|
REAMER PHALANGEAL 18MM AR-8944PR-18
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5459679
|
|
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 PHALANGEAL 18MM AR-8944PR-18
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5459679
|
|
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 PHALANGEAL 20MM AR-8944PR-20
|
Facility
|
OP
|
$4,787.00
|
|
| Hospital Charge Code |
5603772
|
|
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 PHALANGEAL 20MM AR-8944PR-20
|
Facility
|
IP
|
$4,787.00
|
|
| Hospital Charge Code |
5603772
|
|
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 PILOTED HEADED 8MM AR-1454
|
Facility
|
IP
|
$2,403.00
|
|
| Hospital Charge Code |
5190726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,224.57 |
| Max. Negotiated Rate |
$2,299.19 |
| Rate for Payer: Aetna Commercial |
$2,249.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,149.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,324.53
|
| Rate for Payer: Cash Price |
$720.90
|
| Rate for Payer: Cigna Commercial |
$2,299.19
|
| Rate for Payer: Health EOS Commercial |
$2,224.22
|
| Rate for Payer: HFN Commercial |
$2,299.19
|
| Rate for Payer: Multiplan Commercial |
$1,999.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,299.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,224.57
|
| Rate for Payer: Quartz Commercial |
$1,499.47
|
| Rate for Payer: WEA Trust Commercial |
$1,374.52
|
| Rate for Payer: WPS Commercial |
$1,851.03
|
|
|
REAMER PILOTED HEADED 8MM AR-1454
|
Facility
|
OP
|
$2,403.00
|
|
| Hospital Charge Code |
5190726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$699.75 |
| Max. Negotiated Rate |
$2,299.19 |
| Rate for Payer: Aetna Commercial |
$2,249.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,149.24
|
| Rate for Payer: Aetna Managed Medicare |
$699.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,624.43
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,249.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,199.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,324.53
|
| Rate for Payer: Cash Price |
$720.90
|
| Rate for Payer: Cigna Commercial |
$2,299.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,398.55
|
| Rate for Payer: Health EOS Commercial |
$2,224.22
|
| Rate for Payer: HFN Commercial |
$2,299.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,874.34
|
| Rate for Payer: Multiplan Commercial |
$1,999.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,499.47
|
| Rate for Payer: Preferred Network Access Commercial |
$2,299.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,224.57
|
| Rate for Payer: Quartz Commercial |
$1,624.43
|
| Rate for Payer: Quartz Medicare Advantage |
$1,499.47
|
| Rate for Payer: The Alliance Commercial |
$1,249.56
|
| Rate for Payer: WEA Trust Commercial |
$1,374.52
|
| Rate for Payer: WPS Commercial |
$1,851.03
|
|
|
REAMER SHAFT 8.0 X 448MM 0227-3000S
|
Facility
|
IP
|
$1,972.00
|
|
| Hospital Charge Code |
4518612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,004.93 |
| Max. Negotiated Rate |
$1,886.81 |
| Rate for Payer: Aetna Commercial |
$1,845.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,763.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,086.97
|
| Rate for Payer: Cash Price |
$591.60
|
| Rate for Payer: Cigna Commercial |
$1,886.81
|
| Rate for Payer: Health EOS Commercial |
$1,825.28
|
| Rate for Payer: HFN Commercial |
$1,886.81
|
| Rate for Payer: Multiplan Commercial |
$1,640.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,886.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,004.93
|
| Rate for Payer: Quartz Commercial |
$1,230.53
|
| Rate for Payer: WEA Trust Commercial |
$1,127.98
|
| Rate for Payer: WPS Commercial |
$1,519.03
|
|
|
REAMER SHAFT 8.0 X 448MM 0227-3000S
|
Facility
|
OP
|
$1,972.00
|
|
| Hospital Charge Code |
4518612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$574.25 |
| Max. Negotiated Rate |
$1,886.81 |
| Rate for Payer: Aetna Commercial |
$1,845.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,763.76
|
| Rate for Payer: Aetna Managed Medicare |
$574.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,333.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,025.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$984.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,086.97
|
| Rate for Payer: Cash Price |
$591.60
|
| Rate for Payer: Cigna Commercial |
$1,886.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,147.70
|
| Rate for Payer: Health EOS Commercial |
$1,825.28
|
| Rate for Payer: HFN Commercial |
$1,886.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,538.16
|
| Rate for Payer: Multiplan Commercial |
$1,640.70
|
| Rate for Payer: NAPHCARE Commercial |
$1,230.53
|
| Rate for Payer: Preferred Network Access Commercial |
$1,886.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,004.93
|
| Rate for Payer: Quartz Commercial |
$1,333.07
|
| Rate for Payer: Quartz Medicare Advantage |
$1,230.53
|
| Rate for Payer: The Alliance Commercial |
$1,025.44
|
| Rate for Payer: WEA Trust Commercial |
$1,127.98
|
| Rate for Payer: WPS Commercial |
$1,519.03
|
|
|
REAMER SHAFT 8.0 X 510MM 0227-8510S
|
Facility
|
OP
|
$2,624.00
|
|
| Hospital Charge Code |
5349004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$764.11 |
| Max. Negotiated Rate |
$2,510.64 |
| Rate for Payer: Aetna Commercial |
$2,456.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,346.91
|
| Rate for Payer: Aetna Managed Medicare |
$764.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,773.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,364.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,309.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,446.35
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cigna Commercial |
$2,510.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,527.17
|
| Rate for Payer: Health EOS Commercial |
$2,428.77
|
| Rate for Payer: HFN Commercial |
$2,510.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,046.72
|
| Rate for Payer: Multiplan Commercial |
$2,183.17
|
| Rate for Payer: NAPHCARE Commercial |
$1,637.38
|
| Rate for Payer: Preferred Network Access Commercial |
$2,510.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,337.19
|
| Rate for Payer: Quartz Commercial |
$1,773.82
|
| Rate for Payer: Quartz Medicare Advantage |
$1,637.38
|
| Rate for Payer: The Alliance Commercial |
$1,364.48
|
| Rate for Payer: WEA Trust Commercial |
$1,500.93
|
| Rate for Payer: WPS Commercial |
$2,021.27
|
|
|
REAMER SHAFT 8.0 X 510MM 0227-8510S
|
Facility
|
IP
|
$2,624.00
|
|
| Hospital Charge Code |
5349004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,337.19 |
| Max. Negotiated Rate |
$2,510.64 |
| Rate for Payer: Aetna Commercial |
$2,456.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,346.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,446.35
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cigna Commercial |
$2,510.64
|
| Rate for Payer: Health EOS Commercial |
$2,428.77
|
| Rate for Payer: HFN Commercial |
$2,510.64
|
| Rate for Payer: Multiplan Commercial |
$2,183.17
|
| Rate for Payer: Preferred Network Access Commercial |
$2,510.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,337.19
|
| Rate for Payer: Quartz Commercial |
$1,637.38
|
| Rate for Payer: WEA Trust Commercial |
$1,500.93
|
| Rate for Payer: WPS Commercial |
$2,021.27
|
|
|
REAMER TWO-STEP CONCAVE 10MM 220-10-001
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
3693502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$921.94 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Aetna Managed Medicare |
$921.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,140.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,646.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,580.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,842.61
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,469.48
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: NAPHCARE Commercial |
$1,975.58
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$2,140.22
|
| Rate for Payer: Quartz Medicare Advantage |
$1,975.58
|
| Rate for Payer: The Alliance Commercial |
$1,646.32
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONCAVE 10MM 220-10-001
|
Facility
|
IP
|
$3,166.00
|
|
| Hospital Charge Code |
3693502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,613.39 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$1,975.58
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONCAVE 12MM 220-12-001
|
Facility
|
IP
|
$2,660.00
|
|
| Hospital Charge Code |
4858690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,355.54 |
| Max. Negotiated Rate |
$2,545.09 |
| Rate for Payer: Aetna Commercial |
$2,489.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,379.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.19
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,545.09
|
| Rate for Payer: Health EOS Commercial |
$2,462.10
|
| Rate for Payer: HFN Commercial |
$2,545.09
|
| Rate for Payer: Multiplan Commercial |
$2,213.12
|
| Rate for Payer: Preferred Network Access Commercial |
$2,545.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,355.54
|
| Rate for Payer: Quartz Commercial |
$1,659.84
|
| Rate for Payer: WEA Trust Commercial |
$1,521.52
|
| Rate for Payer: WPS Commercial |
$2,049.00
|
|
|
REAMER TWO-STEP CONCAVE 12MM 220-12-001
|
Facility
|
OP
|
$2,660.00
|
|
| Hospital Charge Code |
4858690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$774.59 |
| Max. Negotiated Rate |
$2,545.09 |
| Rate for Payer: Aetna Commercial |
$2,489.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,379.10
|
| Rate for Payer: Aetna Managed Medicare |
$774.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,798.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,383.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,327.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.19
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,545.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,548.12
|
| Rate for Payer: Health EOS Commercial |
$2,462.10
|
| Rate for Payer: HFN Commercial |
$2,545.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,074.80
|
| Rate for Payer: Multiplan Commercial |
$2,213.12
|
| Rate for Payer: NAPHCARE Commercial |
$1,659.84
|
| Rate for Payer: Preferred Network Access Commercial |
$2,545.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,355.54
|
| Rate for Payer: Quartz Commercial |
$1,798.16
|
| Rate for Payer: Quartz Medicare Advantage |
$1,659.84
|
| Rate for Payer: The Alliance Commercial |
$1,383.20
|
| Rate for Payer: WEA Trust Commercial |
$1,521.52
|
| Rate for Payer: WPS Commercial |
$2,049.00
|
|
|
REAMER TWO-STEP CONCAVE 8MM 220-08-001
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
4452943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$921.94 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Aetna Managed Medicare |
$921.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,140.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,646.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,580.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,842.61
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,469.48
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: NAPHCARE Commercial |
$1,975.58
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$2,140.22
|
| Rate for Payer: Quartz Medicare Advantage |
$1,975.58
|
| Rate for Payer: The Alliance Commercial |
$1,646.32
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONCAVE 8MM 220-08-001
|
Facility
|
IP
|
$3,166.00
|
|
| Hospital Charge Code |
4452943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,613.39 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$1,975.58
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONVEX 10MM 220-10-002
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
3693503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$921.94 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Aetna Managed Medicare |
$921.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,140.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,646.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,580.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,842.61
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,469.48
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: NAPHCARE Commercial |
$1,975.58
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$2,140.22
|
| Rate for Payer: Quartz Medicare Advantage |
$1,975.58
|
| Rate for Payer: The Alliance Commercial |
$1,646.32
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONVEX 10MM 220-10-002
|
Facility
|
IP
|
$3,166.00
|
|
| Hospital Charge Code |
3693503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,613.39 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$1,975.58
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONVEX 12MM 220-12-002
|
Facility
|
IP
|
$2,660.00
|
|
| Hospital Charge Code |
4858691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,355.54 |
| Max. Negotiated Rate |
$2,545.09 |
| Rate for Payer: Aetna Commercial |
$2,489.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,379.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.19
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,545.09
|
| Rate for Payer: Health EOS Commercial |
$2,462.10
|
| Rate for Payer: HFN Commercial |
$2,545.09
|
| Rate for Payer: Multiplan Commercial |
$2,213.12
|
| Rate for Payer: Preferred Network Access Commercial |
$2,545.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,355.54
|
| Rate for Payer: Quartz Commercial |
$1,659.84
|
| Rate for Payer: WEA Trust Commercial |
$1,521.52
|
| Rate for Payer: WPS Commercial |
$2,049.00
|
|
|
REAMER TWO-STEP CONVEX 12MM 220-12-002
|
Facility
|
OP
|
$2,660.00
|
|
| Hospital Charge Code |
4858691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$774.59 |
| Max. Negotiated Rate |
$2,545.09 |
| Rate for Payer: Aetna Commercial |
$2,489.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,379.10
|
| Rate for Payer: Aetna Managed Medicare |
$774.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,798.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,383.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,327.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.19
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,545.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,548.12
|
| Rate for Payer: Health EOS Commercial |
$2,462.10
|
| Rate for Payer: HFN Commercial |
$2,545.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,074.80
|
| Rate for Payer: Multiplan Commercial |
$2,213.12
|
| Rate for Payer: NAPHCARE Commercial |
$1,659.84
|
| Rate for Payer: Preferred Network Access Commercial |
$2,545.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,355.54
|
| Rate for Payer: Quartz Commercial |
$1,798.16
|
| Rate for Payer: Quartz Medicare Advantage |
$1,659.84
|
| Rate for Payer: The Alliance Commercial |
$1,383.20
|
| Rate for Payer: WEA Trust Commercial |
$1,521.52
|
| Rate for Payer: WPS Commercial |
$2,049.00
|
|
|
REAMER TWO-STEP CONVEX 8MM 220-08-002
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
4452944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$921.94 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Aetna Managed Medicare |
$921.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,140.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,646.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,580.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,842.61
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,469.48
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: NAPHCARE Commercial |
$1,975.58
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$2,140.22
|
| Rate for Payer: Quartz Medicare Advantage |
$1,975.58
|
| Rate for Payer: The Alliance Commercial |
$1,646.32
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER TWO-STEP CONVEX 8MM 220-08-002
|
Facility
|
IP
|
$3,166.00
|
|
| Hospital Charge Code |
4452944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,613.39 |
| Max. Negotiated Rate |
$3,029.23 |
| Rate for Payer: Aetna Commercial |
$2,963.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,831.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,745.10
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$3,029.23
|
| Rate for Payer: Health EOS Commercial |
$2,930.45
|
| Rate for Payer: HFN Commercial |
$3,029.23
|
| Rate for Payer: Multiplan Commercial |
$2,634.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,029.23
|
| Rate for Payer: Quartz Beloit One Network |
$1,613.39
|
| Rate for Payer: Quartz Commercial |
$1,975.58
|
| Rate for Payer: WEA Trust Commercial |
$1,810.95
|
| Rate for Payer: WPS Commercial |
$2,438.77
|
|
|
REAMER UNIVERS VAULTLOCK AUGMENTED GLENOID ANGLED LARGE AR-9275-L
|
Facility
|
OP
|
$2,902.00
|
|
| Hospital Charge Code |
6151659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$845.06 |
| Max. Negotiated Rate |
$2,776.63 |
| Rate for Payer: Aetna Commercial |
$2,716.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,595.55
|
| Rate for Payer: Aetna Managed Medicare |
$845.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,961.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,509.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,448.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,599.58
|
| Rate for Payer: Cash Price |
$870.60
|
| Rate for Payer: Cigna Commercial |
$2,776.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,688.96
|
| Rate for Payer: Health EOS Commercial |
$2,686.09
|
| Rate for Payer: HFN Commercial |
$2,776.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,263.56
|
| Rate for Payer: Multiplan Commercial |
$2,414.46
|
| Rate for Payer: NAPHCARE Commercial |
$1,810.85
|
| Rate for Payer: Preferred Network Access Commercial |
$2,776.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,478.86
|
| Rate for Payer: Quartz Commercial |
$1,961.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,810.85
|
| Rate for Payer: The Alliance Commercial |
$1,509.04
|
| Rate for Payer: WEA Trust Commercial |
$1,659.94
|
| Rate for Payer: WPS Commercial |
$2,235.41
|
|
|
REAMER UNIVERS VAULTLOCK AUGMENTED GLENOID ANGLED LARGE AR-9275-L
|
Facility
|
IP
|
$2,902.00
|
|
| Hospital Charge Code |
6151659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,478.86 |
| Max. Negotiated Rate |
$2,776.63 |
| Rate for Payer: Aetna Commercial |
$2,716.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,595.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,599.58
|
| Rate for Payer: Cash Price |
$870.60
|
| Rate for Payer: Cigna Commercial |
$2,776.63
|
| Rate for Payer: Health EOS Commercial |
$2,686.09
|
| Rate for Payer: HFN Commercial |
$2,776.63
|
| Rate for Payer: Multiplan Commercial |
$2,414.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,776.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,478.86
|
| Rate for Payer: Quartz Commercial |
$1,810.85
|
| Rate for Payer: WEA Trust Commercial |
$1,659.94
|
| Rate for Payer: WPS Commercial |
$2,235.41
|
|
|
REAMER UNIVERS VAULTOCK AUGMENTED GLENOID ANGLED MEDIUM AR-9275-M
|
Facility
|
OP
|
$3,018.00
|
|
| Hospital Charge Code |
5895635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$878.84 |
| Max. Negotiated Rate |
$2,887.62 |
| Rate for Payer: Aetna Commercial |
$2,824.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,699.30
|
| Rate for Payer: Aetna Managed Medicare |
$878.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,040.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,569.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,506.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,663.52
|
| Rate for Payer: Cash Price |
$905.40
|
| Rate for Payer: Cigna Commercial |
$2,887.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,756.48
|
| Rate for Payer: Health EOS Commercial |
$2,793.46
|
| Rate for Payer: HFN Commercial |
$2,887.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,354.04
|
| Rate for Payer: Multiplan Commercial |
$2,510.98
|
| Rate for Payer: NAPHCARE Commercial |
$1,883.23
|
| Rate for Payer: Preferred Network Access Commercial |
$2,887.62
|
| Rate for Payer: Quartz Beloit One Network |
$1,537.97
|
| Rate for Payer: Quartz Commercial |
$2,040.17
|
| Rate for Payer: Quartz Medicare Advantage |
$1,883.23
|
| Rate for Payer: The Alliance Commercial |
$1,569.36
|
| Rate for Payer: WEA Trust Commercial |
$1,726.30
|
| Rate for Payer: WPS Commercial |
$2,324.77
|
|
