|
NAIL TROCHANTERIC TFN 10MM 456.315S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11MM 456.318S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966625
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11MM 456.318S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966625
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 LT 456.413S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 LT 456.413S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 RT 456.412S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 RT 456.412S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X340 LT 456.415S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X340 LT 456.415S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X340 RT 456.414S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X340 RT 456.414S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X360 LT 456.417S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X360 LT 456.417S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X360 RT 456.416S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X360 RT 456.416S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X380 LT 456.419S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X380 LT 456.419S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X380 RT 456.418S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X380 RT 456.418S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X400 LT 456.421S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X400 LT 456.421S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X400 RT 456.420S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X400 RT 456.420S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X420 LT 456.423S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,979.76 |
| Max. Negotiated Rate |
$42,568.00 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,979.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,917.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,108.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,955.26
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,981.50
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,917.30
|
| Rate for Payer: Quartz Medicare Advantage |
$6,385.20
|
| Rate for Payer: The Alliance Commercial |
$42,568.00
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
|
NAIL TROCHANTERIC TFN 11X420 LT 456.423S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,214.58 |
| Max. Negotiated Rate |
$9,790.64 |
| Rate for Payer: Aetna Commercial |
$9,577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,152.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,640.26
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$9,790.64
|
| Rate for Payer: Health EOS Commercial |
$9,471.38
|
| Rate for Payer: HFN Commercial |
$9,790.64
|
| Rate for Payer: Multiplan Commercial |
$8,513.60
|
| Rate for Payer: NAPHCARE Commercial |
$6,385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$9,790.64
|
| Rate for Payer: Quartz Beloit One Network |
$5,214.58
|
| Rate for Payer: Quartz Commercial |
$6,385.20
|
| Rate for Payer: WEA Trust Commercial |
$5,853.10
|
| Rate for Payer: WPS Commercial |
$7,882.53
|
|
