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Service Code CPT 82157
Hospital Charge Code 977868
Hospital Revenue Code 300
Min. Negotiated Rate $29.28
Max. Negotiated Rate $1,780.00
Rate for Payer: Aetna Commercial $400.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $382.70
Rate for Payer: Aetna Managed Medicare $29.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $109.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $51.24
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $48.60
Rate for Payer: Anthem Medicaid $30.26
Rate for Payer: Anthem Medicare Advantage $29.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $235.85
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $29.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $29.28
Rate for Payer: Cash Price $133.50
Rate for Payer: Cash Price $133.50
Rate for Payer: Cigna Commercial $409.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $29.28
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $30.26
Rate for Payer: Dean Health Medicaid $30.26
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $29.28
Rate for Payer: Health EOS Commercial $396.05
Rate for Payer: HFN Commercial $409.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $108.92
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $29.28
Rate for Payer: Independent Care Health Plan Medicaid $30.26
Rate for Payer: Independent Care Health Plan Medicare $29.28
Rate for Payer: Managed Health Services Medicaid $31.47
Rate for Payer: Managed Health Services Medicare Advantage $29.28
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $29.28
Rate for Payer: Multiplan Commercial $356.00
Rate for Payer: NAPHCARE Commercial $43.92
Rate for Payer: Preferred Network Access Commercial $409.40
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $30.26
Rate for Payer: Quartz Beloit One Network $218.05
Rate for Payer: Quartz Commercial $289.25
Rate for Payer: Quartz Medicare Advantage $29.28
Rate for Payer: The Alliance Commercial $1,780.00
Rate for Payer: United Healthcare Medicaid $30.26
Rate for Payer: United Healthcare Medicare Advantage $29.28
Rate for Payer: United Healthcare PPO $333.75
Rate for Payer: WEA Trust Commercial $244.75
Rate for Payer: Wellcare Medicare $29.28
Rate for Payer: WMAP Medicaid $30.26
Rate for Payer: WPS Commercial $329.61
Service Code CPT 82157
Hospital Charge Code 977868
Hospital Revenue Code 300
Min. Negotiated Rate $29.28
Max. Negotiated Rate $422.75
Rate for Payer: Aetna Commercial $422.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $382.70
Rate for Payer: Aetna Managed Medicare $29.28
Rate for Payer: Anthem Medicare Advantage $29.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $29.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $29.28
Rate for Payer: Cash Price $133.50
Rate for Payer: Cash Price $133.50
Rate for Payer: Cigna Commercial $422.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $222.50
Rate for Payer: Dean Health DHI/DHP/ASO $29.28
Rate for Payer: Health EOS Commercial $404.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $103.36
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $103.36
Rate for Payer: Independent Care Health Plan Medicare $29.28
Rate for Payer: Multiplan Commercial $356.00
Rate for Payer: Preferred Network Access Commercial $422.75
Rate for Payer: Quartz Beloit One Network $195.80
Rate for Payer: Quartz Commercial $253.65
Rate for Payer: Quartz Medicare Advantage $29.28
Rate for Payer: The Alliance Commercial $115.66
Rate for Payer: United Healthcare Medicare Advantage $29.28
Rate for Payer: WEA Trust Commercial $244.75
Rate for Payer: WPS Commercial $128.83
Hospital Charge Code 3101748
Hospital Revenue Code 271
Min. Negotiated Rate $411.11
Max. Negotiated Rate $771.88
Rate for Payer: Aetna Commercial $755.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $444.67
Rate for Payer: Cash Price $251.70
Rate for Payer: Cigna Commercial $771.88
Rate for Payer: Health EOS Commercial $746.71
Rate for Payer: HFN Commercial $771.88
Rate for Payer: Multiplan Commercial $671.20
Rate for Payer: NAPHCARE Commercial $503.40
Rate for Payer: Preferred Network Access Commercial $771.88
Rate for Payer: Quartz Beloit One Network $411.11
Rate for Payer: Quartz Commercial $503.40
Rate for Payer: WEA Trust Commercial $461.45
Rate for Payer: WPS Commercial $621.45
Hospital Charge Code 3101748
Hospital Revenue Code 271
Min. Negotiated Rate $234.92
Max. Negotiated Rate $3,356.00
Rate for Payer: Aetna Commercial $755.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $721.54
Rate for Payer: Aetna Managed Medicare $234.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $545.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $419.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $402.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $444.67
Rate for Payer: Cash Price $251.70
Rate for Payer: Cigna Commercial $771.88
Rate for Payer: Dean Health DHI/DHP/ASO $469.50
Rate for Payer: Health EOS Commercial $746.71
Rate for Payer: HFN Commercial $771.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $629.25
Rate for Payer: Multiplan Commercial $671.20
Rate for Payer: NAPHCARE Commercial $503.40
Rate for Payer: Preferred Network Access Commercial $771.88
Rate for Payer: Quartz Beloit One Network $411.11
Rate for Payer: Quartz Commercial $545.35
Rate for Payer: Quartz Medicare Advantage $503.40
Rate for Payer: The Alliance Commercial $3,356.00
Rate for Payer: WEA Trust Commercial $461.45
Rate for Payer: WPS Commercial $621.45
Hospital Charge Code 2960327
Hospital Revenue Code 360
Min. Negotiated Rate $7,596.96
Max. Negotiated Rate $14,263.68
Rate for Payer: Aetna Commercial $13,953.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,217.12
Rate for Payer: Cash Price $4,651.20
Rate for Payer: Cigna Commercial $14,263.68
Rate for Payer: Health EOS Commercial $13,798.56
Rate for Payer: HFN Commercial $14,263.68
Rate for Payer: Multiplan Commercial $12,403.20
Rate for Payer: NAPHCARE Commercial $9,302.40
Rate for Payer: Preferred Network Access Commercial $14,263.68
Rate for Payer: Quartz Beloit One Network $7,596.96
Rate for Payer: Quartz Commercial $9,302.40
Rate for Payer: WEA Trust Commercial $8,527.20
Rate for Payer: WPS Commercial $11,483.81
Hospital Charge Code 2960327
Hospital Revenue Code 360
Min. Negotiated Rate $4,341.12
Max. Negotiated Rate $62,016.00
Rate for Payer: Aetna Commercial $13,953.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,333.44
Rate for Payer: Aetna Managed Medicare $4,341.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $10,077.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $7,752.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $7,441.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,217.12
Rate for Payer: Cash Price $4,651.20
Rate for Payer: Cigna Commercial $14,263.68
Rate for Payer: Dean Health DHI/DHP/ASO $8,676.04
Rate for Payer: Health EOS Commercial $13,798.56
Rate for Payer: HFN Commercial $14,263.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,628.00
Rate for Payer: Multiplan Commercial $12,403.20
Rate for Payer: NAPHCARE Commercial $9,302.40
Rate for Payer: Preferred Network Access Commercial $14,263.68
Rate for Payer: Quartz Beloit One Network $7,596.96
Rate for Payer: Quartz Commercial $10,077.60
Rate for Payer: Quartz Medicare Advantage $9,302.40
Rate for Payer: The Alliance Commercial $62,016.00
Rate for Payer: WEA Trust Commercial $8,527.20
Rate for Payer: WPS Commercial $11,483.81
Hospital Charge Code 5458899
Hospital Revenue Code 272
Min. Negotiated Rate $2,364.32
Max. Negotiated Rate $33,776.00
Rate for Payer: Aetna Commercial $7,599.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,261.84
Rate for Payer: Aetna Managed Medicare $2,364.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,488.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,222.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,053.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,475.32
Rate for Payer: Cash Price $2,533.20
Rate for Payer: Cigna Commercial $7,768.48
Rate for Payer: Dean Health DHI/DHP/ASO $4,725.26
Rate for Payer: Health EOS Commercial $7,515.16
Rate for Payer: HFN Commercial $7,768.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,333.00
Rate for Payer: Multiplan Commercial $6,755.20
Rate for Payer: NAPHCARE Commercial $5,066.40
Rate for Payer: Preferred Network Access Commercial $7,768.48
Rate for Payer: Quartz Beloit One Network $4,137.56
Rate for Payer: Quartz Commercial $5,488.60
Rate for Payer: Quartz Medicare Advantage $5,066.40
Rate for Payer: The Alliance Commercial $33,776.00
Rate for Payer: WEA Trust Commercial $4,644.20
Rate for Payer: WPS Commercial $6,254.47
Hospital Charge Code 5458899
Hospital Revenue Code 272
Min. Negotiated Rate $4,137.56
Max. Negotiated Rate $7,768.48
Rate for Payer: Aetna Commercial $7,599.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,475.32
Rate for Payer: Cash Price $2,533.20
Rate for Payer: Cigna Commercial $7,768.48
Rate for Payer: Health EOS Commercial $7,515.16
Rate for Payer: HFN Commercial $7,768.48
Rate for Payer: Multiplan Commercial $6,755.20
Rate for Payer: NAPHCARE Commercial $5,066.40
Rate for Payer: Preferred Network Access Commercial $7,768.48
Rate for Payer: Quartz Beloit One Network $4,137.56
Rate for Payer: Quartz Commercial $5,066.40
Rate for Payer: WEA Trust Commercial $4,644.20
Rate for Payer: WPS Commercial $6,254.47
Service Code MS-DRG 311
Min. Negotiated Rate $6,791.40
Max. Negotiated Rate $18,880.00
Rate for Payer: Aetna Managed Medicare $6,791.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $14,686.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $11,256.70
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,694.60
Rate for Payer: Anthem Medicare Advantage $6,791.40
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $6,791.40
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $6,791.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $6,791.40
Rate for Payer: Dean Health DHI/DHP/ASO $11,871.99
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $6,791.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $13,612.95
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $6,791.40
Rate for Payer: Independent Care Health Plan Medicare $6,791.40
Rate for Payer: Managed Health Services Medicare Advantage $6,791.40
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $6,791.40
Rate for Payer: NAPHCARE Commercial $10,187.10
Rate for Payer: Quartz Medicare Advantage $6,791.40
Rate for Payer: The Alliance Commercial $18,880.00
Rate for Payer: United Healthcare Medicare Advantage $6,791.40
Rate for Payer: United Healthcare PPO $10,597.86
Rate for Payer: Wellcare Medicare $6,791.40
Service Code CPT 75625
Hospital Charge Code 3052537
Hospital Revenue Code 320
Min. Negotiated Rate $2,688.63
Max. Negotiated Rate $5,048.04
Rate for Payer: Aetna Commercial $4,938.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,908.11
Rate for Payer: Cash Price $1,646.10
Rate for Payer: Cigna Commercial $5,048.04
Rate for Payer: Health EOS Commercial $4,883.43
Rate for Payer: HFN Commercial $5,048.04
Rate for Payer: Multiplan Commercial $4,389.60
Rate for Payer: NAPHCARE Commercial $3,292.20
Rate for Payer: Preferred Network Access Commercial $5,048.04
Rate for Payer: Quartz Beloit One Network $2,688.63
Rate for Payer: Quartz Commercial $3,292.20
Rate for Payer: WEA Trust Commercial $3,017.85
Rate for Payer: WPS Commercial $4,064.22
Service Code CPT 75625
Hospital Charge Code 3052537
Hospital Revenue Code 320
Min. Negotiated Rate $72.20
Max. Negotiated Rate $11,814.49
Rate for Payer: Aetna Commercial $4,938.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,718.82
Rate for Payer: Aetna Managed Medicare $3,150.53
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $11,814.49
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $9,451.59
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $8,979.01
Rate for Payer: Anthem Medicare Advantage $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,908.11
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,150.53
Rate for Payer: Cash Price $1,646.10
Rate for Payer: Cash Price $1,646.10
Rate for Payer: Cash Price $1,646.10
Rate for Payer: Cigna Commercial $5,048.04
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,150.53
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,150.53
Rate for Payer: Health EOS Commercial $4,883.43
Rate for Payer: HFN Commercial $5,048.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,719.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,150.53
Rate for Payer: Independent Care Health Plan Medicare $3,150.53
Rate for Payer: Managed Health Services Medicare Advantage $3,150.53
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,150.53
Rate for Payer: Multiplan Commercial $4,389.60
Rate for Payer: NAPHCARE Commercial $4,725.80
Rate for Payer: Preferred Network Access Commercial $5,048.04
Rate for Payer: Quartz Beloit One Network $2,688.63
Rate for Payer: Quartz Commercial $3,566.55
Rate for Payer: Quartz Medicare Advantage $3,150.53
Rate for Payer: The Alliance Commercial $72.20
Rate for Payer: United Healthcare Medicare Advantage $3,150.53
Rate for Payer: United Healthcare PPO $301.00
Rate for Payer: WEA Trust Commercial $3,017.85
Rate for Payer: Wellcare Medicare $3,150.53
Rate for Payer: WPS Commercial $4,064.22
Service Code CPT 75630
Hospital Charge Code 3052538
Hospital Revenue Code 481
Min. Negotiated Rate $5,565.42
Max. Negotiated Rate $10,449.36
Rate for Payer: Aetna Commercial $10,222.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,019.74
Rate for Payer: Cash Price $3,407.40
Rate for Payer: Cigna Commercial $10,449.36
Rate for Payer: Health EOS Commercial $10,108.62
Rate for Payer: HFN Commercial $10,449.36
Rate for Payer: Multiplan Commercial $9,086.40
Rate for Payer: NAPHCARE Commercial $6,814.80
Rate for Payer: Preferred Network Access Commercial $10,449.36
Rate for Payer: Quartz Beloit One Network $5,565.42
Rate for Payer: Quartz Commercial $6,814.80
Rate for Payer: WEA Trust Commercial $6,246.90
Rate for Payer: WPS Commercial $8,412.87
Service Code CPT 75630
Hospital Charge Code 3052538
Hospital Revenue Code 481
Min. Negotiated Rate $180.00
Max. Negotiated Rate $11,719.97
Rate for Payer: Aetna Commercial $10,222.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,767.88
Rate for Payer: Aetna Managed Medicare $3,150.53
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $7,382.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,679.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,451.84
Rate for Payer: Anthem Medicare Advantage $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $6,019.74
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,150.53
Rate for Payer: Cash Price $3,407.40
Rate for Payer: Cash Price $3,407.40
Rate for Payer: Cigna Commercial $10,449.36
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,150.53
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,150.53
Rate for Payer: Health EOS Commercial $10,108.62
Rate for Payer: HFN Commercial $10,449.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,719.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,150.53
Rate for Payer: Independent Care Health Plan Medicare $3,150.53
Rate for Payer: Managed Health Services Medicare Advantage $3,150.53
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,150.53
Rate for Payer: Multiplan Commercial $9,086.40
Rate for Payer: NAPHCARE Commercial $4,725.80
Rate for Payer: Preferred Network Access Commercial $10,449.36
Rate for Payer: Quartz Beloit One Network $5,565.42
Rate for Payer: Quartz Commercial $7,382.70
Rate for Payer: Quartz Medicare Advantage $3,150.53
Rate for Payer: The Alliance Commercial $180.00
Rate for Payer: United Healthcare Medicare Advantage $3,150.53
Rate for Payer: WEA Trust Commercial $6,246.90
Rate for Payer: Wellcare Medicare $3,150.53
Rate for Payer: WPS Commercial $8,412.87
Service Code CPT 36221
Hospital Charge Code 3052418
Hospital Revenue Code 481
Min. Negotiated Rate $1,553.30
Max. Negotiated Rate $26,084.76
Rate for Payer: Aetna Commercial $2,853.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,726.20
Rate for Payer: Aetna Managed Medicare $3,150.53
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $9,907.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $8,043.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $7,639.00
Rate for Payer: Anthem Medicare Advantage $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,680.10
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,150.53
Rate for Payer: Cash Price $951.00
Rate for Payer: Cash Price $951.00
Rate for Payer: Cash Price $951.00
Rate for Payer: Cigna Commercial $2,916.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,150.53
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,150.53
Rate for Payer: Health EOS Commercial $2,821.30
Rate for Payer: HFN Commercial $2,916.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,719.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,150.53
Rate for Payer: Independent Care Health Plan Medicare $3,150.53
Rate for Payer: Managed Health Services Medicare Advantage $3,150.53
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,150.53
Rate for Payer: Multiplan Commercial $2,536.00
Rate for Payer: NAPHCARE Commercial $4,725.80
Rate for Payer: Preferred Network Access Commercial $2,916.40
Rate for Payer: Quartz Beloit One Network $1,553.30
Rate for Payer: Quartz Commercial $2,060.50
Rate for Payer: Quartz Medicare Advantage $3,150.53
Rate for Payer: The Alliance Commercial $26,084.76
Rate for Payer: United Healthcare Medicare Advantage $3,150.53
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: WEA Trust Commercial $1,743.50
Rate for Payer: Wellcare Medicare $3,150.53
Rate for Payer: WPS Commercial $2,348.02
Service Code CPT 36221
Hospital Charge Code 3052418
Hospital Revenue Code 481
Min. Negotiated Rate $1,553.30
Max. Negotiated Rate $2,916.40
Rate for Payer: Aetna Commercial $2,853.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,680.10
Rate for Payer: Cash Price $951.00
Rate for Payer: Cigna Commercial $2,916.40
Rate for Payer: Health EOS Commercial $2,821.30
Rate for Payer: HFN Commercial $2,916.40
Rate for Payer: Multiplan Commercial $2,536.00
Rate for Payer: NAPHCARE Commercial $1,902.00
Rate for Payer: Preferred Network Access Commercial $2,916.40
Rate for Payer: Quartz Beloit One Network $1,553.30
Rate for Payer: Quartz Commercial $1,902.00
Rate for Payer: WEA Trust Commercial $1,743.50
Rate for Payer: WPS Commercial $2,348.02
Service Code CPT 36222 50
Hospital Charge Code 5577888
Hospital Revenue Code 481
Min. Negotiated Rate $9,538.83
Max. Negotiated Rate $17,909.64
Rate for Payer: Aetna Commercial $17,520.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $10,317.51
Rate for Payer: Cash Price $5,840.10
Rate for Payer: Cigna Commercial $17,909.64
Rate for Payer: Health EOS Commercial $17,325.63
Rate for Payer: HFN Commercial $17,909.64
Rate for Payer: Multiplan Commercial $15,573.60
Rate for Payer: NAPHCARE Commercial $11,680.20
Rate for Payer: Preferred Network Access Commercial $17,909.64
Rate for Payer: Quartz Beloit One Network $9,538.83
Rate for Payer: Quartz Commercial $11,680.20
Rate for Payer: WEA Trust Commercial $10,706.85
Rate for Payer: WPS Commercial $14,419.21
Service Code CPT 36222 50
Hospital Charge Code 5577888
Hospital Revenue Code 481
Min. Negotiated Rate $5,450.76
Max. Negotiated Rate $77,868.00
Rate for Payer: Aetna Commercial $17,520.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $16,741.62
Rate for Payer: Aetna Managed Medicare $5,450.76
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,653.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $9,733.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $9,344.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $10,317.51
Rate for Payer: Cash Price $5,840.10
Rate for Payer: Cigna Commercial $17,909.64
Rate for Payer: Dean Health DHI/DHP/ASO $10,893.73
Rate for Payer: Health EOS Commercial $17,325.63
Rate for Payer: HFN Commercial $17,909.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $14,600.25
Rate for Payer: Multiplan Commercial $15,573.60
Rate for Payer: NAPHCARE Commercial $11,680.20
Rate for Payer: Preferred Network Access Commercial $17,909.64
Rate for Payer: Quartz Beloit One Network $9,538.83
Rate for Payer: Quartz Commercial $12,653.55
Rate for Payer: Quartz Medicare Advantage $11,680.20
Rate for Payer: The Alliance Commercial $77,868.00
Rate for Payer: WEA Trust Commercial $10,706.85
Rate for Payer: WPS Commercial $14,419.21
Service Code CPT 36224
Hospital Charge Code 4163434
Hospital Revenue Code 481
Min. Negotiated Rate $2,211.37
Max. Negotiated Rate $26,084.76
Rate for Payer: Aetna Commercial $4,061.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,881.18
Rate for Payer: Aetna Managed Medicare $5,431.64
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,238.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $10,914.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,367.00
Rate for Payer: Anthem Medicare Advantage $5,431.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,391.89
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $5,431.64
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $5,431.64
Rate for Payer: Cash Price $1,353.90
Rate for Payer: Cash Price $1,353.90
Rate for Payer: Cash Price $1,353.90
Rate for Payer: Cigna Commercial $4,151.96
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $5,431.64
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $5,431.64
Rate for Payer: Health EOS Commercial $4,016.57
Rate for Payer: HFN Commercial $4,151.96
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $20,205.70
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $5,431.64
Rate for Payer: Independent Care Health Plan Medicare $5,431.64
Rate for Payer: Managed Health Services Medicare Advantage $5,431.64
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $5,431.64
Rate for Payer: Multiplan Commercial $3,610.40
Rate for Payer: NAPHCARE Commercial $8,147.46
Rate for Payer: Preferred Network Access Commercial $4,151.96
Rate for Payer: Quartz Beloit One Network $2,211.37
Rate for Payer: Quartz Commercial $2,933.45
Rate for Payer: Quartz Medicare Advantage $5,431.64
Rate for Payer: The Alliance Commercial $26,084.76
Rate for Payer: United Healthcare Medicare Advantage $5,431.64
Rate for Payer: United Healthcare PPO $4,240.00
Rate for Payer: WEA Trust Commercial $2,482.15
Rate for Payer: Wellcare Medicare $5,431.64
Rate for Payer: WPS Commercial $3,342.78
Service Code CPT 36224
Hospital Charge Code 4163434
Hospital Revenue Code 481
Min. Negotiated Rate $2,211.37
Max. Negotiated Rate $4,151.96
Rate for Payer: Aetna Commercial $4,061.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,391.89
Rate for Payer: Cash Price $1,353.90
Rate for Payer: Cigna Commercial $4,151.96
Rate for Payer: Health EOS Commercial $4,016.57
Rate for Payer: HFN Commercial $4,151.96
Rate for Payer: Multiplan Commercial $3,610.40
Rate for Payer: NAPHCARE Commercial $2,707.80
Rate for Payer: Preferred Network Access Commercial $4,151.96
Rate for Payer: Quartz Beloit One Network $2,211.37
Rate for Payer: Quartz Commercial $2,707.80
Rate for Payer: WEA Trust Commercial $2,482.15
Rate for Payer: WPS Commercial $3,342.78
Service Code CPT 36222
Hospital Charge Code 3052419
Hospital Revenue Code 481
Min. Negotiated Rate $4,952.92
Max. Negotiated Rate $9,299.36
Rate for Payer: Aetna Commercial $9,097.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,357.24
Rate for Payer: Cash Price $3,032.40
Rate for Payer: Cigna Commercial $9,299.36
Rate for Payer: Health EOS Commercial $8,996.12
Rate for Payer: HFN Commercial $9,299.36
Rate for Payer: Multiplan Commercial $8,086.40
Rate for Payer: NAPHCARE Commercial $6,064.80
Rate for Payer: Preferred Network Access Commercial $9,299.36
Rate for Payer: Quartz Beloit One Network $4,952.92
Rate for Payer: Quartz Commercial $6,064.80
Rate for Payer: WEA Trust Commercial $5,559.40
Rate for Payer: WPS Commercial $7,487.00
Service Code CPT 36222
Hospital Charge Code 3052419
Hospital Revenue Code 481
Min. Negotiated Rate $3,150.53
Max. Negotiated Rate $11,719.97
Rate for Payer: Aetna Commercial $9,097.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $8,692.88
Rate for Payer: Aetna Managed Medicare $3,150.53
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $9,907.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $8,043.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $7,639.00
Rate for Payer: Anthem Medicare Advantage $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,357.24
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3,150.53
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3,150.53
Rate for Payer: Cash Price $3,032.40
Rate for Payer: Cash Price $3,032.40
Rate for Payer: Cash Price $3,032.40
Rate for Payer: Cigna Commercial $9,299.36
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3,150.53
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3,150.53
Rate for Payer: Health EOS Commercial $8,996.12
Rate for Payer: HFN Commercial $9,299.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,719.97
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3,150.53
Rate for Payer: Independent Care Health Plan Medicare $3,150.53
Rate for Payer: Managed Health Services Medicare Advantage $3,150.53
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3,150.53
Rate for Payer: Multiplan Commercial $8,086.40
Rate for Payer: NAPHCARE Commercial $4,725.80
Rate for Payer: Preferred Network Access Commercial $9,299.36
Rate for Payer: Quartz Beloit One Network $4,952.92
Rate for Payer: Quartz Commercial $6,570.20
Rate for Payer: Quartz Medicare Advantage $3,150.53
Rate for Payer: The Alliance Commercial $6,468.56
Rate for Payer: United Healthcare Medicare Advantage $3,150.53
Rate for Payer: United Healthcare PPO $4,103.00
Rate for Payer: WEA Trust Commercial $5,559.40
Rate for Payer: Wellcare Medicare $3,150.53
Rate for Payer: WPS Commercial $7,487.00
Service Code HCPCS C1725
Hospital Charge Code 2965510
Hospital Revenue Code 272
Min. Negotiated Rate $97.16
Max. Negotiated Rate $319.24
Rate for Payer: Aetna Commercial $312.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $298.42
Rate for Payer: Aetna Managed Medicare $97.16
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $225.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $173.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $166.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $183.91
Rate for Payer: Cash Price $104.10
Rate for Payer: Cigna Commercial $319.24
Rate for Payer: Dean Health DHI/DHP/ASO $194.18
Rate for Payer: Health EOS Commercial $308.83
Rate for Payer: HFN Commercial $319.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $260.25
Rate for Payer: Multiplan Commercial $277.60
Rate for Payer: NAPHCARE Commercial $208.20
Rate for Payer: Preferred Network Access Commercial $319.24
Rate for Payer: Quartz Beloit One Network $170.03
Rate for Payer: Quartz Commercial $225.55
Rate for Payer: Quartz Medicare Advantage $208.20
Rate for Payer: WEA Trust Commercial $190.85
Rate for Payer: WPS Commercial $257.02
Service Code HCPCS C1725
Hospital Charge Code 2965510
Hospital Revenue Code 272
Min. Negotiated Rate $170.03
Max. Negotiated Rate $319.24
Rate for Payer: Aetna Commercial $312.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $183.91
Rate for Payer: Cash Price $104.10
Rate for Payer: Cigna Commercial $319.24
Rate for Payer: Health EOS Commercial $308.83
Rate for Payer: HFN Commercial $319.24
Rate for Payer: Multiplan Commercial $277.60
Rate for Payer: NAPHCARE Commercial $208.20
Rate for Payer: Preferred Network Access Commercial $319.24
Rate for Payer: Quartz Beloit One Network $170.03
Rate for Payer: Quartz Commercial $208.20
Rate for Payer: WEA Trust Commercial $190.85
Rate for Payer: WPS Commercial $257.02
Hospital Charge Code 3040299
Hospital Revenue Code 271
Min. Negotiated Rate $1.12
Max. Negotiated Rate $16.00
Rate for Payer: Aetna Commercial $3.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3.44
Rate for Payer: Aetna Managed Medicare $1.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2.12
Rate for Payer: Cash Price $1.20
Rate for Payer: Cigna Commercial $3.68
Rate for Payer: Dean Health DHI/DHP/ASO $2.24
Rate for Payer: Health EOS Commercial $3.56
Rate for Payer: HFN Commercial $3.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3.00
Rate for Payer: Multiplan Commercial $3.20
Rate for Payer: NAPHCARE Commercial $2.40
Rate for Payer: Preferred Network Access Commercial $3.68
Rate for Payer: Quartz Beloit One Network $1.96
Rate for Payer: Quartz Commercial $2.60
Rate for Payer: Quartz Medicare Advantage $2.40
Rate for Payer: The Alliance Commercial $16.00
Rate for Payer: WEA Trust Commercial $2.20
Rate for Payer: WPS Commercial $2.96
Hospital Charge Code 3040299
Hospital Revenue Code 271
Min. Negotiated Rate $1.96
Max. Negotiated Rate $3.68
Rate for Payer: Aetna Commercial $3.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2.12
Rate for Payer: Cash Price $1.20
Rate for Payer: Cigna Commercial $3.68
Rate for Payer: Health EOS Commercial $3.56
Rate for Payer: HFN Commercial $3.68
Rate for Payer: Multiplan Commercial $3.20
Rate for Payer: NAPHCARE Commercial $2.40
Rate for Payer: Preferred Network Access Commercial $3.68
Rate for Payer: Quartz Beloit One Network $1.96
Rate for Payer: Quartz Commercial $2.40
Rate for Payer: WEA Trust Commercial $2.20
Rate for Payer: WPS Commercial $2.96