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Service Code CPT 11424
Hospital Charge Code 3013545
Hospital Revenue Code 510
Min. Negotiated Rate $189.05
Max. Negotiated Rate $918.65
Rate for Payer: Aetna Commercial $918.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $831.62
Rate for Payer: Cash Price $290.10
Rate for Payer: Cash Price $290.10
Rate for Payer: Cigna Commercial $918.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $189.05
Rate for Payer: Dean Health DHI/DHP/ASO $580.20
Rate for Payer: Health EOS Commercial $879.97
Rate for Payer: HFN Commercial $918.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $587.78
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $587.78
Rate for Payer: Multiplan Commercial $773.60
Rate for Payer: Preferred Network Access Commercial $918.65
Rate for Payer: Quartz Beloit One Network $425.48
Rate for Payer: Quartz Commercial $551.19
Rate for Payer: The Alliance Commercial $483.50
Rate for Payer: United Healthcare Medicaid $189.05
Rate for Payer: WEA Trust Commercial $531.85
Rate for Payer: WPS Commercial $716.26
Service Code CPT 11426
Hospital Charge Code 3013546
Hospital Revenue Code 510
Min. Negotiated Rate $271.45
Max. Negotiated Rate $1,348.05
Rate for Payer: Aetna Commercial $1,348.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,220.34
Rate for Payer: Cash Price $425.70
Rate for Payer: Cash Price $425.70
Rate for Payer: Cigna Commercial $1,348.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $271.45
Rate for Payer: Dean Health DHI/DHP/ASO $851.40
Rate for Payer: Health EOS Commercial $1,291.29
Rate for Payer: HFN Commercial $1,348.05
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $904.92
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $904.92
Rate for Payer: Multiplan Commercial $1,135.20
Rate for Payer: Preferred Network Access Commercial $1,348.05
Rate for Payer: Quartz Beloit One Network $624.36
Rate for Payer: Quartz Commercial $808.83
Rate for Payer: The Alliance Commercial $709.50
Rate for Payer: United Healthcare Medicaid $271.45
Rate for Payer: WEA Trust Commercial $780.45
Rate for Payer: WPS Commercial $1,051.05
Service Code CPT 11400
Hospital Charge Code 3013536
Hospital Revenue Code 510
Min. Negotiated Rate $47.18
Max. Negotiated Rate $304.95
Rate for Payer: Aetna Commercial $304.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Cash Price $96.30
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $304.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $47.18
Rate for Payer: Dean Health DHI/DHP/ASO $192.60
Rate for Payer: Health EOS Commercial $292.11
Rate for Payer: HFN Commercial $304.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $278.48
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $278.48
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: Preferred Network Access Commercial $304.95
Rate for Payer: Quartz Beloit One Network $141.24
Rate for Payer: Quartz Commercial $182.97
Rate for Payer: The Alliance Commercial $160.50
Rate for Payer: United Healthcare Medicaid $47.18
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code CPT 11401
Hospital Charge Code 1152813
Hospital Revenue Code 510
Min. Negotiated Rate $81.31
Max. Negotiated Rate $401.85
Rate for Payer: Aetna Commercial $401.85
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $363.78
Rate for Payer: Cash Price $126.90
Rate for Payer: Cash Price $126.90
Rate for Payer: Cigna Commercial $401.85
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $81.31
Rate for Payer: Dean Health DHI/DHP/ASO $253.80
Rate for Payer: Health EOS Commercial $384.93
Rate for Payer: HFN Commercial $401.85
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $351.09
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $351.09
Rate for Payer: Multiplan Commercial $338.40
Rate for Payer: Preferred Network Access Commercial $401.85
Rate for Payer: Quartz Beloit One Network $186.12
Rate for Payer: Quartz Commercial $241.11
Rate for Payer: The Alliance Commercial $211.50
Rate for Payer: United Healthcare Medicaid $81.31
Rate for Payer: WEA Trust Commercial $232.65
Rate for Payer: WPS Commercial $313.32
Service Code CPT 11402
Hospital Charge Code 3013537
Hospital Revenue Code 510
Min. Negotiated Rate $131.53
Max. Negotiated Rate $550.05
Rate for Payer: Aetna Commercial $550.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $497.94
Rate for Payer: Cash Price $173.70
Rate for Payer: Cash Price $173.70
Rate for Payer: Cigna Commercial $550.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $131.53
Rate for Payer: Dean Health DHI/DHP/ASO $347.40
Rate for Payer: Health EOS Commercial $526.89
Rate for Payer: HFN Commercial $550.05
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $385.09
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $385.09
Rate for Payer: Multiplan Commercial $463.20
Rate for Payer: Preferred Network Access Commercial $550.05
Rate for Payer: Quartz Beloit One Network $254.76
Rate for Payer: Quartz Commercial $330.03
Rate for Payer: The Alliance Commercial $289.50
Rate for Payer: United Healthcare Medicaid $131.53
Rate for Payer: WEA Trust Commercial $318.45
Rate for Payer: WPS Commercial $428.87
Service Code CPT 11403
Hospital Charge Code 3013538
Hospital Revenue Code 510
Min. Negotiated Rate $151.50
Max. Negotiated Rate $726.75
Rate for Payer: Aetna Commercial $726.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $657.90
Rate for Payer: Cash Price $229.50
Rate for Payer: Cash Price $229.50
Rate for Payer: Cigna Commercial $726.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $151.50
Rate for Payer: Dean Health DHI/DHP/ASO $459.00
Rate for Payer: Health EOS Commercial $696.15
Rate for Payer: HFN Commercial $726.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $492.54
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $492.54
Rate for Payer: Multiplan Commercial $612.00
Rate for Payer: Preferred Network Access Commercial $726.75
Rate for Payer: Quartz Beloit One Network $336.60
Rate for Payer: Quartz Commercial $436.05
Rate for Payer: The Alliance Commercial $382.50
Rate for Payer: United Healthcare Medicaid $151.50
Rate for Payer: WEA Trust Commercial $420.75
Rate for Payer: WPS Commercial $566.64
Service Code CPT 11404
Hospital Charge Code 3013539
Hospital Revenue Code 510
Min. Negotiated Rate $172.45
Max. Negotiated Rate $644.10
Rate for Payer: Aetna Commercial $644.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $583.08
Rate for Payer: Cash Price $203.40
Rate for Payer: Cash Price $203.40
Rate for Payer: Cigna Commercial $644.10
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $172.45
Rate for Payer: Dean Health DHI/DHP/ASO $406.80
Rate for Payer: Health EOS Commercial $616.98
Rate for Payer: HFN Commercial $644.10
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $540.30
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $540.30
Rate for Payer: Multiplan Commercial $542.40
Rate for Payer: Preferred Network Access Commercial $644.10
Rate for Payer: Quartz Beloit One Network $298.32
Rate for Payer: Quartz Commercial $386.46
Rate for Payer: The Alliance Commercial $339.00
Rate for Payer: United Healthcare Medicaid $172.45
Rate for Payer: WEA Trust Commercial $372.90
Rate for Payer: WPS Commercial $502.19
Service Code CPT 11406
Hospital Charge Code 3013540
Hospital Revenue Code 510
Min. Negotiated Rate $373.61
Max. Negotiated Rate $1,179.90
Rate for Payer: Aetna Commercial $1,179.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,068.12
Rate for Payer: Cash Price $372.60
Rate for Payer: Cash Price $372.60
Rate for Payer: Cigna Commercial $1,179.90
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $373.61
Rate for Payer: Dean Health DHI/DHP/ASO $745.20
Rate for Payer: Health EOS Commercial $1,130.22
Rate for Payer: HFN Commercial $1,179.90
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $813.49
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $813.49
Rate for Payer: Multiplan Commercial $993.60
Rate for Payer: Preferred Network Access Commercial $1,179.90
Rate for Payer: Quartz Beloit One Network $546.48
Rate for Payer: Quartz Commercial $707.94
Rate for Payer: The Alliance Commercial $621.00
Rate for Payer: United Healthcare Medicaid $373.61
Rate for Payer: WEA Trust Commercial $683.10
Rate for Payer: WPS Commercial $919.95
Service Code CPT 21048
Hospital Revenue Code 360
Min. Negotiated Rate $4,240.00
Max. Negotiated Rate $23,153.12
Rate for Payer: Aetna Managed Medicare $5,788.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,238.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $10,914.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,367.00
Rate for Payer: Anthem Medicare Advantage $5,788.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $5,788.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $5,788.28
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $5,788.28
Rate for Payer: Dean Health DHI/DHP/ASO $8,339.76
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $5,788.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $21,532.40
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $5,788.28
Rate for Payer: Independent Care Health Plan Medicare $5,788.28
Rate for Payer: Managed Health Services Medicare Advantage $5,788.28
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $5,788.28
Rate for Payer: NAPHCARE Commercial $8,682.42
Rate for Payer: Quartz Medicare Advantage $5,788.28
Rate for Payer: The Alliance Commercial $23,153.12
Rate for Payer: United Healthcare Medicare Advantage $5,788.28
Rate for Payer: United Healthcare PPO $4,240.00
Rate for Payer: Wellcare Medicare $5,788.28
Service Code CPT 19120
Hospital Revenue Code 360
Min. Negotiated Rate $3,767.55
Max. Negotiated Rate $15,070.20
Rate for Payer: Aetna Managed Medicare $3,767.55
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 $3,767.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,767.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,767.55
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,767.55
Rate for Payer: Dean Health DHI/DHP/ASO $6,546.14
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,767.55
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $14,015.29
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,767.55
Rate for Payer: Independent Care Health Plan Medicare $3,767.55
Rate for Payer: Managed Health Services Medicare Advantage $3,767.55
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,767.55
Rate for Payer: NAPHCARE Commercial $5,651.32
Rate for Payer: Quartz Medicare Advantage $3,767.55
Rate for Payer: The Alliance Commercial $15,070.20
Rate for Payer: United Healthcare Medicare Advantage $3,767.55
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: Wellcare Medicare $3,767.55
Service Code CPT 28043
Hospital Charge Code 3014185
Hospital Revenue Code 510
Min. Negotiated Rate $78.52
Max. Negotiated Rate $962.35
Rate for Payer: Aetna Commercial $962.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $871.18
Rate for Payer: Cash Price $303.90
Rate for Payer: Cash Price $303.90
Rate for Payer: Cigna Commercial $962.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $78.52
Rate for Payer: Dean Health DHI/DHP/ASO $607.80
Rate for Payer: Health EOS Commercial $921.83
Rate for Payer: HFN Commercial $962.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $878.72
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $878.72
Rate for Payer: Multiplan Commercial $810.40
Rate for Payer: Preferred Network Access Commercial $962.35
Rate for Payer: Quartz Beloit One Network $445.72
Rate for Payer: Quartz Commercial $577.41
Rate for Payer: The Alliance Commercial $506.50
Rate for Payer: United Healthcare Medicaid $78.52
Rate for Payer: WEA Trust Commercial $557.15
Rate for Payer: WPS Commercial $750.33
Service Code CPT 28045
Hospital Charge Code 3014186
Hospital Revenue Code 510
Min. Negotiated Rate $204.12
Max. Negotiated Rate $2,024.45
Rate for Payer: Aetna Commercial $2,024.45
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,832.66
Rate for Payer: Cash Price $639.30
Rate for Payer: Cash Price $639.30
Rate for Payer: Cigna Commercial $2,024.45
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $204.12
Rate for Payer: Dean Health DHI/DHP/ASO $1,278.60
Rate for Payer: Health EOS Commercial $1,939.21
Rate for Payer: HFN Commercial $2,024.45
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,171.40
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,171.40
Rate for Payer: Multiplan Commercial $1,704.80
Rate for Payer: Preferred Network Access Commercial $2,024.45
Rate for Payer: Quartz Beloit One Network $937.64
Rate for Payer: Quartz Commercial $1,214.67
Rate for Payer: The Alliance Commercial $1,065.50
Rate for Payer: United Healthcare Medicaid $204.12
Rate for Payer: WEA Trust Commercial $1,172.05
Rate for Payer: WPS Commercial $1,578.43
Service Code CPT 25111
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
Service Code CPT 25112
Hospital Revenue Code 360
Min. Negotiated Rate $1,588.57
Max. Negotiated Rate $7,795.33
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 $7,795.33
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
Service Code CPT 55040
Hospital Revenue Code 360
Min. Negotiated Rate $3,419.56
Max. Negotiated Rate $13,678.24
Rate for Payer: Aetna Managed Medicare $3,419.56
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 $3,419.56
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,419.56
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,419.56
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,419.56
Rate for Payer: Dean Health DHI/DHP/ASO $6,546.14
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,419.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $12,720.76
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,419.56
Rate for Payer: Independent Care Health Plan Medicare $3,419.56
Rate for Payer: Managed Health Services Medicare Advantage $3,419.56
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,419.56
Rate for Payer: NAPHCARE Commercial $5,129.34
Rate for Payer: Quartz Medicare Advantage $3,419.56
Rate for Payer: The Alliance Commercial $13,678.24
Rate for Payer: United Healthcare Medicare Advantage $3,419.56
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: Wellcare Medicare $3,419.56
Service Code CPT 35903
Hospital Revenue Code 360
Min. Negotiated Rate $3,150.53
Max. Negotiated Rate $12,602.12
Rate for Payer: Aetna Managed Medicare $3,150.53
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 $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,150.53
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,150.53
Rate for Payer: Dean Health DHI/DHP/ASO $11,874.87
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,150.53
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,719.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,150.53
Rate for Payer: Independent Care Health Plan Medicare $3,150.53
Rate for Payer: Managed Health Services Medicare Advantage $3,150.53
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,150.53
Rate for Payer: NAPHCARE Commercial $4,725.80
Rate for Payer: Quartz Medicare Advantage $3,150.53
Rate for Payer: The Alliance Commercial $12,602.12
Rate for Payer: United Healthcare Medicare Advantage $3,150.53
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: Wellcare Medicare $3,150.53
Service Code CPT 67840
Hospital Charge Code 1188900
Hospital Revenue Code 510
Min. Negotiated Rate $77.21
Max. Negotiated Rate $918.65
Rate for Payer: Aetna Commercial $918.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $831.62
Rate for Payer: Cash Price $290.10
Rate for Payer: Cash Price $290.10
Rate for Payer: Cigna Commercial $918.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $77.21
Rate for Payer: Dean Health DHI/DHP/ASO $580.20
Rate for Payer: Health EOS Commercial $879.97
Rate for Payer: HFN Commercial $918.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $527.81
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $527.81
Rate for Payer: Multiplan Commercial $773.60
Rate for Payer: Preferred Network Access Commercial $918.65
Rate for Payer: Quartz Beloit One Network $425.48
Rate for Payer: Quartz Commercial $551.19
Rate for Payer: The Alliance Commercial $483.50
Rate for Payer: United Healthcare Medicaid $77.21
Rate for Payer: WEA Trust Commercial $531.85
Rate for Payer: WPS Commercial $716.26
Service Code CPT 67840 50
Hospital Charge Code 4628615
Hospital Revenue Code 510
Min. Negotiated Rate $850.96
Max. Negotiated Rate $1,837.30
Rate for Payer: Aetna Commercial $1,837.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,663.24
Rate for Payer: Cash Price $580.20
Rate for Payer: Cash Price $580.20
Rate for Payer: Cigna Commercial $1,837.30
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $967.00
Rate for Payer: Dean Health DHI/DHP/ASO $1,160.40
Rate for Payer: Health EOS Commercial $1,759.94
Rate for Payer: HFN Commercial $1,837.30
Rate for Payer: Multiplan Commercial $1,547.20
Rate for Payer: Preferred Network Access Commercial $1,837.30
Rate for Payer: Quartz Beloit One Network $850.96
Rate for Payer: Quartz Commercial $1,102.38
Rate for Payer: The Alliance Commercial $967.00
Rate for Payer: WEA Trust Commercial $1,063.70
Rate for Payer: WPS Commercial $1,432.51
Service Code CPT 67961
Hospital Charge Code 1188901
Hospital Revenue Code 510
Min. Negotiated Rate $748.19
Max. Negotiated Rate $3,090.35
Rate for Payer: Aetna Commercial $3,090.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,797.58
Rate for Payer: Cash Price $975.90
Rate for Payer: Cash Price $975.90
Rate for Payer: Cigna Commercial $3,090.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $748.19
Rate for Payer: Dean Health DHI/DHP/ASO $1,951.80
Rate for Payer: Health EOS Commercial $2,960.23
Rate for Payer: HFN Commercial $3,090.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,524.08
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,524.08
Rate for Payer: Multiplan Commercial $2,602.40
Rate for Payer: Preferred Network Access Commercial $3,090.35
Rate for Payer: Quartz Beloit One Network $1,431.32
Rate for Payer: Quartz Commercial $1,854.21
Rate for Payer: The Alliance Commercial $1,626.50
Rate for Payer: United Healthcare Medicaid $748.19
Rate for Payer: WEA Trust Commercial $1,789.15
Rate for Payer: WPS Commercial $2,409.50
Service Code CPT 40812
Hospital Revenue Code 360
Min. Negotiated Rate $1,507.37
Max. Negotiated Rate $6,029.48
Rate for Payer: Aetna Managed Medicare $1,507.37
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 $1,507.37
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,507.37
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,507.37
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,507.37
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,507.37
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,607.42
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,507.37
Rate for Payer: Independent Care Health Plan Medicare $1,507.37
Rate for Payer: Managed Health Services Medicare Advantage $1,507.37
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,507.37
Rate for Payer: NAPHCARE Commercial $2,261.06
Rate for Payer: Quartz Medicare Advantage $1,507.37
Rate for Payer: The Alliance Commercial $6,029.48
Rate for Payer: United Healthcare Medicare Advantage $1,507.37
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $1,507.37
Service Code CPT 27630
Hospital Revenue Code 360
Min. Negotiated Rate $3,199.31
Max. Negotiated Rate $12,797.24
Rate for Payer: Aetna Managed Medicare $3,199.31
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 $3,199.31
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,199.31
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,199.31
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,199.31
Rate for Payer: Dean Health DHI/DHP/ASO $6,546.14
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,199.31
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,901.43
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,199.31
Rate for Payer: Independent Care Health Plan Medicare $3,199.31
Rate for Payer: Managed Health Services Medicare Advantage $3,199.31
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,199.31
Rate for Payer: NAPHCARE Commercial $4,798.96
Rate for Payer: Quartz Medicare Advantage $3,199.31
Rate for Payer: The Alliance Commercial $12,797.24
Rate for Payer: United Healthcare Medicare Advantage $3,199.31
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: Wellcare Medicare $3,199.31
Service Code CPT 26160
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
Service Code CPT 41112
Hospital Charge Code 1190857
Hospital Revenue Code 510
Min. Negotiated Rate $139.23
Max. Negotiated Rate $820.87
Rate for Payer: Aetna Commercial $614.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $556.42
Rate for Payer: Cash Price $194.10
Rate for Payer: Cash Price $194.10
Rate for Payer: Cigna Commercial $614.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $139.23
Rate for Payer: Dean Health DHI/DHP/ASO $388.20
Rate for Payer: Health EOS Commercial $588.77
Rate for Payer: HFN Commercial $614.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $820.87
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $820.87
Rate for Payer: Multiplan Commercial $517.60
Rate for Payer: Preferred Network Access Commercial $614.65
Rate for Payer: Quartz Beloit One Network $284.68
Rate for Payer: Quartz Commercial $368.79
Rate for Payer: The Alliance Commercial $323.50
Rate for Payer: United Healthcare Medicaid $139.23
Rate for Payer: WEA Trust Commercial $355.85
Rate for Payer: WPS Commercial $479.23
Service Code CPT 41112
Hospital Revenue Code 360
Min. Negotiated Rate $2,726.00
Max. Negotiated Rate $12,729.16
Rate for Payer: Aetna Managed Medicare $3,182.29
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 $3,182.29
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,182.29
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,182.29
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,182.29
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,182.29
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,838.12
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,182.29
Rate for Payer: Independent Care Health Plan Medicare $3,182.29
Rate for Payer: Managed Health Services Medicare Advantage $3,182.29
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,182.29
Rate for Payer: NAPHCARE Commercial $4,773.44
Rate for Payer: Quartz Medicare Advantage $3,182.29
Rate for Payer: The Alliance Commercial $12,729.16
Rate for Payer: United Healthcare Medicare Advantage $3,182.29
Rate for Payer: United Healthcare PPO $3,583.00
Rate for Payer: Wellcare Medicare $3,182.29
Service Code CPT 41010
Hospital Charge Code 1190859
Hospital Revenue Code 510
Min. Negotiated Rate $95.26
Max. Negotiated Rate $482.60
Rate for Payer: Aetna Commercial $482.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $436.88
Rate for Payer: Cash Price $152.40
Rate for Payer: Cash Price $152.40
Rate for Payer: Cigna Commercial $482.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $95.26
Rate for Payer: Dean Health DHI/DHP/ASO $304.80
Rate for Payer: Health EOS Commercial $462.28
Rate for Payer: HFN Commercial $482.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $366.13
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $366.13
Rate for Payer: Multiplan Commercial $406.40
Rate for Payer: Preferred Network Access Commercial $482.60
Rate for Payer: Quartz Beloit One Network $223.52
Rate for Payer: Quartz Commercial $289.56
Rate for Payer: The Alliance Commercial $254.00
Rate for Payer: United Healthcare Medicaid $95.26
Rate for Payer: WEA Trust Commercial $279.40
Rate for Payer: WPS Commercial $376.28