|
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 |
$2,808.04 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,518.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,014.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,813.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,612.23
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,521.54
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: NAPHCARE Commercial |
$6,017.23
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,518.67
|
| Rate for Payer: Quartz Medicare Advantage |
$6,017.23
|
| Rate for Payer: The Alliance Commercial |
$5,014.36
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$4,914.07 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,017.23
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$2,808.04 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,518.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,014.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,813.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,612.23
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,521.54
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: NAPHCARE Commercial |
$6,017.23
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,518.67
|
| Rate for Payer: Quartz Medicare Advantage |
$6,017.23
|
| Rate for Payer: The Alliance Commercial |
$5,014.36
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$2,808.04 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,518.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,014.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,813.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,612.23
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,521.54
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: NAPHCARE Commercial |
$6,017.23
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,518.67
|
| Rate for Payer: Quartz Medicare Advantage |
$6,017.23
|
| Rate for Payer: The Alliance Commercial |
$5,014.36
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$4,914.07 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,017.23
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$2,808.04 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,518.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,014.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,813.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,612.23
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,521.54
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: NAPHCARE Commercial |
$6,017.23
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,518.67
|
| Rate for Payer: Quartz Medicare Advantage |
$6,017.23
|
| Rate for Payer: The Alliance Commercial |
$5,014.36
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$4,914.07 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,017.23
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$4,914.07 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,017.23
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$2,808.04 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,518.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,014.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,813.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,612.23
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,521.54
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: NAPHCARE Commercial |
$6,017.23
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,518.67
|
| Rate for Payer: Quartz Medicare Advantage |
$6,017.23
|
| Rate for Payer: The Alliance Commercial |
$5,014.36
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
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 |
$2,090.23 |
| Max. Negotiated Rate |
$6,867.91 |
| Rate for Payer: Aetna Commercial |
$6,718.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,420.00
|
| Rate for Payer: Aetna Managed Medicare |
$2,090.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,852.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,732.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,583.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,956.51
|
| Rate for Payer: Cash Price |
$2,153.40
|
| Rate for Payer: Cigna Commercial |
$6,867.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,177.60
|
| Rate for Payer: Health EOS Commercial |
$6,643.96
|
| Rate for Payer: HFN Commercial |
$6,867.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,598.84
|
| Rate for Payer: Multiplan Commercial |
$5,972.10
|
| Rate for Payer: NAPHCARE Commercial |
$4,479.07
|
| Rate for Payer: Preferred Network Access Commercial |
$6,867.91
|
| Rate for Payer: Quartz Beloit One Network |
$3,657.91
|
| Rate for Payer: Quartz Commercial |
$4,852.33
|
| Rate for Payer: Quartz Medicare Advantage |
$4,479.07
|
| Rate for Payer: The Alliance Commercial |
$3,732.56
|
| Rate for Payer: WEA Trust Commercial |
$4,105.82
|
| Rate for Payer: WPS Commercial |
$5,529.21
|
|
|
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 |
$3,657.91 |
| Max. Negotiated Rate |
$6,867.91 |
| Rate for Payer: Aetna Commercial |
$6,718.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,420.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,956.51
|
| Rate for Payer: Cash Price |
$2,153.40
|
| Rate for Payer: Cigna Commercial |
$6,867.91
|
| Rate for Payer: Health EOS Commercial |
$6,643.96
|
| Rate for Payer: HFN Commercial |
$6,867.91
|
| Rate for Payer: Multiplan Commercial |
$5,972.10
|
| Rate for Payer: Preferred Network Access Commercial |
$6,867.91
|
| Rate for Payer: Quartz Beloit One Network |
$3,657.91
|
| Rate for Payer: Quartz Commercial |
$4,479.07
|
| Rate for Payer: WEA Trust Commercial |
$4,105.82
|
| Rate for Payer: WPS Commercial |
$5,529.21
|
|
|
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 |
$3,049.74 |
| Max. Negotiated Rate |
$10,020.57 |
| Rate for Payer: Aetna Commercial |
$9,802.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,367.05
|
| Rate for Payer: Aetna Managed Medicare |
$3,049.74
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,079.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,445.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,228.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,772.72
|
| Rate for Payer: Cash Price |
$3,141.90
|
| Rate for Payer: Cigna Commercial |
$10,020.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,095.29
|
| Rate for Payer: Health EOS Commercial |
$9,693.81
|
| Rate for Payer: HFN Commercial |
$10,020.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,168.94
|
| Rate for Payer: Multiplan Commercial |
$8,713.54
|
| Rate for Payer: NAPHCARE Commercial |
$6,535.15
|
| Rate for Payer: Preferred Network Access Commercial |
$10,020.57
|
| Rate for Payer: Quartz Beloit One Network |
$5,337.04
|
| Rate for Payer: Quartz Commercial |
$7,079.75
|
| Rate for Payer: Quartz Medicare Advantage |
$6,535.15
|
| Rate for Payer: The Alliance Commercial |
$5,445.96
|
| Rate for Payer: WEA Trust Commercial |
$5,990.56
|
| Rate for Payer: WPS Commercial |
$8,067.35
|
|
|
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 |
$5,337.04 |
| Max. Negotiated Rate |
$10,020.57 |
| Rate for Payer: Aetna Commercial |
$9,802.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,367.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,772.72
|
| Rate for Payer: Cash Price |
$3,141.90
|
| Rate for Payer: Cigna Commercial |
$10,020.57
|
| Rate for Payer: Health EOS Commercial |
$9,693.81
|
| Rate for Payer: HFN Commercial |
$10,020.57
|
| Rate for Payer: Multiplan Commercial |
$8,713.54
|
| Rate for Payer: Preferred Network Access Commercial |
$10,020.57
|
| Rate for Payer: Quartz Beloit One Network |
$5,337.04
|
| Rate for Payer: Quartz Commercial |
$6,535.15
|
| Rate for Payer: WEA Trust Commercial |
$5,990.56
|
| Rate for Payer: WPS Commercial |
$8,067.35
|
|
|
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 |
$2,975.48 |
| Max. Negotiated Rate |
$9,776.58 |
| Rate for Payer: Aetna Commercial |
$9,564.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,138.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,975.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,907.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,313.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,100.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,632.16
|
| Rate for Payer: Cash Price |
$3,065.40
|
| Rate for Payer: Cigna Commercial |
$9,776.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,946.88
|
| Rate for Payer: Health EOS Commercial |
$9,457.78
|
| Rate for Payer: HFN Commercial |
$9,776.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,970.04
|
| Rate for Payer: Multiplan Commercial |
$8,501.38
|
| Rate for Payer: NAPHCARE Commercial |
$6,376.03
|
| Rate for Payer: Preferred Network Access Commercial |
$9,776.58
|
| Rate for Payer: Quartz Beloit One Network |
$5,207.09
|
| Rate for Payer: Quartz Commercial |
$6,907.37
|
| Rate for Payer: Quartz Medicare Advantage |
$6,376.03
|
| Rate for Payer: The Alliance Commercial |
$5,313.36
|
| Rate for Payer: WEA Trust Commercial |
$5,844.70
|
| Rate for Payer: WPS Commercial |
$7,870.93
|
|
|
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 |
$5,207.09 |
| Max. Negotiated Rate |
$9,776.58 |
| Rate for Payer: Aetna Commercial |
$9,564.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,138.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,632.16
|
| Rate for Payer: Cash Price |
$3,065.40
|
| Rate for Payer: Cigna Commercial |
$9,776.58
|
| Rate for Payer: Health EOS Commercial |
$9,457.78
|
| Rate for Payer: HFN Commercial |
$9,776.58
|
| Rate for Payer: Multiplan Commercial |
$8,501.38
|
| Rate for Payer: Preferred Network Access Commercial |
$9,776.58
|
| Rate for Payer: Quartz Beloit One Network |
$5,207.09
|
| Rate for Payer: Quartz Commercial |
$6,376.03
|
| Rate for Payer: WEA Trust Commercial |
$5,844.70
|
| Rate for Payer: WPS Commercial |
$7,870.93
|
|
|
NAIL GAMMA LONG 11 X 380 X 125DEG 3425-1380S
|
Facility
|
IP
|
$9,033.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,603.22 |
| Max. Negotiated Rate |
$8,642.77 |
| Rate for Payer: Aetna Commercial |
$8,454.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,079.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,978.99
|
| Rate for Payer: Cash Price |
$2,709.90
|
| Rate for Payer: Cigna Commercial |
$8,642.77
|
| Rate for Payer: Health EOS Commercial |
$8,360.94
|
| Rate for Payer: HFN Commercial |
$8,642.77
|
| Rate for Payer: Multiplan Commercial |
$7,515.46
|
| Rate for Payer: Preferred Network Access Commercial |
$8,642.77
|
| Rate for Payer: Quartz Beloit One Network |
$4,603.22
|
| Rate for Payer: Quartz Commercial |
$5,636.59
|
| Rate for Payer: WEA Trust Commercial |
$5,166.88
|
| Rate for Payer: WPS Commercial |
$6,958.12
|
|
|
NAIL GAMMA LONG 11 X 380 X 125DEG 3425-1380S
|
Facility
|
OP
|
$9,033.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,630.41 |
| Max. Negotiated Rate |
$8,642.77 |
| Rate for Payer: Aetna Commercial |
$8,454.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,079.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,630.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,106.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,697.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,509.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,978.99
|
| Rate for Payer: Cash Price |
$2,709.90
|
| Rate for Payer: Cigna Commercial |
$8,642.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,257.21
|
| Rate for Payer: Health EOS Commercial |
$8,360.94
|
| Rate for Payer: HFN Commercial |
$8,642.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,045.74
|
| Rate for Payer: Multiplan Commercial |
$7,515.46
|
| Rate for Payer: NAPHCARE Commercial |
$5,636.59
|
| Rate for Payer: Preferred Network Access Commercial |
$8,642.77
|
| Rate for Payer: Quartz Beloit One Network |
$4,603.22
|
| Rate for Payer: Quartz Commercial |
$6,106.31
|
| Rate for Payer: Quartz Medicare Advantage |
$5,636.59
|
| Rate for Payer: The Alliance Commercial |
$4,697.16
|
| Rate for Payer: WEA Trust Commercial |
$5,166.88
|
| Rate for Payer: WPS Commercial |
$6,958.12
|
|
|
NAIL GAMMA LONG 13 X 360 X 125DEG TI RT 3425-3360S
|
Facility
|
IP
|
$9,033.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5456726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,603.22 |
| Max. Negotiated Rate |
$8,642.77 |
| Rate for Payer: Aetna Commercial |
$8,454.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,079.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,978.99
|
| Rate for Payer: Cash Price |
$2,709.90
|
| Rate for Payer: Cigna Commercial |
$8,642.77
|
| Rate for Payer: Health EOS Commercial |
$8,360.94
|
| Rate for Payer: HFN Commercial |
$8,642.77
|
| Rate for Payer: Multiplan Commercial |
$7,515.46
|
| Rate for Payer: Preferred Network Access Commercial |
$8,642.77
|
| Rate for Payer: Quartz Beloit One Network |
$4,603.22
|
| Rate for Payer: Quartz Commercial |
$5,636.59
|
| Rate for Payer: WEA Trust Commercial |
$5,166.88
|
| Rate for Payer: WPS Commercial |
$6,958.12
|
|
|
NAIL GAMMA LONG 13 X 360 X 125DEG TI RT 3425-3360S
|
Facility
|
OP
|
$9,033.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5456726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,630.41 |
| Max. Negotiated Rate |
$8,642.77 |
| Rate for Payer: Aetna Commercial |
$8,454.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,079.12
|
| Rate for Payer: Aetna Managed Medicare |
$2,630.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,106.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,697.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,509.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,978.99
|
| Rate for Payer: Cash Price |
$2,709.90
|
| Rate for Payer: Cigna Commercial |
$8,642.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,257.21
|
| Rate for Payer: Health EOS Commercial |
$8,360.94
|
| Rate for Payer: HFN Commercial |
$8,642.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,045.74
|
| Rate for Payer: Multiplan Commercial |
$7,515.46
|
| Rate for Payer: NAPHCARE Commercial |
$5,636.59
|
| Rate for Payer: Preferred Network Access Commercial |
$8,642.77
|
| Rate for Payer: Quartz Beloit One Network |
$4,603.22
|
| Rate for Payer: Quartz Commercial |
$6,106.31
|
| Rate for Payer: Quartz Medicare Advantage |
$5,636.59
|
| Rate for Payer: The Alliance Commercial |
$4,697.16
|
| Rate for Payer: WEA Trust Commercial |
$5,166.88
|
| Rate for Payer: WPS Commercial |
$6,958.12
|
|
|
NAIL GAMMA LONG 13 X 380 X 125DEG TI RT 3425-3380S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4519063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,808.04 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Aetna Managed Medicare |
$2,808.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,518.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,014.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,813.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,612.23
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,521.54
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: NAPHCARE Commercial |
$6,017.23
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,518.67
|
| Rate for Payer: Quartz Medicare Advantage |
$6,017.23
|
| Rate for Payer: The Alliance Commercial |
$5,014.36
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
NAIL GAMMA LONG 13 X 380 X 125DEG TI RT 3425-3380S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4519063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,914.07 |
| Max. Negotiated Rate |
$9,226.42 |
| Rate for Payer: Aetna Commercial |
$9,025.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,624.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,315.22
|
| Rate for Payer: Cash Price |
$2,892.90
|
| Rate for Payer: Cigna Commercial |
$9,226.42
|
| Rate for Payer: Health EOS Commercial |
$8,925.56
|
| Rate for Payer: HFN Commercial |
$9,226.42
|
| Rate for Payer: Multiplan Commercial |
$8,022.98
|
| Rate for Payer: Preferred Network Access Commercial |
$9,226.42
|
| Rate for Payer: Quartz Beloit One Network |
$4,914.07
|
| Rate for Payer: Quartz Commercial |
$6,017.23
|
| Rate for Payer: WEA Trust Commercial |
$5,515.80
|
| Rate for Payer: WPS Commercial |
$7,428.00
|
|
|
NAIL GAMMA LONG 13 X 400 X 125DEG TI LT 3525-3400S
|
Facility
|
OP
|
$7,780.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6169733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,265.54 |
| Max. Negotiated Rate |
$7,443.90 |
| Rate for Payer: Aetna Commercial |
$7,282.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,958.43
|
| Rate for Payer: Aetna Managed Medicare |
$2,265.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,259.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,045.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,883.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,288.34
|
| Rate for Payer: Cash Price |
$2,334.00
|
| Rate for Payer: Cigna Commercial |
$7,443.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,527.96
|
| Rate for Payer: Health EOS Commercial |
$7,201.17
|
| Rate for Payer: HFN Commercial |
$7,443.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,068.40
|
| Rate for Payer: Multiplan Commercial |
$6,472.96
|
| Rate for Payer: NAPHCARE Commercial |
$4,854.72
|
| Rate for Payer: Preferred Network Access Commercial |
$7,443.90
|
| Rate for Payer: Quartz Beloit One Network |
$3,964.69
|
| Rate for Payer: Quartz Commercial |
$5,259.28
|
| Rate for Payer: Quartz Medicare Advantage |
$4,854.72
|
| Rate for Payer: The Alliance Commercial |
$4,045.60
|
| Rate for Payer: WEA Trust Commercial |
$4,450.16
|
| Rate for Payer: WPS Commercial |
$5,992.93
|
|
|
NAIL GAMMA LONG 13 X 400 X 125DEG TI LT 3525-3400S
|
Facility
|
IP
|
$7,780.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6169733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,964.69 |
| Max. Negotiated Rate |
$7,443.90 |
| Rate for Payer: Aetna Commercial |
$7,282.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,958.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,288.34
|
| Rate for Payer: Cash Price |
$2,334.00
|
| Rate for Payer: Cigna Commercial |
$7,443.90
|
| Rate for Payer: Health EOS Commercial |
$7,201.17
|
| Rate for Payer: HFN Commercial |
$7,443.90
|
| Rate for Payer: Multiplan Commercial |
$6,472.96
|
| Rate for Payer: Preferred Network Access Commercial |
$7,443.90
|
| Rate for Payer: Quartz Beloit One Network |
$3,964.69
|
| Rate for Payer: Quartz Commercial |
$4,854.72
|
| Rate for Payer: WEA Trust Commercial |
$4,450.16
|
| Rate for Payer: WPS Commercial |
$5,992.93
|
|
|
NAIL GAMMA LONG 13 X 400 X 125DEG TI RT 3425-3400S
|
Facility
|
IP
|
$7,780.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6169735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,964.69 |
| Max. Negotiated Rate |
$7,443.90 |
| Rate for Payer: Aetna Commercial |
$7,282.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,958.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,288.34
|
| Rate for Payer: Cash Price |
$2,334.00
|
| Rate for Payer: Cigna Commercial |
$7,443.90
|
| Rate for Payer: Health EOS Commercial |
$7,201.17
|
| Rate for Payer: HFN Commercial |
$7,443.90
|
| Rate for Payer: Multiplan Commercial |
$6,472.96
|
| Rate for Payer: Preferred Network Access Commercial |
$7,443.90
|
| Rate for Payer: Quartz Beloit One Network |
$3,964.69
|
| Rate for Payer: Quartz Commercial |
$4,854.72
|
| Rate for Payer: WEA Trust Commercial |
$4,450.16
|
| Rate for Payer: WPS Commercial |
$5,992.93
|
|
|
NAIL GAMMA LONG 13 X 400 X 125DEG TI RT 3425-3400S
|
Facility
|
OP
|
$7,780.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6169735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,265.54 |
| Max. Negotiated Rate |
$7,443.90 |
| Rate for Payer: Aetna Commercial |
$7,282.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,958.43
|
| Rate for Payer: Aetna Managed Medicare |
$2,265.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,259.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,045.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,883.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,288.34
|
| Rate for Payer: Cash Price |
$2,334.00
|
| Rate for Payer: Cigna Commercial |
$7,443.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,527.96
|
| Rate for Payer: Health EOS Commercial |
$7,201.17
|
| Rate for Payer: HFN Commercial |
$7,443.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,068.40
|
| Rate for Payer: Multiplan Commercial |
$6,472.96
|
| Rate for Payer: NAPHCARE Commercial |
$4,854.72
|
| Rate for Payer: Preferred Network Access Commercial |
$7,443.90
|
| Rate for Payer: Quartz Beloit One Network |
$3,964.69
|
| Rate for Payer: Quartz Commercial |
$5,259.28
|
| Rate for Payer: Quartz Medicare Advantage |
$4,854.72
|
| Rate for Payer: The Alliance Commercial |
$4,045.60
|
| Rate for Payer: WEA Trust Commercial |
$4,450.16
|
| Rate for Payer: WPS Commercial |
$5,992.93
|
|
