599.55
Rate for Payer: Quartz Beloit One Network $1,667.16
Rate for Payer: Quartz Commercial $2,159.73
Rate for Payer: The Alliance Commercial $1,894.50
Rate for Payer: WEA Trust Commercial $2,083.95
Rate for Payer: WPS Commercial $2,806.51
Service Code CPT 82668
Hospital Charge Code 977936
Hospital Revenue Code 300
Min. Negotiated Rate $18.79
Max. Negotiated Rate $354.20
Rate for Payer: Aetna Commercial $346.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $331.10
Rate for Payer: Aetna Managed Medicare $18.79
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $70.46
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $32.88
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $31.19
Rate for Payer: Anthem Medicaid $19.42
Rate for Payer: Anthem Medicare Advantage $18.79
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $204.05
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $18.79
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $18.79
Rate for Payer: Cash Price $115.50
Rate for Payer: Cash Price $115.50
Rate for Payer: Cigna Commercial $354.20
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $18.79
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $19.42
Rate for Payer: Dean Health DHI/DHP/ASO $215.45
Rate for Payer: Dean Health Medicaid $19.42
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $18.79
Rate for Payer: Health EOS Commercial $342.65
Rate for Payer: HFN Commercial $354.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $69.90
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $18.79
Rate for Payer: Independent Care Health Plan Medicaid $19.42
Rate for Payer: Independent Care Health Plan Medicare $18.79
Rate for Payer: Managed Health Services Medicaid $20.20
Rate for Payer: Managed Health Services Medicare Advantage $18.79
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $18.79
Rate for Payer: Multiplan Commercial $308.00
Rate for Payer: NAPHCARE Commercial $28.18
Rate for Payer: Preferred Network Access Commercial $354.20
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $19.42
Rate for Payer: Quartz Beloit One Network $188.65
Rate for Payer: Quartz Commercial $250.25
Rate for Payer: Quartz Medicare Advantage $18.79
Rate for Payer: The Alliance Commercial $75.16
Rate for Payer: United Healthcare Medicaid $19.42
Rate for Payer: United Healthcare Medicare Advantage $18.79
Rate for Payer: United Healthcare PPO $288.75
Rate for Payer: WEA Trust Commercial $211.75
Rate for Payer: Wellcare Medicare $18.79
Rate for Payer: WMAP Medicaid $19.42
Rate for Payer: WPS Commercial $285.17
Service Code CPT 82668
Hospital Charge Code 977936
Hospital Revenue Code 300
Min. Negotiated Rate $66.33
Max. Negotiated Rate $365.75
Rate for Payer: Aetna Commercial $365.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $331.10
Rate for Payer: Cash Price $115.50
Rate for Payer: Cash Price $115.50
Rate for Payer: Cigna Commercial $365.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $192.50
Rate for Payer: Dean Health DHI/DHP/ASO $231.00
Rate for Payer: Health EOS Commercial $350.35
Rate for Payer: HFN Commercial $365.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $66.33
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $66.33
Rate for Payer: Multiplan Commercial $308.00
Rate for Payer: Preferred Network Access Commercial $365.75
Rate for Payer: Quartz Beloit One Network $169.40
Rate for Payer: Quartz Commercial $219.45
Rate for Payer: The Alliance Commercial $192.50
Rate for Payer: WEA Trust Commercial $211.75
Rate for Payer: WPS Commercial $285.17
Service Code CPT 82668
Hospital Charge Code 977936
Hospital Revenue Code 300
Min. Negotiated Rate $188.65
Max. Negotiated Rate $354.20
Rate for Payer: Aetna Commercial $346.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $331.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $204.05
Rate for Payer: Cash Price $115.50
Rate for Payer: Cigna Commercial $354.20
Rate for Payer: Health EOS Commercial $342.65
Rate for Payer: HFN Commercial $354.20
Rate for Payer: Multiplan Commercial $308.00
Rate for Payer: NAPHCARE Commercial $231.00
Rate for Payer: Preferred Network Access Commercial $354.20
Rate for Payer: Quartz Beloit One Network $188.65
Rate for Payer: Quartz Commercial $231.00
Rate for Payer: WEA Trust Commercial $211.75
Rate for Payer: WPS Commercial $285.17
Service Code CPT 80299
Hospital Charge Code 1040879
Hospital Revenue Code 300
Min. Negotiated Rate $54.88
Max. Negotiated Rate $103.04
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $67.20
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Service Code CPT 80299
Hospital Charge Code 1040879
Hospital Revenue Code 300
Min. Negotiated Rate $49.28
Max. Negotiated Rate $106.40
Rate for Payer: Aetna Commercial $106.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Cash Price $33.60
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $106.40
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $56.00
Rate for Payer: Dean Health DHI/DHP/ASO $67.20
Rate for Payer: Health EOS Commercial $101.92
Rate for Payer: HFN Commercial $106.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $65.80
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $65.80
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: Preferred Network Access Commercial $106.40
Rate for Payer: Quartz Beloit One Network $49.28
Rate for Payer: Quartz Commercial $63.84
Rate for Payer: The Alliance Commercial $56.00
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Service Code CPT 80299
Hospital Charge Code 1040879
Hospital Revenue Code 300
Min. Negotiated Rate $18.64
Max. Negotiated Rate $103.04
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Aetna Managed Medicare $18.64
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $69.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $32.62
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $30.94
Rate for Payer: Anthem Medicaid $19.26
Rate for Payer: Anthem Medicare Advantage $18.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $18.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $18.64
Rate for Payer: Cash Price $33.60
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $18.64
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $19.26
Rate for Payer: Dean Health DHI/DHP/ASO $62.68
Rate for Payer: Dean Health Medicaid $19.26
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $18.64
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $69.34
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $18.64
Rate for Payer: Independent Care Health Plan Medicaid $19.26
Rate for Payer: Independent Care Health Plan Medicare $18.64
Rate for Payer: Managed Health Services Medicaid $20.03
Rate for Payer: Managed Health Services Medicare Advantage $18.64
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $18.64
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $27.96
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $19.26
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $72.80
Rate for Payer: Quartz Medicare Advantage $18.64
Rate for Payer: The Alliance Commercial $74.56
Rate for Payer: United Healthcare Medicaid $19.26
Rate for Payer: United Healthcare Medicare Advantage $18.64
Rate for Payer: United Healthcare PPO $84.00
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: Wellcare Medicare $18.64
Rate for Payer: WMAP Medicaid $19.26
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 4858710
Hospital Revenue Code 272
Min. Negotiated Rate $61.25
Max. Negotiated Rate $115.00
Rate for Payer: Aetna Commercial $112.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $107.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $66.25
Rate for Payer: Cash Price $37.50
Rate for Payer: Cigna Commercial $115.00
Rate for Payer: Health EOS Commercial $111.25
Rate for Payer: HFN Commercial $115.00
Rate for Payer: Multiplan Commercial $100.00
Rate for Payer: NAPHCARE Commercial $75.00
Rate for Payer: Preferred Network Access Commercial $115.00
Rate for Payer: Quartz Beloit One Network $61.25
Rate for Payer: Quartz Commercial $75.00
Rate for Payer: WEA Trust Commercial $68.75
Rate for Payer: WPS Commercial $92.59
Hospital Charge Code 4858710
Hospital Revenue Code 272
Min. Negotiated Rate $35.00
Max. Negotiated Rate $500.00
Rate for Payer: Aetna Commercial $112.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $107.50
Rate for Payer: Aetna Managed Medicare $35.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $81.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $62.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $60.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $66.25
Rate for Payer: Cash Price $37.50
Rate for Payer: Cigna Commercial $115.00
Rate for Payer: Dean Health DHI/DHP/ASO $69.95
Rate for Payer: Health EOS Commercial $111.25
Rate for Payer: HFN Commercial $115.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $93.75
Rate for Payer: Multiplan Commercial $100.00
Rate for Payer: NAPHCARE Commercial $75.00
Rate for Payer: Preferred Network Access Commercial $115.00
Rate for Payer: Quartz Beloit One Network $61.25
Rate for Payer: Quartz Commercial $81.25
Rate for Payer: Quartz Medicare Advantage $75.00
Rate for Payer: The Alliance Commercial $500.00
Rate for Payer: WEA Trust Commercial $68.75
Rate for Payer: WPS Commercial $92.59
Hospital Charge Code 3911538
Hospital Revenue Code 272
Min. Negotiated Rate $23.52
Max. Negotiated Rate $336.00
Rate for Payer: Aetna Commercial $75.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $72.24
Rate for Payer: Aetna Managed Medicare $23.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $54.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $42.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $40.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $44.52
Rate for Payer: Cash Price $25.20
Rate for Payer: Cigna Commercial $77.28
Rate for Payer: Dean Health DHI/DHP/ASO $47.01
Rate for Payer: Health EOS Commercial $74.76
Rate for Payer: HFN Commercial $77.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $63.00
Rate for Payer: Multiplan Commercial $67.20
Rate for Payer: NAPHCARE Commercial $50.40
Rate for Payer: Preferred Network Access Commercial $77.28
Rate for Payer: Quartz Beloit One Network $41.16
Rate for Payer: Quartz Commercial $54.60
Rate for Payer: Quartz Medicare Advantage $50.40
Rate for Payer: The Alliance Commercial $336.00
Rate for Payer: WEA Trust Commercial $46.20
Rate for Payer: WPS Commercial $62.22
Hospital Charge Code 3911538
Hospital Revenue Code 272
Min. Negotiated Rate $41.16
Max. Negotiated Rate $77.28
Rate for Payer: Aetna Commercial $75.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $72.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $44.52
Rate for Payer: Cash Price $25.20
Rate for Payer: Cigna Commercial $77.28
Rate for Payer: Health EOS Commercial $74.76
Rate for Payer: HFN Commercial $77.28
Rate for Payer: Multiplan Commercial $67.20
Rate for Payer: NAPHCARE Commercial $50.40
Rate for Payer: Preferred Network Access Commercial $77.28
Rate for Payer: Quartz Beloit One Network $41.16
Rate for Payer: Quartz Commercial $50.40
Rate for Payer: WEA Trust Commercial $46.20
Rate for Payer: WPS Commercial $62.22
Hospital Charge Code 2965841
Hospital Revenue Code 272
Min. Negotiated Rate $93.52
Max. Negotiated Rate $1,336.00
Rate for Payer: Aetna Commercial $300.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $287.24
Rate for Payer: Aetna Managed Medicare $93.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $217.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $167.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $160.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $177.02
Rate for Payer: Cash Price $100.20
Rate for Payer: Cigna Commercial $307.28
Rate for Payer: Dean Health DHI/DHP/ASO $186.91
Rate for Payer: Health EOS Commercial $297.26
Rate for Payer: HFN Commercial $307.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $250.50
Rate for Payer: Multiplan Commercial $267.20
Rate for Payer: NAPHCARE Commercial $200.40
Rate for Payer: Preferred Network Access Commercial $307.28
Rate for Payer: Quartz Beloit One Network $163.66
Rate for Payer: Quartz Commercial $217.10
Rate for Payer: Quartz Medicare Advantage $200.40
Rate for Payer: The Alliance Commercial $1,336.00
Rate for Payer: WEA Trust Commercial $183.70
Rate for Payer: WPS Commercial $247.39