|
NAIL TIBIAL CANN 9MM X 285MM TI 04.034.337S
|
Facility
|
IP
|
$9,692.00
|
|
| Hospital Charge Code |
2966296
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,939.04 |
| Max. Negotiated Rate |
$9,273.31 |
| Rate for Payer: Aetna Commercial |
$9,071.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,668.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,342.23
|
| Rate for Payer: Cash Price |
$2,907.60
|
| Rate for Payer: Cigna Commercial |
$9,273.31
|
| Rate for Payer: Health EOS Commercial |
$8,970.92
|
| Rate for Payer: HFN Commercial |
$9,273.31
|
| Rate for Payer: Multiplan Commercial |
$8,063.74
|
| Rate for Payer: Preferred Network Access Commercial |
$9,273.31
|
| Rate for Payer: Quartz Beloit One Network |
$4,939.04
|
| Rate for Payer: Quartz Commercial |
$6,047.81
|
| Rate for Payer: WEA Trust Commercial |
$5,543.82
|
| Rate for Payer: WPS Commercial |
$7,465.75
|
|
|
NAIL TIBIAL CANN ADVANCED 12MM X 315MM TI 04.043.425S
|
Facility
|
IP
|
$9,309.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6175602
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,743.87 |
| Max. Negotiated Rate |
$8,906.85 |
| Rate for Payer: Aetna Commercial |
$8,713.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,325.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,131.12
|
| Rate for Payer: Cash Price |
$2,792.70
|
| Rate for Payer: Cigna Commercial |
$8,906.85
|
| Rate for Payer: Health EOS Commercial |
$8,616.41
|
| Rate for Payer: HFN Commercial |
$8,906.85
|
| Rate for Payer: Multiplan Commercial |
$7,745.09
|
| Rate for Payer: Preferred Network Access Commercial |
$8,906.85
|
| Rate for Payer: Quartz Beloit One Network |
$4,743.87
|
| Rate for Payer: Quartz Commercial |
$5,808.82
|
| Rate for Payer: WEA Trust Commercial |
$5,324.75
|
| Rate for Payer: WPS Commercial |
$7,170.72
|
|
|
NAIL TIBIAL CANN ADVANCED 12MM X 315MM TI 04.043.425S
|
Facility
|
OP
|
$9,309.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6175602
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,710.78 |
| Max. Negotiated Rate |
$8,906.85 |
| Rate for Payer: Aetna Commercial |
$8,713.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,325.97
|
| Rate for Payer: Aetna Managed Medicare |
$2,710.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,292.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,840.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,647.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,131.12
|
| Rate for Payer: Cash Price |
$2,792.70
|
| Rate for Payer: Cigna Commercial |
$8,906.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,417.84
|
| Rate for Payer: Health EOS Commercial |
$8,616.41
|
| Rate for Payer: HFN Commercial |
$8,906.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,261.02
|
| Rate for Payer: Multiplan Commercial |
$7,745.09
|
| Rate for Payer: NAPHCARE Commercial |
$5,808.82
|
| Rate for Payer: Preferred Network Access Commercial |
$8,906.85
|
| Rate for Payer: Quartz Beloit One Network |
$4,743.87
|
| Rate for Payer: Quartz Commercial |
$6,292.88
|
| Rate for Payer: Quartz Medicare Advantage |
$5,808.82
|
| Rate for Payer: The Alliance Commercial |
$4,840.68
|
| Rate for Payer: WEA Trust Commercial |
$5,324.75
|
| Rate for Payer: WPS Commercial |
$7,170.72
|
|
|
NAIL TI CANN TIBIAL W/PROX BEN
|
Facility
|
OP
|
$9,352.00
|
|
| Hospital Charge Code |
2966297
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,723.30 |
| Max. Negotiated Rate |
$8,947.99 |
| Rate for Payer: Aetna Commercial |
$8,753.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,364.43
|
| Rate for Payer: Aetna Managed Medicare |
$2,723.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$6,321.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$4,863.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$4,668.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,154.82
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cigna Commercial |
$8,947.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5,442.86
|
| Rate for Payer: Health EOS Commercial |
$8,656.21
|
| Rate for Payer: HFN Commercial |
$8,947.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$7,294.56
|
| Rate for Payer: Multiplan Commercial |
$7,780.86
|
| Rate for Payer: NAPHCARE Commercial |
$5,835.65
|
| Rate for Payer: Preferred Network Access Commercial |
$8,947.99
|
| Rate for Payer: Quartz Beloit One Network |
$4,765.78
|
| Rate for Payer: Quartz Commercial |
$6,321.95
|
| Rate for Payer: Quartz Medicare Advantage |
$5,835.65
|
| Rate for Payer: The Alliance Commercial |
$4,863.04
|
| Rate for Payer: WEA Trust Commercial |
$5,349.34
|
| Rate for Payer: WPS Commercial |
$7,203.85
|
|
|
NAIL TI CANN TIBIAL W/PROX BEN
|
Facility
|
IP
|
$9,352.00
|
|
| Hospital Charge Code |
2966297
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,765.78 |
| Max. Negotiated Rate |
$8,947.99 |
| Rate for Payer: Aetna Commercial |
$8,753.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$8,364.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,154.82
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cigna Commercial |
$8,947.99
|
| Rate for Payer: Health EOS Commercial |
$8,656.21
|
| Rate for Payer: HFN Commercial |
$8,947.99
|
| Rate for Payer: Multiplan Commercial |
$7,780.86
|
| Rate for Payer: Preferred Network Access Commercial |
$8,947.99
|
| Rate for Payer: Quartz Beloit One Network |
$4,765.78
|
| Rate for Payer: Quartz Commercial |
$5,835.65
|
| Rate for Payer: WEA Trust Commercial |
$5,349.34
|
| Rate for Payer: WPS Commercial |
$7,203.85
|
|
|
NAIL TI FEMORAL RECON 12MM
|
Facility
|
IP
|
$10,429.00
|
|
| Hospital Charge Code |
2966298
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,314.62 |
| Max. Negotiated Rate |
$9,978.47 |
| Rate for Payer: Aetna Commercial |
$9,761.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,327.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,748.46
|
| Rate for Payer: Cash Price |
$3,128.70
|
| Rate for Payer: Cigna Commercial |
$9,978.47
|
| Rate for Payer: Health EOS Commercial |
$9,653.08
|
| Rate for Payer: HFN Commercial |
$9,978.47
|
| Rate for Payer: Multiplan Commercial |
$8,676.93
|
| Rate for Payer: Preferred Network Access Commercial |
$9,978.47
|
| Rate for Payer: Quartz Beloit One Network |
$5,314.62
|
| Rate for Payer: Quartz Commercial |
$6,507.70
|
| Rate for Payer: WEA Trust Commercial |
$5,965.39
|
| Rate for Payer: WPS Commercial |
$8,033.46
|
|
|
NAIL TI FEMORAL RECON 12MM
|
Facility
|
OP
|
$10,429.00
|
|
| Hospital Charge Code |
2966298
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,036.92 |
| Max. Negotiated Rate |
$9,978.47 |
| Rate for Payer: Aetna Commercial |
$9,761.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,327.70
|
| Rate for Payer: Aetna Managed Medicare |
$3,036.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,050.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,423.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,206.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,748.46
|
| Rate for Payer: Cash Price |
$3,128.70
|
| Rate for Payer: Cigna Commercial |
$9,978.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,069.68
|
| Rate for Payer: Health EOS Commercial |
$9,653.08
|
| Rate for Payer: HFN Commercial |
$9,978.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,134.62
|
| Rate for Payer: Multiplan Commercial |
$8,676.93
|
| Rate for Payer: NAPHCARE Commercial |
$6,507.70
|
| Rate for Payer: Preferred Network Access Commercial |
$9,978.47
|
| Rate for Payer: Quartz Beloit One Network |
$5,314.62
|
| Rate for Payer: Quartz Commercial |
$7,050.00
|
| Rate for Payer: Quartz Medicare Advantage |
$6,507.70
|
| Rate for Payer: The Alliance Commercial |
$5,423.08
|
| Rate for Payer: WEA Trust Commercial |
$5,965.39
|
| Rate for Payer: WPS Commercial |
$8,033.46
|
|
|
NAIL TROCHANTERIC 11X125DX170 TFN 456.317S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC 11X125DX170 TFN 456.317S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC 11X135DX170 TFN 456.319S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC 11X135DX170 TFN 456.319S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC ES 11MMX42CMX130 RT 1059-425
|
Facility
|
OP
|
$14,374.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6232139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,185.71 |
| Max. Negotiated Rate |
$13,753.04 |
| Rate for Payer: Aetna Commercial |
$13,454.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12,856.11
|
| Rate for Payer: Aetna Managed Medicare |
$4,185.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,716.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$7,474.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,175.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,922.95
|
| Rate for Payer: Cash Price |
$4,312.20
|
| Rate for Payer: Cigna Commercial |
$13,753.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,365.67
|
| Rate for Payer: Health EOS Commercial |
$13,304.57
|
| Rate for Payer: HFN Commercial |
$13,753.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,211.72
|
| Rate for Payer: Multiplan Commercial |
$11,959.17
|
| Rate for Payer: NAPHCARE Commercial |
$8,969.38
|
| Rate for Payer: Preferred Network Access Commercial |
$13,753.04
|
| Rate for Payer: Quartz Beloit One Network |
$7,324.99
|
| Rate for Payer: Quartz Commercial |
$9,716.82
|
| Rate for Payer: Quartz Medicare Advantage |
$8,969.38
|
| Rate for Payer: The Alliance Commercial |
$7,474.48
|
| Rate for Payer: WEA Trust Commercial |
$8,221.93
|
| Rate for Payer: WPS Commercial |
$11,072.29
|
|
|
NAIL TROCHANTERIC ES 11MMX42CMX130 RT 1059-425
|
Facility
|
IP
|
$14,374.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6232139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,324.99 |
| Max. Negotiated Rate |
$13,753.04 |
| Rate for Payer: Aetna Commercial |
$13,454.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$12,856.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$7,922.95
|
| Rate for Payer: Cash Price |
$4,312.20
|
| Rate for Payer: Cigna Commercial |
$13,753.04
|
| Rate for Payer: Health EOS Commercial |
$13,304.57
|
| Rate for Payer: HFN Commercial |
$13,753.04
|
| Rate for Payer: Multiplan Commercial |
$11,959.17
|
| Rate for Payer: Preferred Network Access Commercial |
$13,753.04
|
| Rate for Payer: Quartz Beloit One Network |
$7,324.99
|
| Rate for Payer: Quartz Commercial |
$8,969.38
|
| Rate for Payer: WEA Trust Commercial |
$8,221.93
|
| Rate for Payer: WPS Commercial |
$11,072.29
|
|
|
NAIL TROCHANTERIC SHORT 11MMX20CMX130 RT 1036-200
|
Facility
|
IP
|
$10,898.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6234134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,553.62 |
| Max. Negotiated Rate |
$10,427.21 |
| Rate for Payer: Aetna Commercial |
$10,200.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,747.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,006.98
|
| Rate for Payer: Cash Price |
$3,269.40
|
| Rate for Payer: Cigna Commercial |
$10,427.21
|
| Rate for Payer: Health EOS Commercial |
$10,087.19
|
| Rate for Payer: HFN Commercial |
$10,427.21
|
| Rate for Payer: Multiplan Commercial |
$9,067.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,427.21
|
| Rate for Payer: Quartz Beloit One Network |
$5,553.62
|
| Rate for Payer: Quartz Commercial |
$6,800.35
|
| Rate for Payer: WEA Trust Commercial |
$6,233.66
|
| Rate for Payer: WPS Commercial |
$8,394.73
|
|
|
NAIL TROCHANTERIC SHORT 11MMX20CMX130 RT 1036-200
|
Facility
|
OP
|
$10,898.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6234134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,173.50 |
| Max. Negotiated Rate |
$10,427.21 |
| Rate for Payer: Aetna Commercial |
$10,200.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,747.17
|
| Rate for Payer: Aetna Managed Medicare |
$3,173.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,367.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,666.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,440.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$6,006.98
|
| Rate for Payer: Cash Price |
$3,269.40
|
| Rate for Payer: Cigna Commercial |
$10,427.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,342.64
|
| Rate for Payer: Health EOS Commercial |
$10,087.19
|
| Rate for Payer: HFN Commercial |
$10,427.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,500.44
|
| Rate for Payer: Multiplan Commercial |
$9,067.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,800.35
|
| Rate for Payer: Preferred Network Access Commercial |
$10,427.21
|
| Rate for Payer: Quartz Beloit One Network |
$5,553.62
|
| Rate for Payer: Quartz Commercial |
$7,367.05
|
| Rate for Payer: Quartz Medicare Advantage |
$6,800.35
|
| Rate for Payer: The Alliance Commercial |
$5,666.96
|
| Rate for Payer: WEA Trust Commercial |
$6,233.66
|
| Rate for Payer: WPS Commercial |
$8,394.73
|
|
|
NAIL TROCHANTERIC TFN 10MM 456.315S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 10MM 456.315S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11MM 456.318S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966625
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11MM 456.318S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966625
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 LT 456.413S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 LT 456.413S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 RT 456.412S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11X320 RT 456.412S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11X340 LT 456.415S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,423.16 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$6,640.61
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
|
NAIL TROCHANTERIC TFN 11X340 LT 456.415S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,098.95 |
| Max. Negotiated Rate |
$10,182.27 |
| Rate for Payer: Aetna Commercial |
$9,960.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$9,518.20
|
| Rate for Payer: Aetna Managed Medicare |
$3,098.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$7,193.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$5,533.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$5,312.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$5,865.87
|
| Rate for Payer: Cash Price |
$3,192.60
|
| Rate for Payer: Cigna Commercial |
$10,182.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,193.64
|
| Rate for Payer: Health EOS Commercial |
$9,850.24
|
| Rate for Payer: HFN Commercial |
$10,182.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$8,300.76
|
| Rate for Payer: Multiplan Commercial |
$8,854.14
|
| Rate for Payer: NAPHCARE Commercial |
$6,640.61
|
| Rate for Payer: Preferred Network Access Commercial |
$10,182.27
|
| Rate for Payer: Quartz Beloit One Network |
$5,423.16
|
| Rate for Payer: Quartz Commercial |
$7,193.99
|
| Rate for Payer: Quartz Medicare Advantage |
$6,640.61
|
| Rate for Payer: The Alliance Commercial |
$5,533.84
|
| Rate for Payer: WEA Trust Commercial |
$6,087.22
|
| Rate for Payer: WPS Commercial |
$8,197.53
|
|
