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Service Code CPT 93924 26
Hospital Charge Code 3015432
Hospital Revenue Code 510
Min. Negotiated Rate $73.04
Max. Negotiated Rate $157.70
Rate for Payer: Aetna Commercial $157.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $142.76
Rate for Payer: Cash Price $49.80
Rate for Payer: Cash Price $49.80
Rate for Payer: Cigna Commercial $157.70
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $83.00
Rate for Payer: Dean Health DHI/DHP/ASO $99.60
Rate for Payer: Health EOS Commercial $151.06
Rate for Payer: HFN Commercial $157.70
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $80.80
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $80.80
Rate for Payer: Multiplan Commercial $132.80
Rate for Payer: Preferred Network Access Commercial $157.70
Rate for Payer: Quartz Beloit One Network $73.04
Rate for Payer: Quartz Commercial $94.62
Rate for Payer: The Alliance Commercial $83.00
Rate for Payer: WEA Trust Commercial $91.30
Rate for Payer: WPS Commercial $122.96
Service Code CPT 93970 26
Hospital Charge Code 3015442
Hospital Revenue Code 510
Min. Negotiated Rate $113.56
Max. Negotiated Rate $1,019.35
Rate for Payer: Aetna Commercial $1,019.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $922.78
Rate for Payer: Cash Price $321.90
Rate for Payer: Cash Price $321.90
Rate for Payer: Cigna Commercial $1,019.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $536.50
Rate for Payer: Dean Health DHI/DHP/ASO $643.80
Rate for Payer: Health EOS Commercial $976.43
Rate for Payer: HFN Commercial $1,019.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $113.56
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $113.56
Rate for Payer: Multiplan Commercial $858.40
Rate for Payer: Preferred Network Access Commercial $1,019.35
Rate for Payer: Quartz Beloit One Network $472.12
Rate for Payer: Quartz Commercial $611.61
Rate for Payer: The Alliance Commercial $536.50
Rate for Payer: WEA Trust Commercial $590.15
Rate for Payer: WPS Commercial $794.77
Service Code CPT 93923 26
Hospital Charge Code 3015431
Hospital Revenue Code 510
Min. Negotiated Rate $49.72
Max. Negotiated Rate $107.35
Rate for Payer: Aetna Commercial $107.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $97.18
Rate for Payer: Cash Price $33.90
Rate for Payer: Cash Price $33.90
Rate for Payer: Cigna Commercial $107.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $56.50
Rate for Payer: Dean Health DHI/DHP/ASO $67.80
Rate for Payer: Health EOS Commercial $102.83
Rate for Payer: HFN Commercial $107.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $72.33
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $72.33
Rate for Payer: Multiplan Commercial $90.40
Rate for Payer: Preferred Network Access Commercial $107.35
Rate for Payer: Quartz Beloit One Network $49.72
Rate for Payer: Quartz Commercial $64.41
Rate for Payer: The Alliance Commercial $56.50
Rate for Payer: WEA Trust Commercial $62.15
Rate for Payer: WPS Commercial $83.70
Service Code CPT 93922 26
Hospital Charge Code 3015430
Hospital Revenue Code 510
Min. Negotiated Rate $41.55
Max. Negotiated Rate $142.50
Rate for Payer: Aetna Commercial $142.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $129.00
Rate for Payer: Cash Price $45.00
Rate for Payer: Cash Price $45.00
Rate for Payer: Cigna Commercial $142.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $75.00
Rate for Payer: Dean Health DHI/DHP/ASO $90.00
Rate for Payer: Health EOS Commercial $136.50
Rate for Payer: HFN Commercial $142.50
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $41.55
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $41.55
Rate for Payer: Multiplan Commercial $120.00
Rate for Payer: Preferred Network Access Commercial $142.50
Rate for Payer: Quartz Beloit One Network $66.00
Rate for Payer: Quartz Commercial $85.50
Rate for Payer: The Alliance Commercial $75.00
Rate for Payer: WEA Trust Commercial $82.50
Rate for Payer: WPS Commercial $111.10
Service Code CPT 93242
Hospital Charge Code 5753623
Hospital Revenue Code 730
Min. Negotiated Rate $49.00
Max. Negotiated Rate $92.00
Rate for Payer: Aetna Commercial $90.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $86.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $53.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $92.00
Rate for Payer: Health EOS Commercial $89.00
Rate for Payer: HFN Commercial $92.00
Rate for Payer: Multiplan Commercial $80.00
Rate for Payer: NAPHCARE Commercial $60.00
Rate for Payer: Preferred Network Access Commercial $92.00
Rate for Payer: Quartz Beloit One Network $49.00
Rate for Payer: Quartz Commercial $60.00
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: WPS Commercial $74.07
Service Code CPT 93242
Hospital Charge Code 5753623
Hospital Revenue Code 730
Min. Negotiated Rate $39.64
Max. Negotiated Rate $158.56
Rate for Payer: Aetna Commercial $90.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $86.00
Rate for Payer: Aetna Managed Medicare $39.64
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $65.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $50.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $48.00
Rate for Payer: Anthem Medicare Advantage $39.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $53.00
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $39.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $39.64
Rate for Payer: Cash Price $30.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $92.00
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $39.64
Rate for Payer: Dean Health DHI/DHP/ASO $55.96
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $39.64
Rate for Payer: Health EOS Commercial $89.00
Rate for Payer: HFN Commercial $92.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $147.46
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $39.64
Rate for Payer: Independent Care Health Plan Medicare $39.64
Rate for Payer: Managed Health Services Medicare Advantage $39.64
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $39.64
Rate for Payer: Multiplan Commercial $80.00
Rate for Payer: NAPHCARE Commercial $59.46
Rate for Payer: Preferred Network Access Commercial $92.00
Rate for Payer: Quartz Beloit One Network $49.00
Rate for Payer: Quartz Commercial $65.00
Rate for Payer: Quartz Medicare Advantage $39.64
Rate for Payer: The Alliance Commercial $158.56
Rate for Payer: United Healthcare Medicare Advantage $39.64
Rate for Payer: United Healthcare PPO $75.00
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: Wellcare Medicare $39.64
Rate for Payer: WPS Commercial $74.07
Service Code CPT 93242
Hospital Charge Code 5753623
Hospital Revenue Code 730
Min. Negotiated Rate $11.39
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 $11.39
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 $50.27
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $50.27
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: United Healthcare Medicaid $11.39
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: WPS Commercial $74.07
Service Code CPT 93246
Hospital Charge Code 5753624
Hospital Revenue Code 730
Min. Negotiated Rate $39.64
Max. Negotiated Rate $158.56
Rate for Payer: Aetna Commercial $90.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $86.00
Rate for Payer: Aetna Managed Medicare $39.64
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $65.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $50.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $48.00
Rate for Payer: Anthem Medicare Advantage $39.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $53.00
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $39.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $39.64
Rate for Payer: Cash Price $30.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $92.00
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $39.64
Rate for Payer: Dean Health DHI/DHP/ASO $55.96
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $39.64
Rate for Payer: Health EOS Commercial $89.00
Rate for Payer: HFN Commercial $92.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $147.46
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $39.64
Rate for Payer: Independent Care Health Plan Medicare $39.64
Rate for Payer: Managed Health Services Medicare Advantage $39.64
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $39.64
Rate for Payer: Multiplan Commercial $80.00
Rate for Payer: NAPHCARE Commercial $59.46
Rate for Payer: Preferred Network Access Commercial $92.00
Rate for Payer: Quartz Beloit One Network $49.00
Rate for Payer: Quartz Commercial $65.00
Rate for Payer: Quartz Medicare Advantage $39.64
Rate for Payer: The Alliance Commercial $158.56
Rate for Payer: United Healthcare Medicare Advantage $39.64
Rate for Payer: United Healthcare PPO $75.00
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: Wellcare Medicare $39.64
Rate for Payer: WPS Commercial $74.07
Service Code CPT 93246
Hospital Charge Code 5753624
Hospital Revenue Code 730
Min. Negotiated Rate $49.00
Max. Negotiated Rate $92.00
Rate for Payer: Aetna Commercial $90.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $86.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $53.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $92.00
Rate for Payer: Health EOS Commercial $89.00
Rate for Payer: HFN Commercial $92.00
Rate for Payer: Multiplan Commercial $80.00
Rate for Payer: NAPHCARE Commercial $60.00
Rate for Payer: Preferred Network Access Commercial $92.00
Rate for Payer: Quartz Beloit One Network $49.00
Rate for Payer: Quartz Commercial $60.00
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: WPS Commercial $74.07
Service Code CPT 93246
Hospital Charge Code 5753624
Hospital Revenue Code 730
Min. Negotiated Rate $11.39
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 $11.39
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 $50.27
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $50.27
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: United Healthcare Medicaid $11.39
Rate for Payer: WEA Trust Commercial $55.00
Rate for Payer: WPS Commercial $74.07
Service Code CPT 87070
Hospital Charge Code 633892
Hospital Revenue Code 300
Min. Negotiated Rate $30.43
Max. Negotiated Rate $213.75
Rate for Payer: Aetna Commercial $213.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $193.50
Rate for Payer: Cash Price $67.50
Rate for Payer: Cash Price $67.50
Rate for Payer: Cigna Commercial $213.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $112.50
Rate for Payer: Dean Health DHI/DHP/ASO $135.00
Rate for Payer: Health EOS Commercial $204.75
Rate for Payer: HFN Commercial $213.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $30.43
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $30.43
Rate for Payer: Multiplan Commercial $180.00
Rate for Payer: Preferred Network Access Commercial $213.75
Rate for Payer: Quartz Beloit One Network $99.00
Rate for Payer: Quartz Commercial $128.25
Rate for Payer: The Alliance Commercial $112.50
Rate for Payer: WEA Trust Commercial $123.75
Rate for Payer: WPS Commercial $166.66
Service Code CPT 87070
Hospital Charge Code 633892
Hospital Revenue Code 300
Min. Negotiated Rate $110.25
Max. Negotiated Rate $207.00
Rate for Payer: Aetna Commercial $202.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $193.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $119.25
Rate for Payer: Cash Price $67.50
Rate for Payer: Cigna Commercial $207.00
Rate for Payer: Health EOS Commercial $200.25
Rate for Payer: HFN Commercial $207.00
Rate for Payer: Multiplan Commercial $180.00
Rate for Payer: NAPHCARE Commercial $135.00
Rate for Payer: Preferred Network Access Commercial $207.00
Rate for Payer: Quartz Beloit One Network $110.25
Rate for Payer: Quartz Commercial $135.00
Rate for Payer: WEA Trust Commercial $123.75
Rate for Payer: WPS Commercial $166.66
Service Code CPT 87070
Hospital Charge Code 633892
Hospital Revenue Code 300
Min. Negotiated Rate $8.62
Max. Negotiated Rate $207.00
Rate for Payer: Aetna Commercial $202.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $193.50
Rate for Payer: Aetna Managed Medicare $8.62
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $32.32
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15.08
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $14.31
Rate for Payer: Anthem Medicaid $8.91
Rate for Payer: Anthem Medicare Advantage $8.62
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $119.25
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $8.62
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $8.62
Rate for Payer: Cash Price $67.50
Rate for Payer: Cash Price $67.50
Rate for Payer: Cigna Commercial $207.00
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $8.62
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $8.91
Rate for Payer: Dean Health DHI/DHP/ASO $125.91
Rate for Payer: Dean Health Medicaid $8.91
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $8.62
Rate for Payer: Health EOS Commercial $200.25
Rate for Payer: HFN Commercial $207.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $32.07
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $8.62
Rate for Payer: Independent Care Health Plan Medicaid $8.91
Rate for Payer: Independent Care Health Plan Medicare $8.62
Rate for Payer: Managed Health Services Medicaid $9.27
Rate for Payer: Managed Health Services Medicare Advantage $8.62
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $8.62
Rate for Payer: Multiplan Commercial $180.00
Rate for Payer: NAPHCARE Commercial $12.93
Rate for Payer: Preferred Network Access Commercial $207.00
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $8.91
Rate for Payer: Quartz Beloit One Network $110.25
Rate for Payer: Quartz Commercial $146.25
Rate for Payer: Quartz Medicare Advantage $8.62
Rate for Payer: The Alliance Commercial $34.48
Rate for Payer: United Healthcare Medicaid $8.91
Rate for Payer: United Healthcare Medicare Advantage $8.62
Rate for Payer: United Healthcare PPO $168.75
Rate for Payer: WEA Trust Commercial $123.75
Rate for Payer: Wellcare Medicare $8.62
Rate for Payer: WMAP Medicaid $8.91
Rate for Payer: WPS Commercial $166.66
Hospital Charge Code 2960359
Hospital Revenue Code 360
Min. Negotiated Rate $1,928.15
Max. Negotiated Rate $3,620.20
Rate for Payer: Aetna Commercial $3,541.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,384.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,085.55
Rate for Payer: Cash Price $1,180.50
Rate for Payer: Cigna Commercial $3,620.20
Rate for Payer: Health EOS Commercial $3,502.15
Rate for Payer: HFN Commercial $3,620.20
Rate for Payer: Multiplan Commercial $3,148.00
Rate for Payer: NAPHCARE Commercial $2,361.00
Rate for Payer: Preferred Network Access Commercial $3,620.20
Rate for Payer: Quartz Beloit One Network $1,928.15
Rate for Payer: Quartz Commercial $2,361.00
Rate for Payer: WEA Trust Commercial $2,164.25
Rate for Payer: WPS Commercial $2,914.65
Hospital Charge Code 2960359
Hospital Revenue Code 360
Min. Negotiated Rate $1,101.80
Max. Negotiated Rate $15,740.00
Rate for Payer: Aetna Commercial $3,541.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,384.10
Rate for Payer: Aetna Managed Medicare $1,101.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,557.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,967.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,888.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,085.55
Rate for Payer: Cash Price $1,180.50
Rate for Payer: Cigna Commercial $3,620.20
Rate for Payer: Dean Health DHI/DHP/ASO $2,202.03
Rate for Payer: Health EOS Commercial $3,502.15
Rate for Payer: HFN Commercial $3,620.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,951.25
Rate for Payer: Multiplan Commercial $3,148.00
Rate for Payer: NAPHCARE Commercial $2,361.00
Rate for Payer: Preferred Network Access Commercial $3,620.20
Rate for Payer: Quartz Beloit One Network $1,928.15
Rate for Payer: Quartz Commercial $2,557.75
Rate for Payer: Quartz Medicare Advantage $2,361.00
Rate for Payer: The Alliance Commercial $15,740.00
Rate for Payer: WEA Trust Commercial $2,164.25
Rate for Payer: WPS Commercial $2,914.65
Service Code CPT 92014
Hospital Charge Code 5551272
Hospital Revenue Code 510
Min. Negotiated Rate $44.54
Max. Negotiated Rate $264.93
Rate for Payer: Aetna Commercial $179.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $162.54
Rate for Payer: Cash Price $56.70
Rate for Payer: Cash Price $56.70
Rate for Payer: Cigna Commercial $179.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $44.54
Rate for Payer: Dean Health DHI/DHP/ASO $113.40
Rate for Payer: Health EOS Commercial $171.99
Rate for Payer: HFN Commercial $179.55
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $264.93
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $264.93
Rate for Payer: Multiplan Commercial $151.20
Rate for Payer: Preferred Network Access Commercial $179.55
Rate for Payer: Quartz Beloit One Network $83.16
Rate for Payer: Quartz Commercial $107.73
Rate for Payer: The Alliance Commercial $94.50
Rate for Payer: United Healthcare Medicaid $44.54
Rate for Payer: WEA Trust Commercial $103.95
Rate for Payer: WPS Commercial $139.99
Service Code CPT 92235 26
Hospital Charge Code 3190204
Hospital Revenue Code 510
Min. Negotiated Rate $146.11
Max. Negotiated Rate $512.05
Rate for Payer: Aetna Commercial $512.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $463.54
Rate for Payer: Cash Price $161.70
Rate for Payer: Cash Price $161.70
Rate for Payer: Cigna Commercial $512.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $269.50
Rate for Payer: Dean Health DHI/DHP/ASO $323.40
Rate for Payer: Health EOS Commercial $490.49
Rate for Payer: HFN Commercial $512.05
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $146.11
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $146.11
Rate for Payer: Multiplan Commercial $431.20
Rate for Payer: Preferred Network Access Commercial $512.05
Rate for Payer: Quartz Beloit One Network $237.16
Rate for Payer: Quartz Commercial $307.23
Rate for Payer: The Alliance Commercial $269.50
Rate for Payer: WEA Trust Commercial $296.45
Rate for Payer: WPS Commercial $399.24
Service Code CPT 92250 26
Hospital Charge Code 3165648
Hospital Revenue Code 510
Min. Negotiated Rate $71.72
Max. Negotiated Rate $154.85
Rate for Payer: Aetna Commercial $154.85
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $140.18
Rate for Payer: Cash Price $48.90
Rate for Payer: Cash Price $48.90
Rate for Payer: Cigna Commercial $154.85
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $81.50
Rate for Payer: Dean Health DHI/DHP/ASO $97.80
Rate for Payer: Health EOS Commercial $148.33
Rate for Payer: HFN Commercial $154.85
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $72.82
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $72.82
Rate for Payer: Multiplan Commercial $130.40
Rate for Payer: Preferred Network Access Commercial $154.85
Rate for Payer: Quartz Beloit One Network $71.72
Rate for Payer: Quartz Commercial $92.91
Rate for Payer: The Alliance Commercial $81.50
Rate for Payer: WEA Trust Commercial $89.65
Rate for Payer: WPS Commercial $120.73
Hospital Charge Code 2960042
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 2960042
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 67820
Hospital Charge Code 1188898
Hospital Revenue Code 510
Min. Negotiated Rate $24.10
Max. Negotiated Rate $269.80
Rate for Payer: Aetna Commercial $269.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $244.24
Rate for Payer: Cash Price $85.20
Rate for Payer: Cash Price $85.20
Rate for Payer: Cigna Commercial $269.80
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $24.10
Rate for Payer: Dean Health DHI/DHP/ASO $170.40
Rate for Payer: Health EOS Commercial $258.44
Rate for Payer: HFN Commercial $269.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $76.11
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $76.11
Rate for Payer: Multiplan Commercial $227.20
Rate for Payer: Preferred Network Access Commercial $269.80
Rate for Payer: Quartz Beloit One Network $124.96
Rate for Payer: Quartz Commercial $161.88
Rate for Payer: The Alliance Commercial $142.00
Rate for Payer: United Healthcare Medicaid $24.10
Rate for Payer: WEA Trust Commercial $156.20
Rate for Payer: WPS Commercial $210.36
Service Code CPT 67825
Hospital Charge Code 1188899
Hospital Revenue Code 510
Min. Negotiated Rate $60.27
Max. Negotiated Rate $499.70
Rate for Payer: Aetna Commercial $499.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $452.36
Rate for Payer: Cash Price $157.80
Rate for Payer: Cash Price $157.80
Rate for Payer: Cigna Commercial $499.70
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $60.27
Rate for Payer: Dean Health DHI/DHP/ASO $315.60
Rate for Payer: Health EOS Commercial $478.66
Rate for Payer: HFN Commercial $499.70
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $408.74
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $408.74
Rate for Payer: Multiplan Commercial $420.80
Rate for Payer: Preferred Network Access Commercial $499.70
Rate for Payer: Quartz Beloit One Network $231.44
Rate for Payer: Quartz Commercial $299.82
Rate for Payer: The Alliance Commercial $263.00
Rate for Payer: United Healthcare Medicaid $60.27
Rate for Payer: WEA Trust Commercial $289.30
Rate for Payer: WPS Commercial $389.61
Service Code CPT 67820
Hospital Charge Code 5673626
Hospital Revenue Code 510
Min. Negotiated Rate $24.10
Max. Negotiated Rate $538.65
Rate for Payer: Aetna Commercial $538.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $487.62
Rate for Payer: Cash Price $170.10
Rate for Payer: Cash Price $170.10
Rate for Payer: Cigna Commercial $538.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $24.10
Rate for Payer: Dean Health DHI/DHP/ASO $340.20
Rate for Payer: Health EOS Commercial $515.97
Rate for Payer: HFN Commercial $538.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $76.11
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $76.11
Rate for Payer: Multiplan Commercial $453.60
Rate for Payer: Preferred Network Access Commercial $538.65
Rate for Payer: Quartz Beloit One Network $249.48
Rate for Payer: Quartz Commercial $323.19
Rate for Payer: The Alliance Commercial $283.50
Rate for Payer: United Healthcare Medicaid $24.10
Rate for Payer: WEA Trust Commercial $311.85
Rate for Payer: WPS Commercial $419.98
Service Code CPT 67805
Hospital Charge Code 1188897
Hospital Revenue Code 510
Min. Negotiated Rate $89.78
Max. Negotiated Rate $748.60
Rate for Payer: Aetna Commercial $748.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $677.68
Rate for Payer: Cash Price $236.40
Rate for Payer: Cash Price $236.40
Rate for Payer: Cigna Commercial $748.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $89.78
Rate for Payer: Dean Health DHI/DHP/ASO $472.80
Rate for Payer: Health EOS Commercial $717.08
Rate for Payer: HFN Commercial $748.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $549.20
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $549.20
Rate for Payer: Multiplan Commercial $630.40
Rate for Payer: Preferred Network Access Commercial $748.60
Rate for Payer: Quartz Beloit One Network $346.72
Rate for Payer: Quartz Commercial $449.16
Rate for Payer: The Alliance Commercial $394.00
Rate for Payer: United Healthcare Medicaid $89.78
Rate for Payer: WEA Trust Commercial $433.40
Rate for Payer: WPS Commercial $583.67
Service Code CPT 67801
Hospital Charge Code 1188896
Hospital Revenue Code 510
Min. Negotiated Rate $82.25
Max. Negotiated Rate $831.25
Rate for Payer: Aetna Commercial $831.25
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $752.50
Rate for Payer: Cash Price $262.50
Rate for Payer: Cash Price $262.50
Rate for Payer: Cigna Commercial $831.25
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $82.25
Rate for Payer: Dean Health DHI/DHP/ASO $525.00
Rate for Payer: Health EOS Commercial $796.25
Rate for Payer: HFN Commercial $831.25
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $443.79
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $443.79
Rate for Payer: Multiplan Commercial $700.00
Rate for Payer: Preferred Network Access Commercial $831.25
Rate for Payer: Quartz Beloit One Network $385.00
Rate for Payer: Quartz Commercial $498.75
Rate for Payer: The Alliance Commercial $437.50
Rate for Payer: United Healthcare Medicaid $82.25
Rate for Payer: WEA Trust Commercial $481.25
Rate for Payer: WPS Commercial $648.11