|
REAMER HEAD RIA 2 10.5MM STERILE 03.404.017S
|
Facility
|
IP
|
$4,835.00
|
|
| Hospital Charge Code |
6001636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,369.15 |
| Max. Negotiated Rate |
$4,448.20 |
| Rate for Payer: Aetna Commercial |
$4,351.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,158.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,562.55
|
| Rate for Payer: Cash Price |
$1,450.50
|
| Rate for Payer: Cigna Commercial |
$4,448.20
|
| Rate for Payer: Health EOS Commercial |
$4,303.15
|
| Rate for Payer: HFN Commercial |
$4,448.20
|
| Rate for Payer: Multiplan Commercial |
$3,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,901.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,448.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,369.15
|
| Rate for Payer: Quartz Commercial |
$2,901.00
|
| Rate for Payer: WEA Trust Commercial |
$2,659.25
|
| Rate for Payer: WPS Commercial |
$3,581.28
|
|
|
REAMER HEAD RIA 2 10.5MM STERILE 03.404.017S
|
Facility
|
OP
|
$4,835.00
|
|
| Hospital Charge Code |
6001636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,353.80 |
| Max. Negotiated Rate |
$19,340.00 |
| Rate for Payer: Aetna Commercial |
$4,351.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,158.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,353.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,142.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,417.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,320.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,562.55
|
| Rate for Payer: Cash Price |
$1,450.50
|
| Rate for Payer: Cigna Commercial |
$4,448.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,705.67
|
| Rate for Payer: Health EOS Commercial |
$4,303.15
|
| Rate for Payer: HFN Commercial |
$4,448.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,626.25
|
| Rate for Payer: Multiplan Commercial |
$3,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,901.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,448.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,369.15
|
| Rate for Payer: Quartz Commercial |
$3,142.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,901.00
|
| Rate for Payer: The Alliance Commercial |
$19,340.00
|
| Rate for Payer: WEA Trust Commercial |
$2,659.25
|
| Rate for Payer: WPS Commercial |
$3,581.28
|
|
|
REAMER HEAD RIA 2 11.0MM STERILE 03.404.018S
|
Facility
|
OP
|
$4,835.00
|
|
| Hospital Charge Code |
6001635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,353.80 |
| Max. Negotiated Rate |
$19,340.00 |
| Rate for Payer: Aetna Commercial |
$4,351.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,158.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,353.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,142.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,417.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,320.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,562.55
|
| Rate for Payer: Cash Price |
$1,450.50
|
| Rate for Payer: Cigna Commercial |
$4,448.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,705.67
|
| Rate for Payer: Health EOS Commercial |
$4,303.15
|
| Rate for Payer: HFN Commercial |
$4,448.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,626.25
|
| Rate for Payer: Multiplan Commercial |
$3,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,901.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,448.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,369.15
|
| Rate for Payer: Quartz Commercial |
$3,142.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,901.00
|
| Rate for Payer: The Alliance Commercial |
$19,340.00
|
| Rate for Payer: WEA Trust Commercial |
$2,659.25
|
| Rate for Payer: WPS Commercial |
$3,581.28
|
|
|
REAMER HEAD RIA 2 11.0MM STERILE 03.404.018S
|
Facility
|
IP
|
$4,835.00
|
|
| Hospital Charge Code |
6001635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,369.15 |
| Max. Negotiated Rate |
$4,448.20 |
| Rate for Payer: Aetna Commercial |
$4,351.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,158.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,562.55
|
| Rate for Payer: Cash Price |
$1,450.50
|
| Rate for Payer: Cigna Commercial |
$4,448.20
|
| Rate for Payer: Health EOS Commercial |
$4,303.15
|
| Rate for Payer: HFN Commercial |
$4,448.20
|
| Rate for Payer: Multiplan Commercial |
$3,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,901.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,448.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,369.15
|
| Rate for Payer: Quartz Commercial |
$2,901.00
|
| Rate for Payer: WEA Trust Commercial |
$2,659.25
|
| Rate for Payer: WPS Commercial |
$3,581.28
|
|
|
REAMER METATARSAL 18MM AR-8944MR-18
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5459678
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,340.36 |
| Max. Negotiated Rate |
$19,148.00 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Aetna Managed Medicare |
$1,340.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,111.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,393.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,297.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,678.81
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,590.25
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$3,111.55
|
| Rate for Payer: Quartz Medicare Advantage |
$2,872.20
|
| Rate for Payer: The Alliance Commercial |
$19,148.00
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER METATARSAL 18MM AR-8944MR-18
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5459678
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,345.63 |
| Max. Negotiated Rate |
$4,404.04 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$2,872.20
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER METATARSAL 22MM AR-8944MR-22
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5603771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,340.36 |
| Max. Negotiated Rate |
$19,148.00 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Aetna Managed Medicare |
$1,340.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,111.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,393.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,297.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,678.81
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,590.25
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$3,111.55
|
| Rate for Payer: Quartz Medicare Advantage |
$2,872.20
|
| Rate for Payer: The Alliance Commercial |
$19,148.00
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER METATARSAL 22MM AR-8944MR-22
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5603771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,345.63 |
| Max. Negotiated Rate |
$4,404.04 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$2,872.20
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER OPENING DRILL ASSEMBLY 12.5MM 03.168.006
|
Facility
|
IP
|
$5,721.00
|
|
| Hospital Charge Code |
6178985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,803.29 |
| Max. Negotiated Rate |
$5,263.32 |
| Rate for Payer: Aetna Commercial |
$5,148.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,920.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,032.13
|
| Rate for Payer: Cash Price |
$1,716.30
|
| Rate for Payer: Cigna Commercial |
$5,263.32
|
| Rate for Payer: Health EOS Commercial |
$5,091.69
|
| Rate for Payer: HFN Commercial |
$5,263.32
|
| Rate for Payer: Multiplan Commercial |
$4,576.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,432.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,263.32
|
| Rate for Payer: Quartz Beloit One Network |
$2,803.29
|
| Rate for Payer: Quartz Commercial |
$3,432.60
|
| Rate for Payer: WEA Trust Commercial |
$3,146.55
|
| Rate for Payer: WPS Commercial |
$4,237.54
|
|
|
REAMER OPENING DRILL ASSEMBLY 12.5MM 03.168.006
|
Facility
|
OP
|
$5,721.00
|
|
| Hospital Charge Code |
6178985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,601.88 |
| Max. Negotiated Rate |
$22,884.00 |
| Rate for Payer: Aetna Commercial |
$5,148.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,920.06
|
| Rate for Payer: Aetna Managed Medicare |
$1,601.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,718.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,860.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,746.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,032.13
|
| Rate for Payer: Cash Price |
$1,716.30
|
| Rate for Payer: Cigna Commercial |
$5,263.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,201.47
|
| Rate for Payer: Health EOS Commercial |
$5,091.69
|
| Rate for Payer: HFN Commercial |
$5,263.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,290.75
|
| Rate for Payer: Multiplan Commercial |
$4,576.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,432.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,263.32
|
| Rate for Payer: Quartz Beloit One Network |
$2,803.29
|
| Rate for Payer: Quartz Commercial |
$3,718.65
|
| Rate for Payer: Quartz Medicare Advantage |
$3,432.60
|
| Rate for Payer: The Alliance Commercial |
$22,884.00
|
| Rate for Payer: WEA Trust Commercial |
$3,146.55
|
| Rate for Payer: WPS Commercial |
$4,237.54
|
|
|
REAMER PHALANGEAL 18MM AR-8944PR-18
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5459679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,345.63 |
| Max. Negotiated Rate |
$4,404.04 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$2,872.20
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER PHALANGEAL 18MM AR-8944PR-18
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5459679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,340.36 |
| Max. Negotiated Rate |
$19,148.00 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Aetna Managed Medicare |
$1,340.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,111.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,393.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,297.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,678.81
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,590.25
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$3,111.55
|
| Rate for Payer: Quartz Medicare Advantage |
$2,872.20
|
| Rate for Payer: The Alliance Commercial |
$19,148.00
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER PHALANGEAL 20MM AR-8944PR-20
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5603772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,340.36 |
| Max. Negotiated Rate |
$19,148.00 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Aetna Managed Medicare |
$1,340.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,111.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,393.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,297.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,678.81
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,590.25
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$3,111.55
|
| Rate for Payer: Quartz Medicare Advantage |
$2,872.20
|
| Rate for Payer: The Alliance Commercial |
$19,148.00
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER PHALANGEAL 20MM AR-8944PR-20
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5603772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,345.63 |
| Max. Negotiated Rate |
$4,404.04 |
| Rate for Payer: Aetna Commercial |
$4,308.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,116.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,537.11
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,404.04
|
| Rate for Payer: Health EOS Commercial |
$4,260.43
|
| Rate for Payer: HFN Commercial |
$4,404.04
|
| Rate for Payer: Multiplan Commercial |
$3,829.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,872.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,404.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,345.63
|
| Rate for Payer: Quartz Commercial |
$2,872.20
|
| Rate for Payer: WEA Trust Commercial |
$2,632.85
|
| Rate for Payer: WPS Commercial |
$3,545.73
|
|
|
REAMER PILOTED HEADED 8MM AR-1454
|
Facility
|
IP
|
$2,403.00
|
|
| Hospital Charge Code |
5190726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,177.47 |
| Max. Negotiated Rate |
$2,210.76 |
| Rate for Payer: Aetna Commercial |
$2,162.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,066.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,273.59
|
| Rate for Payer: Cash Price |
$720.90
|
| Rate for Payer: Cigna Commercial |
$2,210.76
|
| Rate for Payer: Health EOS Commercial |
$2,138.67
|
| Rate for Payer: HFN Commercial |
$2,210.76
|
| Rate for Payer: Multiplan Commercial |
$1,922.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,441.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,210.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,177.47
|
| Rate for Payer: Quartz Commercial |
$1,441.80
|
| Rate for Payer: WEA Trust Commercial |
$1,321.65
|
| Rate for Payer: WPS Commercial |
$1,779.90
|
|
|
REAMER PILOTED HEADED 8MM AR-1454
|
Facility
|
OP
|
$2,403.00
|
|
| Hospital Charge Code |
5190726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$672.84 |
| Max. Negotiated Rate |
$9,612.00 |
| Rate for Payer: Aetna Commercial |
$2,162.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,066.58
|
| Rate for Payer: Aetna Managed Medicare |
$672.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,561.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,201.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,153.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,273.59
|
| Rate for Payer: Cash Price |
$720.90
|
| Rate for Payer: Cigna Commercial |
$2,210.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,344.72
|
| Rate for Payer: Health EOS Commercial |
$2,138.67
|
| Rate for Payer: HFN Commercial |
$2,210.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,802.25
|
| Rate for Payer: Multiplan Commercial |
$1,922.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,441.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,210.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,177.47
|
| Rate for Payer: Quartz Commercial |
$1,561.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,441.80
|
| Rate for Payer: The Alliance Commercial |
$9,612.00
|
| Rate for Payer: WEA Trust Commercial |
$1,321.65
|
| Rate for Payer: WPS Commercial |
$1,779.90
|
|
|
REAMER SHAFT 8.0 X 448MM 0227-3000S
|
Facility
|
OP
|
$1,972.00
|
|
| Hospital Charge Code |
4518612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$552.16 |
| Max. Negotiated Rate |
$7,888.00 |
| Rate for Payer: Aetna Commercial |
$1,774.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,695.92
|
| Rate for Payer: Aetna Managed Medicare |
$552.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,281.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$986.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$946.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,045.16
|
| Rate for Payer: Cash Price |
$591.60
|
| Rate for Payer: Cigna Commercial |
$1,814.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,103.53
|
| Rate for Payer: Health EOS Commercial |
$1,755.08
|
| Rate for Payer: HFN Commercial |
$1,814.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,479.00
|
| Rate for Payer: Multiplan Commercial |
$1,577.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,183.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,814.24
|
| Rate for Payer: Quartz Beloit One Network |
$966.28
|
| Rate for Payer: Quartz Commercial |
$1,281.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,183.20
|
| Rate for Payer: The Alliance Commercial |
$7,888.00
|
| Rate for Payer: WEA Trust Commercial |
$1,084.60
|
| Rate for Payer: WPS Commercial |
$1,460.66
|
|
|
REAMER SHAFT 8.0 X 448MM 0227-3000S
|
Facility
|
IP
|
$1,972.00
|
|
| Hospital Charge Code |
4518612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$966.28 |
| Max. Negotiated Rate |
$1,814.24 |
| Rate for Payer: Aetna Commercial |
$1,774.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,695.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,045.16
|
| Rate for Payer: Cash Price |
$591.60
|
| Rate for Payer: Cigna Commercial |
$1,814.24
|
| Rate for Payer: Health EOS Commercial |
$1,755.08
|
| Rate for Payer: HFN Commercial |
$1,814.24
|
| Rate for Payer: Multiplan Commercial |
$1,577.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,183.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,814.24
|
| Rate for Payer: Quartz Beloit One Network |
$966.28
|
| Rate for Payer: Quartz Commercial |
$1,183.20
|
| Rate for Payer: WEA Trust Commercial |
$1,084.60
|
| Rate for Payer: WPS Commercial |
$1,460.66
|
|
|
REAMER SHAFT 8.0 X 510MM 0227-8510S
|
Facility
|
IP
|
$2,624.00
|
|
| Hospital Charge Code |
5349004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,285.76 |
| Max. Negotiated Rate |
$2,414.08 |
| Rate for Payer: Aetna Commercial |
$2,361.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,256.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,390.72
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cigna Commercial |
$2,414.08
|
| Rate for Payer: Health EOS Commercial |
$2,335.36
|
| Rate for Payer: HFN Commercial |
$2,414.08
|
| Rate for Payer: Multiplan Commercial |
$2,099.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,574.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,414.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,285.76
|
| Rate for Payer: Quartz Commercial |
$1,574.40
|
| Rate for Payer: WEA Trust Commercial |
$1,443.20
|
| Rate for Payer: WPS Commercial |
$1,943.60
|
|
|
REAMER SHAFT 8.0 X 510MM 0227-8510S
|
Facility
|
OP
|
$2,624.00
|
|
| Hospital Charge Code |
5349004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$734.72 |
| Max. Negotiated Rate |
$10,496.00 |
| Rate for Payer: Aetna Commercial |
$2,361.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,256.64
|
| Rate for Payer: Aetna Managed Medicare |
$734.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,705.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,312.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,259.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,390.72
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cigna Commercial |
$2,414.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,468.39
|
| Rate for Payer: Health EOS Commercial |
$2,335.36
|
| Rate for Payer: HFN Commercial |
$2,414.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,968.00
|
| Rate for Payer: Multiplan Commercial |
$2,099.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,574.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,414.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,285.76
|
| Rate for Payer: Quartz Commercial |
$1,705.60
|
| Rate for Payer: Quartz Medicare Advantage |
$1,574.40
|
| Rate for Payer: The Alliance Commercial |
$10,496.00
|
| Rate for Payer: WEA Trust Commercial |
$1,443.20
|
| Rate for Payer: WPS Commercial |
$1,943.60
|
|
|
REAMER TWO-STEP CONCAVE 10MM 220-10-001
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
3693502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.48 |
| Max. Negotiated Rate |
$12,664.00 |
| Rate for Payer: Aetna Commercial |
$2,849.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,722.76
|
| Rate for Payer: Aetna Managed Medicare |
$886.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,057.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,583.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,519.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,677.98
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$2,912.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,771.69
|
| Rate for Payer: Health EOS Commercial |
$2,817.74
|
| Rate for Payer: HFN Commercial |
$2,912.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,374.50
|
| Rate for Payer: Multiplan Commercial |
$2,532.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,899.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,912.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,551.34
|
| Rate for Payer: Quartz Commercial |
$2,057.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,899.60
|
| Rate for Payer: The Alliance Commercial |
$12,664.00
|
| Rate for Payer: WEA Trust Commercial |
$1,741.30
|
| Rate for Payer: WPS Commercial |
$2,345.06
|
|
|
REAMER TWO-STEP CONCAVE 10MM 220-10-001
|
Facility
|
IP
|
$3,166.00
|
|
| Hospital Charge Code |
3693502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,551.34 |
| Max. Negotiated Rate |
$2,912.72 |
| Rate for Payer: Aetna Commercial |
$2,849.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,722.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,677.98
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$2,912.72
|
| Rate for Payer: Health EOS Commercial |
$2,817.74
|
| Rate for Payer: HFN Commercial |
$2,912.72
|
| Rate for Payer: Multiplan Commercial |
$2,532.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,899.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,912.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,551.34
|
| Rate for Payer: Quartz Commercial |
$1,899.60
|
| Rate for Payer: WEA Trust Commercial |
$1,741.30
|
| Rate for Payer: WPS Commercial |
$2,345.06
|
|
|
REAMER TWO-STEP CONCAVE 12MM 220-12-001
|
Facility
|
IP
|
$2,660.00
|
|
| Hospital Charge Code |
4858690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,303.40 |
| Max. Negotiated Rate |
$2,447.20 |
| Rate for Payer: Aetna Commercial |
$2,394.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,287.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.80
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,447.20
|
| Rate for Payer: Health EOS Commercial |
$2,367.40
|
| Rate for Payer: HFN Commercial |
$2,447.20
|
| Rate for Payer: Multiplan Commercial |
$2,128.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,596.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,447.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.40
|
| Rate for Payer: Quartz Commercial |
$1,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,463.00
|
| Rate for Payer: WPS Commercial |
$1,970.26
|
|
|
REAMER TWO-STEP CONCAVE 12MM 220-12-001
|
Facility
|
OP
|
$2,660.00
|
|
| Hospital Charge Code |
4858690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$744.80 |
| Max. Negotiated Rate |
$10,640.00 |
| Rate for Payer: Aetna Commercial |
$2,394.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,287.60
|
| Rate for Payer: Aetna Managed Medicare |
$744.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,729.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,330.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,276.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.80
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,447.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,488.54
|
| Rate for Payer: Health EOS Commercial |
$2,367.40
|
| Rate for Payer: HFN Commercial |
$2,447.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,995.00
|
| Rate for Payer: Multiplan Commercial |
$2,128.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,596.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,447.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.40
|
| Rate for Payer: Quartz Commercial |
$1,729.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,596.00
|
| Rate for Payer: The Alliance Commercial |
$10,640.00
|
| Rate for Payer: WEA Trust Commercial |
$1,463.00
|
| Rate for Payer: WPS Commercial |
$1,970.26
|
|
|
REAMER TWO-STEP CONCAVE 8MM 220-08-001
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
4452943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.48 |
| Max. Negotiated Rate |
$12,664.00 |
| Rate for Payer: Aetna Commercial |
$2,849.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,722.76
|
| Rate for Payer: Aetna Managed Medicare |
$886.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,057.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,583.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,519.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,677.98
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$2,912.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,771.69
|
| Rate for Payer: Health EOS Commercial |
$2,817.74
|
| Rate for Payer: HFN Commercial |
$2,912.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,374.50
|
| Rate for Payer: Multiplan Commercial |
$2,532.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,899.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,912.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,551.34
|
| Rate for Payer: Quartz Commercial |
$2,057.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,899.60
|
| Rate for Payer: The Alliance Commercial |
$12,664.00
|
| Rate for Payer: WEA Trust Commercial |
$1,741.30
|
| Rate for Payer: WPS Commercial |
$2,345.06
|
|
