|
NAIL SUPRACONDYLAR 13 X 340 1826-1332S
|
Facility
|
OP
|
$10,819.00
|
|
| Hospital Charge Code |
3072608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,029.32 |
| Max. Negotiated Rate |
$43,276.00 |
| Rate for Payer: Aetna Commercial |
$9,737.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,304.34
|
| Rate for Payer: Aetna Managed Medicare |
$3,029.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,032.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,409.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,193.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,734.07
|
| Rate for Payer: Cash Price |
$3,245.70
|
| Rate for Payer: Cigna Commercial |
$9,953.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,054.31
|
| Rate for Payer: Health EOS Commercial |
$9,628.91
|
| Rate for Payer: HFN Commercial |
$9,953.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,114.25
|
| Rate for Payer: Multiplan Commercial |
$8,655.20
|
| Rate for Payer: NAPHCARE Commercial |
$6,491.40
|
| Rate for Payer: Preferred Network Access Commercial |
$9,953.48
|
| Rate for Payer: Quartz Beloit One Network |
$5,301.31
|
| Rate for Payer: Quartz Commercial |
$7,032.35
|
| Rate for Payer: Quartz Medicare Advantage |
$6,491.40
|
| Rate for Payer: The Alliance Commercial |
$43,276.00
|
| Rate for Payer: WEA Trust Commercial |
$5,950.45
|
| Rate for Payer: WPS Commercial |
$8,013.63
|
|
|
NAIL TFNA 12MM/125 DEG 170MM 04.037.212S
|
Facility
|
OP
|
$8,323.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4641031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,330.44 |
| Max. Negotiated Rate |
$33,292.00 |
| Rate for Payer: Aetna Commercial |
$7,490.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,157.78
|
| Rate for Payer: Aetna Managed Medicare |
$2,330.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,409.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,161.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,995.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,411.19
|
| Rate for Payer: Cash Price |
$2,496.90
|
| Rate for Payer: Cigna Commercial |
$7,657.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,657.55
|
| Rate for Payer: Health EOS Commercial |
$7,407.47
|
| Rate for Payer: HFN Commercial |
$7,657.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,242.25
|
| Rate for Payer: Multiplan Commercial |
$6,658.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,993.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,657.16
|
| Rate for Payer: Quartz Beloit One Network |
$4,078.27
|
| Rate for Payer: Quartz Commercial |
$5,409.95
|
| Rate for Payer: Quartz Medicare Advantage |
$4,993.80
|
| Rate for Payer: The Alliance Commercial |
$33,292.00
|
| Rate for Payer: WEA Trust Commercial |
$4,577.65
|
| Rate for Payer: WPS Commercial |
$6,164.85
|
|
|
NAIL TFNA 12MM/125 DEG 170MM 04.037.212S
|
Facility
|
IP
|
$8,323.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4641031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,078.27 |
| Max. Negotiated Rate |
$7,657.16 |
| Rate for Payer: Aetna Commercial |
$7,490.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,157.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,411.19
|
| Rate for Payer: Cash Price |
$2,496.90
|
| Rate for Payer: Cigna Commercial |
$7,657.16
|
| Rate for Payer: Health EOS Commercial |
$7,407.47
|
| Rate for Payer: HFN Commercial |
$7,657.16
|
| Rate for Payer: Multiplan Commercial |
$6,658.40
|
| Rate for Payer: NAPHCARE Commercial |
$4,993.80
|
| Rate for Payer: Preferred Network Access Commercial |
$7,657.16
|
| Rate for Payer: Quartz Beloit One Network |
$4,078.27
|
| Rate for Payer: Quartz Commercial |
$4,993.80
|
| Rate for Payer: WEA Trust Commercial |
$4,577.65
|
| Rate for Payer: WPS Commercial |
$6,164.85
|
|
|
NAIL TFNA 12MM/125 DEG 235MM LT 04.037.215S
|
Facility
|
IP
|
$9,215.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5264778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,515.35 |
| Max. Negotiated Rate |
$8,477.80 |
| Rate for Payer: Aetna Commercial |
$8,293.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,924.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,883.95
|
| Rate for Payer: Cash Price |
$2,764.50
|
| Rate for Payer: Cigna Commercial |
$8,477.80
|
| Rate for Payer: Health EOS Commercial |
$8,201.35
|
| Rate for Payer: HFN Commercial |
$8,477.80
|
| Rate for Payer: Multiplan Commercial |
$7,372.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,529.00
|
| Rate for Payer: Preferred Network Access Commercial |
$8,477.80
|
| Rate for Payer: Quartz Beloit One Network |
$4,515.35
|
| Rate for Payer: Quartz Commercial |
$5,529.00
|
| Rate for Payer: WEA Trust Commercial |
$5,068.25
|
| Rate for Payer: WPS Commercial |
$6,825.55
|
|
|
NAIL TFNA 12MM/125 DEG 235MM LT 04.037.215S
|
Facility
|
OP
|
$9,215.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5264778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,580.20 |
| Max. Negotiated Rate |
$36,860.00 |
| Rate for Payer: Aetna Commercial |
$8,293.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,924.90
|
| Rate for Payer: Aetna Managed Medicare |
$2,580.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,989.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,607.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,423.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,883.95
|
| Rate for Payer: Cash Price |
$2,764.50
|
| Rate for Payer: Cigna Commercial |
$8,477.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,156.71
|
| Rate for Payer: Health EOS Commercial |
$8,201.35
|
| Rate for Payer: HFN Commercial |
$8,477.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,911.25
|
| Rate for Payer: Multiplan Commercial |
$7,372.00
|
| Rate for Payer: NAPHCARE Commercial |
$5,529.00
|
| Rate for Payer: Preferred Network Access Commercial |
$8,477.80
|
| Rate for Payer: Quartz Beloit One Network |
$4,515.35
|
| Rate for Payer: Quartz Commercial |
$5,989.75
|
| Rate for Payer: Quartz Medicare Advantage |
$5,529.00
|
| Rate for Payer: The Alliance Commercial |
$36,860.00
|
| Rate for Payer: WEA Trust Commercial |
$5,068.25
|
| Rate for Payer: WPS Commercial |
$6,825.55
|
|
|
NAIL TFNA 12MM/125 DEG 320MM LT 04.037.223S
|
Facility
|
IP
|
$11,232.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5415000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,503.68 |
| Max. Negotiated Rate |
$10,333.44 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$6,739.20
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 320MM LT 04.037.223S
|
Facility
|
OP
|
$11,232.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5415000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,144.96 |
| Max. Negotiated Rate |
$44,928.00 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Aetna Managed Medicare |
$3,144.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,300.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,616.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,391.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,285.43
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,424.00
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$7,300.80
|
| Rate for Payer: Quartz Medicare Advantage |
$6,739.20
|
| Rate for Payer: The Alliance Commercial |
$44,928.00
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 360MM LT 04.037.227S
|
Facility
|
OP
|
$10,800.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5506868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,024.00 |
| Max. Negotiated Rate |
$43,200.00 |
| Rate for Payer: Aetna Commercial |
$9,720.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,288.00
|
| Rate for Payer: Aetna Managed Medicare |
$3,024.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,020.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,400.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,184.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,724.00
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cigna Commercial |
$9,936.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,043.68
|
| Rate for Payer: Health EOS Commercial |
$9,612.00
|
| Rate for Payer: HFN Commercial |
$9,936.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,100.00
|
| Rate for Payer: Multiplan Commercial |
$8,640.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,480.00
|
| Rate for Payer: Preferred Network Access Commercial |
$9,936.00
|
| Rate for Payer: Quartz Beloit One Network |
$5,292.00
|
| Rate for Payer: Quartz Commercial |
$7,020.00
|
| Rate for Payer: Quartz Medicare Advantage |
$6,480.00
|
| Rate for Payer: The Alliance Commercial |
$43,200.00
|
| Rate for Payer: WEA Trust Commercial |
$5,940.00
|
| Rate for Payer: WPS Commercial |
$7,999.56
|
|
|
NAIL TFNA 12MM/125 DEG 360MM LT 04.037.227S
|
Facility
|
IP
|
$10,800.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5506868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,292.00 |
| Max. Negotiated Rate |
$9,936.00 |
| Rate for Payer: Aetna Commercial |
$9,720.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,288.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,724.00
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cigna Commercial |
$9,936.00
|
| Rate for Payer: Health EOS Commercial |
$9,612.00
|
| Rate for Payer: HFN Commercial |
$9,936.00
|
| Rate for Payer: Multiplan Commercial |
$8,640.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,480.00
|
| Rate for Payer: Preferred Network Access Commercial |
$9,936.00
|
| Rate for Payer: Quartz Beloit One Network |
$5,292.00
|
| Rate for Payer: Quartz Commercial |
$6,480.00
|
| Rate for Payer: WEA Trust Commercial |
$5,940.00
|
| Rate for Payer: WPS Commercial |
$7,999.56
|
|
|
NAIL TFNA 12MM/ 125 DEG 360MM RT 04.037.226S
|
Facility
|
IP
|
$11,232.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5179267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,503.68 |
| Max. Negotiated Rate |
$10,333.44 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$6,739.20
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/ 125 DEG 360MM RT 04.037.226S
|
Facility
|
OP
|
$11,232.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5179267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,144.96 |
| Max. Negotiated Rate |
$44,928.00 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Aetna Managed Medicare |
$3,144.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,300.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,616.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,391.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,285.43
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,424.00
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$7,300.80
|
| Rate for Payer: Quartz Medicare Advantage |
$6,739.20
|
| Rate for Payer: The Alliance Commercial |
$44,928.00
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 380MM LT 04.037.229S
|
Facility
|
OP
|
$11,232.00
|
|
| Hospital Charge Code |
4594777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,144.96 |
| Max. Negotiated Rate |
$44,928.00 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Aetna Managed Medicare |
$3,144.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,300.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,616.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,391.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,285.43
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,424.00
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$7,300.80
|
| Rate for Payer: Quartz Medicare Advantage |
$6,739.20
|
| Rate for Payer: The Alliance Commercial |
$44,928.00
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 380MM LT 04.037.229S
|
Facility
|
IP
|
$11,232.00
|
|
| Hospital Charge Code |
4594777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,503.68 |
| Max. Negotiated Rate |
$10,333.44 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$6,739.20
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 380MM RT 04.037.228S
|
Facility
|
OP
|
$11,232.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4858909
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,144.96 |
| Max. Negotiated Rate |
$44,928.00 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Aetna Managed Medicare |
$3,144.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,300.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,616.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,391.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,285.43
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,424.00
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$7,300.80
|
| Rate for Payer: Quartz Medicare Advantage |
$6,739.20
|
| Rate for Payer: The Alliance Commercial |
$44,928.00
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 380MM RT 04.037.228S
|
Facility
|
IP
|
$11,232.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4858909
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,503.68 |
| Max. Negotiated Rate |
$10,333.44 |
| Rate for Payer: Aetna Commercial |
$10,108.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,659.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,952.96
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Health EOS Commercial |
$9,996.48
|
| Rate for Payer: HFN Commercial |
$10,333.44
|
| Rate for Payer: Multiplan Commercial |
$8,985.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,739.20
|
| Rate for Payer: Preferred Network Access Commercial |
$10,333.44
|
| Rate for Payer: Quartz Beloit One Network |
$5,503.68
|
| Rate for Payer: Quartz Commercial |
$6,739.20
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.54
|
|
|
NAIL TFNA 12MM/125 DEG 400MM LT 04.037.231S
|
Facility
|
IP
|
$11,665.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5384959
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,715.85 |
| Max. Negotiated Rate |
$10,731.80 |
| Rate for Payer: Aetna Commercial |
$10,498.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,031.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,182.45
|
| Rate for Payer: Cash Price |
$3,499.50
|
| Rate for Payer: Cigna Commercial |
$10,731.80
|
| Rate for Payer: Health EOS Commercial |
$10,381.85
|
| Rate for Payer: HFN Commercial |
$10,731.80
|
| Rate for Payer: Multiplan Commercial |
$9,332.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,999.00
|
| Rate for Payer: Preferred Network Access Commercial |
$10,731.80
|
| Rate for Payer: Quartz Beloit One Network |
$5,715.85
|
| Rate for Payer: Quartz Commercial |
$6,999.00
|
| Rate for Payer: WEA Trust Commercial |
$6,415.75
|
| Rate for Payer: WPS Commercial |
$8,640.27
|
|
|
NAIL TFNA 12MM/125 DEG 400MM LT 04.037.231S
|
Facility
|
OP
|
$11,665.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5384959
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,266.20 |
| Max. Negotiated Rate |
$46,660.00 |
| Rate for Payer: Aetna Commercial |
$10,498.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,031.90
|
| Rate for Payer: Aetna Managed Medicare |
$3,266.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,582.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,832.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,599.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,182.45
|
| Rate for Payer: Cash Price |
$3,499.50
|
| Rate for Payer: Cigna Commercial |
$10,731.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,527.73
|
| Rate for Payer: Health EOS Commercial |
$10,381.85
|
| Rate for Payer: HFN Commercial |
$10,731.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,748.75
|
| Rate for Payer: Multiplan Commercial |
$9,332.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,999.00
|
| Rate for Payer: Preferred Network Access Commercial |
$10,731.80
|
| Rate for Payer: Quartz Beloit One Network |
$5,715.85
|
| Rate for Payer: Quartz Commercial |
$7,582.25
|
| Rate for Payer: Quartz Medicare Advantage |
$6,999.00
|
| Rate for Payer: The Alliance Commercial |
$46,660.00
|
| Rate for Payer: WEA Trust Commercial |
$6,415.75
|
| Rate for Payer: WPS Commercial |
$8,640.27
|
|
|
NAIL TFNA 12MM/125 DEG 420MM LT 04.037.233S
|
Facility
|
OP
|
$10,385.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5729710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,907.80 |
| Max. Negotiated Rate |
$41,540.00 |
| Rate for Payer: Aetna Commercial |
$9,346.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,931.10
|
| Rate for Payer: Aetna Managed Medicare |
$2,907.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,750.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,192.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,984.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,504.05
|
| Rate for Payer: Cash Price |
$3,115.50
|
| Rate for Payer: Cigna Commercial |
$9,554.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,811.45
|
| Rate for Payer: Health EOS Commercial |
$9,242.65
|
| Rate for Payer: HFN Commercial |
$9,554.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,788.75
|
| Rate for Payer: Multiplan Commercial |
$8,308.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,231.00
|
| Rate for Payer: Preferred Network Access Commercial |
$9,554.20
|
| Rate for Payer: Quartz Beloit One Network |
$5,088.65
|
| Rate for Payer: Quartz Commercial |
$6,750.25
|
| Rate for Payer: Quartz Medicare Advantage |
$6,231.00
|
| Rate for Payer: The Alliance Commercial |
$41,540.00
|
| Rate for Payer: WEA Trust Commercial |
$5,711.75
|
| Rate for Payer: WPS Commercial |
$7,692.17
|
|
|
NAIL TFNA 12MM/125 DEG 420MM LT 04.037.233S
|
Facility
|
IP
|
$10,385.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5729710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,088.65 |
| Max. Negotiated Rate |
$9,554.20 |
| Rate for Payer: Aetna Commercial |
$9,346.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,931.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,504.05
|
| Rate for Payer: Cash Price |
$3,115.50
|
| Rate for Payer: Cigna Commercial |
$9,554.20
|
| Rate for Payer: Health EOS Commercial |
$9,242.65
|
| Rate for Payer: HFN Commercial |
$9,554.20
|
| Rate for Payer: Multiplan Commercial |
$8,308.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,231.00
|
| Rate for Payer: Preferred Network Access Commercial |
$9,554.20
|
| Rate for Payer: Quartz Beloit One Network |
$5,088.65
|
| Rate for Payer: Quartz Commercial |
$6,231.00
|
| Rate for Payer: WEA Trust Commercial |
$5,711.75
|
| Rate for Payer: WPS Commercial |
$7,692.17
|
|
|
NAIL TFNA 12MM/130 DEG 170MM 04.037.242S
|
Facility
|
OP
|
$7,706.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5591353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,157.68 |
| Max. Negotiated Rate |
$30,824.00 |
| Rate for Payer: Aetna Commercial |
$6,935.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,627.16
|
| Rate for Payer: Aetna Managed Medicare |
$2,157.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,008.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,853.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,698.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,084.18
|
| Rate for Payer: Cash Price |
$2,311.80
|
| Rate for Payer: Cigna Commercial |
$7,089.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,312.28
|
| Rate for Payer: Health EOS Commercial |
$6,858.34
|
| Rate for Payer: HFN Commercial |
$7,089.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,779.50
|
| Rate for Payer: Multiplan Commercial |
$6,164.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,623.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,089.52
|
| Rate for Payer: Quartz Beloit One Network |
$3,775.94
|
| Rate for Payer: Quartz Commercial |
$5,008.90
|
| Rate for Payer: Quartz Medicare Advantage |
$4,623.60
|
| Rate for Payer: The Alliance Commercial |
$30,824.00
|
| Rate for Payer: WEA Trust Commercial |
$4,238.30
|
| Rate for Payer: WPS Commercial |
$5,707.83
|
|
|
NAIL TFNA 12MM/130 DEG 170MM 04.037.242S
|
Facility
|
IP
|
$7,706.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5591353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,775.94 |
| Max. Negotiated Rate |
$7,089.52 |
| Rate for Payer: Aetna Commercial |
$6,935.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,627.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,084.18
|
| Rate for Payer: Cash Price |
$2,311.80
|
| Rate for Payer: Cigna Commercial |
$7,089.52
|
| Rate for Payer: Health EOS Commercial |
$6,858.34
|
| Rate for Payer: HFN Commercial |
$7,089.52
|
| Rate for Payer: Multiplan Commercial |
$6,164.80
|
| Rate for Payer: NAPHCARE Commercial |
$4,623.60
|
| Rate for Payer: Preferred Network Access Commercial |
$7,089.52
|
| Rate for Payer: Quartz Beloit One Network |
$3,775.94
|
| Rate for Payer: Quartz Commercial |
$4,623.60
|
| Rate for Payer: WEA Trust Commercial |
$4,238.30
|
| Rate for Payer: WPS Commercial |
$5,707.83
|
|
|
NAIL TFNA 12MM/130 DEG 360MM LT 04.037.257S
|
Facility
|
IP
|
$10,155.71
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6246250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,976.30 |
| Max. Negotiated Rate |
$9,343.25 |
| Rate for Payer: Aetna Commercial |
$9,140.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,733.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,382.53
|
| Rate for Payer: Cash Price |
$3,046.71
|
| Rate for Payer: Cigna Commercial |
$9,343.25
|
| Rate for Payer: Health EOS Commercial |
$9,038.58
|
| Rate for Payer: HFN Commercial |
$9,343.25
|
| Rate for Payer: Multiplan Commercial |
$8,124.57
|
| Rate for Payer: NAPHCARE Commercial |
$6,093.43
|
| Rate for Payer: Preferred Network Access Commercial |
$9,343.25
|
| Rate for Payer: Quartz Beloit One Network |
$4,976.30
|
| Rate for Payer: Quartz Commercial |
$6,093.43
|
| Rate for Payer: WEA Trust Commercial |
$5,585.64
|
| Rate for Payer: WPS Commercial |
$7,522.33
|
|
|
NAIL TFNA 12MM/130 DEG 360MM LT 04.037.257S
|
Facility
|
OP
|
$10,155.71
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6246250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,843.60 |
| Max. Negotiated Rate |
$40,622.84 |
| Rate for Payer: Aetna Commercial |
$9,140.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,733.91
|
| Rate for Payer: Aetna Managed Medicare |
$2,843.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,601.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,077.86
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,874.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,382.53
|
| Rate for Payer: Cash Price |
$3,046.71
|
| Rate for Payer: Cigna Commercial |
$9,343.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,683.14
|
| Rate for Payer: Health EOS Commercial |
$9,038.58
|
| Rate for Payer: HFN Commercial |
$9,343.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,616.78
|
| Rate for Payer: Multiplan Commercial |
$8,124.57
|
| Rate for Payer: NAPHCARE Commercial |
$6,093.43
|
| Rate for Payer: Preferred Network Access Commercial |
$9,343.25
|
| Rate for Payer: Quartz Beloit One Network |
$4,976.30
|
| Rate for Payer: Quartz Commercial |
$6,601.21
|
| Rate for Payer: Quartz Medicare Advantage |
$6,093.43
|
| Rate for Payer: The Alliance Commercial |
$40,622.84
|
| Rate for Payer: WEA Trust Commercial |
$5,585.64
|
| Rate for Payer: WPS Commercial |
$7,522.33
|
|
|
NAIL TFNA 14MM/130 DEG 360MM LT 04.037.457S
|
Facility
|
OP
|
$10,800.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5563472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,024.00 |
| Max. Negotiated Rate |
$43,200.00 |
| Rate for Payer: Aetna Commercial |
$9,720.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,288.00
|
| Rate for Payer: Aetna Managed Medicare |
$3,024.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,020.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,400.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,184.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,724.00
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cigna Commercial |
$9,936.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,043.68
|
| Rate for Payer: Health EOS Commercial |
$9,612.00
|
| Rate for Payer: HFN Commercial |
$9,936.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,100.00
|
| Rate for Payer: Multiplan Commercial |
$8,640.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,480.00
|
| Rate for Payer: Preferred Network Access Commercial |
$9,936.00
|
| Rate for Payer: Quartz Beloit One Network |
$5,292.00
|
| Rate for Payer: Quartz Commercial |
$7,020.00
|
| Rate for Payer: Quartz Medicare Advantage |
$6,480.00
|
| Rate for Payer: The Alliance Commercial |
$43,200.00
|
| Rate for Payer: WEA Trust Commercial |
$5,940.00
|
| Rate for Payer: WPS Commercial |
$7,999.56
|
|
|
NAIL TFNA 14MM/130 DEG 360MM LT 04.037.457S
|
Facility
|
IP
|
$10,800.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5563472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,292.00 |
| Max. Negotiated Rate |
$9,936.00 |
| Rate for Payer: Aetna Commercial |
$9,720.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,288.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,724.00
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cigna Commercial |
$9,936.00
|
| Rate for Payer: Health EOS Commercial |
$9,612.00
|
| Rate for Payer: HFN Commercial |
$9,936.00
|
| Rate for Payer: Multiplan Commercial |
$8,640.00
|
| Rate for Payer: NAPHCARE Commercial |
$6,480.00
|
| Rate for Payer: Preferred Network Access Commercial |
$9,936.00
|
| Rate for Payer: Quartz Beloit One Network |
$5,292.00
|
| Rate for Payer: Quartz Commercial |
$6,480.00
|
| Rate for Payer: WEA Trust Commercial |
$5,940.00
|
| Rate for Payer: WPS Commercial |
$7,999.56
|
|
