|
NAIL TROCHANTERIC TFN 11X340 RT 456.414S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966630
|
|
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 RT 456.414S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966630
|
|
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 11X360 LT 456.417S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966633
|
|
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 11X360 LT 456.417S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966633
|
|
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 11X360 RT 456.416S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966632
|
|
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 11X360 RT 456.416S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966632
|
|
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 11X380 LT 456.419S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966635
|
|
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 11X380 LT 456.419S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966635
|
|
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 11X380 RT 456.418S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966634
|
|
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 11X380 RT 456.418S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966634
|
|
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 11X400 LT 456.421S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966637
|
|
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 11X400 LT 456.421S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966637
|
|
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 11X400 RT 456.420S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966636
|
|
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 11X400 RT 456.420S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966636
|
|
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 11X420 LT 456.423S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966639
|
|
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 11X420 LT 456.423S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966639
|
|
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 11X420 RT 456.422S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966638
|
|
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 11X420 RT 456.422S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966638
|
|
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 11X440 LT 456.425S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966641
|
|
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 11X440 LT 456.425S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966641
|
|
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 11X440 RT 456.424S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966640
|
|
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 11X440 RT 456.424S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966640
|
|
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 12MM 456.322S
|
Facility
|
IP
|
$10,642.00
|
|
| Hospital Charge Code |
2966627
|
|
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 12MM 456.322S
|
Facility
|
OP
|
$10,642.00
|
|
| Hospital Charge Code |
2966627
|
|
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 TFNA 10MMX125 DEG 170MM TI 04.037.012S
|
Facility
|
IP
|
$7,706.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
5490792
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3,926.98 |
| Max. Negotiated Rate |
$7,373.10 |
| Rate for Payer: Aetna Commercial |
$7,212.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,892.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,247.55
|
| Rate for Payer: Cash Price |
$2,311.80
|
| Rate for Payer: Cigna Commercial |
$7,373.10
|
| Rate for Payer: Health EOS Commercial |
$7,132.67
|
| Rate for Payer: HFN Commercial |
$7,373.10
|
| Rate for Payer: Multiplan Commercial |
$6,411.39
|
| Rate for Payer: Preferred Network Access Commercial |
$7,373.10
|
| Rate for Payer: Quartz Beloit One Network |
$3,926.98
|
| Rate for Payer: Quartz Commercial |
$4,808.54
|
| Rate for Payer: WEA Trust Commercial |
$4,407.83
|
| Rate for Payer: WPS Commercial |
$5,935.93
|
|
