Price Transparency.

Search and browse your out-of-pocket costs for provider care & services.

search
Charge Type Price  
Service Code HCPCS C1713
Hospital Charge Code 2965061
Hospital Revenue Code 278
Min. Negotiated Rate $2,230.48
Max. Negotiated Rate $4,187.84
Rate for Payer: Aetna Commercial $4,096.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,412.56
Rate for Payer: Cash Price $1,365.60
Rate for Payer: Cigna Commercial $4,187.84
Rate for Payer: Health EOS Commercial $4,051.28
Rate for Payer: HFN Commercial $4,187.84
Rate for Payer: Multiplan Commercial $3,641.60
Rate for Payer: NAPHCARE Commercial $2,731.20
Rate for Payer: Preferred Network Access Commercial $4,187.84
Rate for Payer: Quartz Beloit One Network $2,230.48
Rate for Payer: Quartz Commercial $2,731.20
Rate for Payer: WEA Trust Commercial $2,503.60
Rate for Payer: WPS Commercial $3,371.67
Service Code HCPCS C1713
Hospital Charge Code 2965037
Hospital Revenue Code 278
Min. Negotiated Rate $2,098.67
Max. Negotiated Rate $3,940.36
Rate for Payer: Aetna Commercial $3,854.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,269.99
Rate for Payer: Cash Price $1,284.90
Rate for Payer: Cigna Commercial $3,940.36
Rate for Payer: Health EOS Commercial $3,811.87
Rate for Payer: HFN Commercial $3,940.36
Rate for Payer: Multiplan Commercial $3,426.40
Rate for Payer: NAPHCARE Commercial $2,569.80
Rate for Payer: Preferred Network Access Commercial $3,940.36
Rate for Payer: Quartz Beloit One Network $2,098.67
Rate for Payer: Quartz Commercial $2,569.80
Rate for Payer: WEA Trust Commercial $2,355.65
Rate for Payer: WPS Commercial $3,172.42
Service Code HCPCS C1713
Hospital Charge Code 2965037
Hospital Revenue Code 278
Min. Negotiated Rate $1,199.24
Max. Negotiated Rate $3,940.36
Rate for Payer: Aetna Commercial $3,854.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,683.38
Rate for Payer: Aetna Managed Medicare $1,199.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,783.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,141.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,055.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,269.99
Rate for Payer: Cash Price $1,284.90
Rate for Payer: Cigna Commercial $3,940.36
Rate for Payer: Dean Health DHI/DHP/ASO $2,396.77
Rate for Payer: Health EOS Commercial $3,811.87
Rate for Payer: HFN Commercial $3,940.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,212.25
Rate for Payer: Multiplan Commercial $3,426.40
Rate for Payer: NAPHCARE Commercial $2,569.80
Rate for Payer: Preferred Network Access Commercial $3,940.36
Rate for Payer: Quartz Beloit One Network $2,098.67
Rate for Payer: Quartz Commercial $2,783.95
Rate for Payer: Quartz Medicare Advantage $2,569.80
Rate for Payer: WEA Trust Commercial $2,355.65
Rate for Payer: WPS Commercial $3,172.42
Service Code HCPCS C1713
Hospital Charge Code 5384925
Hospital Revenue Code 278
Min. Negotiated Rate $1,861.51
Max. Negotiated Rate $3,495.08
Rate for Payer: Aetna Commercial $3,419.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,013.47
Rate for Payer: Cash Price $1,139.70
Rate for Payer: Cigna Commercial $3,495.08
Rate for Payer: Health EOS Commercial $3,381.11
Rate for Payer: HFN Commercial $3,495.08
Rate for Payer: Multiplan Commercial $3,039.20
Rate for Payer: NAPHCARE Commercial $2,279.40
Rate for Payer: Preferred Network Access Commercial $3,495.08
Rate for Payer: Quartz Beloit One Network $1,861.51
Rate for Payer: Quartz Commercial $2,279.40
Rate for Payer: WEA Trust Commercial $2,089.45
Rate for Payer: WPS Commercial $2,813.92
Service Code HCPCS C1713
Hospital Charge Code 5384925
Hospital Revenue Code 278
Min. Negotiated Rate $1,063.72
Max. Negotiated Rate $3,495.08
Rate for Payer: Aetna Commercial $3,419.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,267.14
Rate for Payer: Aetna Managed Medicare $1,063.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,469.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,899.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,823.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,013.47
Rate for Payer: Cash Price $1,139.70
Rate for Payer: Cigna Commercial $3,495.08
Rate for Payer: Dean Health DHI/DHP/ASO $2,125.92
Rate for Payer: Health EOS Commercial $3,381.11
Rate for Payer: HFN Commercial $3,495.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,849.25
Rate for Payer: Multiplan Commercial $3,039.20
Rate for Payer: NAPHCARE Commercial $2,279.40
Rate for Payer: Preferred Network Access Commercial $3,495.08
Rate for Payer: Quartz Beloit One Network $1,861.51
Rate for Payer: Quartz Commercial $2,469.35
Rate for Payer: Quartz Medicare Advantage $2,279.40
Rate for Payer: WEA Trust Commercial $2,089.45
Rate for Payer: WPS Commercial $2,813.92
Service Code HCPCS C1713
Hospital Charge Code 5627630
Hospital Revenue Code 278
Min. Negotiated Rate $1,063.72
Max. Negotiated Rate $3,495.08
Rate for Payer: Aetna Commercial $3,419.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,267.14
Rate for Payer: Aetna Managed Medicare $1,063.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,469.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,899.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,823.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,013.47
Rate for Payer: Cash Price $1,139.70
Rate for Payer: Cigna Commercial $3,495.08
Rate for Payer: Dean Health DHI/DHP/ASO $2,125.92
Rate for Payer: Health EOS Commercial $3,381.11
Rate for Payer: HFN Commercial $3,495.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,849.25
Rate for Payer: Multiplan Commercial $3,039.20
Rate for Payer: NAPHCARE Commercial $2,279.40
Rate for Payer: Preferred Network Access Commercial $3,495.08
Rate for Payer: Quartz Beloit One Network $1,861.51
Rate for Payer: Quartz Commercial $2,469.35
Rate for Payer: Quartz Medicare Advantage $2,279.40
Rate for Payer: WEA Trust Commercial $2,089.45
Rate for Payer: WPS Commercial $2,813.92
Service Code HCPCS C1713
Hospital Charge Code 5627630
Hospital Revenue Code 278
Min. Negotiated Rate $1,861.51
Max. Negotiated Rate $3,495.08
Rate for Payer: Aetna Commercial $3,419.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,013.47
Rate for Payer: Cash Price $1,139.70
Rate for Payer: Cigna Commercial $3,495.08
Rate for Payer: Health EOS Commercial $3,381.11
Rate for Payer: HFN Commercial $3,495.08
Rate for Payer: Multiplan Commercial $3,039.20
Rate for Payer: NAPHCARE Commercial $2,279.40
Rate for Payer: Preferred Network Access Commercial $3,495.08
Rate for Payer: Quartz Beloit One Network $1,861.51
Rate for Payer: Quartz Commercial $2,279.40
Rate for Payer: WEA Trust Commercial $2,089.45
Rate for Payer: WPS Commercial $2,813.92
Service Code HCPCS C1713
Hospital Charge Code 5414768
Hospital Revenue Code 278
Min. Negotiated Rate $1,121.40
Max. Negotiated Rate $3,684.60
Rate for Payer: Aetna Commercial $3,604.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,444.30
Rate for Payer: Aetna Managed Medicare $1,121.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,603.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,002.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,922.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,122.65
Rate for Payer: Cash Price $1,201.50
Rate for Payer: Cigna Commercial $3,684.60
Rate for Payer: Dean Health DHI/DHP/ASO $2,241.20
Rate for Payer: Health EOS Commercial $3,564.45
Rate for Payer: HFN Commercial $3,684.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,003.75
Rate for Payer: Multiplan Commercial $3,204.00
Rate for Payer: NAPHCARE Commercial $2,403.00
Rate for Payer: Preferred Network Access Commercial $3,684.60
Rate for Payer: Quartz Beloit One Network $1,962.45
Rate for Payer: Quartz Commercial $2,603.25
Rate for Payer: Quartz Medicare Advantage $2,403.00
Rate for Payer: WEA Trust Commercial $2,202.75
Rate for Payer: WPS Commercial $2,966.50
Service Code HCPCS C1713
Hospital Charge Code 5414768
Hospital Revenue Code 278
Min. Negotiated Rate $1,962.45
Max. Negotiated Rate $3,684.60
Rate for Payer: Aetna Commercial $3,604.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,122.65
Rate for Payer: Cash Price $1,201.50
Rate for Payer: Cigna Commercial $3,684.60
Rate for Payer: Health EOS Commercial $3,564.45
Rate for Payer: HFN Commercial $3,684.60
Rate for Payer: Multiplan Commercial $3,204.00
Rate for Payer: NAPHCARE Commercial $2,403.00
Rate for Payer: Preferred Network Access Commercial $3,684.60
Rate for Payer: Quartz Beloit One Network $1,962.45
Rate for Payer: Quartz Commercial $2,403.00
Rate for Payer: WEA Trust Commercial $2,202.75
Rate for Payer: WPS Commercial $2,966.50
Service Code HCPCS C1713
Hospital Charge Code 3072505
Hospital Revenue Code 278
Min. Negotiated Rate $2,435.30
Max. Negotiated Rate $4,572.40
Rate for Payer: Aetna Commercial $4,473.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,634.10
Rate for Payer: Cash Price $1,491.00
Rate for Payer: Cigna Commercial $4,572.40
Rate for Payer: Health EOS Commercial $4,423.30
Rate for Payer: HFN Commercial $4,572.40
Rate for Payer: Multiplan Commercial $3,976.00
Rate for Payer: NAPHCARE Commercial $2,982.00
Rate for Payer: Preferred Network Access Commercial $4,572.40
Rate for Payer: Quartz Beloit One Network $2,435.30
Rate for Payer: Quartz Commercial $2,982.00
Rate for Payer: WEA Trust Commercial $2,733.50
Rate for Payer: WPS Commercial $3,681.28
Service Code HCPCS C1713
Hospital Charge Code 3072505
Hospital Revenue Code 278
Min. Negotiated Rate $1,391.60
Max. Negotiated Rate $4,572.40
Rate for Payer: Aetna Commercial $4,473.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,274.20
Rate for Payer: Aetna Managed Medicare $1,391.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,230.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,485.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,385.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,634.10
Rate for Payer: Cash Price $1,491.00
Rate for Payer: Cigna Commercial $4,572.40
Rate for Payer: Dean Health DHI/DHP/ASO $2,781.21
Rate for Payer: Health EOS Commercial $4,423.30
Rate for Payer: HFN Commercial $4,572.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,727.50
Rate for Payer: Multiplan Commercial $3,976.00
Rate for Payer: NAPHCARE Commercial $2,982.00
Rate for Payer: Preferred Network Access Commercial $4,572.40
Rate for Payer: Quartz Beloit One Network $2,435.30
Rate for Payer: Quartz Commercial $3,230.50
Rate for Payer: Quartz Medicare Advantage $2,982.00
Rate for Payer: WEA Trust Commercial $2,733.50
Rate for Payer: WPS Commercial $3,681.28
Service Code HCPCS C1713
Hospital Charge Code 5349153
Hospital Revenue Code 278
Min. Negotiated Rate $1,101.52
Max. Negotiated Rate $3,619.28
Rate for Payer: Aetna Commercial $3,540.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,383.24
Rate for Payer: Aetna Managed Medicare $1,101.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,557.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,967.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,888.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,085.02
Rate for Payer: Cash Price $1,180.20
Rate for Payer: Cigna Commercial $3,619.28
Rate for Payer: Dean Health DHI/DHP/ASO $2,201.47
Rate for Payer: Health EOS Commercial $3,501.26
Rate for Payer: HFN Commercial $3,619.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,950.50
Rate for Payer: Multiplan Commercial $3,147.20
Rate for Payer: NAPHCARE Commercial $2,360.40
Rate for Payer: Preferred Network Access Commercial $3,619.28
Rate for Payer: Quartz Beloit One Network $1,927.66
Rate for Payer: Quartz Commercial $2,557.10
Rate for Payer: Quartz Medicare Advantage $2,360.40
Rate for Payer: WEA Trust Commercial $2,163.70
Rate for Payer: WPS Commercial $2,913.91
Service Code HCPCS C1713
Hospital Charge Code 5349153
Hospital Revenue Code 278
Min. Negotiated Rate $1,927.66
Max. Negotiated Rate $3,619.28
Rate for Payer: Aetna Commercial $3,540.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,085.02
Rate for Payer: Cash Price $1,180.20
Rate for Payer: Cigna Commercial $3,619.28
Rate for Payer: Health EOS Commercial $3,501.26
Rate for Payer: HFN Commercial $3,619.28
Rate for Payer: Multiplan Commercial $3,147.20
Rate for Payer: NAPHCARE Commercial $2,360.40
Rate for Payer: Preferred Network Access Commercial $3,619.28
Rate for Payer: Quartz Beloit One Network $1,927.66
Rate for Payer: Quartz Commercial $2,360.40
Rate for Payer: WEA Trust Commercial $2,163.70
Rate for Payer: WPS Commercial $2,913.91
Service Code HCPCS C1713
Hospital Charge Code 2964657
Hospital Revenue Code 278
Min. Negotiated Rate $2,191.28
Max. Negotiated Rate $4,114.24
Rate for Payer: Aetna Commercial $4,024.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,370.16
Rate for Payer: Cash Price $1,341.60
Rate for Payer: Cigna Commercial $4,114.24
Rate for Payer: Health EOS Commercial $3,980.08
Rate for Payer: HFN Commercial $4,114.24
Rate for Payer: Multiplan Commercial $3,577.60
Rate for Payer: NAPHCARE Commercial $2,683.20
Rate for Payer: Preferred Network Access Commercial $4,114.24
Rate for Payer: Quartz Beloit One Network $2,191.28
Rate for Payer: Quartz Commercial $2,683.20
Rate for Payer: WEA Trust Commercial $2,459.60
Rate for Payer: WPS Commercial $3,312.41
Service Code HCPCS C1713
Hospital Charge Code 2964657
Hospital Revenue Code 278
Min. Negotiated Rate $1,252.16
Max. Negotiated Rate $4,114.24
Rate for Payer: Aetna Commercial $4,024.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,845.92
Rate for Payer: Aetna Managed Medicare $1,252.16
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,906.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,236.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,146.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,370.16
Rate for Payer: Cash Price $1,341.60
Rate for Payer: Cigna Commercial $4,114.24
Rate for Payer: Dean Health DHI/DHP/ASO $2,502.53
Rate for Payer: Health EOS Commercial $3,980.08
Rate for Payer: HFN Commercial $4,114.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,354.00
Rate for Payer: Multiplan Commercial $3,577.60
Rate for Payer: NAPHCARE Commercial $2,683.20
Rate for Payer: Preferred Network Access Commercial $4,114.24
Rate for Payer: Quartz Beloit One Network $2,191.28
Rate for Payer: Quartz Commercial $2,906.80
Rate for Payer: Quartz Medicare Advantage $2,683.20
Rate for Payer: WEA Trust Commercial $2,459.60
Rate for Payer: WPS Commercial $3,312.41
Service Code HCPCS C1713
Hospital Charge Code 6226126
Hospital Revenue Code 278
Min. Negotiated Rate $1,251.32
Max. Negotiated Rate $4,111.48
Rate for Payer: Aetna Commercial $4,022.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,843.34
Rate for Payer: Aetna Managed Medicare $1,251.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,904.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,234.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,145.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,368.57
Rate for Payer: Cash Price $1,340.70
Rate for Payer: Cigna Commercial $4,111.48
Rate for Payer: Dean Health DHI/DHP/ASO $2,500.85
Rate for Payer: Health EOS Commercial $3,977.41
Rate for Payer: HFN Commercial $4,111.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,351.75
Rate for Payer: Multiplan Commercial $3,575.20
Rate for Payer: NAPHCARE Commercial $2,681.40
Rate for Payer: Preferred Network Access Commercial $4,111.48
Rate for Payer: Quartz Beloit One Network $2,189.81
Rate for Payer: Quartz Commercial $2,904.85
Rate for Payer: Quartz Medicare Advantage $2,681.40
Rate for Payer: WEA Trust Commercial $2,457.95
Rate for Payer: WPS Commercial $3,310.19
Service Code HCPCS C1713
Hospital Charge Code 6226126
Hospital Revenue Code 278
Min. Negotiated Rate $2,189.81
Max. Negotiated Rate $4,111.48
Rate for Payer: Aetna Commercial $4,022.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,368.57
Rate for Payer: Cash Price $1,340.70
Rate for Payer: Cigna Commercial $4,111.48
Rate for Payer: Health EOS Commercial $3,977.41
Rate for Payer: HFN Commercial $4,111.48
Rate for Payer: Multiplan Commercial $3,575.20
Rate for Payer: NAPHCARE Commercial $2,681.40
Rate for Payer: Preferred Network Access Commercial $4,111.48
Rate for Payer: Quartz Beloit One Network $2,189.81
Rate for Payer: Quartz Commercial $2,681.40
Rate for Payer: WEA Trust Commercial $2,457.95
Rate for Payer: WPS Commercial $3,310.19
Service Code HCPCS C1713
Hospital Charge Code 5106880
Hospital Revenue Code 278
Min. Negotiated Rate $1,464.40
Max. Negotiated Rate $4,811.60
Rate for Payer: Aetna Commercial $4,707.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,497.80
Rate for Payer: Aetna Managed Medicare $1,464.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,399.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,615.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,510.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,771.90
Rate for Payer: Cash Price $1,569.00
Rate for Payer: Cigna Commercial $4,811.60
Rate for Payer: Dean Health DHI/DHP/ASO $2,926.71
Rate for Payer: Health EOS Commercial $4,654.70
Rate for Payer: HFN Commercial $4,811.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,922.50
Rate for Payer: Multiplan Commercial $4,184.00
Rate for Payer: NAPHCARE Commercial $3,138.00
Rate for Payer: Preferred Network Access Commercial $4,811.60
Rate for Payer: Quartz Beloit One Network $2,562.70
Rate for Payer: Quartz Commercial $3,399.50
Rate for Payer: Quartz Medicare Advantage $3,138.00
Rate for Payer: WEA Trust Commercial $2,876.50
Rate for Payer: WPS Commercial $3,873.86
Service Code HCPCS C1713
Hospital Charge Code 5106880
Hospital Revenue Code 278
Min. Negotiated Rate $2,562.70
Max. Negotiated Rate $4,811.60
Rate for Payer: Aetna Commercial $4,707.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,771.90
Rate for Payer: Cash Price $1,569.00
Rate for Payer: Cigna Commercial $4,811.60
Rate for Payer: Health EOS Commercial $4,654.70
Rate for Payer: HFN Commercial $4,811.60
Rate for Payer: Multiplan Commercial $4,184.00
Rate for Payer: NAPHCARE Commercial $3,138.00
Rate for Payer: Preferred Network Access Commercial $4,811.60
Rate for Payer: Quartz Beloit One Network $2,562.70
Rate for Payer: Quartz Commercial $3,138.00
Rate for Payer: WEA Trust Commercial $2,876.50
Rate for Payer: WPS Commercial $3,873.86
Service Code HCPCS C1713
Hospital Charge Code 4632646
Hospital Revenue Code 278
Min. Negotiated Rate $1,358.00
Max. Negotiated Rate $4,462.00
Rate for Payer: Aetna Commercial $4,365.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,171.00
Rate for Payer: Aetna Managed Medicare $1,358.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,152.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,425.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,328.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,570.50
Rate for Payer: Cash Price $1,455.00
Rate for Payer: Cigna Commercial $4,462.00
Rate for Payer: Dean Health DHI/DHP/ASO $2,714.06
Rate for Payer: Health EOS Commercial $4,316.50
Rate for Payer: HFN Commercial $4,462.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,637.50
Rate for Payer: Multiplan Commercial $3,880.00
Rate for Payer: NAPHCARE Commercial $2,910.00
Rate for Payer: Preferred Network Access Commercial $4,462.00
Rate for Payer: Quartz Beloit One Network $2,376.50
Rate for Payer: Quartz Commercial $3,152.50
Rate for Payer: Quartz Medicare Advantage $2,910.00
Rate for Payer: WEA Trust Commercial $2,667.50
Rate for Payer: WPS Commercial $3,592.40
Service Code HCPCS C1713
Hospital Charge Code 4632646
Hospital Revenue Code 278
Min. Negotiated Rate $2,376.50
Max. Negotiated Rate $4,462.00
Rate for Payer: Aetna Commercial $4,365.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,570.50
Rate for Payer: Cash Price $1,455.00
Rate for Payer: Cigna Commercial $4,462.00
Rate for Payer: Health EOS Commercial $4,316.50
Rate for Payer: HFN Commercial $4,462.00
Rate for Payer: Multiplan Commercial $3,880.00
Rate for Payer: NAPHCARE Commercial $2,910.00
Rate for Payer: Preferred Network Access Commercial $4,462.00
Rate for Payer: Quartz Beloit One Network $2,376.50
Rate for Payer: Quartz Commercial $2,910.00
Rate for Payer: WEA Trust Commercial $2,667.50
Rate for Payer: WPS Commercial $3,592.40
Service Code HCPCS C1713
Hospital Charge Code 2964674
Hospital Revenue Code 278
Min. Negotiated Rate $1,756.44
Max. Negotiated Rate $5,771.16
Rate for Payer: Aetna Commercial $5,645.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,394.78
Rate for Payer: Aetna Managed Medicare $1,756.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,077.45
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,136.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,011.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,324.69
Rate for Payer: Cash Price $1,881.90
Rate for Payer: Cigna Commercial $5,771.16
Rate for Payer: Dean Health DHI/DHP/ASO $3,510.37
Rate for Payer: Health EOS Commercial $5,582.97
Rate for Payer: HFN Commercial $5,771.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,704.75
Rate for Payer: Multiplan Commercial $5,018.40
Rate for Payer: NAPHCARE Commercial $3,763.80
Rate for Payer: Preferred Network Access Commercial $5,771.16
Rate for Payer: Quartz Beloit One Network $3,073.77
Rate for Payer: Quartz Commercial $4,077.45
Rate for Payer: Quartz Medicare Advantage $3,763.80
Rate for Payer: WEA Trust Commercial $3,450.15
Rate for Payer: WPS Commercial $4,646.41
Service Code HCPCS C1713
Hospital Charge Code 2964674
Hospital Revenue Code 278
Min. Negotiated Rate $3,073.77
Max. Negotiated Rate $5,771.16
Rate for Payer: Aetna Commercial $5,645.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,324.69
Rate for Payer: Cash Price $1,881.90
Rate for Payer: Cigna Commercial $5,771.16
Rate for Payer: Health EOS Commercial $5,582.97
Rate for Payer: HFN Commercial $5,771.16
Rate for Payer: Multiplan Commercial $5,018.40
Rate for Payer: NAPHCARE Commercial $3,763.80
Rate for Payer: Preferred Network Access Commercial $5,771.16
Rate for Payer: Quartz Beloit One Network $3,073.77
Rate for Payer: Quartz Commercial $3,763.80
Rate for Payer: WEA Trust Commercial $3,450.15
Rate for Payer: WPS Commercial $4,646.41
Service Code HCPCS C1713
Hospital Charge Code 3661498
Hospital Revenue Code 278
Min. Negotiated Rate $2,894.43
Max. Negotiated Rate $5,434.44
Rate for Payer: Aetna Commercial $5,316.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,130.71
Rate for Payer: Cash Price $1,772.10
Rate for Payer: Cigna Commercial $5,434.44
Rate for Payer: Health EOS Commercial $5,257.23
Rate for Payer: HFN Commercial $5,434.44
Rate for Payer: Multiplan Commercial $4,725.60
Rate for Payer: NAPHCARE Commercial $3,544.20
Rate for Payer: Preferred Network Access Commercial $5,434.44
Rate for Payer: Quartz Beloit One Network $2,894.43
Rate for Payer: Quartz Commercial $3,544.20
Rate for Payer: WEA Trust Commercial $3,248.85
Rate for Payer: WPS Commercial $4,375.31
Service Code HCPCS C1713
Hospital Charge Code 3661498
Hospital Revenue Code 278
Min. Negotiated Rate $1,653.96
Max. Negotiated Rate $5,434.44
Rate for Payer: Aetna Commercial $5,316.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $5,080.02
Rate for Payer: Aetna Managed Medicare $1,653.96
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,839.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,953.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,835.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,130.71
Rate for Payer: Cash Price $1,772.10
Rate for Payer: Cigna Commercial $5,434.44
Rate for Payer: Dean Health DHI/DHP/ASO $3,305.56
Rate for Payer: Health EOS Commercial $5,257.23
Rate for Payer: HFN Commercial $5,434.44
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4,430.25
Rate for Payer: Multiplan Commercial $4,725.60
Rate for Payer: NAPHCARE Commercial $3,544.20
Rate for Payer: Preferred Network Access Commercial $5,434.44
Rate for Payer: Quartz Beloit One Network $2,894.43
Rate for Payer: Quartz Commercial $3,839.55
Rate for Payer: Quartz Medicare Advantage $3,544.20
Rate for Payer: WEA Trust Commercial $3,248.85
Rate for Payer: WPS Commercial $4,375.31