|
REAMER 9.0MM CORING CR8849
|
Facility
|
OP
|
$2,578.00
|
|
| Hospital Charge Code |
2969481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$750.71 |
| Max. Negotiated Rate |
$2,466.63 |
| Rate for Payer: Aetna Commercial |
$2,413.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,305.76
|
| Rate for Payer: Aetna Managed Medicare |
$750.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,742.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,340.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,286.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,420.99
|
| Rate for Payer: Cash Price |
$773.40
|
| Rate for Payer: Cigna Commercial |
$2,466.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,500.40
|
| Rate for Payer: Health EOS Commercial |
$2,386.20
|
| Rate for Payer: HFN Commercial |
$2,466.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,010.84
|
| Rate for Payer: Multiplan Commercial |
$2,144.90
|
| Rate for Payer: NAPHCARE Commercial |
$1,608.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,466.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,313.75
|
| Rate for Payer: Quartz Commercial |
$1,742.73
|
| Rate for Payer: Quartz Medicare Advantage |
$1,608.67
|
| Rate for Payer: The Alliance Commercial |
$1,340.56
|
| Rate for Payer: WEA Trust Commercial |
$1,474.62
|
| Rate for Payer: WPS Commercial |
$1,985.83
|
|
|
REAMER 9.0MM CORING CR8849
|
Facility
|
IP
|
$2,578.00
|
|
| Hospital Charge Code |
2969481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,313.75 |
| Max. Negotiated Rate |
$2,466.63 |
| Rate for Payer: Aetna Commercial |
$2,413.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,305.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,420.99
|
| Rate for Payer: Cash Price |
$773.40
|
| Rate for Payer: Cigna Commercial |
$2,466.63
|
| Rate for Payer: Health EOS Commercial |
$2,386.20
|
| Rate for Payer: HFN Commercial |
$2,466.63
|
| Rate for Payer: Multiplan Commercial |
$2,144.90
|
| Rate for Payer: Preferred Network Access Commercial |
$2,466.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,313.75
|
| Rate for Payer: Quartz Commercial |
$1,608.67
|
| Rate for Payer: WEA Trust Commercial |
$1,474.62
|
| Rate for Payer: WPS Commercial |
$1,985.83
|
|
|
REAMER CIRCULAR MTP 18MM AR-8944MC-18
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5459677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,439.46 |
| Max. Negotiated Rate |
$4,580.20 |
| Rate for Payer: Aetna Commercial |
$4,480.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,281.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,638.59
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,580.20
|
| Rate for Payer: Health EOS Commercial |
$4,430.85
|
| Rate for Payer: HFN Commercial |
$4,580.20
|
| Rate for Payer: Multiplan Commercial |
$3,982.78
|
| Rate for Payer: Preferred Network Access Commercial |
$4,580.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,439.46
|
| Rate for Payer: Quartz Commercial |
$2,987.09
|
| Rate for Payer: WEA Trust Commercial |
$2,738.16
|
| Rate for Payer: WPS Commercial |
$3,687.43
|
|
|
REAMER CIRCULAR MTP 18MM AR-8944MC-18
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5459677
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,393.97 |
| Max. Negotiated Rate |
$4,580.20 |
| Rate for Payer: Aetna Commercial |
$4,480.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,281.49
|
| Rate for Payer: Aetna Managed Medicare |
$1,393.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,236.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,489.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,389.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,638.59
|
| Rate for Payer: Cash Price |
$1,436.10
|
| Rate for Payer: Cigna Commercial |
$4,580.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,786.03
|
| Rate for Payer: Health EOS Commercial |
$4,430.85
|
| Rate for Payer: HFN Commercial |
$4,580.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,733.86
|
| Rate for Payer: Multiplan Commercial |
$3,982.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,987.09
|
| Rate for Payer: Preferred Network Access Commercial |
$4,580.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,439.46
|
| Rate for Payer: Quartz Commercial |
$3,236.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,987.09
|
| Rate for Payer: The Alliance Commercial |
$2,489.24
|
| Rate for Payer: WEA Trust Commercial |
$2,738.16
|
| Rate for Payer: WPS Commercial |
$3,687.43
|
|
|
REAMER CONCAVE 16MM XFR004116
|
Facility
|
IP
|
$5,087.00
|
|
| Hospital Charge Code |
5804044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,592.34 |
| Max. Negotiated Rate |
$4,867.24 |
| Rate for Payer: Aetna Commercial |
$4,761.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,549.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,803.95
|
| Rate for Payer: Cash Price |
$1,526.10
|
| Rate for Payer: Cigna Commercial |
$4,867.24
|
| Rate for Payer: Health EOS Commercial |
$4,708.53
|
| Rate for Payer: HFN Commercial |
$4,867.24
|
| Rate for Payer: Multiplan Commercial |
$4,232.38
|
| Rate for Payer: Preferred Network Access Commercial |
$4,867.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,592.34
|
| Rate for Payer: Quartz Commercial |
$3,174.29
|
| Rate for Payer: WEA Trust Commercial |
$2,909.76
|
| Rate for Payer: WPS Commercial |
$3,918.52
|
|
|
REAMER CONCAVE 16MM XFR004116
|
Facility
|
OP
|
$5,087.00
|
|
| Hospital Charge Code |
5804044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,481.33 |
| Max. Negotiated Rate |
$4,867.24 |
| Rate for Payer: Aetna Commercial |
$4,761.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,549.81
|
| Rate for Payer: Aetna Managed Medicare |
$1,481.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,438.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,645.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,539.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,803.95
|
| Rate for Payer: Cash Price |
$1,526.10
|
| Rate for Payer: Cigna Commercial |
$4,867.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,960.63
|
| Rate for Payer: Health EOS Commercial |
$4,708.53
|
| Rate for Payer: HFN Commercial |
$4,867.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,967.86
|
| Rate for Payer: Multiplan Commercial |
$4,232.38
|
| Rate for Payer: NAPHCARE Commercial |
$3,174.29
|
| Rate for Payer: Preferred Network Access Commercial |
$4,867.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,592.34
|
| Rate for Payer: Quartz Commercial |
$3,438.81
|
| Rate for Payer: Quartz Medicare Advantage |
$3,174.29
|
| Rate for Payer: The Alliance Commercial |
$2,645.24
|
| Rate for Payer: WEA Trust Commercial |
$2,909.76
|
| Rate for Payer: WPS Commercial |
$3,918.52
|
|
|
REAMER CONCAVE 18MM XFR004118
|
Facility
|
IP
|
$4,857.00
|
|
| Hospital Charge Code |
5617675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,475.13 |
| Max. Negotiated Rate |
$4,647.18 |
| Rate for Payer: Aetna Commercial |
$4,546.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,344.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,677.18
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Cigna Commercial |
$4,647.18
|
| Rate for Payer: Health EOS Commercial |
$4,495.64
|
| Rate for Payer: HFN Commercial |
$4,647.18
|
| Rate for Payer: Multiplan Commercial |
$4,041.02
|
| Rate for Payer: Preferred Network Access Commercial |
$4,647.18
|
| Rate for Payer: Quartz Beloit One Network |
$2,475.13
|
| Rate for Payer: Quartz Commercial |
$3,030.77
|
| Rate for Payer: WEA Trust Commercial |
$2,778.20
|
| Rate for Payer: WPS Commercial |
$3,741.35
|
|
|
REAMER CONCAVE 18MM XFR004118
|
Facility
|
OP
|
$4,857.00
|
|
| Hospital Charge Code |
5617675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,414.36 |
| Max. Negotiated Rate |
$4,647.18 |
| Rate for Payer: Aetna Commercial |
$4,546.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,344.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,414.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,283.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,525.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,424.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,677.18
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Cigna Commercial |
$4,647.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,826.77
|
| Rate for Payer: Health EOS Commercial |
$4,495.64
|
| Rate for Payer: HFN Commercial |
$4,647.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,788.46
|
| Rate for Payer: Multiplan Commercial |
$4,041.02
|
| Rate for Payer: NAPHCARE Commercial |
$3,030.77
|
| Rate for Payer: Preferred Network Access Commercial |
$4,647.18
|
| Rate for Payer: Quartz Beloit One Network |
$2,475.13
|
| Rate for Payer: Quartz Commercial |
$3,283.33
|
| Rate for Payer: Quartz Medicare Advantage |
$3,030.77
|
| Rate for Payer: The Alliance Commercial |
$2,525.64
|
| Rate for Payer: WEA Trust Commercial |
$2,778.20
|
| Rate for Payer: WPS Commercial |
$3,741.35
|
|
|
REAMER CONE 20MM XFR004220
|
Facility
|
OP
|
$1,907.00
|
|
| Hospital Charge Code |
2967968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$555.32 |
| Max. Negotiated Rate |
$1,824.62 |
| Rate for Payer: Aetna Commercial |
$1,784.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,705.62
|
| Rate for Payer: Aetna Managed Medicare |
$555.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,289.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$991.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$951.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,051.14
|
| Rate for Payer: Cash Price |
$572.10
|
| Rate for Payer: Cigna Commercial |
$1,824.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,109.87
|
| Rate for Payer: Health EOS Commercial |
$1,765.12
|
| Rate for Payer: HFN Commercial |
$1,824.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,487.46
|
| Rate for Payer: Multiplan Commercial |
$1,586.62
|
| Rate for Payer: NAPHCARE Commercial |
$1,189.97
|
| Rate for Payer: Preferred Network Access Commercial |
$1,824.62
|
| Rate for Payer: Quartz Beloit One Network |
$971.81
|
| Rate for Payer: Quartz Commercial |
$1,289.13
|
| Rate for Payer: Quartz Medicare Advantage |
$1,189.97
|
| Rate for Payer: The Alliance Commercial |
$991.64
|
| Rate for Payer: WEA Trust Commercial |
$1,090.80
|
| Rate for Payer: WPS Commercial |
$1,468.96
|
|
|
REAMER CONE 20MM XFR004220
|
Facility
|
IP
|
$1,907.00
|
|
| Hospital Charge Code |
2967968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$971.81 |
| Max. Negotiated Rate |
$1,824.62 |
| Rate for Payer: Aetna Commercial |
$1,784.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,705.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,051.14
|
| Rate for Payer: Cash Price |
$572.10
|
| Rate for Payer: Cigna Commercial |
$1,824.62
|
| Rate for Payer: Health EOS Commercial |
$1,765.12
|
| Rate for Payer: HFN Commercial |
$1,824.62
|
| Rate for Payer: Multiplan Commercial |
$1,586.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,824.62
|
| Rate for Payer: Quartz Beloit One Network |
$971.81
|
| Rate for Payer: Quartz Commercial |
$1,189.97
|
| Rate for Payer: WEA Trust Commercial |
$1,090.80
|
| Rate for Payer: WPS Commercial |
$1,468.96
|
|
|
REAMER CONE 22MM XFR004222
|
Facility
|
IP
|
$5,087.00
|
|
| Hospital Charge Code |
5831733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,592.34 |
| Max. Negotiated Rate |
$4,867.24 |
| Rate for Payer: Aetna Commercial |
$4,761.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,549.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,803.95
|
| Rate for Payer: Cash Price |
$1,526.10
|
| Rate for Payer: Cigna Commercial |
$4,867.24
|
| Rate for Payer: Health EOS Commercial |
$4,708.53
|
| Rate for Payer: HFN Commercial |
$4,867.24
|
| Rate for Payer: Multiplan Commercial |
$4,232.38
|
| Rate for Payer: Preferred Network Access Commercial |
$4,867.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,592.34
|
| Rate for Payer: Quartz Commercial |
$3,174.29
|
| Rate for Payer: WEA Trust Commercial |
$2,909.76
|
| Rate for Payer: WPS Commercial |
$3,918.52
|
|
|
REAMER CONE 22MM XFR004222
|
Facility
|
OP
|
$5,087.00
|
|
| Hospital Charge Code |
5831733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,481.33 |
| Max. Negotiated Rate |
$4,867.24 |
| Rate for Payer: Aetna Commercial |
$4,761.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,549.81
|
| Rate for Payer: Aetna Managed Medicare |
$1,481.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,438.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,645.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,539.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,803.95
|
| Rate for Payer: Cash Price |
$1,526.10
|
| Rate for Payer: Cigna Commercial |
$4,867.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,960.63
|
| Rate for Payer: Health EOS Commercial |
$4,708.53
|
| Rate for Payer: HFN Commercial |
$4,867.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,967.86
|
| Rate for Payer: Multiplan Commercial |
$4,232.38
|
| Rate for Payer: NAPHCARE Commercial |
$3,174.29
|
| Rate for Payer: Preferred Network Access Commercial |
$4,867.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,592.34
|
| Rate for Payer: Quartz Commercial |
$3,438.81
|
| Rate for Payer: Quartz Medicare Advantage |
$3,174.29
|
| Rate for Payer: The Alliance Commercial |
$2,645.24
|
| Rate for Payer: WEA Trust Commercial |
$2,909.76
|
| Rate for Payer: WPS Commercial |
$3,918.52
|
|
|
REAMER CONE MTP 16MM GEN 2 455 SS 58890216
|
Facility
|
IP
|
$2,111.00
|
|
| Hospital Charge Code |
6206991
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,075.77 |
| Max. Negotiated Rate |
$2,019.80 |
| Rate for Payer: Aetna Commercial |
$1,975.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,888.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,163.58
|
| Rate for Payer: Cash Price |
$633.30
|
| Rate for Payer: Cigna Commercial |
$2,019.80
|
| Rate for Payer: Health EOS Commercial |
$1,953.94
|
| Rate for Payer: HFN Commercial |
$2,019.80
|
| Rate for Payer: Multiplan Commercial |
$1,756.35
|
| Rate for Payer: Preferred Network Access Commercial |
$2,019.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,075.77
|
| Rate for Payer: Quartz Commercial |
$1,317.26
|
| Rate for Payer: WEA Trust Commercial |
$1,207.49
|
| Rate for Payer: WPS Commercial |
$1,626.10
|
|
|
REAMER CONE MTP 16MM GEN 2 455 SS 58890216
|
Facility
|
OP
|
$2,111.00
|
|
| Hospital Charge Code |
6206991
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$614.72 |
| Max. Negotiated Rate |
$2,019.80 |
| Rate for Payer: Aetna Commercial |
$1,975.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,888.08
|
| Rate for Payer: Aetna Managed Medicare |
$614.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,427.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,097.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,053.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,163.58
|
| Rate for Payer: Cash Price |
$633.30
|
| Rate for Payer: Cigna Commercial |
$2,019.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,228.60
|
| Rate for Payer: Health EOS Commercial |
$1,953.94
|
| Rate for Payer: HFN Commercial |
$2,019.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,646.58
|
| Rate for Payer: Multiplan Commercial |
$1,756.35
|
| Rate for Payer: NAPHCARE Commercial |
$1,317.26
|
| Rate for Payer: Preferred Network Access Commercial |
$2,019.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,075.77
|
| Rate for Payer: Quartz Commercial |
$1,427.04
|
| Rate for Payer: Quartz Medicare Advantage |
$1,317.26
|
| Rate for Payer: The Alliance Commercial |
$1,097.72
|
| Rate for Payer: WEA Trust Commercial |
$1,207.49
|
| Rate for Payer: WPS Commercial |
$1,626.10
|
|
|
REAMER CONE MTP 18MM GEN 2 455 SS 58890218
|
Facility
|
OP
|
$2,298.00
|
|
| Hospital Charge Code |
6181324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$669.18 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Aetna Managed Medicare |
$669.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,553.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,194.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,147.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,337.44
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,792.44
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,433.95
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,553.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,433.95
|
| Rate for Payer: The Alliance Commercial |
$1,194.96
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
REAMER CONE MTP 18MM GEN 2 455 SS 58890218
|
Facility
|
IP
|
$2,298.00
|
|
| Hospital Charge Code |
6181324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,171.06 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,433.95
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
REAMER CONE MTP 20MM 58890220
|
Facility
|
IP
|
$3,322.00
|
|
| Hospital Charge Code |
5895658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,692.89 |
| Max. Negotiated Rate |
$3,178.49 |
| Rate for Payer: Aetna Commercial |
$3,109.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,971.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,831.09
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Cigna Commercial |
$3,178.49
|
| Rate for Payer: Health EOS Commercial |
$3,074.84
|
| Rate for Payer: HFN Commercial |
$3,178.49
|
| Rate for Payer: Multiplan Commercial |
$2,763.90
|
| Rate for Payer: Preferred Network Access Commercial |
$3,178.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,692.89
|
| Rate for Payer: Quartz Commercial |
$2,072.93
|
| Rate for Payer: WEA Trust Commercial |
$1,900.18
|
| Rate for Payer: WPS Commercial |
$2,558.94
|
|
|
REAMER CONE MTP 20MM 58890220
|
Facility
|
OP
|
$3,322.00
|
|
| Hospital Charge Code |
5895658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$967.37 |
| Max. Negotiated Rate |
$3,178.49 |
| Rate for Payer: Aetna Commercial |
$3,109.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,971.20
|
| Rate for Payer: Aetna Managed Medicare |
$967.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,245.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,727.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,658.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,831.09
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Cigna Commercial |
$3,178.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,933.40
|
| Rate for Payer: Health EOS Commercial |
$3,074.84
|
| Rate for Payer: HFN Commercial |
$3,178.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,591.16
|
| Rate for Payer: Multiplan Commercial |
$2,763.90
|
| Rate for Payer: NAPHCARE Commercial |
$2,072.93
|
| Rate for Payer: Preferred Network Access Commercial |
$3,178.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,692.89
|
| Rate for Payer: Quartz Commercial |
$2,245.67
|
| Rate for Payer: Quartz Medicare Advantage |
$2,072.93
|
| Rate for Payer: The Alliance Commercial |
$1,727.44
|
| Rate for Payer: WEA Trust Commercial |
$1,900.18
|
| Rate for Payer: WPS Commercial |
$2,558.94
|
|
|
REAMER CONE MTP 22MM 58890222
|
Facility
|
OP
|
$2,402.00
|
|
| Hospital Charge Code |
6216986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$699.46 |
| Max. Negotiated Rate |
$2,298.23 |
| Rate for Payer: Aetna Commercial |
$2,248.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,148.35
|
| Rate for Payer: Aetna Managed Medicare |
$699.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,623.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,249.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,199.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,323.98
|
| Rate for Payer: Cash Price |
$720.60
|
| Rate for Payer: Cigna Commercial |
$2,298.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,397.96
|
| Rate for Payer: Health EOS Commercial |
$2,223.29
|
| Rate for Payer: HFN Commercial |
$2,298.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,873.56
|
| Rate for Payer: Multiplan Commercial |
$1,998.46
|
| Rate for Payer: NAPHCARE Commercial |
$1,498.85
|
| Rate for Payer: Preferred Network Access Commercial |
$2,298.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,224.06
|
| Rate for Payer: Quartz Commercial |
$1,623.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,498.85
|
| Rate for Payer: The Alliance Commercial |
$1,249.04
|
| Rate for Payer: WEA Trust Commercial |
$1,373.94
|
| Rate for Payer: WPS Commercial |
$1,850.26
|
|
|
REAMER CONE MTP 22MM 58890222
|
Facility
|
IP
|
$2,402.00
|
|
| Hospital Charge Code |
6216986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,224.06 |
| Max. Negotiated Rate |
$2,298.23 |
| Rate for Payer: Aetna Commercial |
$2,248.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,148.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,323.98
|
| Rate for Payer: Cash Price |
$720.60
|
| Rate for Payer: Cigna Commercial |
$2,298.23
|
| Rate for Payer: Health EOS Commercial |
$2,223.29
|
| Rate for Payer: HFN Commercial |
$2,298.23
|
| Rate for Payer: Multiplan Commercial |
$1,998.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,298.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,224.06
|
| Rate for Payer: Quartz Commercial |
$1,498.85
|
| Rate for Payer: WEA Trust Commercial |
$1,373.94
|
| Rate for Payer: WPS Commercial |
$1,850.26
|
|
|
REAMER CONVEX 16MM XFR004216
|
Facility
|
IP
|
$5,087.00
|
|
| Hospital Charge Code |
5804045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,592.34 |
| Max. Negotiated Rate |
$4,867.24 |
| Rate for Payer: Aetna Commercial |
$4,761.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,549.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,803.95
|
| Rate for Payer: Cash Price |
$1,526.10
|
| Rate for Payer: Cigna Commercial |
$4,867.24
|
| Rate for Payer: Health EOS Commercial |
$4,708.53
|
| Rate for Payer: HFN Commercial |
$4,867.24
|
| Rate for Payer: Multiplan Commercial |
$4,232.38
|
| Rate for Payer: Preferred Network Access Commercial |
$4,867.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,592.34
|
| Rate for Payer: Quartz Commercial |
$3,174.29
|
| Rate for Payer: WEA Trust Commercial |
$2,909.76
|
| Rate for Payer: WPS Commercial |
$3,918.52
|
|
|
REAMER CONVEX 16MM XFR004216
|
Facility
|
OP
|
$5,087.00
|
|
| Hospital Charge Code |
5804045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,481.33 |
| Max. Negotiated Rate |
$4,867.24 |
| Rate for Payer: Aetna Commercial |
$4,761.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,549.81
|
| Rate for Payer: Aetna Managed Medicare |
$1,481.33
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,438.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,645.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,539.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,803.95
|
| Rate for Payer: Cash Price |
$1,526.10
|
| Rate for Payer: Cigna Commercial |
$4,867.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,960.63
|
| Rate for Payer: Health EOS Commercial |
$4,708.53
|
| Rate for Payer: HFN Commercial |
$4,867.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,967.86
|
| Rate for Payer: Multiplan Commercial |
$4,232.38
|
| Rate for Payer: NAPHCARE Commercial |
$3,174.29
|
| Rate for Payer: Preferred Network Access Commercial |
$4,867.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,592.34
|
| Rate for Payer: Quartz Commercial |
$3,438.81
|
| Rate for Payer: Quartz Medicare Advantage |
$3,174.29
|
| Rate for Payer: The Alliance Commercial |
$2,645.24
|
| Rate for Payer: WEA Trust Commercial |
$2,909.76
|
| Rate for Payer: WPS Commercial |
$3,918.52
|
|
|
REAMER CONVEX 18MM XFR004218
|
Facility
|
OP
|
$4,857.00
|
|
| Hospital Charge Code |
5617676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,414.36 |
| Max. Negotiated Rate |
$4,647.18 |
| Rate for Payer: Aetna Commercial |
$4,546.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,344.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,414.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,283.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,525.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,424.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,677.18
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Cigna Commercial |
$4,647.18
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,826.77
|
| Rate for Payer: Health EOS Commercial |
$4,495.64
|
| Rate for Payer: HFN Commercial |
$4,647.18
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,788.46
|
| Rate for Payer: Multiplan Commercial |
$4,041.02
|
| Rate for Payer: NAPHCARE Commercial |
$3,030.77
|
| Rate for Payer: Preferred Network Access Commercial |
$4,647.18
|
| Rate for Payer: Quartz Beloit One Network |
$2,475.13
|
| Rate for Payer: Quartz Commercial |
$3,283.33
|
| Rate for Payer: Quartz Medicare Advantage |
$3,030.77
|
| Rate for Payer: The Alliance Commercial |
$2,525.64
|
| Rate for Payer: WEA Trust Commercial |
$2,778.20
|
| Rate for Payer: WPS Commercial |
$3,741.35
|
|
|
REAMER CONVEX 18MM XFR004218
|
Facility
|
IP
|
$4,857.00
|
|
| Hospital Charge Code |
5617676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,475.13 |
| Max. Negotiated Rate |
$4,647.18 |
| Rate for Payer: Aetna Commercial |
$4,546.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,344.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,677.18
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Cigna Commercial |
$4,647.18
|
| Rate for Payer: Health EOS Commercial |
$4,495.64
|
| Rate for Payer: HFN Commercial |
$4,647.18
|
| Rate for Payer: Multiplan Commercial |
$4,041.02
|
| Rate for Payer: Preferred Network Access Commercial |
$4,647.18
|
| Rate for Payer: Quartz Beloit One Network |
$2,475.13
|
| Rate for Payer: Quartz Commercial |
$3,030.77
|
| Rate for Payer: WEA Trust Commercial |
$2,778.20
|
| Rate for Payer: WPS Commercial |
$3,741.35
|
|
|
REAMER CUP 20MM XFR004120
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
5591288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,820.00 |
| Max. Negotiated Rate |
$5,980.00 |
| Rate for Payer: Aetna Commercial |
$5,850.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,590.00
|
| Rate for Payer: Aetna Managed Medicare |
$1,820.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,225.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,250.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,120.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,445.00
|
| Rate for Payer: Cash Price |
$1,875.00
|
| Rate for Payer: Cigna Commercial |
$5,980.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,637.50
|
| Rate for Payer: Health EOS Commercial |
$5,785.00
|
| Rate for Payer: HFN Commercial |
$5,980.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,875.00
|
| Rate for Payer: Multiplan Commercial |
$5,200.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,900.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,980.00
|
| Rate for Payer: Quartz Beloit One Network |
$3,185.00
|
| Rate for Payer: Quartz Commercial |
$4,225.00
|
| Rate for Payer: Quartz Medicare Advantage |
$3,900.00
|
| Rate for Payer: The Alliance Commercial |
$3,250.00
|
| Rate for Payer: WEA Trust Commercial |
$3,575.00
|
| Rate for Payer: WPS Commercial |
$4,814.38
|
|
