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Service Code HCPCS C1776
Hospital Charge Code 6172433
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6172433
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6089645
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6089645
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6177671
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6177671
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6089630
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6089630
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6037660
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6037660
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6170100
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6170100
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6141628
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6141628
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6170127
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6170127
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6037630
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6037630
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6179725
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 6179725
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 6111642
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6111642
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6169702
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6169702
Hospital Revenue Code 278
Min. Negotiated Rate $5,722.71
Max. Negotiated Rate $10,744.68
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,007.40
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64
Service Code HCPCS C1776
Hospital Charge Code 6174938
Hospital Revenue Code 278
Min. Negotiated Rate $3,270.12
Max. Negotiated Rate $46,716.00
Rate for Payer: Aetna Commercial $10,511.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $10,043.94
Rate for Payer: Aetna Managed Medicare $3,270.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,591.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,839.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,605.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,189.87
Rate for Payer: Cash Price $3,503.70
Rate for Payer: Cigna Commercial $10,744.68
Rate for Payer: Dean Health DHI/DHP/ASO $6,535.57
Rate for Payer: Health EOS Commercial $10,394.31
Rate for Payer: HFN Commercial $10,744.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $8,759.25
Rate for Payer: Multiplan Commercial $9,343.20
Rate for Payer: NAPHCARE Commercial $7,007.40
Rate for Payer: Preferred Network Access Commercial $10,744.68
Rate for Payer: Quartz Beloit One Network $5,722.71
Rate for Payer: Quartz Commercial $7,591.35
Rate for Payer: Quartz Medicare Advantage $7,007.40
Rate for Payer: The Alliance Commercial $46,716.00
Rate for Payer: WEA Trust Commercial $6,423.45
Rate for Payer: WPS Commercial $8,650.64