Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS C1725
Hospital Charge Code 2972520
Hospital Revenue Code 272
Min. Negotiated Rate $478.24
Max. Negotiated Rate $6,832.00
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Aetna Managed Medicare $478.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,110.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $854.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $819.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Dean Health DHI/DHP/ASO $955.80
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,281.00
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,110.20
Rate for Payer: Quartz Medicare Advantage $1,024.80
Rate for Payer: The Alliance Commercial $6,832.00
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1725
Hospital Charge Code 2972520
Hospital Revenue Code 272
Min. Negotiated Rate $836.92
Max. Negotiated Rate $1,571.36
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,024.80
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1725
Hospital Charge Code 2972521
Hospital Revenue Code 272
Min. Negotiated Rate $478.24
Max. Negotiated Rate $6,832.00
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Aetna Managed Medicare $478.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,110.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $854.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $819.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Dean Health DHI/DHP/ASO $955.80
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,281.00
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,110.20
Rate for Payer: Quartz Medicare Advantage $1,024.80
Rate for Payer: The Alliance Commercial $6,832.00
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1725
Hospital Charge Code 2972521
Hospital Revenue Code 272
Min. Negotiated Rate $836.92
Max. Negotiated Rate $1,571.36
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,024.80
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code CPT 80169
Hospital Charge Code 3475536
Hospital Revenue Code 300
Min. Negotiated Rate $48.47
Max. Negotiated Rate $228.95
Rate for Payer: Aetna Commercial $228.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $207.26
Rate for Payer: Cash Price $72.30
Rate for Payer: Cash Price $72.30
Rate for Payer: Cigna Commercial $228.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $120.50
Rate for Payer: Dean Health DHI/DHP/ASO $144.60
Rate for Payer: Health EOS Commercial $219.31
Rate for Payer: HFN Commercial $228.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $48.47
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $48.47
Rate for Payer: Multiplan Commercial $192.80
Rate for Payer: Preferred Network Access Commercial $228.95
Rate for Payer: Quartz Beloit One Network $106.04
Rate for Payer: Quartz Commercial $137.37
Rate for Payer: The Alliance Commercial $120.50
Rate for Payer: WEA Trust Commercial $132.55
Rate for Payer: WPS Commercial $178.51
Service Code CPT 80169
Hospital Charge Code 3475536
Hospital Revenue Code 300
Min. Negotiated Rate $13.73
Max. Negotiated Rate $221.72
Rate for Payer: Aetna Commercial $216.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $207.26
Rate for Payer: Aetna Managed Medicare $13.73
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $51.49
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $24.03
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $22.79
Rate for Payer: Anthem Medicaid $14.19
Rate for Payer: Anthem Medicare Advantage $13.73
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $127.73
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $13.73
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $13.73
Rate for Payer: Cash Price $72.30
Rate for Payer: Cash Price $72.30
Rate for Payer: Cigna Commercial $221.72
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $13.73
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $14.19
Rate for Payer: Dean Health DHI/DHP/ASO $134.86
Rate for Payer: Dean Health Medicaid $14.19
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $13.73
Rate for Payer: Health EOS Commercial $214.49
Rate for Payer: HFN Commercial $221.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $51.08
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $13.73
Rate for Payer: Independent Care Health Plan Medicaid $14.19
Rate for Payer: Independent Care Health Plan Medicare $13.73
Rate for Payer: Managed Health Services Medicaid $14.76
Rate for Payer: Managed Health Services Medicare Advantage $13.73
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $13.73
Rate for Payer: Multiplan Commercial $192.80
Rate for Payer: NAPHCARE Commercial $20.60
Rate for Payer: Preferred Network Access Commercial $221.72
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $14.19
Rate for Payer: Quartz Beloit One Network $118.09
Rate for Payer: Quartz Commercial $156.65
Rate for Payer: Quartz Medicare Advantage $13.73
Rate for Payer: The Alliance Commercial $54.92
Rate for Payer: United Healthcare Medicaid $14.19
Rate for Payer: United Healthcare Medicare Advantage $13.73
Rate for Payer: United Healthcare PPO $180.75
Rate for Payer: WEA Trust Commercial $132.55
Rate for Payer: Wellcare Medicare $13.73
Rate for Payer: WMAP Medicaid $14.19
Rate for Payer: WPS Commercial $178.51
Service Code CPT 80169
Hospital Charge Code 3475536
Hospital Revenue Code 300
Min. Negotiated Rate $118.09
Max. Negotiated Rate $221.72
Rate for Payer: Aetna Commercial $216.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $207.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $127.73
Rate for Payer: Cash Price $72.30
Rate for Payer: Cigna Commercial $221.72
Rate for Payer: Health EOS Commercial $214.49
Rate for Payer: HFN Commercial $221.72
Rate for Payer: Multiplan Commercial $192.80
Rate for Payer: NAPHCARE Commercial $144.60
Rate for Payer: Preferred Network Access Commercial $221.72
Rate for Payer: Quartz Beloit One Network $118.09
Rate for Payer: Quartz Commercial $144.60
Rate for Payer: WEA Trust Commercial $132.55
Rate for Payer: WPS Commercial $178.51
Service Code CPT 92587 26
Hospital Charge Code 3015342
Hospital Revenue Code 510
Min. Negotiated Rate $44.00
Max. Negotiated Rate $95.00
Rate for Payer: Aetna Commercial $95.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $86.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $95.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $50.00
Rate for Payer: Dean Health DHI/DHP/ASO $60.00
Rate for Payer: Health EOS Commercial $91.00
Rate for Payer: HFN Commercial $95.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $63.19
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $63.19
Rate for Payer: Multiplan Commercial $80.00
Rate for Payer: Preferred Network Access Commercial $95.00
Rate for Payer: Quartz Beloit One Network $44.00
Rate for Payer: Quartz Commercial $57.00
Rate for Payer: The Alliance Commercial $50.00
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: WPS Commercial $74.07
Service Code CPT 92588
Hospital Charge Code 1188813
Hospital Revenue Code 510
Min. Negotiated Rate $77.96
Max. Negotiated Rate $505.40
Rate for Payer: Aetna Commercial $505.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $457.52
Rate for Payer: Cash Price $159.60
Rate for Payer: Cash Price $159.60
Rate for Payer: Cigna Commercial $505.40
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $77.96
Rate for Payer: Dean Health DHI/DHP/ASO $319.20
Rate for Payer: Health EOS Commercial $484.12
Rate for Payer: HFN Commercial $505.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $117.20
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $117.20
Rate for Payer: Multiplan Commercial $425.60
Rate for Payer: Preferred Network Access Commercial $505.40
Rate for Payer: Quartz Beloit One Network $234.08
Rate for Payer: Quartz Commercial $303.24
Rate for Payer: The Alliance Commercial $266.00
Rate for Payer: United Healthcare Medicaid $77.96
Rate for Payer: WEA Trust Commercial $292.60
Rate for Payer: WPS Commercial $394.05
Service Code CPT 92588
Hospital Charge Code 1188813
Hospital Revenue Code 510
Min. Negotiated Rate $260.68
Max. Negotiated Rate $489.44
Rate for Payer: Aetna Commercial $478.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $457.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $281.96
Rate for Payer: Cash Price $159.60
Rate for Payer: Cigna Commercial $489.44
Rate for Payer: Health EOS Commercial $473.48
Rate for Payer: HFN Commercial $489.44
Rate for Payer: Multiplan Commercial $425.60
Rate for Payer: NAPHCARE Commercial $319.20
Rate for Payer: Preferred Network Access Commercial $489.44
Rate for Payer: Quartz Beloit One Network $260.68
Rate for Payer: Quartz Commercial $319.20
Rate for Payer: WEA Trust Commercial $292.60
Rate for Payer: WPS Commercial $394.05
Service Code CPT 92588
Hospital Charge Code 1188813
Hospital Revenue Code 510
Min. Negotiated Rate $255.36
Max. Negotiated Rate $1,240.96
Rate for Payer: Aetna Commercial $478.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $457.52
Rate for Payer: Aetna Managed Medicare $310.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $345.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $266.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $255.36
Rate for Payer: Anthem Medicare Advantage $310.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $281.96
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $310.24
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $310.24
Rate for Payer: Cash Price $159.60
Rate for Payer: Cash Price $159.60
Rate for Payer: Cigna Commercial $489.44
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $310.24
Rate for Payer: Dean Health DHI/DHP/ASO $297.71
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $310.24
Rate for Payer: Health EOS Commercial $473.48
Rate for Payer: HFN Commercial $489.44
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,154.09
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $310.24
Rate for Payer: Independent Care Health Plan Medicare $310.24
Rate for Payer: Managed Health Services Medicare Advantage $310.24
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $310.24
Rate for Payer: Multiplan Commercial $425.60
Rate for Payer: NAPHCARE Commercial $465.36
Rate for Payer: Preferred Network Access Commercial $489.44
Rate for Payer: Quartz Beloit One Network $260.68
Rate for Payer: Quartz Commercial $345.80
Rate for Payer: Quartz Medicare Advantage $310.24
Rate for Payer: The Alliance Commercial $1,240.96
Rate for Payer: United Healthcare Medicare Advantage $310.24
Rate for Payer: WEA Trust Commercial $292.60
Rate for Payer: Wellcare Medicare $310.24
Rate for Payer: WPS Commercial $394.05
Hospital Charge Code 5074914
Hospital Revenue Code 272
Min. Negotiated Rate $268.52
Max. Negotiated Rate $3,836.00
Rate for Payer: Aetna Commercial $863.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $824.74
Rate for Payer: Aetna Managed Medicare $268.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $623.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $479.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $460.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $508.27
Rate for Payer: Cash Price $287.70
Rate for Payer: Cigna Commercial $882.28
Rate for Payer: Dean Health DHI/DHP/ASO $536.66
Rate for Payer: Health EOS Commercial $853.51
Rate for Payer: HFN Commercial $882.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $719.25
Rate for Payer: Multiplan Commercial $767.20
Rate for Payer: NAPHCARE Commercial $575.40
Rate for Payer: Preferred Network Access Commercial $882.28
Rate for Payer: Quartz Beloit One Network $469.91
Rate for Payer: Quartz Commercial $623.35
Rate for Payer: Quartz Medicare Advantage $575.40
Rate for Payer: The Alliance Commercial $3,836.00
Rate for Payer: WEA Trust Commercial $527.45
Rate for Payer: WPS Commercial $710.33
Hospital Charge Code 5074914
Hospital Revenue Code 272
Min. Negotiated Rate $469.91
Max. Negotiated Rate $882.28
Rate for Payer: Aetna Commercial $863.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $824.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $508.27
Rate for Payer: Cash Price $287.70
Rate for Payer: Cigna Commercial $882.28
Rate for Payer: Health EOS Commercial $853.51
Rate for Payer: HFN Commercial $882.28
Rate for Payer: Multiplan Commercial $767.20
Rate for Payer: NAPHCARE Commercial $575.40
Rate for Payer: Preferred Network Access Commercial $882.28
Rate for Payer: Quartz Beloit One Network $469.91
Rate for Payer: Quartz Commercial $575.40
Rate for Payer: WEA Trust Commercial $527.45
Rate for Payer: WPS Commercial $710.33
Hospital Charge Code 5074915
Hospital Revenue Code 272
Min. Negotiated Rate $268.52
Max. Negotiated Rate $3,836.00
Rate for Payer: Aetna Commercial $863.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $824.74
Rate for Payer: Aetna Managed Medicare $268.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $623.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $479.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $460.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $508.27
Rate for Payer: Cash Price $287.70
Rate for Payer: Cigna Commercial $882.28
Rate for Payer: Dean Health DHI/DHP/ASO $536.66
Rate for Payer: Health EOS Commercial $853.51
Rate for Payer: HFN Commercial $882.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $719.25
Rate for Payer: Multiplan Commercial $767.20
Rate for Payer: NAPHCARE Commercial $575.40
Rate for Payer: Preferred Network Access Commercial $882.28
Rate for Payer: Quartz Beloit One Network $469.91
Rate for Payer: Quartz Commercial $623.35
Rate for Payer: Quartz Medicare Advantage $575.40
Rate for Payer: The Alliance Commercial $3,836.00
Rate for Payer: WEA Trust Commercial $527.45
Rate for Payer: WPS Commercial $710.33
Hospital Charge Code 5074915
Hospital Revenue Code 272
Min. Negotiated Rate $469.91
Max. Negotiated Rate $882.28
Rate for Payer: Aetna Commercial $863.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $824.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $508.27
Rate for Payer: Cash Price $287.70
Rate for Payer: Cigna Commercial $882.28
Rate for Payer: Health EOS Commercial $853.51
Rate for Payer: HFN Commercial $882.28
Rate for Payer: Multiplan Commercial $767.20
Rate for Payer: NAPHCARE Commercial $575.40
Rate for Payer: Preferred Network Access Commercial $882.28
Rate for Payer: Quartz Beloit One Network $469.91
Rate for Payer: Quartz Commercial $575.40
Rate for Payer: WEA Trust Commercial $527.45
Rate for Payer: WPS Commercial $710.33
Hospital Charge Code 5074891
Hospital Revenue Code 272
Min. Negotiated Rate $344.12
Max. Negotiated Rate $4,916.00
Rate for Payer: Aetna Commercial $1,106.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,056.94
Rate for Payer: Aetna Managed Medicare $344.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $798.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $614.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $589.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $651.37
Rate for Payer: Cash Price $368.70
Rate for Payer: Cigna Commercial $1,130.68
Rate for Payer: Dean Health DHI/DHP/ASO $687.75
Rate for Payer: Health EOS Commercial $1,093.81
Rate for Payer: HFN Commercial $1,130.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $921.75
Rate for Payer: Multiplan Commercial $983.20
Rate for Payer: NAPHCARE Commercial $737.40
Rate for Payer: Preferred Network Access Commercial $1,130.68
Rate for Payer: Quartz Beloit One Network $602.21
Rate for Payer: Quartz Commercial $798.85
Rate for Payer: Quartz Medicare Advantage $737.40
Rate for Payer: The Alliance Commercial $4,916.00
Rate for Payer: WEA Trust Commercial $675.95
Rate for Payer: WPS Commercial $910.32
Hospital Charge Code 5074891
Hospital Revenue Code 272
Min. Negotiated Rate $602.21
Max. Negotiated Rate $1,130.68
Rate for Payer: Aetna Commercial $1,106.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,056.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $651.37
Rate for Payer: Cash Price $368.70
Rate for Payer: Cigna Commercial $1,130.68
Rate for Payer: Health EOS Commercial $1,093.81
Rate for Payer: HFN Commercial $1,130.68
Rate for Payer: Multiplan Commercial $983.20
Rate for Payer: NAPHCARE Commercial $737.40
Rate for Payer: Preferred Network Access Commercial $1,130.68
Rate for Payer: Quartz Beloit One Network $602.21
Rate for Payer: Quartz Commercial $737.40
Rate for Payer: WEA Trust Commercial $675.95
Rate for Payer: WPS Commercial $910.32
Hospital Charge Code 5206673
Hospital Revenue Code 272
Min. Negotiated Rate $469.91
Max. Negotiated Rate $882.28
Rate for Payer: Aetna Commercial $863.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $824.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $508.27
Rate for Payer: Cash Price $287.70
Rate for Payer: Cigna Commercial $882.28
Rate for Payer: Health EOS Commercial $853.51
Rate for Payer: HFN Commercial $882.28
Rate for Payer: Multiplan Commercial $767.20
Rate for Payer: NAPHCARE Commercial $575.40
Rate for Payer: Preferred Network Access Commercial $882.28
Rate for Payer: Quartz Beloit One Network $469.91
Rate for Payer: Quartz Commercial $575.40
Rate for Payer: WEA Trust Commercial $527.45
Rate for Payer: WPS Commercial $710.33
Hospital Charge Code 5206673
Hospital Revenue Code 272
Min. Negotiated Rate $268.52
Max. Negotiated Rate $3,836.00
Rate for Payer: Aetna Commercial $863.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $824.74
Rate for Payer: Aetna Managed Medicare $268.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $623.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $479.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $460.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $508.27
Rate for Payer: Cash Price $287.70
Rate for Payer: Cigna Commercial $882.28
Rate for Payer: Dean Health DHI/DHP/ASO $536.66
Rate for Payer: Health EOS Commercial $853.51
Rate for Payer: HFN Commercial $882.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $719.25
Rate for Payer: Multiplan Commercial $767.20
Rate for Payer: NAPHCARE Commercial $575.40
Rate for Payer: Preferred Network Access Commercial $882.28
Rate for Payer: Quartz Beloit One Network $469.91
Rate for Payer: Quartz Commercial $623.35
Rate for Payer: Quartz Medicare Advantage $575.40
Rate for Payer: The Alliance Commercial $3,836.00
Rate for Payer: WEA Trust Commercial $527.45
Rate for Payer: WPS Commercial $710.33
Service Code CPT 50435
Hospital Revenue Code 360
Min. Negotiated Rate $2,013.20
Max. Negotiated Rate $8,052.80
Rate for Payer: Aetna Managed Medicare $2,013.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,496.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,871.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,726.00
Rate for Payer: Anthem Medicare Advantage $2,013.20
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $2,013.20
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $2,013.20
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $2,013.20
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $2,013.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $7,489.10
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $2,013.20
Rate for Payer: Independent Care Health Plan Medicare $2,013.20
Rate for Payer: Managed Health Services Medicare Advantage $2,013.20
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $2,013.20
Rate for Payer: NAPHCARE Commercial $3,019.80
Rate for Payer: Quartz Medicare Advantage $2,013.20
Rate for Payer: The Alliance Commercial $8,052.80
Rate for Payer: United Healthcare Medicare Advantage $2,013.20
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $2,013.20
Service Code CPT 27043
Hospital Charge Code 3014009
Hospital Revenue Code 510
Min. Negotiated Rate $377.55
Max. Negotiated Rate $2,888.00
Rate for Payer: Aetna Commercial $2,888.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,614.40
Rate for Payer: Cash Price $912.00
Rate for Payer: Cash Price $912.00
Rate for Payer: Cigna Commercial $2,888.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $377.55
Rate for Payer: Dean Health DHI/DHP/ASO $1,824.00
Rate for Payer: Health EOS Commercial $2,766.40
Rate for Payer: HFN Commercial $2,888.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,528.91
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,528.91
Rate for Payer: Multiplan Commercial $2,432.00
Rate for Payer: Preferred Network Access Commercial $2,888.00
Rate for Payer: Quartz Beloit One Network $1,337.60
Rate for Payer: Quartz Commercial $1,732.80
Rate for Payer: The Alliance Commercial $1,520.00
Rate for Payer: United Healthcare Medicaid $377.55
Rate for Payer: WEA Trust Commercial $1,672.00
Rate for Payer: WPS Commercial $2,251.73
Service Code CPT 49423
Hospital Charge Code 6180166
Hospital Revenue Code 510
Min. Negotiated Rate $204.60
Max. Negotiated Rate $500.61
Rate for Payer: Aetna Commercial $441.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $399.90
Rate for Payer: Cash Price $139.50
Rate for Payer: Cash Price $139.50
Rate for Payer: Cigna Commercial $441.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $500.61
Rate for Payer: Dean Health DHI/DHP/ASO $279.00
Rate for Payer: Health EOS Commercial $423.15
Rate for Payer: HFN Commercial $441.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $237.96
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $237.96
Rate for Payer: Multiplan Commercial $372.00
Rate for Payer: Preferred Network Access Commercial $441.75
Rate for Payer: Quartz Beloit One Network $204.60
Rate for Payer: Quartz Commercial $265.05
Rate for Payer: The Alliance Commercial $232.50
Rate for Payer: United Healthcare Medicaid $500.61
Rate for Payer: WEA Trust Commercial $255.75
Rate for Payer: WPS Commercial $344.43
Service Code CPT 28086
Hospital Charge Code 3014195
Hospital Revenue Code 510
Min. Negotiated Rate $421.85
Max. Negotiated Rate $2,246.75
Rate for Payer: Aetna Commercial $2,246.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,033.90
Rate for Payer: Cash Price $709.50
Rate for Payer: Cash Price $709.50
Rate for Payer: Cigna Commercial $2,246.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $421.85
Rate for Payer: Dean Health DHI/DHP/ASO $1,419.00
Rate for Payer: Health EOS Commercial $2,152.15
Rate for Payer: HFN Commercial $2,246.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,195.58
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,195.58
Rate for Payer: Multiplan Commercial $1,892.00
Rate for Payer: Preferred Network Access Commercial $2,246.75
Rate for Payer: Quartz Beloit One Network $1,040.60
Rate for Payer: Quartz Commercial $1,348.05
Rate for Payer: The Alliance Commercial $1,182.50
Rate for Payer: United Healthcare Medicaid $421.85
Rate for Payer: WEA Trust Commercial $1,300.75
Rate for Payer: WPS Commercial $1,751.76
Service Code CPT 40819
Hospital Charge Code 3014609
Hospital Revenue Code 510
Min. Negotiated Rate $134.77
Max. Negotiated Rate $686.94
Rate for Payer: Aetna Commercial $533.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $483.32
Rate for Payer: Cash Price $168.60
Rate for Payer: Cash Price $168.60
Rate for Payer: Cigna Commercial $533.90
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $134.77
Rate for Payer: Dean Health DHI/DHP/ASO $337.20
Rate for Payer: Health EOS Commercial $511.42
Rate for Payer: HFN Commercial $533.90
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $686.94
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $686.94
Rate for Payer: Multiplan Commercial $449.60
Rate for Payer: Preferred Network Access Commercial $533.90
Rate for Payer: Quartz Beloit One Network $247.28
Rate for Payer: Quartz Commercial $320.34
Rate for Payer: The Alliance Commercial $281.00
Rate for Payer: United Healthcare Medicaid $134.77
Rate for Payer: WEA Trust Commercial $309.10
Rate for Payer: WPS Commercial $416.27
Service Code CPT 21040
Hospital Charge Code 4157351
Hospital Revenue Code 510
Min. Negotiated Rate $376.66
Max. Negotiated Rate $1,915.20
Rate for Payer: Aetna Commercial $1,915.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,733.76
Rate for Payer: Cash Price $604.80
Rate for Payer: Cash Price $604.80
Rate for Payer: Cigna Commercial $1,915.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $376.66
Rate for Payer: Dean Health DHI/DHP/ASO $1,209.60
Rate for Payer: Health EOS Commercial $1,834.56
Rate for Payer: HFN Commercial $1,915.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,270.94
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,270.94
Rate for Payer: Multiplan Commercial $1,612.80
Rate for Payer: Preferred Network Access Commercial $1,915.20
Rate for Payer: Quartz Beloit One Network $887.04
Rate for Payer: Quartz Commercial $1,149.12
Rate for Payer: The Alliance Commercial $1,008.00
Rate for Payer: United Healthcare Medicaid $376.66
Rate for Payer: WEA Trust Commercial $1,108.80
Rate for Payer: WPS Commercial $1,493.25