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Charge Type Setting Price  
Hospital Charge Code 2967469
Hospital Revenue Code 278
Min. Negotiated Rate $5,585.02
Max. Negotiated Rate $10,486.16
Rate for Payer: Aetna Commercial $10,258.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,802.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,040.94
Rate for Payer: Cash Price $3,419.40
Rate for Payer: Cigna Commercial $10,486.16
Rate for Payer: Health EOS Commercial $10,144.22
Rate for Payer: HFN Commercial $10,486.16
Rate for Payer: Multiplan Commercial $9,118.40
Rate for Payer: NAPHCARE Commercial $6,838.80
Rate for Payer: Preferred Network Access Commercial $10,486.16
Rate for Payer: Quartz Beloit One Network $5,585.02
Rate for Payer: Quartz Commercial $6,838.80
Rate for Payer: WEA Trust Commercial $6,268.90
Rate for Payer: WPS Commercial $8,442.50
Hospital Charge Code 2966011
Hospital Revenue Code 278
Min. Negotiated Rate $16,742.32
Max. Negotiated Rate $31,434.56
Rate for Payer: Aetna Commercial $30,751.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $29,384.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $18,109.04
Rate for Payer: Cash Price $10,250.40
Rate for Payer: Cigna Commercial $31,434.56
Rate for Payer: Health EOS Commercial $30,409.52
Rate for Payer: HFN Commercial $31,434.56
Rate for Payer: Multiplan Commercial $27,334.40
Rate for Payer: NAPHCARE Commercial $20,500.80
Rate for Payer: Preferred Network Access Commercial $31,434.56
Rate for Payer: Quartz Beloit One Network $16,742.32
Rate for Payer: Quartz Commercial $20,500.80
Rate for Payer: WEA Trust Commercial $18,792.40
Rate for Payer: WPS Commercial $25,308.24
Hospital Charge Code 2966011
Hospital Revenue Code 278
Min. Negotiated Rate $9,567.04
Max. Negotiated Rate $136,672.00
Rate for Payer: Aetna Commercial $30,751.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $29,384.48
Rate for Payer: Aetna Managed Medicare $9,567.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $22,209.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $17,084.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $16,400.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $18,109.04
Rate for Payer: Cash Price $10,250.40
Rate for Payer: Cigna Commercial $31,434.56
Rate for Payer: Dean Health DHI/DHP/ASO $19,120.41
Rate for Payer: Health EOS Commercial $30,409.52
Rate for Payer: HFN Commercial $31,434.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $25,626.00
Rate for Payer: Multiplan Commercial $27,334.40
Rate for Payer: NAPHCARE Commercial $20,500.80
Rate for Payer: Preferred Network Access Commercial $31,434.56
Rate for Payer: Quartz Beloit One Network $16,742.32
Rate for Payer: Quartz Commercial $22,209.20
Rate for Payer: Quartz Medicare Advantage $20,500.80
Rate for Payer: The Alliance Commercial $136,672.00
Rate for Payer: WEA Trust Commercial $18,792.40
Rate for Payer: WPS Commercial $25,308.24
Hospital Charge Code 2964728
Hospital Revenue Code 278
Min. Negotiated Rate $3,416.56
Max. Negotiated Rate $48,808.00
Rate for Payer: Aetna Commercial $10,981.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,493.72
Rate for Payer: Aetna Managed Medicare $3,416.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,931.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $6,101.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,856.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,467.06
Rate for Payer: Cash Price $3,660.60
Rate for Payer: Cigna Commercial $11,225.84
Rate for Payer: Dean Health DHI/DHP/ASO $6,828.24
Rate for Payer: Health EOS Commercial $10,859.78
Rate for Payer: HFN Commercial $11,225.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $9,151.50
Rate for Payer: Multiplan Commercial $9,761.60
Rate for Payer: NAPHCARE Commercial $7,321.20
Rate for Payer: Preferred Network Access Commercial $11,225.84
Rate for Payer: Quartz Beloit One Network $5,978.98
Rate for Payer: Quartz Commercial $7,931.30
Rate for Payer: Quartz Medicare Advantage $7,321.20
Rate for Payer: The Alliance Commercial $48,808.00
Rate for Payer: WEA Trust Commercial $6,711.10
Rate for Payer: WPS Commercial $9,038.02
Hospital Charge Code 2964728
Hospital Revenue Code 278
Min. Negotiated Rate $5,978.98
Max. Negotiated Rate $11,225.84
Rate for Payer: Aetna Commercial $10,981.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,493.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,467.06
Rate for Payer: Cash Price $3,660.60
Rate for Payer: Cigna Commercial $11,225.84
Rate for Payer: Health EOS Commercial $10,859.78
Rate for Payer: HFN Commercial $11,225.84
Rate for Payer: Multiplan Commercial $9,761.60
Rate for Payer: NAPHCARE Commercial $7,321.20
Rate for Payer: Preferred Network Access Commercial $11,225.84
Rate for Payer: Quartz Beloit One Network $5,978.98
Rate for Payer: Quartz Commercial $7,321.20
Rate for Payer: WEA Trust Commercial $6,711.10
Rate for Payer: WPS Commercial $9,038.02
Service Code HCPCS C1776
Hospital Charge Code 5659634
Hospital Revenue Code 278
Min. Negotiated Rate $4,216.94
Max. Negotiated Rate $7,917.52
Rate for Payer: Aetna Commercial $7,745.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,401.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,561.18
Rate for Payer: Cash Price $2,581.80
Rate for Payer: Cigna Commercial $7,917.52
Rate for Payer: Health EOS Commercial $7,659.34
Rate for Payer: HFN Commercial $7,917.52
Rate for Payer: Multiplan Commercial $6,884.80
Rate for Payer: NAPHCARE Commercial $5,163.60
Rate for Payer: Preferred Network Access Commercial $7,917.52
Rate for Payer: Quartz Beloit One Network $4,216.94
Rate for Payer: Quartz Commercial $5,163.60
Rate for Payer: WEA Trust Commercial $4,733.30
Rate for Payer: WPS Commercial $6,374.46
Service Code HCPCS C1776
Hospital Charge Code 5659634
Hospital Revenue Code 278
Min. Negotiated Rate $2,409.68
Max. Negotiated Rate $34,424.00
Rate for Payer: Aetna Commercial $7,745.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,401.16
Rate for Payer: Aetna Managed Medicare $2,409.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,593.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,303.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,130.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,561.18
Rate for Payer: Cash Price $2,581.80
Rate for Payer: Cigna Commercial $7,917.52
Rate for Payer: Dean Health DHI/DHP/ASO $4,815.92
Rate for Payer: Health EOS Commercial $7,659.34
Rate for Payer: HFN Commercial $7,917.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,454.50
Rate for Payer: Multiplan Commercial $6,884.80
Rate for Payer: NAPHCARE Commercial $5,163.60
Rate for Payer: Preferred Network Access Commercial $7,917.52
Rate for Payer: Quartz Beloit One Network $4,216.94
Rate for Payer: Quartz Commercial $5,593.90
Rate for Payer: Quartz Medicare Advantage $5,163.60
Rate for Payer: The Alliance Commercial $34,424.00
Rate for Payer: WEA Trust Commercial $4,733.30
Rate for Payer: WPS Commercial $6,374.46
Hospital Charge Code 3259461
Hospital Revenue Code 278
Min. Negotiated Rate $5,207.44
Max. Negotiated Rate $74,392.00
Rate for Payer: Aetna Commercial $16,738.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $15,994.28
Rate for Payer: Aetna Managed Medicare $5,207.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,088.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $9,299.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $8,927.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $9,856.94
Rate for Payer: Cash Price $5,579.40
Rate for Payer: Cigna Commercial $17,110.16
Rate for Payer: Dean Health DHI/DHP/ASO $10,407.44
Rate for Payer: Health EOS Commercial $16,552.22
Rate for Payer: HFN Commercial $17,110.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $13,948.50
Rate for Payer: Multiplan Commercial $14,878.40
Rate for Payer: NAPHCARE Commercial $11,158.80
Rate for Payer: Preferred Network Access Commercial $17,110.16
Rate for Payer: Quartz Beloit One Network $9,113.02
Rate for Payer: Quartz Commercial $12,088.70
Rate for Payer: Quartz Medicare Advantage $11,158.80
Rate for Payer: The Alliance Commercial $74,392.00
Rate for Payer: WEA Trust Commercial $10,228.90
Rate for Payer: WPS Commercial $13,775.54
Hospital Charge Code 3259461
Hospital Revenue Code 278
Min. Negotiated Rate $9,113.02
Max. Negotiated Rate $17,110.16
Rate for Payer: Aetna Commercial $16,738.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $15,994.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $9,856.94
Rate for Payer: Cash Price $5,579.40
Rate for Payer: Cigna Commercial $17,110.16
Rate for Payer: Health EOS Commercial $16,552.22
Rate for Payer: HFN Commercial $17,110.16
Rate for Payer: Multiplan Commercial $14,878.40
Rate for Payer: NAPHCARE Commercial $11,158.80
Rate for Payer: Preferred Network Access Commercial $17,110.16
Rate for Payer: Quartz Beloit One Network $9,113.02
Rate for Payer: Quartz Commercial $11,158.80
Rate for Payer: WEA Trust Commercial $10,228.90
Rate for Payer: WPS Commercial $13,775.54
Hospital Charge Code 2967470
Hospital Revenue Code 278
Min. Negotiated Rate $6,353.20
Max. Negotiated Rate $90,760.00
Rate for Payer: Aetna Commercial $20,421.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19,513.40
Rate for Payer: Aetna Managed Medicare $6,353.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $14,748.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $11,345.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,891.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12,025.70
Rate for Payer: Cash Price $6,807.00
Rate for Payer: Cigna Commercial $20,874.80
Rate for Payer: Dean Health DHI/DHP/ASO $12,697.32
Rate for Payer: Health EOS Commercial $20,194.10
Rate for Payer: HFN Commercial $20,874.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $17,017.50
Rate for Payer: Multiplan Commercial $18,152.00
Rate for Payer: NAPHCARE Commercial $13,614.00
Rate for Payer: Preferred Network Access Commercial $20,874.80
Rate for Payer: Quartz Beloit One Network $11,118.10
Rate for Payer: Quartz Commercial $14,748.50
Rate for Payer: Quartz Medicare Advantage $13,614.00
Rate for Payer: The Alliance Commercial $90,760.00
Rate for Payer: WEA Trust Commercial $12,479.50
Rate for Payer: WPS Commercial $16,806.48
Hospital Charge Code 2967470
Hospital Revenue Code 278
Min. Negotiated Rate $11,118.10
Max. Negotiated Rate $20,874.80
Rate for Payer: Aetna Commercial $20,421.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19,513.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12,025.70
Rate for Payer: Cash Price $6,807.00
Rate for Payer: Cigna Commercial $20,874.80
Rate for Payer: Health EOS Commercial $20,194.10
Rate for Payer: HFN Commercial $20,874.80
Rate for Payer: Multiplan Commercial $18,152.00
Rate for Payer: NAPHCARE Commercial $13,614.00
Rate for Payer: Preferred Network Access Commercial $20,874.80
Rate for Payer: Quartz Beloit One Network $11,118.10
Rate for Payer: Quartz Commercial $13,614.00
Rate for Payer: WEA Trust Commercial $12,479.50
Rate for Payer: WPS Commercial $16,806.48
Hospital Charge Code 2967472
Hospital Revenue Code 278
Min. Negotiated Rate $10,706.01
Max. Negotiated Rate $20,101.08
Rate for Payer: Aetna Commercial $19,664.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $18,790.14
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $11,579.97
Rate for Payer: Cash Price $6,554.70
Rate for Payer: Cigna Commercial $20,101.08
Rate for Payer: Health EOS Commercial $19,445.61
Rate for Payer: HFN Commercial $20,101.08
Rate for Payer: Multiplan Commercial $17,479.20
Rate for Payer: NAPHCARE Commercial $13,109.40
Rate for Payer: Preferred Network Access Commercial $20,101.08
Rate for Payer: Quartz Beloit One Network $10,706.01
Rate for Payer: Quartz Commercial $13,109.40
Rate for Payer: WEA Trust Commercial $12,016.95
Rate for Payer: WPS Commercial $16,183.55
Hospital Charge Code 2967472
Hospital Revenue Code 278
Min. Negotiated Rate $6,117.72
Max. Negotiated Rate $87,396.00
Rate for Payer: Aetna Commercial $19,664.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $18,790.14
Rate for Payer: Aetna Managed Medicare $6,117.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $14,201.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $10,924.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,487.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $11,579.97
Rate for Payer: Cash Price $6,554.70
Rate for Payer: Cigna Commercial $20,101.08
Rate for Payer: Dean Health DHI/DHP/ASO $12,226.70
Rate for Payer: Health EOS Commercial $19,445.61
Rate for Payer: HFN Commercial $20,101.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $16,386.75
Rate for Payer: Multiplan Commercial $17,479.20
Rate for Payer: NAPHCARE Commercial $13,109.40
Rate for Payer: Preferred Network Access Commercial $20,101.08
Rate for Payer: Quartz Beloit One Network $10,706.01
Rate for Payer: Quartz Commercial $14,201.85
Rate for Payer: Quartz Medicare Advantage $13,109.40
Rate for Payer: The Alliance Commercial $87,396.00
Rate for Payer: WEA Trust Commercial $12,016.95
Rate for Payer: WPS Commercial $16,183.55
Hospital Charge Code 2967473
Hospital Revenue Code 278
Min. Negotiated Rate $5,576.76
Max. Negotiated Rate $79,668.00
Rate for Payer: Aetna Commercial $17,925.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $17,128.62
Rate for Payer: Aetna Managed Medicare $5,576.76
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,946.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $9,958.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $9,560.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $10,556.01
Rate for Payer: Cash Price $5,975.10
Rate for Payer: Cigna Commercial $18,323.64
Rate for Payer: Dean Health DHI/DHP/ASO $11,145.55
Rate for Payer: Health EOS Commercial $17,726.13
Rate for Payer: HFN Commercial $18,323.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $14,937.75
Rate for Payer: Multiplan Commercial $15,933.60
Rate for Payer: NAPHCARE Commercial $11,950.20
Rate for Payer: Preferred Network Access Commercial $18,323.64
Rate for Payer: Quartz Beloit One Network $9,759.33
Rate for Payer: Quartz Commercial $12,946.05
Rate for Payer: Quartz Medicare Advantage $11,950.20
Rate for Payer: The Alliance Commercial $79,668.00
Rate for Payer: WEA Trust Commercial $10,954.35
Rate for Payer: WPS Commercial $14,752.52
Hospital Charge Code 2967473
Hospital Revenue Code 278
Min. Negotiated Rate $9,759.33
Max. Negotiated Rate $18,323.64
Rate for Payer: Aetna Commercial $17,925.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $17,128.62
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $10,556.01
Rate for Payer: Cash Price $5,975.10
Rate for Payer: Cigna Commercial $18,323.64
Rate for Payer: Health EOS Commercial $17,726.13
Rate for Payer: HFN Commercial $18,323.64
Rate for Payer: Multiplan Commercial $15,933.60
Rate for Payer: NAPHCARE Commercial $11,950.20
Rate for Payer: Preferred Network Access Commercial $18,323.64
Rate for Payer: Quartz Beloit One Network $9,759.33
Rate for Payer: Quartz Commercial $11,950.20
Rate for Payer: WEA Trust Commercial $10,954.35
Rate for Payer: WPS Commercial $14,752.52
Hospital Charge Code 2974026
Hospital Revenue Code 278
Min. Negotiated Rate $20,090.49
Max. Negotiated Rate $37,720.92
Rate for Payer: Aetna Commercial $36,900.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $35,260.86
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $21,730.53
Rate for Payer: Cash Price $12,300.30
Rate for Payer: Cigna Commercial $37,720.92
Rate for Payer: Health EOS Commercial $36,490.89
Rate for Payer: HFN Commercial $37,720.92
Rate for Payer: Multiplan Commercial $32,800.80
Rate for Payer: NAPHCARE Commercial $24,600.60
Rate for Payer: Preferred Network Access Commercial $37,720.92
Rate for Payer: Quartz Beloit One Network $20,090.49
Rate for Payer: Quartz Commercial $24,600.60
Rate for Payer: WEA Trust Commercial $22,550.55
Rate for Payer: WPS Commercial $30,369.44
Hospital Charge Code 2974026
Hospital Revenue Code 278
Min. Negotiated Rate $11,480.28
Max. Negotiated Rate $164,004.00
Rate for Payer: Aetna Commercial $36,900.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $35,260.86
Rate for Payer: Aetna Managed Medicare $11,480.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $26,650.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $20,500.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $19,680.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $21,730.53
Rate for Payer: Cash Price $12,300.30
Rate for Payer: Cigna Commercial $37,720.92
Rate for Payer: Dean Health DHI/DHP/ASO $22,944.16
Rate for Payer: Health EOS Commercial $36,490.89
Rate for Payer: HFN Commercial $37,720.92
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $30,750.75
Rate for Payer: Multiplan Commercial $32,800.80
Rate for Payer: NAPHCARE Commercial $24,600.60
Rate for Payer: Preferred Network Access Commercial $37,720.92
Rate for Payer: Quartz Beloit One Network $20,090.49
Rate for Payer: Quartz Commercial $26,650.65
Rate for Payer: Quartz Medicare Advantage $24,600.60
Rate for Payer: The Alliance Commercial $164,004.00
Rate for Payer: WEA Trust Commercial $22,550.55
Rate for Payer: WPS Commercial $30,369.44
Hospital Charge Code 2974019
Hospital Revenue Code 278
Min. Negotiated Rate $8,958.60
Max. Negotiated Rate $127,980.00
Rate for Payer: Aetna Commercial $28,795.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,515.70
Rate for Payer: Aetna Managed Medicare $8,958.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20,796.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15,997.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,357.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,957.35
Rate for Payer: Cash Price $9,598.50
Rate for Payer: Cigna Commercial $29,435.40
Rate for Payer: Dean Health DHI/DHP/ASO $17,904.40
Rate for Payer: Health EOS Commercial $28,475.55
Rate for Payer: HFN Commercial $29,435.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $23,996.25
Rate for Payer: Multiplan Commercial $25,596.00
Rate for Payer: NAPHCARE Commercial $19,197.00
Rate for Payer: Preferred Network Access Commercial $29,435.40
Rate for Payer: Quartz Beloit One Network $15,677.55
Rate for Payer: Quartz Commercial $20,796.75
Rate for Payer: Quartz Medicare Advantage $19,197.00
Rate for Payer: The Alliance Commercial $127,980.00
Rate for Payer: WEA Trust Commercial $17,597.25
Rate for Payer: WPS Commercial $23,698.70
Hospital Charge Code 2974019
Hospital Revenue Code 278
Min. Negotiated Rate $15,677.55
Max. Negotiated Rate $29,435.40
Rate for Payer: Aetna Commercial $28,795.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,515.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,957.35
Rate for Payer: Cash Price $9,598.50
Rate for Payer: Cigna Commercial $29,435.40
Rate for Payer: Health EOS Commercial $28,475.55
Rate for Payer: HFN Commercial $29,435.40
Rate for Payer: Multiplan Commercial $25,596.00
Rate for Payer: NAPHCARE Commercial $19,197.00
Rate for Payer: Preferred Network Access Commercial $29,435.40
Rate for Payer: Quartz Beloit One Network $15,677.55
Rate for Payer: Quartz Commercial $19,197.00
Rate for Payer: WEA Trust Commercial $17,597.25
Rate for Payer: WPS Commercial $23,698.70
Hospital Charge Code 2974021
Hospital Revenue Code 278
Min. Negotiated Rate $15,677.55
Max. Negotiated Rate $29,435.40
Rate for Payer: Aetna Commercial $28,795.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,515.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,957.35
Rate for Payer: Cash Price $9,598.50
Rate for Payer: Cigna Commercial $29,435.40
Rate for Payer: Health EOS Commercial $28,475.55
Rate for Payer: HFN Commercial $29,435.40
Rate for Payer: Multiplan Commercial $25,596.00
Rate for Payer: NAPHCARE Commercial $19,197.00
Rate for Payer: Preferred Network Access Commercial $29,435.40
Rate for Payer: Quartz Beloit One Network $15,677.55
Rate for Payer: Quartz Commercial $19,197.00
Rate for Payer: WEA Trust Commercial $17,597.25
Rate for Payer: WPS Commercial $23,698.70
Hospital Charge Code 2974021
Hospital Revenue Code 278
Min. Negotiated Rate $8,958.60
Max. Negotiated Rate $127,980.00
Rate for Payer: Aetna Commercial $28,795.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,515.70
Rate for Payer: Aetna Managed Medicare $8,958.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20,796.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15,997.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,357.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,957.35
Rate for Payer: Cash Price $9,598.50
Rate for Payer: Cigna Commercial $29,435.40
Rate for Payer: Dean Health DHI/DHP/ASO $17,904.40
Rate for Payer: Health EOS Commercial $28,475.55
Rate for Payer: HFN Commercial $29,435.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $23,996.25
Rate for Payer: Multiplan Commercial $25,596.00
Rate for Payer: NAPHCARE Commercial $19,197.00
Rate for Payer: Preferred Network Access Commercial $29,435.40
Rate for Payer: Quartz Beloit One Network $15,677.55
Rate for Payer: Quartz Commercial $20,796.75
Rate for Payer: Quartz Medicare Advantage $19,197.00
Rate for Payer: The Alliance Commercial $127,980.00
Rate for Payer: WEA Trust Commercial $17,597.25
Rate for Payer: WPS Commercial $23,698.70
Hospital Charge Code 2974023
Hospital Revenue Code 278
Min. Negotiated Rate $15,677.55
Max. Negotiated Rate $29,435.40
Rate for Payer: Aetna Commercial $28,795.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,515.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,957.35
Rate for Payer: Cash Price $9,598.50
Rate for Payer: Cigna Commercial $29,435.40
Rate for Payer: Health EOS Commercial $28,475.55
Rate for Payer: HFN Commercial $29,435.40
Rate for Payer: Multiplan Commercial $25,596.00
Rate for Payer: NAPHCARE Commercial $19,197.00
Rate for Payer: Preferred Network Access Commercial $29,435.40
Rate for Payer: Quartz Beloit One Network $15,677.55
Rate for Payer: Quartz Commercial $19,197.00
Rate for Payer: WEA Trust Commercial $17,597.25
Rate for Payer: WPS Commercial $23,698.70
Hospital Charge Code 2974023
Hospital Revenue Code 278
Min. Negotiated Rate $8,958.60
Max. Negotiated Rate $127,980.00
Rate for Payer: Aetna Commercial $28,795.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,515.70
Rate for Payer: Aetna Managed Medicare $8,958.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20,796.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15,997.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,357.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,957.35
Rate for Payer: Cash Price $9,598.50
Rate for Payer: Cigna Commercial $29,435.40
Rate for Payer: Dean Health DHI/DHP/ASO $17,904.40
Rate for Payer: Health EOS Commercial $28,475.55
Rate for Payer: HFN Commercial $29,435.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $23,996.25
Rate for Payer: Multiplan Commercial $25,596.00
Rate for Payer: NAPHCARE Commercial $19,197.00
Rate for Payer: Preferred Network Access Commercial $29,435.40
Rate for Payer: Quartz Beloit One Network $15,677.55
Rate for Payer: Quartz Commercial $20,796.75
Rate for Payer: Quartz Medicare Advantage $19,197.00
Rate for Payer: The Alliance Commercial $127,980.00
Rate for Payer: WEA Trust Commercial $17,597.25
Rate for Payer: WPS Commercial $23,698.70
Hospital Charge Code 2974024
Hospital Revenue Code 278
Min. Negotiated Rate $18,307.38
Max. Negotiated Rate $34,373.04
Rate for Payer: Aetna Commercial $33,625.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $32,131.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $19,801.86
Rate for Payer: Cash Price $11,208.60
Rate for Payer: Cigna Commercial $34,373.04
Rate for Payer: Health EOS Commercial $33,252.18
Rate for Payer: HFN Commercial $34,373.04
Rate for Payer: Multiplan Commercial $29,889.60
Rate for Payer: NAPHCARE Commercial $22,417.20
Rate for Payer: Preferred Network Access Commercial $34,373.04
Rate for Payer: Quartz Beloit One Network $18,307.38
Rate for Payer: Quartz Commercial $22,417.20
Rate for Payer: WEA Trust Commercial $20,549.10
Rate for Payer: WPS Commercial $27,674.03
Hospital Charge Code 2974024
Hospital Revenue Code 278
Min. Negotiated Rate $10,461.36
Max. Negotiated Rate $149,448.00
Rate for Payer: Aetna Commercial $33,625.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $32,131.32
Rate for Payer: Aetna Managed Medicare $10,461.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $24,285.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $18,681.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $17,933.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $19,801.86
Rate for Payer: Cash Price $11,208.60
Rate for Payer: Cigna Commercial $34,373.04
Rate for Payer: Dean Health DHI/DHP/ASO $20,907.78
Rate for Payer: Health EOS Commercial $33,252.18
Rate for Payer: HFN Commercial $34,373.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $28,021.50
Rate for Payer: Multiplan Commercial $29,889.60
Rate for Payer: NAPHCARE Commercial $22,417.20
Rate for Payer: Preferred Network Access Commercial $34,373.04
Rate for Payer: Quartz Beloit One Network $18,307.38
Rate for Payer: Quartz Commercial $24,285.30
Rate for Payer: Quartz Medicare Advantage $22,417.20
Rate for Payer: The Alliance Commercial $149,448.00
Rate for Payer: WEA Trust Commercial $20,549.10
Rate for Payer: WPS Commercial $27,674.03