|
NAIL GAMMA LONG 13 X 420 X 125DEG TI RT 3425-3420S
|
Facility
|
OP
|
$9,271.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5627697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,699.72 |
| Max. Negotiated Rate |
$8,870.49 |
| Rate for Payer: Aetna Commercial |
$8,677.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,291.98
|
| Rate for Payer: Aetna Managed Medicare |
$2,699.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,267.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,820.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,628.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.18
|
| Rate for Payer: Cash Price |
$2,781.30
|
| Rate for Payer: Cigna Commercial |
$8,870.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,395.72
|
| Rate for Payer: Health EOS Commercial |
$8,581.24
|
| Rate for Payer: HFN Commercial |
$8,870.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,231.38
|
| Rate for Payer: Multiplan Commercial |
$7,713.47
|
| Rate for Payer: NAPHCARE Commercial |
$5,785.10
|
| Rate for Payer: Preferred Network Access Commercial |
$8,870.49
|
| Rate for Payer: Quartz Beloit One Network |
$4,724.50
|
| Rate for Payer: Quartz Commercial |
$6,267.20
|
| Rate for Payer: Quartz Medicare Advantage |
$5,785.10
|
| Rate for Payer: The Alliance Commercial |
$4,820.92
|
| Rate for Payer: WEA Trust Commercial |
$5,303.01
|
| Rate for Payer: WPS Commercial |
$7,141.45
|
|
|
NAIL GAMMA LONG 13 X 420 X 125DEG TI RT 3425-3420S
|
Facility
|
IP
|
$9,271.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5627697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,724.50 |
| Max. Negotiated Rate |
$8,870.49 |
| Rate for Payer: Aetna Commercial |
$8,677.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,291.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,110.18
|
| Rate for Payer: Cash Price |
$2,781.30
|
| Rate for Payer: Cigna Commercial |
$8,870.49
|
| Rate for Payer: Health EOS Commercial |
$8,581.24
|
| Rate for Payer: HFN Commercial |
$8,870.49
|
| Rate for Payer: Multiplan Commercial |
$7,713.47
|
| Rate for Payer: Preferred Network Access Commercial |
$8,870.49
|
| Rate for Payer: Quartz Beloit One Network |
$4,724.50
|
| Rate for Payer: Quartz Commercial |
$5,785.10
|
| Rate for Payer: WEA Trust Commercial |
$5,303.01
|
| Rate for Payer: WPS Commercial |
$7,141.45
|
|
|
NAIL GAMMA LONG 13 X 440 X 125DEG TI RT 3425-3440S
|
Facility
|
OP
|
$9,033.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5415174
|
|
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 440 X 125DEG TI RT 3425-3440S
|
Facility
|
IP
|
$9,033.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5415174
|
|
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 15 X 420 X 125DEG TI RT 3425-5420S
|
Facility
|
OP
|
$7,481.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6178001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,178.47 |
| Max. Negotiated Rate |
$7,157.82 |
| Rate for Payer: Aetna Commercial |
$7,002.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,691.01
|
| Rate for Payer: Aetna Managed Medicare |
$2,178.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,057.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,890.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,734.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,123.53
|
| Rate for Payer: Cash Price |
$2,244.30
|
| Rate for Payer: Cigna Commercial |
$7,157.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,353.94
|
| Rate for Payer: Health EOS Commercial |
$6,924.41
|
| Rate for Payer: HFN Commercial |
$7,157.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,835.18
|
| Rate for Payer: Multiplan Commercial |
$6,224.19
|
| Rate for Payer: NAPHCARE Commercial |
$4,668.14
|
| Rate for Payer: Preferred Network Access Commercial |
$7,157.82
|
| Rate for Payer: Quartz Beloit One Network |
$3,812.32
|
| Rate for Payer: Quartz Commercial |
$5,057.16
|
| Rate for Payer: Quartz Medicare Advantage |
$4,668.14
|
| Rate for Payer: The Alliance Commercial |
$3,890.12
|
| Rate for Payer: WEA Trust Commercial |
$4,279.13
|
| Rate for Payer: WPS Commercial |
$5,762.61
|
|
|
NAIL GAMMA LONG 15 X 420 X 125DEG TI RT 3425-5420S
|
Facility
|
IP
|
$7,481.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6178001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,812.32 |
| Max. Negotiated Rate |
$7,157.82 |
| Rate for Payer: Aetna Commercial |
$7,002.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,691.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,123.53
|
| Rate for Payer: Cash Price |
$2,244.30
|
| Rate for Payer: Cigna Commercial |
$7,157.82
|
| Rate for Payer: Health EOS Commercial |
$6,924.41
|
| Rate for Payer: HFN Commercial |
$7,157.82
|
| Rate for Payer: Multiplan Commercial |
$6,224.19
|
| Rate for Payer: Preferred Network Access Commercial |
$7,157.82
|
| Rate for Payer: Quartz Beloit One Network |
$3,812.32
|
| Rate for Payer: Quartz Commercial |
$4,668.14
|
| Rate for Payer: WEA Trust Commercial |
$4,279.13
|
| Rate for Payer: WPS Commercial |
$5,762.61
|
|
|
NAIL GAMMA RT 11 X 400 X 125 3425-1400S
|
Facility
|
IP
|
$10,217.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
3072444
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,206.58 |
| Max. Negotiated Rate |
$9,775.63 |
| Rate for Payer: Aetna Commercial |
$9,563.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,138.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,631.61
|
| Rate for Payer: Cash Price |
$3,065.10
|
| Rate for Payer: Cigna Commercial |
$9,775.63
|
| Rate for Payer: Health EOS Commercial |
$9,456.86
|
| Rate for Payer: HFN Commercial |
$9,775.63
|
| Rate for Payer: Multiplan Commercial |
$8,500.54
|
| Rate for Payer: Preferred Network Access Commercial |
$9,775.63
|
| Rate for Payer: Quartz Beloit One Network |
$5,206.58
|
| Rate for Payer: Quartz Commercial |
$6,375.41
|
| Rate for Payer: WEA Trust Commercial |
$5,844.12
|
| Rate for Payer: WPS Commercial |
$7,870.16
|
|
|
NAIL GAMMA RT 11 X 400 X 125 3425-1400S
|
Facility
|
OP
|
$10,217.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
3072444
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,975.19 |
| Max. Negotiated Rate |
$9,775.63 |
| Rate for Payer: Aetna Commercial |
$9,563.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,138.08
|
| Rate for Payer: Aetna Managed Medicare |
$2,975.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,906.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,312.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,100.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,631.61
|
| Rate for Payer: Cash Price |
$3,065.10
|
| Rate for Payer: Cigna Commercial |
$9,775.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,946.29
|
| Rate for Payer: Health EOS Commercial |
$9,456.86
|
| Rate for Payer: HFN Commercial |
$9,775.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,969.26
|
| Rate for Payer: Multiplan Commercial |
$8,500.54
|
| Rate for Payer: NAPHCARE Commercial |
$6,375.41
|
| Rate for Payer: Preferred Network Access Commercial |
$9,775.63
|
| Rate for Payer: Quartz Beloit One Network |
$5,206.58
|
| Rate for Payer: Quartz Commercial |
$6,906.69
|
| Rate for Payer: Quartz Medicare Advantage |
$6,375.41
|
| Rate for Payer: The Alliance Commercial |
$5,312.84
|
| Rate for Payer: WEA Trust Commercial |
$5,844.12
|
| Rate for Payer: WPS Commercial |
$7,870.16
|
|
|
NAIL GAMMA RT 11 X 420 X 125 3425-1420S
|
Facility
|
IP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509047
|
|
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 RT 11 X 420 X 125 3425-1420S
|
Facility
|
OP
|
$9,643.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
4509047
|
|
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 PROCEDURES
|
Facility
|
OP
|
$65.52
|
|
|
Service Code
|
EAPG 00005
|
| Min. Negotiated Rate |
$62.99 |
| Max. Negotiated Rate |
$65.52 |
| Rate for Payer: Anthem Medicaid |
$62.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$62.99
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$62.99
|
| Rate for Payer: Dean Health Medicaid |
$62.99
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$62.99
|
| Rate for Payer: Managed Health Services Medicaid |
$65.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$62.99
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$62.99
|
| Rate for Payer: United Healthcare Medicaid |
$62.99
|
|
|
NAIL SPLINT INRO 14MM *Need Size (sm-med-lg)
|
Facility
|
OP
|
$705.00
|
|
| Hospital Charge Code |
2969528
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$205.30 |
| Max. Negotiated Rate |
$674.54 |
| Rate for Payer: Aetna Commercial |
$659.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$630.55
|
| Rate for Payer: Aetna Managed Medicare |
$205.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$476.58
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$366.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$351.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$388.60
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cigna Commercial |
$674.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$410.31
|
| Rate for Payer: Health EOS Commercial |
$652.55
|
| Rate for Payer: HFN Commercial |
$674.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$549.90
|
| Rate for Payer: Multiplan Commercial |
$586.56
|
| Rate for Payer: NAPHCARE Commercial |
$439.92
|
| Rate for Payer: Preferred Network Access Commercial |
$674.54
|
| Rate for Payer: Quartz Beloit One Network |
$359.27
|
| Rate for Payer: Quartz Commercial |
$476.58
|
| Rate for Payer: Quartz Medicare Advantage |
$439.92
|
| Rate for Payer: The Alliance Commercial |
$366.60
|
| Rate for Payer: WEA Trust Commercial |
$403.26
|
| Rate for Payer: WPS Commercial |
$543.06
|
|
|
NAIL SPLINT INRO 14MM *Need Size (sm-med-lg)
|
Facility
|
IP
|
$705.00
|
|
| Hospital Charge Code |
2969528
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$359.27 |
| Max. Negotiated Rate |
$674.54 |
| Rate for Payer: Aetna Commercial |
$659.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$630.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$388.60
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cigna Commercial |
$674.54
|
| Rate for Payer: Health EOS Commercial |
$652.55
|
| Rate for Payer: HFN Commercial |
$674.54
|
| Rate for Payer: Multiplan Commercial |
$586.56
|
| Rate for Payer: Preferred Network Access Commercial |
$674.54
|
| Rate for Payer: Quartz Beloit One Network |
$359.27
|
| Rate for Payer: Quartz Commercial |
$439.92
|
| Rate for Payer: WEA Trust Commercial |
$403.26
|
| Rate for Payer: WPS Commercial |
$543.06
|
|
|
NAIL SUPRACONDYLAR 12 X 300 1826-1230S
|
Facility
|
OP
|
$7,898.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5659734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,299.90 |
| Max. Negotiated Rate |
$7,556.81 |
| Rate for Payer: Aetna Commercial |
$7,392.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,063.97
|
| Rate for Payer: Aetna Managed Medicare |
$2,299.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,339.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,106.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,942.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,353.38
|
| Rate for Payer: Cash Price |
$2,369.40
|
| Rate for Payer: Cigna Commercial |
$7,556.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,596.64
|
| Rate for Payer: Health EOS Commercial |
$7,310.39
|
| Rate for Payer: HFN Commercial |
$7,556.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,160.44
|
| Rate for Payer: Multiplan Commercial |
$6,571.14
|
| Rate for Payer: NAPHCARE Commercial |
$4,928.35
|
| Rate for Payer: Preferred Network Access Commercial |
$7,556.81
|
| Rate for Payer: Quartz Beloit One Network |
$4,024.82
|
| Rate for Payer: Quartz Commercial |
$5,339.05
|
| Rate for Payer: Quartz Medicare Advantage |
$4,928.35
|
| Rate for Payer: The Alliance Commercial |
$4,106.96
|
| Rate for Payer: WEA Trust Commercial |
$4,517.66
|
| Rate for Payer: WPS Commercial |
$6,083.83
|
|
|
NAIL SUPRACONDYLAR 12 X 300 1826-1230S
|
Facility
|
IP
|
$7,898.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5659734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,024.82 |
| Max. Negotiated Rate |
$7,556.81 |
| Rate for Payer: Aetna Commercial |
$7,392.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,063.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,353.38
|
| Rate for Payer: Cash Price |
$2,369.40
|
| Rate for Payer: Cigna Commercial |
$7,556.81
|
| Rate for Payer: Health EOS Commercial |
$7,310.39
|
| Rate for Payer: HFN Commercial |
$7,556.81
|
| Rate for Payer: Multiplan Commercial |
$6,571.14
|
| Rate for Payer: Preferred Network Access Commercial |
$7,556.81
|
| Rate for Payer: Quartz Beloit One Network |
$4,024.82
|
| Rate for Payer: Quartz Commercial |
$4,928.35
|
| Rate for Payer: WEA Trust Commercial |
$4,517.66
|
| Rate for Payer: WPS Commercial |
$6,083.83
|
|
|
NAIL SUPRACONDYLAR 13 X 340 1826-1332S
|
Facility
|
OP
|
$10,819.00
|
|
| Hospital Charge Code |
3072608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,150.49 |
| Max. Negotiated Rate |
$10,351.62 |
| Rate for Payer: Aetna Commercial |
$10,126.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,676.51
|
| Rate for Payer: Aetna Managed Medicare |
$3,150.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,313.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,625.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,400.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,963.43
|
| Rate for Payer: Cash Price |
$3,245.70
|
| Rate for Payer: Cigna Commercial |
$10,351.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,296.66
|
| Rate for Payer: Health EOS Commercial |
$10,014.07
|
| Rate for Payer: HFN Commercial |
$10,351.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,438.82
|
| Rate for Payer: Multiplan Commercial |
$9,001.41
|
| Rate for Payer: NAPHCARE Commercial |
$6,751.06
|
| Rate for Payer: Preferred Network Access Commercial |
$10,351.62
|
| Rate for Payer: Quartz Beloit One Network |
$5,513.36
|
| Rate for Payer: Quartz Commercial |
$7,313.64
|
| Rate for Payer: Quartz Medicare Advantage |
$6,751.06
|
| Rate for Payer: The Alliance Commercial |
$5,625.88
|
| Rate for Payer: WEA Trust Commercial |
$6,188.47
|
| Rate for Payer: WPS Commercial |
$8,333.88
|
|
|
NAIL SUPRACONDYLAR 13 X 340 1826-1332S
|
Facility
|
IP
|
$10,819.00
|
|
| Hospital Charge Code |
3072608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,513.36 |
| Max. Negotiated Rate |
$10,351.62 |
| Rate for Payer: Aetna Commercial |
$10,126.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,676.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,963.43
|
| Rate for Payer: Cash Price |
$3,245.70
|
| Rate for Payer: Cigna Commercial |
$10,351.62
|
| Rate for Payer: Health EOS Commercial |
$10,014.07
|
| Rate for Payer: HFN Commercial |
$10,351.62
|
| Rate for Payer: Multiplan Commercial |
$9,001.41
|
| Rate for Payer: Preferred Network Access Commercial |
$10,351.62
|
| Rate for Payer: Quartz Beloit One Network |
$5,513.36
|
| Rate for Payer: Quartz Commercial |
$6,751.06
|
| Rate for Payer: WEA Trust Commercial |
$6,188.47
|
| Rate for Payer: WPS Commercial |
$8,333.88
|
|
|
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 |
$4,241.40 |
| Max. Negotiated Rate |
$7,963.45 |
| Rate for Payer: Aetna Commercial |
$7,790.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,444.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,587.64
|
| Rate for Payer: Cash Price |
$2,496.90
|
| Rate for Payer: Cigna Commercial |
$7,963.45
|
| Rate for Payer: Health EOS Commercial |
$7,703.77
|
| Rate for Payer: HFN Commercial |
$7,963.45
|
| Rate for Payer: Multiplan Commercial |
$6,924.74
|
| Rate for Payer: Preferred Network Access Commercial |
$7,963.45
|
| Rate for Payer: Quartz Beloit One Network |
$4,241.40
|
| Rate for Payer: Quartz Commercial |
$5,193.55
|
| Rate for Payer: WEA Trust Commercial |
$4,760.76
|
| Rate for Payer: WPS Commercial |
$6,411.21
|
|
|
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 |
$2,423.66 |
| Max. Negotiated Rate |
$7,963.45 |
| Rate for Payer: Aetna Commercial |
$7,790.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$7,444.09
|
| Rate for Payer: Aetna Managed Medicare |
$2,423.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$5,626.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,327.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,154.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,587.64
|
| Rate for Payer: Cash Price |
$2,496.90
|
| Rate for Payer: Cigna Commercial |
$7,963.45
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,843.99
|
| Rate for Payer: Health EOS Commercial |
$7,703.77
|
| Rate for Payer: HFN Commercial |
$7,963.45
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$6,491.94
|
| Rate for Payer: Multiplan Commercial |
$6,924.74
|
| Rate for Payer: NAPHCARE Commercial |
$5,193.55
|
| Rate for Payer: Preferred Network Access Commercial |
$7,963.45
|
| Rate for Payer: Quartz Beloit One Network |
$4,241.40
|
| Rate for Payer: Quartz Commercial |
$5,626.35
|
| Rate for Payer: Quartz Medicare Advantage |
$5,193.55
|
| Rate for Payer: The Alliance Commercial |
$4,327.96
|
| Rate for Payer: WEA Trust Commercial |
$4,760.76
|
| Rate for Payer: WPS Commercial |
$6,411.21
|
|
|
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 |
$2,683.41 |
| Max. Negotiated Rate |
$8,816.91 |
| Rate for Payer: Aetna Commercial |
$8,625.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,241.90
|
| Rate for Payer: Aetna Managed Medicare |
$2,683.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,229.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,791.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,600.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,079.31
|
| Rate for Payer: Cash Price |
$2,764.50
|
| Rate for Payer: Cigna Commercial |
$8,816.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,363.13
|
| Rate for Payer: Health EOS Commercial |
$8,529.40
|
| Rate for Payer: HFN Commercial |
$8,816.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,187.70
|
| Rate for Payer: Multiplan Commercial |
$7,666.88
|
| Rate for Payer: NAPHCARE Commercial |
$5,750.16
|
| Rate for Payer: Preferred Network Access Commercial |
$8,816.91
|
| Rate for Payer: Quartz Beloit One Network |
$4,695.96
|
| Rate for Payer: Quartz Commercial |
$6,229.34
|
| Rate for Payer: Quartz Medicare Advantage |
$5,750.16
|
| Rate for Payer: The Alliance Commercial |
$4,791.80
|
| Rate for Payer: WEA Trust Commercial |
$5,270.98
|
| Rate for Payer: WPS Commercial |
$7,098.31
|
|
|
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 |
$4,695.96 |
| Max. Negotiated Rate |
$8,816.91 |
| Rate for Payer: Aetna Commercial |
$8,625.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,241.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,079.31
|
| Rate for Payer: Cash Price |
$2,764.50
|
| Rate for Payer: Cigna Commercial |
$8,816.91
|
| Rate for Payer: Health EOS Commercial |
$8,529.40
|
| Rate for Payer: HFN Commercial |
$8,816.91
|
| Rate for Payer: Multiplan Commercial |
$7,666.88
|
| Rate for Payer: Preferred Network Access Commercial |
$8,816.91
|
| Rate for Payer: Quartz Beloit One Network |
$4,695.96
|
| Rate for Payer: Quartz Commercial |
$5,750.16
|
| Rate for Payer: WEA Trust Commercial |
$5,270.98
|
| Rate for Payer: WPS Commercial |
$7,098.31
|
|
|
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 |
$5,723.83 |
| Max. Negotiated Rate |
$10,746.78 |
| Rate for Payer: Aetna Commercial |
$10,513.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,045.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,191.08
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,746.78
|
| Rate for Payer: Health EOS Commercial |
$10,396.34
|
| Rate for Payer: HFN Commercial |
$10,746.78
|
| Rate for Payer: Multiplan Commercial |
$9,345.02
|
| Rate for Payer: Preferred Network Access Commercial |
$10,746.78
|
| Rate for Payer: Quartz Beloit One Network |
$5,723.83
|
| Rate for Payer: Quartz Commercial |
$7,008.77
|
| Rate for Payer: WEA Trust Commercial |
$6,424.70
|
| Rate for Payer: WPS Commercial |
$8,652.01
|
|
|
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 |
$3,270.76 |
| Max. Negotiated Rate |
$10,746.78 |
| Rate for Payer: Aetna Commercial |
$10,513.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$10,045.90
|
| Rate for Payer: Aetna Managed Medicare |
$3,270.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,592.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,840.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,607.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,191.08
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cigna Commercial |
$10,746.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,537.02
|
| Rate for Payer: Health EOS Commercial |
$10,396.34
|
| Rate for Payer: HFN Commercial |
$10,746.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,760.96
|
| Rate for Payer: Multiplan Commercial |
$9,345.02
|
| Rate for Payer: NAPHCARE Commercial |
$7,008.77
|
| Rate for Payer: Preferred Network Access Commercial |
$10,746.78
|
| Rate for Payer: Quartz Beloit One Network |
$5,723.83
|
| Rate for Payer: Quartz Commercial |
$7,592.83
|
| Rate for Payer: Quartz Medicare Advantage |
$7,008.77
|
| Rate for Payer: The Alliance Commercial |
$5,840.64
|
| Rate for Payer: WEA Trust Commercial |
$6,424.70
|
| Rate for Payer: WPS Commercial |
$8,652.01
|
|
|
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 |
$5,503.68 |
| 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 |
$3,240.00
|
| 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: 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 |
$8,319.24
|
|
|
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 |
$3,144.96 |
| 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: 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 |
$3,240.00
|
| Rate for Payer: Cigna Commercial |
$10,333.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,285.60
|
| 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 |
$5,616.00
|
| Rate for Payer: WEA Trust Commercial |
$6,177.60
|
| Rate for Payer: WPS Commercial |
$8,319.24
|
|
