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Service Code CPT 40814
Hospital Charge Code 3014607
Hospital Revenue Code 510
Min. Negotiated Rate $109.38
Max. Negotiated Rate $1,330.00
Rate for Payer: Aetna Commercial $1,330.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,204.00
Rate for Payer: Cash Price $420.00
Rate for Payer: Cash Price $420.00
Rate for Payer: Cigna Commercial $1,330.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $109.38
Rate for Payer: Dean Health DHI/DHP/ASO $840.00
Rate for Payer: Health EOS Commercial $1,274.00
Rate for Payer: HFN Commercial $1,330.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $973.47
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $973.47
Rate for Payer: Multiplan Commercial $1,120.00
Rate for Payer: Preferred Network Access Commercial $1,330.00
Rate for Payer: Quartz Beloit One Network $616.00
Rate for Payer: Quartz Commercial $798.00
Rate for Payer: The Alliance Commercial $700.00
Rate for Payer: United Healthcare Medicaid $109.38
Rate for Payer: WEA Trust Commercial $770.00
Rate for Payer: WPS Commercial $1,036.98
Service Code CPT 40814 50
Hospital Charge Code 4605682
Hospital Revenue Code 510
Min. Negotiated Rate $1,232.44
Max. Negotiated Rate $2,660.95
Rate for Payer: Aetna Commercial $2,660.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,408.86
Rate for Payer: Cash Price $840.30
Rate for Payer: Cash Price $840.30
Rate for Payer: Cigna Commercial $2,660.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,400.50
Rate for Payer: Dean Health DHI/DHP/ASO $1,680.60
Rate for Payer: Health EOS Commercial $2,548.91
Rate for Payer: HFN Commercial $2,660.95
Rate for Payer: Multiplan Commercial $2,240.80
Rate for Payer: Preferred Network Access Commercial $2,660.95
Rate for Payer: Quartz Beloit One Network $1,232.44
Rate for Payer: Quartz Commercial $1,596.57
Rate for Payer: The Alliance Commercial $1,400.50
Rate for Payer: WEA Trust Commercial $1,540.55
Rate for Payer: WPS Commercial $2,074.70
Hospital Charge Code 2960026
Hospital Revenue Code 360
Min. Negotiated Rate $303.52
Max. Negotiated Rate $4,336.00
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Aetna Managed Medicare $303.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $704.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $542.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $520.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Dean Health DHI/DHP/ASO $606.61
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $813.00
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $704.60
Rate for Payer: Quartz Medicare Advantage $650.40
Rate for Payer: The Alliance Commercial $4,336.00
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960026
Hospital Revenue Code 360
Min. Negotiated Rate $531.16
Max. Negotiated Rate $997.28
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $650.40
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Service Code CPT 11420
Hospital Revenue Code 360
Min. Negotiated Rate $1,602.49
Max. Negotiated Rate $6,409.96
Rate for Payer: Aetna Managed Medicare $1,602.49
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 $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,602.49
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,602.49
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,602.49
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,961.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,602.49
Rate for Payer: Independent Care Health Plan Medicare $1,602.49
Rate for Payer: Managed Health Services Medicare Advantage $1,602.49
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,602.49
Rate for Payer: NAPHCARE Commercial $2,403.74
Rate for Payer: Quartz Medicare Advantage $1,602.49
Rate for Payer: The Alliance Commercial $6,409.96
Rate for Payer: United Healthcare Medicare Advantage $1,602.49
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,602.49
Service Code CPT 11421
Hospital Revenue Code 360
Min. Negotiated Rate $695.42
Max. Negotiated Rate $4,218.22
Rate for Payer: Aetna Managed Medicare $695.42
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,914.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,297.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,183.00
Rate for Payer: Anthem Medicare Advantage $695.42
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $695.42
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $695.42
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $695.42
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $695.42
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,586.96
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $695.42
Rate for Payer: Independent Care Health Plan Medicare $695.42
Rate for Payer: Managed Health Services Medicare Advantage $695.42
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $695.42
Rate for Payer: NAPHCARE Commercial $1,043.13
Rate for Payer: Quartz Medicare Advantage $695.42
Rate for Payer: The Alliance Commercial $2,781.68
Rate for Payer: United Healthcare Medicare Advantage $695.42
Rate for Payer: United Healthcare PPO $2,257.00
Rate for Payer: Wellcare Medicare $695.42
Service Code CPT 11422
Hospital Revenue Code 360
Min. Negotiated Rate $1,602.49
Max. Negotiated Rate $6,409.96
Rate for Payer: Aetna Managed Medicare $1,602.49
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 $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,602.49
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,602.49
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,602.49
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,961.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,602.49
Rate for Payer: Independent Care Health Plan Medicare $1,602.49
Rate for Payer: Managed Health Services Medicare Advantage $1,602.49
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,602.49
Rate for Payer: NAPHCARE Commercial $2,403.74
Rate for Payer: Quartz Medicare Advantage $1,602.49
Rate for Payer: The Alliance Commercial $6,409.96
Rate for Payer: United Healthcare Medicare Advantage $1,602.49
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,602.49
Service Code CPT 11423
Hospital Revenue Code 360
Min. Negotiated Rate $1,602.49
Max. Negotiated Rate $6,409.96
Rate for Payer: Aetna Managed Medicare $1,602.49
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 $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,602.49
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,602.49
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,602.49
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,961.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,602.49
Rate for Payer: Independent Care Health Plan Medicare $1,602.49
Rate for Payer: Managed Health Services Medicare Advantage $1,602.49
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,602.49
Rate for Payer: NAPHCARE Commercial $2,403.74
Rate for Payer: Quartz Medicare Advantage $1,602.49
Rate for Payer: The Alliance Commercial $6,409.96
Rate for Payer: United Healthcare Medicare Advantage $1,602.49
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,602.49
Service Code CPT 11424
Hospital Revenue Code 360
Min. Negotiated Rate $1,602.49
Max. Negotiated Rate $6,409.96
Rate for Payer: Aetna Managed Medicare $1,602.49
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 $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,602.49
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,602.49
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,602.49
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,961.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,602.49
Rate for Payer: Independent Care Health Plan Medicare $1,602.49
Rate for Payer: Managed Health Services Medicare Advantage $1,602.49
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,602.49
Rate for Payer: NAPHCARE Commercial $2,403.74
Rate for Payer: Quartz Medicare Advantage $1,602.49
Rate for Payer: The Alliance Commercial $6,409.96
Rate for Payer: United Healthcare Medicare Advantage $1,602.49
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,602.49
Service Code CPT 11426
Hospital Revenue Code 360
Min. Negotiated Rate $2,808.55
Max. Negotiated Rate $11,234.20
Rate for Payer: Aetna Managed Medicare $2,808.55
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $9,907.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $8,043.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $7,639.00
Rate for Payer: Anthem Medicare Advantage $2,808.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $2,808.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $2,808.55
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $2,808.55
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $2,808.55
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $10,447.81
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $2,808.55
Rate for Payer: Independent Care Health Plan Medicare $2,808.55
Rate for Payer: Managed Health Services Medicare Advantage $2,808.55
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $2,808.55
Rate for Payer: NAPHCARE Commercial $4,212.82
Rate for Payer: Quartz Medicare Advantage $2,808.55
Rate for Payer: The Alliance Commercial $11,234.20
Rate for Payer: United Healthcare Medicare Advantage $2,808.55
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: Wellcare Medicare $2,808.55
Service Code CPT 11406
Hospital Revenue Code 360
Min. Negotiated Rate $1,602.49
Max. Negotiated Rate $6,409.96
Rate for Payer: Aetna Managed Medicare $1,602.49
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 $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,602.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,602.49
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,602.49
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,602.49
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,961.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,602.49
Rate for Payer: Independent Care Health Plan Medicare $1,602.49
Rate for Payer: Managed Health Services Medicare Advantage $1,602.49
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,602.49
Rate for Payer: NAPHCARE Commercial $2,403.74
Rate for Payer: Quartz Medicare Advantage $1,602.49
Rate for Payer: The Alliance Commercial $6,409.96
Rate for Payer: United Healthcare Medicare Advantage $1,602.49
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,602.49
Service Code CPT 19125
Hospital Charge Code 3013680
Hospital Revenue Code 510
Min. Negotiated Rate $340.70
Max. Negotiated Rate $2,924.10
Rate for Payer: Aetna Commercial $2,924.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,647.08
Rate for Payer: Cash Price $923.40
Rate for Payer: Cash Price $923.40
Rate for Payer: Cigna Commercial $2,924.10
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $340.70
Rate for Payer: Dean Health DHI/DHP/ASO $1,846.80
Rate for Payer: Health EOS Commercial $2,800.98
Rate for Payer: HFN Commercial $2,924.10
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,499.19
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,499.19
Rate for Payer: Multiplan Commercial $2,462.40
Rate for Payer: Preferred Network Access Commercial $2,924.10
Rate for Payer: Quartz Beloit One Network $1,354.32
Rate for Payer: Quartz Commercial $1,754.46
Rate for Payer: The Alliance Commercial $1,539.00
Rate for Payer: United Healthcare Medicaid $340.70
Rate for Payer: WEA Trust Commercial $1,692.90
Rate for Payer: WPS Commercial $2,279.87
Hospital Charge Code 2960024
Hospital Revenue Code 360
Min. Negotiated Rate $531.16
Max. Negotiated Rate $997.28
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $650.40
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960024
Hospital Revenue Code 360
Min. Negotiated Rate $303.52
Max. Negotiated Rate $4,336.00
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Aetna Managed Medicare $303.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $704.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $542.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $520.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Dean Health DHI/DHP/ASO $606.61
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $813.00
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $704.60
Rate for Payer: Quartz Medicare Advantage $650.40
Rate for Payer: The Alliance Commercial $4,336.00
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960030
Hospital Revenue Code 360
Min. Negotiated Rate $303.52
Max. Negotiated Rate $4,336.00
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Aetna Managed Medicare $303.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $704.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $542.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $520.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Dean Health DHI/DHP/ASO $606.61
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $813.00
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $704.60
Rate for Payer: Quartz Medicare Advantage $650.40
Rate for Payer: The Alliance Commercial $4,336.00
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960030
Hospital Revenue Code 360
Min. Negotiated Rate $531.16
Max. Negotiated Rate $997.28
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $650.40
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Service Code CPT 40812
Hospital Charge Code 1190860
Hospital Revenue Code 510
Min. Negotiated Rate $88.94
Max. Negotiated Rate $684.00
Rate for Payer: Aetna Commercial $684.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $619.20
Rate for Payer: Cash Price $216.00
Rate for Payer: Cash Price $216.00
Rate for Payer: Cigna Commercial $684.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $88.94
Rate for Payer: Dean Health DHI/DHP/ASO $432.00
Rate for Payer: Health EOS Commercial $655.20
Rate for Payer: HFN Commercial $684.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $631.73
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $631.73
Rate for Payer: Multiplan Commercial $576.00
Rate for Payer: Preferred Network Access Commercial $684.00
Rate for Payer: Quartz Beloit One Network $316.80
Rate for Payer: Quartz Commercial $410.40
Rate for Payer: The Alliance Commercial $360.00
Rate for Payer: United Healthcare Medicaid $88.94
Rate for Payer: WEA Trust Commercial $396.00
Rate for Payer: WPS Commercial $533.30
Hospital Charge Code 2960162
Hospital Revenue Code 360
Min. Negotiated Rate $303.52
Max. Negotiated Rate $4,336.00
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Aetna Managed Medicare $303.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $704.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $542.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $520.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Dean Health DHI/DHP/ASO $606.61
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $813.00
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $704.60
Rate for Payer: Quartz Medicare Advantage $650.40
Rate for Payer: The Alliance Commercial $4,336.00
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960162
Hospital Revenue Code 360
Min. Negotiated Rate $531.16
Max. Negotiated Rate $997.28
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $650.40
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960025
Hospital Revenue Code 360
Min. Negotiated Rate $492.94
Max. Negotiated Rate $925.52
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $603.60
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960025
Hospital Revenue Code 360
Min. Negotiated Rate $281.68
Max. Negotiated Rate $4,024.00
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Aetna Managed Medicare $281.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $653.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $503.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $482.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Dean Health DHI/DHP/ASO $562.96
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.50
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $653.90
Rate for Payer: Quartz Medicare Advantage $603.60
Rate for Payer: The Alliance Commercial $4,024.00
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2959985
Hospital Revenue Code 360
Min. Negotiated Rate $374.36
Max. Negotiated Rate $5,348.00
Rate for Payer: Aetna Commercial $1,203.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,149.82
Rate for Payer: Aetna Managed Medicare $374.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $869.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $668.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $641.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $708.61
Rate for Payer: Cash Price $401.10
Rate for Payer: Cigna Commercial $1,230.04
Rate for Payer: Dean Health DHI/DHP/ASO $748.19
Rate for Payer: Health EOS Commercial $1,189.93
Rate for Payer: HFN Commercial $1,230.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,002.75
Rate for Payer: Multiplan Commercial $1,069.60
Rate for Payer: NAPHCARE Commercial $802.20
Rate for Payer: Preferred Network Access Commercial $1,230.04
Rate for Payer: Quartz Beloit One Network $655.13
Rate for Payer: Quartz Commercial $869.05
Rate for Payer: Quartz Medicare Advantage $802.20
Rate for Payer: The Alliance Commercial $5,348.00
Rate for Payer: WEA Trust Commercial $735.35
Rate for Payer: WPS Commercial $990.32
Hospital Charge Code 2959985
Hospital Revenue Code 360
Min. Negotiated Rate $655.13
Max. Negotiated Rate $1,230.04
Rate for Payer: Aetna Commercial $1,203.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,149.82
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $708.61
Rate for Payer: Cash Price $401.10
Rate for Payer: Cigna Commercial $1,230.04
Rate for Payer: Health EOS Commercial $1,189.93
Rate for Payer: HFN Commercial $1,230.04
Rate for Payer: Multiplan Commercial $1,069.60
Rate for Payer: NAPHCARE Commercial $802.20
Rate for Payer: Preferred Network Access Commercial $1,230.04
Rate for Payer: Quartz Beloit One Network $655.13
Rate for Payer: Quartz Commercial $802.20
Rate for Payer: WEA Trust Commercial $735.35
Rate for Payer: WPS Commercial $990.32
Service Code CPT 28080
Hospital Revenue Code 360
Min. Negotiated Rate $1,588.57
Max. Negotiated Rate $6,546.14
Rate for Payer: Aetna Managed Medicare $1,588.57
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 $1,588.57
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,588.57
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,588.57
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,588.57
Rate for Payer: Dean Health DHI/DHP/ASO $6,546.14
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,588.57
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,909.48
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,588.57
Rate for Payer: Independent Care Health Plan Medicare $1,588.57
Rate for Payer: Managed Health Services Medicare Advantage $1,588.57
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,588.57
Rate for Payer: NAPHCARE Commercial $2,382.86
Rate for Payer: Quartz Medicare Advantage $1,588.57
Rate for Payer: The Alliance Commercial $6,354.28
Rate for Payer: United Healthcare Medicare Advantage $1,588.57
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,588.57
Hospital Charge Code 2959986
Hospital Revenue Code 360
Min. Negotiated Rate $492.94
Max. Negotiated Rate $925.52
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $603.60
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14