|
NAIL GAMMA 11.0 X 420 X 125DEG LONG LT TI 3525-1420S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509051
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 11 X 440 X 125 RT LONG 3425-1440S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5459254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 11 X 440 X 125 RT LONG 3425-1440S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5459254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 12.0 X 170MM X 125DEG TROCHANTERIC 8125-2170S
|
Facility
|
OP
|
$6,979.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6207009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.12 |
| Max. Negotiated Rate |
$27,916.00 |
| Rate for Payer: Aetna Commercial |
$6,281.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,001.94
|
| Rate for Payer: Aetna Managed Medicare |
$1,954.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,536.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,489.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,349.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,698.87
|
| Rate for Payer: Cash Price |
$2,093.70
|
| Rate for Payer: Cigna Commercial |
$6,420.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,905.45
|
| Rate for Payer: Health EOS Commercial |
$6,211.31
|
| Rate for Payer: HFN Commercial |
$6,420.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,234.25
|
| Rate for Payer: Multiplan Commercial |
$5,583.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,187.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,420.68
|
| Rate for Payer: Quartz Beloit One Network |
$3,419.71
|
| Rate for Payer: Quartz Commercial |
$4,536.35
|
| Rate for Payer: Quartz Medicare Advantage |
$4,187.40
|
| Rate for Payer: The Alliance Commercial |
$27,916.00
|
| Rate for Payer: WEA Trust Commercial |
$3,838.45
|
| Rate for Payer: WPS Commercial |
$5,169.35
|
|
|
NAIL GAMMA 12.0 X 170MM X 125DEG TROCHANTERIC 8125-2170S
|
Facility
|
IP
|
$6,979.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6207009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,419.71 |
| Max. Negotiated Rate |
$6,420.68 |
| Rate for Payer: Aetna Commercial |
$6,281.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,001.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,698.87
|
| Rate for Payer: Cash Price |
$2,093.70
|
| Rate for Payer: Cigna Commercial |
$6,420.68
|
| Rate for Payer: Health EOS Commercial |
$6,211.31
|
| Rate for Payer: HFN Commercial |
$6,420.68
|
| Rate for Payer: Multiplan Commercial |
$5,583.20
|
| Rate for Payer: NAPHCARE Commercial |
$4,187.40
|
| Rate for Payer: Preferred Network Access Commercial |
$6,420.68
|
| Rate for Payer: Quartz Beloit One Network |
$3,419.71
|
| Rate for Payer: Quartz Commercial |
$4,187.40
|
| Rate for Payer: WEA Trust Commercial |
$3,838.45
|
| Rate for Payer: WPS Commercial |
$5,169.35
|
|
|
NAIL GAMMA 13.0 X 280 X 125DEG LONG LT TI 3525-3280S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5106962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 280 X 125DEG LONG LT TI 3525-3280S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5106962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 340 X 125DEG LONG RT TI 3525-3340S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5306830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 340 X 125DEG LONG RT TI 3525-3340S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5306830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 360 X 125DEG LONG RT TI 3525-3360S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5074815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 360 X 125DEG LONG RT TI 3525-3360S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5074815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 380 X 125DEG LONG RT TI 3525-3380S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4632621
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 13.0 X 380 X 125DEG LONG RT TI 3525-3380S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4632621
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 15.0 X 380 X 125DEG LONG LT TI 3525-5380S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5496878
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 15.0 X 380 X 125DEG LONG LT TI 3525-5380S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5496878
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 15.0 X 400 X 125DEG LONG LT TI 3525-5400S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5459201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA 15.0 X 400 X 125DEG LONG LT TI 3525-5400S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5459201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA3 11 X 320MM X 125DEG RIGHT 3425-1320S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.04 |
| Max. Negotiated Rate |
$38,572.00 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,700.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,821.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,396.22
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,232.25
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$6,267.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.80
|
| Rate for Payer: The Alliance Commercial |
$38,572.00
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA3 11 X 320MM X 125DEG RIGHT 3425-1320S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,725.07 |
| Max. Negotiated Rate |
$8,871.56 |
| Rate for Payer: Aetna Commercial |
$8,678.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,292.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.79
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$8,871.56
|
| Rate for Payer: Health EOS Commercial |
$8,582.27
|
| Rate for Payer: HFN Commercial |
$8,871.56
|
| Rate for Payer: Multiplan Commercial |
$7,714.40
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.80
|
| Rate for Payer: Preferred Network Access Commercial |
$8,871.56
|
| Rate for Payer: Quartz Beloit One Network |
$4,725.07
|
| Rate for Payer: Quartz Commercial |
$5,785.80
|
| Rate for Payer: WEA Trust Commercial |
$5,303.65
|
| Rate for Payer: WPS Commercial |
$7,142.57
|
|
|
NAIL GAMMA3 11 X 340MM X 125DEG RIGHT 3425-1340S
|
Facility
|
IP
|
$7,178.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
3605501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,517.22 |
| Max. Negotiated Rate |
$6,603.76 |
| Rate for Payer: Aetna Commercial |
$6,460.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,173.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,804.34
|
| Rate for Payer: Cash Price |
$2,153.40
|
| Rate for Payer: Cigna Commercial |
$6,603.76
|
| Rate for Payer: Health EOS Commercial |
$6,388.42
|
| Rate for Payer: HFN Commercial |
$6,603.76
|
| Rate for Payer: Multiplan Commercial |
$5,742.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,306.80
|
| Rate for Payer: Preferred Network Access Commercial |
$6,603.76
|
| Rate for Payer: Quartz Beloit One Network |
$3,517.22
|
| Rate for Payer: Quartz Commercial |
$4,306.80
|
| Rate for Payer: WEA Trust Commercial |
$3,947.90
|
| Rate for Payer: WPS Commercial |
$5,316.74
|
|
|
NAIL GAMMA3 11 X 340MM X 125DEG RIGHT 3425-1340S
|
Facility
|
OP
|
$7,178.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
3605501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,009.84 |
| Max. Negotiated Rate |
$28,712.00 |
| Rate for Payer: Aetna Commercial |
$6,460.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,173.08
|
| Rate for Payer: Aetna Managed Medicare |
$2,009.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,665.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,589.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,445.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,804.34
|
| Rate for Payer: Cash Price |
$2,153.40
|
| Rate for Payer: Cigna Commercial |
$6,603.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,016.81
|
| Rate for Payer: Health EOS Commercial |
$6,388.42
|
| Rate for Payer: HFN Commercial |
$6,603.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,383.50
|
| Rate for Payer: Multiplan Commercial |
$5,742.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,306.80
|
| Rate for Payer: Preferred Network Access Commercial |
$6,603.76
|
| Rate for Payer: Quartz Beloit One Network |
$3,517.22
|
| Rate for Payer: Quartz Commercial |
$4,665.70
|
| Rate for Payer: Quartz Medicare Advantage |
$4,306.80
|
| Rate for Payer: The Alliance Commercial |
$28,712.00
|
| Rate for Payer: WEA Trust Commercial |
$3,947.90
|
| Rate for Payer: WPS Commercial |
$5,316.74
|
|
|
NAIL GAMMA4 LONG 11 X 340 X 125DEG RT 8425-1340S
|
Facility
|
IP
|
$10,473.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6181746
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,131.77 |
| Max. Negotiated Rate |
$9,635.16 |
| Rate for Payer: Aetna Commercial |
$9,425.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,006.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,550.69
|
| Rate for Payer: Cash Price |
$3,141.90
|
| Rate for Payer: Cigna Commercial |
$9,635.16
|
| Rate for Payer: Health EOS Commercial |
$9,320.97
|
| Rate for Payer: HFN Commercial |
$9,635.16
|
| Rate for Payer: Multiplan Commercial |
$8,378.40
|
| Rate for Payer: NAPHCARE Commercial |
$6,283.80
|
| Rate for Payer: Preferred Network Access Commercial |
$9,635.16
|
| Rate for Payer: Quartz Beloit One Network |
$5,131.77
|
| Rate for Payer: Quartz Commercial |
$6,283.80
|
| Rate for Payer: WEA Trust Commercial |
$5,760.15
|
| Rate for Payer: WPS Commercial |
$7,757.35
|
|
|
NAIL GAMMA4 LONG 11 X 340 X 125DEG RT 8425-1340S
|
Facility
|
OP
|
$10,473.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6181746
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,932.44 |
| Max. Negotiated Rate |
$41,892.00 |
| Rate for Payer: Aetna Commercial |
$9,425.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,006.78
|
| Rate for Payer: Aetna Managed Medicare |
$2,932.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,807.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,236.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,027.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,550.69
|
| Rate for Payer: Cash Price |
$3,141.90
|
| Rate for Payer: Cigna Commercial |
$9,635.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,860.69
|
| Rate for Payer: Health EOS Commercial |
$9,320.97
|
| Rate for Payer: HFN Commercial |
$9,635.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,854.75
|
| Rate for Payer: Multiplan Commercial |
$8,378.40
|
| Rate for Payer: NAPHCARE Commercial |
$6,283.80
|
| Rate for Payer: Preferred Network Access Commercial |
$9,635.16
|
| Rate for Payer: Quartz Beloit One Network |
$5,131.77
|
| Rate for Payer: Quartz Commercial |
$6,807.45
|
| Rate for Payer: Quartz Medicare Advantage |
$6,283.80
|
| Rate for Payer: The Alliance Commercial |
$41,892.00
|
| Rate for Payer: WEA Trust Commercial |
$5,760.15
|
| Rate for Payer: WPS Commercial |
$7,757.35
|
|
|
NAIL GAMMA LONG 11 X 360 X 125DEG 3425-1360S
|
Facility
|
IP
|
$10,218.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4263457
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,006.82 |
| Max. Negotiated Rate |
$9,400.56 |
| Rate for Payer: Aetna Commercial |
$9,196.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,787.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,415.54
|
| Rate for Payer: Cash Price |
$3,065.40
|
| Rate for Payer: Cigna Commercial |
$9,400.56
|
| Rate for Payer: Health EOS Commercial |
$9,094.02
|
| Rate for Payer: HFN Commercial |
$9,400.56
|
| Rate for Payer: Multiplan Commercial |
$8,174.40
|
| Rate for Payer: NAPHCARE Commercial |
$6,130.80
|
| Rate for Payer: Preferred Network Access Commercial |
$9,400.56
|
| Rate for Payer: Quartz Beloit One Network |
$5,006.82
|
| Rate for Payer: Quartz Commercial |
$6,130.80
|
| Rate for Payer: WEA Trust Commercial |
$5,619.90
|
| Rate for Payer: WPS Commercial |
$7,568.47
|
|
|
NAIL GAMMA LONG 11 X 360 X 125DEG 3425-1360S
|
Facility
|
OP
|
$10,218.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4263457
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,861.04 |
| Max. Negotiated Rate |
$40,872.00 |
| Rate for Payer: Aetna Commercial |
$9,196.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,787.48
|
| Rate for Payer: Aetna Managed Medicare |
$2,861.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,641.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,109.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,904.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,415.54
|
| Rate for Payer: Cash Price |
$3,065.40
|
| Rate for Payer: Cigna Commercial |
$9,400.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,717.99
|
| Rate for Payer: Health EOS Commercial |
$9,094.02
|
| Rate for Payer: HFN Commercial |
$9,400.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,663.50
|
| Rate for Payer: Multiplan Commercial |
$8,174.40
|
| Rate for Payer: NAPHCARE Commercial |
$6,130.80
|
| Rate for Payer: Preferred Network Access Commercial |
$9,400.56
|
| Rate for Payer: Quartz Beloit One Network |
$5,006.82
|
| Rate for Payer: Quartz Commercial |
$6,641.70
|
| Rate for Payer: Quartz Medicare Advantage |
$6,130.80
|
| Rate for Payer: The Alliance Commercial |
$40,872.00
|
| Rate for Payer: WEA Trust Commercial |
$5,619.90
|
| Rate for Payer: WPS Commercial |
$7,568.47
|
|
