|
REAMER CUP MTP 20MM 58890120
|
Facility
|
OP
|
$3,322.00
|
|
| Hospital Charge Code |
5895657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$930.16 |
| Max. Negotiated Rate |
$13,288.00 |
| Rate for Payer: Aetna Commercial |
$2,989.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,856.92
|
| Rate for Payer: Aetna Managed Medicare |
$930.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,159.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,661.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,594.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,760.66
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Cigna Commercial |
$3,056.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,858.99
|
| Rate for Payer: Health EOS Commercial |
$2,956.58
|
| Rate for Payer: HFN Commercial |
$3,056.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,491.50
|
| Rate for Payer: Multiplan Commercial |
$2,657.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,993.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,056.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,627.78
|
| Rate for Payer: Quartz Commercial |
$2,159.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,993.20
|
| Rate for Payer: The Alliance Commercial |
$13,288.00
|
| Rate for Payer: WEA Trust Commercial |
$1,827.10
|
| Rate for Payer: WPS Commercial |
$2,460.61
|
|
|
REAMER CUP MTP 22MM 58890122
|
Facility
|
OP
|
$2,204.00
|
|
| Hospital Charge Code |
6216985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$617.12 |
| Max. Negotiated Rate |
$8,816.00 |
| Rate for Payer: Aetna Commercial |
$1,983.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,895.44
|
| Rate for Payer: Aetna Managed Medicare |
$617.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,432.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,057.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,168.12
|
| Rate for Payer: Cash Price |
$661.20
|
| Rate for Payer: Cigna Commercial |
$2,027.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,233.36
|
| Rate for Payer: Health EOS Commercial |
$1,961.56
|
| Rate for Payer: HFN Commercial |
$2,027.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,653.00
|
| Rate for Payer: Multiplan Commercial |
$1,763.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,322.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,027.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,079.96
|
| Rate for Payer: Quartz Commercial |
$1,432.60
|
| Rate for Payer: Quartz Medicare Advantage |
$1,322.40
|
| Rate for Payer: The Alliance Commercial |
$8,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,212.20
|
| Rate for Payer: WPS Commercial |
$1,632.50
|
|
|
REAMER CUP MTP 22MM 58890122
|
Facility
|
IP
|
$2,204.00
|
|
| Hospital Charge Code |
6216985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,079.96 |
| Max. Negotiated Rate |
$2,027.68 |
| Rate for Payer: Aetna Commercial |
$1,983.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,895.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,168.12
|
| Rate for Payer: Cash Price |
$661.20
|
| Rate for Payer: Cigna Commercial |
$2,027.68
|
| Rate for Payer: Health EOS Commercial |
$1,961.56
|
| Rate for Payer: HFN Commercial |
$2,027.68
|
| Rate for Payer: Multiplan Commercial |
$1,763.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,322.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,027.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,079.96
|
| Rate for Payer: Quartz Commercial |
$1,322.40
|
| Rate for Payer: WEA Trust Commercial |
$1,212.20
|
| Rate for Payer: WPS Commercial |
$1,632.50
|
|
|
REAMER FOR CROSS-PLATE 705172
|
Facility
|
OP
|
$3,655.00
|
|
| Hospital Charge Code |
5547412
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,023.40 |
| Max. Negotiated Rate |
$14,620.00 |
| Rate for Payer: Aetna Commercial |
$3,289.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,143.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,023.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,375.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,827.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,754.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,937.15
|
| Rate for Payer: Cash Price |
$1,096.50
|
| Rate for Payer: Cigna Commercial |
$3,362.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,045.34
|
| Rate for Payer: Health EOS Commercial |
$3,252.95
|
| Rate for Payer: HFN Commercial |
$3,362.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,741.25
|
| Rate for Payer: Multiplan Commercial |
$2,924.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,193.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,362.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,790.95
|
| Rate for Payer: Quartz Commercial |
$2,375.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,193.00
|
| Rate for Payer: The Alliance Commercial |
$14,620.00
|
| Rate for Payer: WEA Trust Commercial |
$2,010.25
|
| Rate for Payer: WPS Commercial |
$2,707.26
|
|
|
REAMER FOR CROSS-PLATE 705172
|
Facility
|
IP
|
$3,655.00
|
|
| Hospital Charge Code |
5547412
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,790.95 |
| Max. Negotiated Rate |
$3,362.60 |
| Rate for Payer: Aetna Commercial |
$3,289.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,143.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,937.15
|
| Rate for Payer: Cash Price |
$1,096.50
|
| Rate for Payer: Cigna Commercial |
$3,362.60
|
| Rate for Payer: Health EOS Commercial |
$3,252.95
|
| Rate for Payer: HFN Commercial |
$3,362.60
|
| Rate for Payer: Multiplan Commercial |
$2,924.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,193.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,362.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,790.95
|
| Rate for Payer: Quartz Commercial |
$2,193.00
|
| Rate for Payer: WEA Trust Commercial |
$2,010.25
|
| Rate for Payer: WPS Commercial |
$2,707.26
|
|
|
REAMER HEAD ANGLED S AR-9675-S
|
Facility
|
IP
|
$3,018.00
|
|
| Hospital Charge Code |
5659648
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,478.82 |
| Max. Negotiated Rate |
$2,776.56 |
| Rate for Payer: Aetna Commercial |
$2,716.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,595.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,599.54
|
| Rate for Payer: Cash Price |
$905.40
|
| Rate for Payer: Cigna Commercial |
$2,776.56
|
| Rate for Payer: Health EOS Commercial |
$2,686.02
|
| Rate for Payer: HFN Commercial |
$2,776.56
|
| Rate for Payer: Multiplan Commercial |
$2,414.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,810.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,776.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,478.82
|
| Rate for Payer: Quartz Commercial |
$1,810.80
|
| Rate for Payer: WEA Trust Commercial |
$1,659.90
|
| Rate for Payer: WPS Commercial |
$2,235.43
|
|
|
REAMER HEAD ANGLED S AR-9675-S
|
Facility
|
OP
|
$3,018.00
|
|
| Hospital Charge Code |
5659648
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$845.04 |
| Max. Negotiated Rate |
$12,072.00 |
| Rate for Payer: Aetna Commercial |
$2,716.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,595.48
|
| Rate for Payer: Aetna Managed Medicare |
$845.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,961.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,509.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,448.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,599.54
|
| Rate for Payer: Cash Price |
$905.40
|
| Rate for Payer: Cigna Commercial |
$2,776.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,688.87
|
| Rate for Payer: Health EOS Commercial |
$2,686.02
|
| Rate for Payer: HFN Commercial |
$2,776.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,263.50
|
| Rate for Payer: Multiplan Commercial |
$2,414.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,810.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,776.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,478.82
|
| Rate for Payer: Quartz Commercial |
$1,961.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,810.80
|
| Rate for Payer: The Alliance Commercial |
$12,072.00
|
| Rate for Payer: WEA Trust Commercial |
$1,659.90
|
| Rate for Payer: WPS Commercial |
$2,235.43
|
|
|
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 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 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
|
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 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 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
|
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 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 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 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 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 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 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 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 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 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
|
|
