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Service Code HCPCS C1776
Hospital Charge Code 6226145
Hospital Revenue Code 278
Min. Negotiated Rate $16,568.86
Max. Negotiated Rate $31,108.88
Rate for Payer: Aetna Commercial $30,432.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $29,080.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $17,921.42
Rate for Payer: Cash Price $10,144.20
Rate for Payer: Cigna Commercial $31,108.88
Rate for Payer: Health EOS Commercial $30,094.46
Rate for Payer: HFN Commercial $31,108.88
Rate for Payer: Multiplan Commercial $27,051.20
Rate for Payer: NAPHCARE Commercial $20,288.40
Rate for Payer: Preferred Network Access Commercial $31,108.88
Rate for Payer: Quartz Beloit One Network $16,568.86
Rate for Payer: Quartz Commercial $20,288.40
Rate for Payer: WEA Trust Commercial $18,597.70
Rate for Payer: WPS Commercial $25,046.03
Service Code HCPCS C1776
Hospital Charge Code 6201076
Hospital Revenue Code 278
Min. Negotiated Rate $15,048.88
Max. Negotiated Rate $28,255.04
Rate for Payer: Aetna Commercial $27,640.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26,412.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,277.36
Rate for Payer: Cash Price $9,213.60
Rate for Payer: Cigna Commercial $28,255.04
Rate for Payer: Health EOS Commercial $27,333.68
Rate for Payer: HFN Commercial $28,255.04
Rate for Payer: Multiplan Commercial $24,569.60
Rate for Payer: NAPHCARE Commercial $18,427.20
Rate for Payer: Preferred Network Access Commercial $28,255.04
Rate for Payer: Quartz Beloit One Network $15,048.88
Rate for Payer: Quartz Commercial $18,427.20
Rate for Payer: WEA Trust Commercial $16,891.60
Rate for Payer: WPS Commercial $22,748.38
Service Code HCPCS C1776
Hospital Charge Code 6201076
Hospital Revenue Code 278
Min. Negotiated Rate $8,599.36
Max. Negotiated Rate $122,848.00
Rate for Payer: Aetna Commercial $27,640.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $26,412.32
Rate for Payer: Aetna Managed Medicare $8,599.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $19,962.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15,356.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $14,741.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,277.36
Rate for Payer: Cash Price $9,213.60
Rate for Payer: Cigna Commercial $28,255.04
Rate for Payer: Dean Health DHI/DHP/ASO $17,186.44
Rate for Payer: Health EOS Commercial $27,333.68
Rate for Payer: HFN Commercial $28,255.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $23,034.00
Rate for Payer: Multiplan Commercial $24,569.60
Rate for Payer: NAPHCARE Commercial $18,427.20
Rate for Payer: Preferred Network Access Commercial $28,255.04
Rate for Payer: Quartz Beloit One Network $15,048.88
Rate for Payer: Quartz Commercial $19,962.80
Rate for Payer: Quartz Medicare Advantage $18,427.20
Rate for Payer: The Alliance Commercial $122,848.00
Rate for Payer: WEA Trust Commercial $16,891.60
Rate for Payer: WPS Commercial $22,748.38
Service Code HCPCS C1776
Hospital Charge Code 6165875
Hospital Revenue Code 278
Min. Negotiated Rate $15,650.60
Max. Negotiated Rate $29,384.80
Rate for Payer: Aetna Commercial $28,746.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,468.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,928.20
Rate for Payer: Cash Price $9,582.00
Rate for Payer: Cigna Commercial $29,384.80
Rate for Payer: Health EOS Commercial $28,426.60
Rate for Payer: HFN Commercial $29,384.80
Rate for Payer: Multiplan Commercial $25,552.00
Rate for Payer: NAPHCARE Commercial $19,164.00
Rate for Payer: Preferred Network Access Commercial $29,384.80
Rate for Payer: Quartz Beloit One Network $15,650.60
Rate for Payer: Quartz Commercial $19,164.00
Rate for Payer: WEA Trust Commercial $17,567.00
Rate for Payer: WPS Commercial $23,657.96
Service Code HCPCS C1776
Hospital Charge Code 6165875
Hospital Revenue Code 278
Min. Negotiated Rate $8,943.20
Max. Negotiated Rate $127,760.00
Rate for Payer: Aetna Commercial $28,746.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,468.40
Rate for Payer: Aetna Managed Medicare $8,943.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20,761.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15,970.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,331.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $16,928.20
Rate for Payer: Cash Price $9,582.00
Rate for Payer: Cigna Commercial $29,384.80
Rate for Payer: Dean Health DHI/DHP/ASO $17,873.62
Rate for Payer: Health EOS Commercial $28,426.60
Rate for Payer: HFN Commercial $29,384.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $23,955.00
Rate for Payer: Multiplan Commercial $25,552.00
Rate for Payer: NAPHCARE Commercial $19,164.00
Rate for Payer: Preferred Network Access Commercial $29,384.80
Rate for Payer: Quartz Beloit One Network $15,650.60
Rate for Payer: Quartz Commercial $20,761.00
Rate for Payer: Quartz Medicare Advantage $19,164.00
Rate for Payer: The Alliance Commercial $127,760.00
Rate for Payer: WEA Trust Commercial $17,567.00
Rate for Payer: WPS Commercial $23,657.96
Service Code HCPCS C1776
Hospital Charge Code 5521071
Hospital Revenue Code 278
Min. Negotiated Rate $24,195.22
Max. Negotiated Rate $45,427.76
Rate for Payer: Aetna Commercial $44,440.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $42,465.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $26,170.34
Rate for Payer: Cash Price $14,813.40
Rate for Payer: Cigna Commercial $45,427.76
Rate for Payer: Health EOS Commercial $43,946.42
Rate for Payer: HFN Commercial $45,427.76
Rate for Payer: Multiplan Commercial $39,502.40
Rate for Payer: NAPHCARE Commercial $29,626.80
Rate for Payer: Preferred Network Access Commercial $45,427.76
Rate for Payer: Quartz Beloit One Network $24,195.22
Rate for Payer: Quartz Commercial $29,626.80
Rate for Payer: WEA Trust Commercial $27,157.90
Rate for Payer: WPS Commercial $36,574.28
Service Code HCPCS C1776
Hospital Charge Code 5521071
Hospital Revenue Code 278
Min. Negotiated Rate $13,825.84
Max. Negotiated Rate $197,512.00
Rate for Payer: Aetna Commercial $44,440.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $42,465.08
Rate for Payer: Aetna Managed Medicare $13,825.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $32,095.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $24,689.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $23,701.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $26,170.34
Rate for Payer: Cash Price $14,813.40
Rate for Payer: Cigna Commercial $45,427.76
Rate for Payer: Dean Health DHI/DHP/ASO $27,631.93
Rate for Payer: Health EOS Commercial $43,946.42
Rate for Payer: HFN Commercial $45,427.76
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $37,033.50
Rate for Payer: Multiplan Commercial $39,502.40
Rate for Payer: NAPHCARE Commercial $29,626.80
Rate for Payer: Preferred Network Access Commercial $45,427.76
Rate for Payer: Quartz Beloit One Network $24,195.22
Rate for Payer: Quartz Commercial $32,095.70
Rate for Payer: Quartz Medicare Advantage $29,626.80
Rate for Payer: The Alliance Commercial $197,512.00
Rate for Payer: WEA Trust Commercial $27,157.90
Rate for Payer: WPS Commercial $36,574.28
Service Code HCPCS C1776
Hospital Charge Code 5831778
Hospital Revenue Code 278
Min. Negotiated Rate $9,301.04
Max. Negotiated Rate $132,872.00
Rate for Payer: Aetna Commercial $29,896.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $28,567.48
Rate for Payer: Aetna Managed Medicare $9,301.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $21,591.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $16,609.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,944.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $17,605.54
Rate for Payer: Cash Price $9,965.40
Rate for Payer: Cigna Commercial $30,560.56
Rate for Payer: Dean Health DHI/DHP/ASO $18,588.79
Rate for Payer: Health EOS Commercial $29,564.02
Rate for Payer: HFN Commercial $30,560.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $24,913.50
Rate for Payer: Multiplan Commercial $26,574.40
Rate for Payer: NAPHCARE Commercial $19,930.80
Rate for Payer: Preferred Network Access Commercial $30,560.56
Rate for Payer: Quartz Beloit One Network $16,276.82
Rate for Payer: Quartz Commercial $21,591.70
Rate for Payer: Quartz Medicare Advantage $19,930.80
Rate for Payer: The Alliance Commercial $132,872.00
Rate for Payer: WEA Trust Commercial $18,269.90
Rate for Payer: WPS Commercial $24,604.57
Service Code HCPCS C1776
Hospital Charge Code 5831778
Hospital Revenue Code 278
Min. Negotiated Rate $16,276.82
Max. Negotiated Rate $30,560.56
Rate for Payer: Aetna Commercial $29,896.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $28,567.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $17,605.54
Rate for Payer: Cash Price $9,965.40
Rate for Payer: Cigna Commercial $30,560.56
Rate for Payer: Health EOS Commercial $29,564.02
Rate for Payer: HFN Commercial $30,560.56
Rate for Payer: Multiplan Commercial $26,574.40
Rate for Payer: NAPHCARE Commercial $19,930.80
Rate for Payer: Preferred Network Access Commercial $30,560.56
Rate for Payer: Quartz Beloit One Network $16,276.82
Rate for Payer: Quartz Commercial $19,930.80
Rate for Payer: WEA Trust Commercial $18,269.90
Rate for Payer: WPS Commercial $24,604.57
Service Code HCPCS C1776
Hospital Charge Code 5641691
Hospital Revenue Code 278
Min. Negotiated Rate $9,054.92
Max. Negotiated Rate $129,356.00
Rate for Payer: Aetna Commercial $29,105.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,811.54
Rate for Payer: Aetna Managed Medicare $9,054.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $21,020.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $16,169.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,522.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $17,139.67
Rate for Payer: Cash Price $9,701.70
Rate for Payer: Cigna Commercial $29,751.88
Rate for Payer: Dean Health DHI/DHP/ASO $18,096.90
Rate for Payer: Health EOS Commercial $28,781.71
Rate for Payer: HFN Commercial $29,751.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $24,254.25
Rate for Payer: Multiplan Commercial $25,871.20
Rate for Payer: NAPHCARE Commercial $19,403.40
Rate for Payer: Preferred Network Access Commercial $29,751.88
Rate for Payer: Quartz Beloit One Network $15,846.11
Rate for Payer: Quartz Commercial $21,020.35
Rate for Payer: Quartz Medicare Advantage $19,403.40
Rate for Payer: The Alliance Commercial $129,356.00
Rate for Payer: WEA Trust Commercial $17,786.45
Rate for Payer: WPS Commercial $23,953.50
Service Code HCPCS C1776
Hospital Charge Code 5641691
Hospital Revenue Code 278
Min. Negotiated Rate $15,846.11
Max. Negotiated Rate $29,751.88
Rate for Payer: Aetna Commercial $29,105.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $27,811.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $17,139.67
Rate for Payer: Cash Price $9,701.70
Rate for Payer: Cigna Commercial $29,751.88
Rate for Payer: Health EOS Commercial $28,781.71
Rate for Payer: HFN Commercial $29,751.88
Rate for Payer: Multiplan Commercial $25,871.20
Rate for Payer: NAPHCARE Commercial $19,403.40
Rate for Payer: Preferred Network Access Commercial $29,751.88
Rate for Payer: Quartz Beloit One Network $15,846.11
Rate for Payer: Quartz Commercial $19,403.40
Rate for Payer: WEA Trust Commercial $17,786.45
Rate for Payer: WPS Commercial $23,953.50
Service Code HCPCS C1776
Hospital Charge Code 6192965
Hospital Revenue Code 278
Min. Negotiated Rate $20,482.00
Max. Negotiated Rate $38,456.00
Rate for Payer: Aetna Commercial $37,620.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $35,948.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $22,154.00
Rate for Payer: Cash Price $12,540.00
Rate for Payer: Cigna Commercial $38,456.00
Rate for Payer: Health EOS Commercial $37,202.00
Rate for Payer: HFN Commercial $38,456.00
Rate for Payer: Multiplan Commercial $33,440.00
Rate for Payer: NAPHCARE Commercial $25,080.00
Rate for Payer: Preferred Network Access Commercial $38,456.00
Rate for Payer: Quartz Beloit One Network $20,482.00
Rate for Payer: Quartz Commercial $25,080.00
Rate for Payer: WEA Trust Commercial $22,990.00
Rate for Payer: WPS Commercial $30,961.26
Service Code HCPCS C1776
Hospital Charge Code 6192965
Hospital Revenue Code 278
Min. Negotiated Rate $11,704.00
Max. Negotiated Rate $167,200.00
Rate for Payer: Aetna Commercial $37,620.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $35,948.00
Rate for Payer: Aetna Managed Medicare $11,704.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $27,170.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $20,900.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $20,064.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $22,154.00
Rate for Payer: Cash Price $12,540.00
Rate for Payer: Cigna Commercial $38,456.00
Rate for Payer: Dean Health DHI/DHP/ASO $23,391.28
Rate for Payer: Health EOS Commercial $37,202.00
Rate for Payer: HFN Commercial $38,456.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $31,350.00
Rate for Payer: Multiplan Commercial $33,440.00
Rate for Payer: NAPHCARE Commercial $25,080.00
Rate for Payer: Preferred Network Access Commercial $38,456.00
Rate for Payer: Quartz Beloit One Network $20,482.00
Rate for Payer: Quartz Commercial $27,170.00
Rate for Payer: Quartz Medicare Advantage $25,080.00
Rate for Payer: The Alliance Commercial $167,200.00
Rate for Payer: WEA Trust Commercial $22,990.00
Rate for Payer: WPS Commercial $30,961.26
Service Code HCPCS C1776
Hospital Charge Code 5803648
Hospital Revenue Code 278
Min. Negotiated Rate $1,729.28
Max. Negotiated Rate $24,704.00
Rate for Payer: Aetna Commercial $5,558.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,311.36
Rate for Payer: Aetna Managed Medicare $1,729.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,014.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,088.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,964.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,273.28
Rate for Payer: Cash Price $1,852.80
Rate for Payer: Cigna Commercial $5,681.92
Rate for Payer: Dean Health DHI/DHP/ASO $3,456.09
Rate for Payer: Health EOS Commercial $5,496.64
Rate for Payer: HFN Commercial $5,681.92
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,632.00
Rate for Payer: Multiplan Commercial $4,940.80
Rate for Payer: NAPHCARE Commercial $3,705.60
Rate for Payer: Preferred Network Access Commercial $5,681.92
Rate for Payer: Quartz Beloit One Network $3,026.24
Rate for Payer: Quartz Commercial $4,014.40
Rate for Payer: Quartz Medicare Advantage $3,705.60
Rate for Payer: The Alliance Commercial $24,704.00
Rate for Payer: WEA Trust Commercial $3,396.80
Rate for Payer: WPS Commercial $4,574.56
Service Code HCPCS C1776
Hospital Charge Code 5803648
Hospital Revenue Code 278
Min. Negotiated Rate $3,026.24
Max. Negotiated Rate $5,681.92
Rate for Payer: Aetna Commercial $5,558.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,311.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,273.28
Rate for Payer: Cash Price $1,852.80
Rate for Payer: Cigna Commercial $5,681.92
Rate for Payer: Health EOS Commercial $5,496.64
Rate for Payer: HFN Commercial $5,681.92
Rate for Payer: Multiplan Commercial $4,940.80
Rate for Payer: NAPHCARE Commercial $3,705.60
Rate for Payer: Preferred Network Access Commercial $5,681.92
Rate for Payer: Quartz Beloit One Network $3,026.24
Rate for Payer: Quartz Commercial $3,705.60
Rate for Payer: WEA Trust Commercial $3,396.80
Rate for Payer: WPS Commercial $4,574.56
Service Code HCPCS C1776
Hospital Charge Code 5641692
Hospital Revenue Code 278
Min. Negotiated Rate $8,276.59
Max. Negotiated Rate $15,539.72
Rate for Payer: Aetna Commercial $15,201.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $14,526.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,952.23
Rate for Payer: Cash Price $5,067.30
Rate for Payer: Cigna Commercial $15,539.72
Rate for Payer: Health EOS Commercial $15,032.99
Rate for Payer: HFN Commercial $15,539.72
Rate for Payer: Multiplan Commercial $13,512.80
Rate for Payer: NAPHCARE Commercial $10,134.60
Rate for Payer: Preferred Network Access Commercial $15,539.72
Rate for Payer: Quartz Beloit One Network $8,276.59
Rate for Payer: Quartz Commercial $10,134.60
Rate for Payer: WEA Trust Commercial $9,290.05
Rate for Payer: WPS Commercial $12,511.16
Service Code HCPCS C1776
Hospital Charge Code 5641692
Hospital Revenue Code 278
Min. Negotiated Rate $4,729.48
Max. Negotiated Rate $67,564.00
Rate for Payer: Aetna Commercial $15,201.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $14,526.26
Rate for Payer: Aetna Managed Medicare $4,729.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $10,979.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $8,445.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $8,107.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,952.23
Rate for Payer: Cash Price $5,067.30
Rate for Payer: Cigna Commercial $15,539.72
Rate for Payer: Dean Health DHI/DHP/ASO $9,452.20
Rate for Payer: Health EOS Commercial $15,032.99
Rate for Payer: HFN Commercial $15,539.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $12,668.25
Rate for Payer: Multiplan Commercial $13,512.80
Rate for Payer: NAPHCARE Commercial $10,134.60
Rate for Payer: Preferred Network Access Commercial $15,539.72
Rate for Payer: Quartz Beloit One Network $8,276.59
Rate for Payer: Quartz Commercial $10,979.15
Rate for Payer: Quartz Medicare Advantage $10,134.60
Rate for Payer: The Alliance Commercial $67,564.00
Rate for Payer: WEA Trust Commercial $9,290.05
Rate for Payer: WPS Commercial $12,511.16
Service Code HCPCS C1776
Hospital Charge Code 5459697
Hospital Revenue Code 278
Min. Negotiated Rate $11,380.25
Max. Negotiated Rate $21,367.00
Rate for Payer: Aetna Commercial $20,902.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19,973.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12,309.25
Rate for Payer: Cash Price $6,967.50
Rate for Payer: Cigna Commercial $21,367.00
Rate for Payer: Health EOS Commercial $20,670.25
Rate for Payer: HFN Commercial $21,367.00
Rate for Payer: Multiplan Commercial $18,580.00
Rate for Payer: NAPHCARE Commercial $13,935.00
Rate for Payer: Preferred Network Access Commercial $21,367.00
Rate for Payer: Quartz Beloit One Network $11,380.25
Rate for Payer: Quartz Commercial $13,935.00
Rate for Payer: WEA Trust Commercial $12,773.75
Rate for Payer: WPS Commercial $17,202.76
Service Code HCPCS C1776
Hospital Charge Code 5459697
Hospital Revenue Code 278
Min. Negotiated Rate $6,503.00
Max. Negotiated Rate $92,900.00
Rate for Payer: Aetna Commercial $20,902.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19,973.50
Rate for Payer: Aetna Managed Medicare $6,503.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $15,096.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $11,612.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $11,148.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12,309.25
Rate for Payer: Cash Price $6,967.50
Rate for Payer: Cigna Commercial $21,367.00
Rate for Payer: Dean Health DHI/DHP/ASO $12,996.71
Rate for Payer: Health EOS Commercial $20,670.25
Rate for Payer: HFN Commercial $21,367.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $17,418.75
Rate for Payer: Multiplan Commercial $18,580.00
Rate for Payer: NAPHCARE Commercial $13,935.00
Rate for Payer: Preferred Network Access Commercial $21,367.00
Rate for Payer: Quartz Beloit One Network $11,380.25
Rate for Payer: Quartz Commercial $15,096.25
Rate for Payer: Quartz Medicare Advantage $13,935.00
Rate for Payer: The Alliance Commercial $92,900.00
Rate for Payer: WEA Trust Commercial $12,773.75
Rate for Payer: WPS Commercial $17,202.76
Service Code HCPCS C1776
Hospital Charge Code 5528742
Hospital Revenue Code 278
Min. Negotiated Rate $11,896.71
Max. Negotiated Rate $22,336.68
Rate for Payer: Aetna Commercial $21,851.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $20,879.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12,867.87
Rate for Payer: Cash Price $7,283.70
Rate for Payer: Cigna Commercial $22,336.68
Rate for Payer: Health EOS Commercial $21,608.31
Rate for Payer: HFN Commercial $22,336.68
Rate for Payer: Multiplan Commercial $19,423.20
Rate for Payer: NAPHCARE Commercial $14,567.40
Rate for Payer: Preferred Network Access Commercial $22,336.68
Rate for Payer: Quartz Beloit One Network $11,896.71
Rate for Payer: Quartz Commercial $14,567.40
Rate for Payer: WEA Trust Commercial $13,353.45
Rate for Payer: WPS Commercial $17,983.46
Service Code HCPCS C1776
Hospital Charge Code 5528742
Hospital Revenue Code 278
Min. Negotiated Rate $6,798.12
Max. Negotiated Rate $97,116.00
Rate for Payer: Aetna Commercial $21,851.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $20,879.94
Rate for Payer: Aetna Managed Medicare $6,798.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $15,781.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $12,139.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $11,653.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $12,867.87
Rate for Payer: Cash Price $7,283.70
Rate for Payer: Cigna Commercial $22,336.68
Rate for Payer: Dean Health DHI/DHP/ASO $13,586.53
Rate for Payer: Health EOS Commercial $21,608.31
Rate for Payer: HFN Commercial $22,336.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $18,209.25
Rate for Payer: Multiplan Commercial $19,423.20
Rate for Payer: NAPHCARE Commercial $14,567.40
Rate for Payer: Preferred Network Access Commercial $22,336.68
Rate for Payer: Quartz Beloit One Network $11,896.71
Rate for Payer: Quartz Commercial $15,781.35
Rate for Payer: Quartz Medicare Advantage $14,567.40
Rate for Payer: The Alliance Commercial $97,116.00
Rate for Payer: WEA Trust Commercial $13,353.45
Rate for Payer: WPS Commercial $17,983.46
Service Code HCPCS C1776
Hospital Charge Code 6178523
Hospital Revenue Code 278
Min. Negotiated Rate $5,502.70
Max. Negotiated Rate $10,331.60
Rate for Payer: Aetna Commercial $10,107.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,657.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,951.90
Rate for Payer: Cash Price $3,369.00
Rate for Payer: Cigna Commercial $10,331.60
Rate for Payer: Health EOS Commercial $9,994.70
Rate for Payer: HFN Commercial $10,331.60
Rate for Payer: Multiplan Commercial $8,984.00
Rate for Payer: NAPHCARE Commercial $6,738.00
Rate for Payer: Preferred Network Access Commercial $10,331.60
Rate for Payer: Quartz Beloit One Network $5,502.70
Rate for Payer: Quartz Commercial $6,738.00
Rate for Payer: WEA Trust Commercial $6,176.50
Rate for Payer: WPS Commercial $8,318.06
Service Code HCPCS C1776
Hospital Charge Code 6178523
Hospital Revenue Code 278
Min. Negotiated Rate $3,144.40
Max. Negotiated Rate $44,920.00
Rate for Payer: Aetna Commercial $10,107.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,657.80
Rate for Payer: Aetna Managed Medicare $3,144.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,299.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,615.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,390.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,951.90
Rate for Payer: Cash Price $3,369.00
Rate for Payer: Cigna Commercial $10,331.60
Rate for Payer: Dean Health DHI/DHP/ASO $6,284.31
Rate for Payer: Health EOS Commercial $9,994.70
Rate for Payer: HFN Commercial $10,331.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,422.50
Rate for Payer: Multiplan Commercial $8,984.00
Rate for Payer: NAPHCARE Commercial $6,738.00
Rate for Payer: Preferred Network Access Commercial $10,331.60
Rate for Payer: Quartz Beloit One Network $5,502.70
Rate for Payer: Quartz Commercial $7,299.50
Rate for Payer: Quartz Medicare Advantage $6,738.00
Rate for Payer: The Alliance Commercial $44,920.00
Rate for Payer: WEA Trust Commercial $6,176.50
Rate for Payer: WPS Commercial $8,318.06
Service Code HCPCS C1776
Hospital Charge Code 6181472
Hospital Revenue Code 278
Min. Negotiated Rate $5,502.70
Max. Negotiated Rate $10,331.60
Rate for Payer: Aetna Commercial $10,107.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,657.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,951.90
Rate for Payer: Cash Price $3,369.00
Rate for Payer: Cigna Commercial $10,331.60
Rate for Payer: Health EOS Commercial $9,994.70
Rate for Payer: HFN Commercial $10,331.60
Rate for Payer: Multiplan Commercial $8,984.00
Rate for Payer: NAPHCARE Commercial $6,738.00
Rate for Payer: Preferred Network Access Commercial $10,331.60
Rate for Payer: Quartz Beloit One Network $5,502.70
Rate for Payer: Quartz Commercial $6,738.00
Rate for Payer: WEA Trust Commercial $6,176.50
Rate for Payer: WPS Commercial $8,318.06
Service Code HCPCS C1776
Hospital Charge Code 6181472
Hospital Revenue Code 278
Min. Negotiated Rate $3,144.40
Max. Negotiated Rate $44,920.00
Rate for Payer: Aetna Commercial $10,107.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,657.80
Rate for Payer: Aetna Managed Medicare $3,144.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,299.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,615.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,390.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,951.90
Rate for Payer: Cash Price $3,369.00
Rate for Payer: Cigna Commercial $10,331.60
Rate for Payer: Dean Health DHI/DHP/ASO $6,284.31
Rate for Payer: Health EOS Commercial $9,994.70
Rate for Payer: HFN Commercial $10,331.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,422.50
Rate for Payer: Multiplan Commercial $8,984.00
Rate for Payer: NAPHCARE Commercial $6,738.00
Rate for Payer: Preferred Network Access Commercial $10,331.60
Rate for Payer: Quartz Beloit One Network $5,502.70
Rate for Payer: Quartz Commercial $7,299.50
Rate for Payer: Quartz Medicare Advantage $6,738.00
Rate for Payer: The Alliance Commercial $44,920.00
Rate for Payer: WEA Trust Commercial $6,176.50
Rate for Payer: WPS Commercial $8,318.06