|
SCREW 2.3 X 10 LOCK CO-T2310
|
Facility
|
OP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.32 |
| Max. Negotiated Rate |
$1,650.48 |
| Rate for Payer: Aetna Commercial |
$1,614.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,542.84
|
| Rate for Payer: Aetna Managed Medicare |
$502.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,166.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$897.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$861.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.82
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,650.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,003.95
|
| Rate for Payer: Health EOS Commercial |
$1,596.66
|
| Rate for Payer: HFN Commercial |
$1,650.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,345.50
|
| Rate for Payer: Multiplan Commercial |
$1,435.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,076.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.48
|
| Rate for Payer: Quartz Beloit One Network |
$879.06
|
| Rate for Payer: Quartz Commercial |
$1,166.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,076.40
|
| Rate for Payer: The Alliance Commercial |
$897.00
|
| Rate for Payer: WEA Trust Commercial |
$986.70
|
| Rate for Payer: WPS Commercial |
$1,328.77
|
|
|
SCREW 2.3 X 10 LOCK CO-T2310
|
Facility
|
IP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$879.06 |
| Max. Negotiated Rate |
$1,650.48 |
| Rate for Payer: Aetna Commercial |
$1,614.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,542.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.82
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,650.48
|
| Rate for Payer: Health EOS Commercial |
$1,596.66
|
| Rate for Payer: HFN Commercial |
$1,650.48
|
| Rate for Payer: Multiplan Commercial |
$1,435.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.48
|
| Rate for Payer: Quartz Beloit One Network |
$879.06
|
| Rate for Payer: Quartz Commercial |
$1,076.40
|
| Rate for Payer: WEA Trust Commercial |
$986.70
|
| Rate for Payer: WPS Commercial |
$1,328.77
|
|
|
SCREW 2.3 X 12 LOCK CO-T2312
|
Facility
|
IP
|
$1,429.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415919
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.22 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$891.70
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW 2.3 X 12 LOCK CO-T2312
|
Facility
|
OP
|
$1,429.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415919
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.12 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Aetna Managed Medicare |
$416.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$831.68
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,114.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: NAPHCARE Commercial |
$891.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$966.00
|
| Rate for Payer: Quartz Medicare Advantage |
$891.70
|
| Rate for Payer: The Alliance Commercial |
$743.08
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW 2.3x13 MAX DRIVE
|
Facility
|
IP
|
$1,172.00
|
|
| Hospital Charge Code |
2965255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,121.37 |
| Rate for Payer: Aetna Commercial |
$1,096.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,048.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$646.01
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,121.37
|
| Rate for Payer: Health EOS Commercial |
$1,084.80
|
| Rate for Payer: HFN Commercial |
$1,121.37
|
| Rate for Payer: Multiplan Commercial |
$975.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,121.37
|
| Rate for Payer: Quartz Beloit One Network |
$597.25
|
| Rate for Payer: Quartz Commercial |
$731.33
|
| Rate for Payer: WEA Trust Commercial |
$670.38
|
| Rate for Payer: WPS Commercial |
$902.79
|
|
|
SCREW 2.3x13 MAX DRIVE
|
Facility
|
OP
|
$1,172.00
|
|
| Hospital Charge Code |
2965255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$341.29 |
| Max. Negotiated Rate |
$1,121.37 |
| Rate for Payer: Aetna Commercial |
$1,096.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,048.24
|
| Rate for Payer: Aetna Managed Medicare |
$341.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$792.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$609.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$585.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$646.01
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,121.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$682.10
|
| Rate for Payer: Health EOS Commercial |
$1,084.80
|
| Rate for Payer: HFN Commercial |
$1,121.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$914.16
|
| Rate for Payer: Multiplan Commercial |
$975.10
|
| Rate for Payer: NAPHCARE Commercial |
$731.33
|
| Rate for Payer: Preferred Network Access Commercial |
$1,121.37
|
| Rate for Payer: Quartz Beloit One Network |
$597.25
|
| Rate for Payer: Quartz Commercial |
$792.27
|
| Rate for Payer: Quartz Medicare Advantage |
$731.33
|
| Rate for Payer: The Alliance Commercial |
$609.44
|
| Rate for Payer: WEA Trust Commercial |
$670.38
|
| Rate for Payer: WPS Commercial |
$902.79
|
|
|
SCREW 2.3 X 14 LOCK CO-T2314
|
Facility
|
OP
|
$1,484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.14 |
| Max. Negotiated Rate |
$1,419.89 |
| Rate for Payer: Aetna Commercial |
$1,389.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,327.29
|
| Rate for Payer: Aetna Managed Medicare |
$432.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,003.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$771.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$740.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$817.98
|
| Rate for Payer: Cash Price |
$445.20
|
| Rate for Payer: Cigna Commercial |
$1,419.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$863.69
|
| Rate for Payer: Health EOS Commercial |
$1,373.59
|
| Rate for Payer: HFN Commercial |
$1,419.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,157.52
|
| Rate for Payer: Multiplan Commercial |
$1,234.69
|
| Rate for Payer: NAPHCARE Commercial |
$926.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,419.89
|
| Rate for Payer: Quartz Beloit One Network |
$756.25
|
| Rate for Payer: Quartz Commercial |
$1,003.18
|
| Rate for Payer: Quartz Medicare Advantage |
$926.02
|
| Rate for Payer: The Alliance Commercial |
$771.68
|
| Rate for Payer: WEA Trust Commercial |
$848.85
|
| Rate for Payer: WPS Commercial |
$1,143.13
|
|
|
SCREW 2.3 X 14 LOCK CO-T2314
|
Facility
|
IP
|
$1,484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$756.25 |
| Max. Negotiated Rate |
$1,419.89 |
| Rate for Payer: Aetna Commercial |
$1,389.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,327.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$817.98
|
| Rate for Payer: Cash Price |
$445.20
|
| Rate for Payer: Cigna Commercial |
$1,419.89
|
| Rate for Payer: Health EOS Commercial |
$1,373.59
|
| Rate for Payer: HFN Commercial |
$1,419.89
|
| Rate for Payer: Multiplan Commercial |
$1,234.69
|
| Rate for Payer: Preferred Network Access Commercial |
$1,419.89
|
| Rate for Payer: Quartz Beloit One Network |
$756.25
|
| Rate for Payer: Quartz Commercial |
$926.02
|
| Rate for Payer: WEA Trust Commercial |
$848.85
|
| Rate for Payer: WPS Commercial |
$1,143.13
|
|
|
SCREW 2.3x15 MAX DRIVE
|
Facility
|
OP
|
$1,172.00
|
|
| Hospital Charge Code |
2965256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$341.29 |
| Max. Negotiated Rate |
$1,121.37 |
| Rate for Payer: Aetna Commercial |
$1,096.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,048.24
|
| Rate for Payer: Aetna Managed Medicare |
$341.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$792.27
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$609.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$585.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$646.01
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,121.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$682.10
|
| Rate for Payer: Health EOS Commercial |
$1,084.80
|
| Rate for Payer: HFN Commercial |
$1,121.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$914.16
|
| Rate for Payer: Multiplan Commercial |
$975.10
|
| Rate for Payer: NAPHCARE Commercial |
$731.33
|
| Rate for Payer: Preferred Network Access Commercial |
$1,121.37
|
| Rate for Payer: Quartz Beloit One Network |
$597.25
|
| Rate for Payer: Quartz Commercial |
$792.27
|
| Rate for Payer: Quartz Medicare Advantage |
$731.33
|
| Rate for Payer: The Alliance Commercial |
$609.44
|
| Rate for Payer: WEA Trust Commercial |
$670.38
|
| Rate for Payer: WPS Commercial |
$902.79
|
|
|
SCREW 2.3x15 MAX DRIVE
|
Facility
|
IP
|
$1,172.00
|
|
| Hospital Charge Code |
2965256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,121.37 |
| Rate for Payer: Aetna Commercial |
$1,096.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,048.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$646.01
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,121.37
|
| Rate for Payer: Health EOS Commercial |
$1,084.80
|
| Rate for Payer: HFN Commercial |
$1,121.37
|
| Rate for Payer: Multiplan Commercial |
$975.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,121.37
|
| Rate for Payer: Quartz Beloit One Network |
$597.25
|
| Rate for Payer: Quartz Commercial |
$731.33
|
| Rate for Payer: WEA Trust Commercial |
$670.38
|
| Rate for Payer: WPS Commercial |
$902.79
|
|
|
SCREW 2.3 X 16 LOCK CO-T2316
|
Facility
|
OP
|
$1,484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.14 |
| Max. Negotiated Rate |
$1,419.89 |
| Rate for Payer: Aetna Commercial |
$1,389.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,327.29
|
| Rate for Payer: Aetna Managed Medicare |
$432.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,003.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$771.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$740.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$817.98
|
| Rate for Payer: Cash Price |
$445.20
|
| Rate for Payer: Cigna Commercial |
$1,419.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$863.69
|
| Rate for Payer: Health EOS Commercial |
$1,373.59
|
| Rate for Payer: HFN Commercial |
$1,419.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,157.52
|
| Rate for Payer: Multiplan Commercial |
$1,234.69
|
| Rate for Payer: NAPHCARE Commercial |
$926.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,419.89
|
| Rate for Payer: Quartz Beloit One Network |
$756.25
|
| Rate for Payer: Quartz Commercial |
$1,003.18
|
| Rate for Payer: Quartz Medicare Advantage |
$926.02
|
| Rate for Payer: The Alliance Commercial |
$771.68
|
| Rate for Payer: WEA Trust Commercial |
$848.85
|
| Rate for Payer: WPS Commercial |
$1,143.13
|
|
|
SCREW 2.3 X 16 LOCK CO-T2316
|
Facility
|
IP
|
$1,484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$756.25 |
| Max. Negotiated Rate |
$1,419.89 |
| Rate for Payer: Aetna Commercial |
$1,389.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,327.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$817.98
|
| Rate for Payer: Cash Price |
$445.20
|
| Rate for Payer: Cigna Commercial |
$1,419.89
|
| Rate for Payer: Health EOS Commercial |
$1,373.59
|
| Rate for Payer: HFN Commercial |
$1,419.89
|
| Rate for Payer: Multiplan Commercial |
$1,234.69
|
| Rate for Payer: Preferred Network Access Commercial |
$1,419.89
|
| Rate for Payer: Quartz Beloit One Network |
$756.25
|
| Rate for Payer: Quartz Commercial |
$926.02
|
| Rate for Payer: WEA Trust Commercial |
$848.85
|
| Rate for Payer: WPS Commercial |
$1,143.13
|
|
|
SCREW 2.3 X 18 LOCK CO-T2318
|
Facility
|
IP
|
$1,647.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$839.31 |
| Max. Negotiated Rate |
$1,575.85 |
| Rate for Payer: Aetna Commercial |
$1,541.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,473.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$907.83
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,575.85
|
| Rate for Payer: Health EOS Commercial |
$1,524.46
|
| Rate for Payer: HFN Commercial |
$1,575.85
|
| Rate for Payer: Multiplan Commercial |
$1,370.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,575.85
|
| Rate for Payer: Quartz Beloit One Network |
$839.31
|
| Rate for Payer: Quartz Commercial |
$1,027.73
|
| Rate for Payer: WEA Trust Commercial |
$942.08
|
| Rate for Payer: WPS Commercial |
$1,268.68
|
|
|
SCREW 2.3 X 18 LOCK CO-T2318
|
Facility
|
OP
|
$1,647.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$479.61 |
| Max. Negotiated Rate |
$1,575.85 |
| Rate for Payer: Aetna Commercial |
$1,541.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,473.08
|
| Rate for Payer: Aetna Managed Medicare |
$479.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,113.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$856.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$822.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$907.83
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,575.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$958.55
|
| Rate for Payer: Health EOS Commercial |
$1,524.46
|
| Rate for Payer: HFN Commercial |
$1,575.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,284.66
|
| Rate for Payer: Multiplan Commercial |
$1,370.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,027.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,575.85
|
| Rate for Payer: Quartz Beloit One Network |
$839.31
|
| Rate for Payer: Quartz Commercial |
$1,113.37
|
| Rate for Payer: Quartz Medicare Advantage |
$1,027.73
|
| Rate for Payer: The Alliance Commercial |
$856.44
|
| Rate for Payer: WEA Trust Commercial |
$942.08
|
| Rate for Payer: WPS Commercial |
$1,268.68
|
|
|
SCREW 2.3 X 20 C0-2320
|
Facility
|
OP
|
$1,429.00
|
|
| Hospital Charge Code |
2964153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.12 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Aetna Managed Medicare |
$416.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$831.68
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,114.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: NAPHCARE Commercial |
$891.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$966.00
|
| Rate for Payer: Quartz Medicare Advantage |
$891.70
|
| Rate for Payer: The Alliance Commercial |
$743.08
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW 2.3 X 20 C0-2320
|
Facility
|
IP
|
$1,429.00
|
|
| Hospital Charge Code |
2964153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.22 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$891.70
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW 2.3 X 20 LOCK CO-T2320
|
Facility
|
IP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3487506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$879.06 |
| Max. Negotiated Rate |
$1,650.48 |
| Rate for Payer: Aetna Commercial |
$1,614.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,542.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.82
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,650.48
|
| Rate for Payer: Health EOS Commercial |
$1,596.66
|
| Rate for Payer: HFN Commercial |
$1,650.48
|
| Rate for Payer: Multiplan Commercial |
$1,435.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.48
|
| Rate for Payer: Quartz Beloit One Network |
$879.06
|
| Rate for Payer: Quartz Commercial |
$1,076.40
|
| Rate for Payer: WEA Trust Commercial |
$986.70
|
| Rate for Payer: WPS Commercial |
$1,328.77
|
|
|
SCREW 2.3 X 20 LOCK CO-T2320
|
Facility
|
OP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3487506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.32 |
| Max. Negotiated Rate |
$1,650.48 |
| Rate for Payer: Aetna Commercial |
$1,614.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,542.84
|
| Rate for Payer: Aetna Managed Medicare |
$502.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,166.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$897.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$861.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.82
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,650.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,003.95
|
| Rate for Payer: Health EOS Commercial |
$1,596.66
|
| Rate for Payer: HFN Commercial |
$1,650.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,345.50
|
| Rate for Payer: Multiplan Commercial |
$1,435.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,076.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.48
|
| Rate for Payer: Quartz Beloit One Network |
$879.06
|
| Rate for Payer: Quartz Commercial |
$1,166.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,076.40
|
| Rate for Payer: The Alliance Commercial |
$897.00
|
| Rate for Payer: WEA Trust Commercial |
$986.70
|
| Rate for Payer: WPS Commercial |
$1,328.77
|
|
|
SCREW 2.3 X 22 LOCK CO-T2322
|
Facility
|
OP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.32 |
| Max. Negotiated Rate |
$1,650.48 |
| Rate for Payer: Aetna Commercial |
$1,614.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,542.84
|
| Rate for Payer: Aetna Managed Medicare |
$502.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,166.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$897.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$861.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.82
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,650.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,003.95
|
| Rate for Payer: Health EOS Commercial |
$1,596.66
|
| Rate for Payer: HFN Commercial |
$1,650.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,345.50
|
| Rate for Payer: Multiplan Commercial |
$1,435.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,076.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.48
|
| Rate for Payer: Quartz Beloit One Network |
$879.06
|
| Rate for Payer: Quartz Commercial |
$1,166.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,076.40
|
| Rate for Payer: The Alliance Commercial |
$897.00
|
| Rate for Payer: WEA Trust Commercial |
$986.70
|
| Rate for Payer: WPS Commercial |
$1,328.77
|
|
|
SCREW 2.3 X 22 LOCK CO-T2322
|
Facility
|
IP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$879.06 |
| Max. Negotiated Rate |
$1,650.48 |
| Rate for Payer: Aetna Commercial |
$1,614.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,542.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.82
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,650.48
|
| Rate for Payer: Health EOS Commercial |
$1,596.66
|
| Rate for Payer: HFN Commercial |
$1,650.48
|
| Rate for Payer: Multiplan Commercial |
$1,435.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,650.48
|
| Rate for Payer: Quartz Beloit One Network |
$879.06
|
| Rate for Payer: Quartz Commercial |
$1,076.40
|
| Rate for Payer: WEA Trust Commercial |
$986.70
|
| Rate for Payer: WPS Commercial |
$1,328.77
|
|
|
SCREW 2.3 X 24 LOCL CO-T2324
|
Facility
|
IP
|
$2,137.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3381507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,089.02 |
| Max. Negotiated Rate |
$2,044.68 |
| Rate for Payer: Aetna Commercial |
$2,000.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,911.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,177.91
|
| Rate for Payer: Cash Price |
$641.10
|
| Rate for Payer: Cigna Commercial |
$2,044.68
|
| Rate for Payer: Health EOS Commercial |
$1,978.01
|
| Rate for Payer: HFN Commercial |
$2,044.68
|
| Rate for Payer: Multiplan Commercial |
$1,777.98
|
| Rate for Payer: Preferred Network Access Commercial |
$2,044.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,089.02
|
| Rate for Payer: Quartz Commercial |
$1,333.49
|
| Rate for Payer: WEA Trust Commercial |
$1,222.36
|
| Rate for Payer: WPS Commercial |
$1,646.13
|
|
|
SCREW 2.3 X 24 LOCL CO-T2324
|
Facility
|
OP
|
$2,137.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3381507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.29 |
| Max. Negotiated Rate |
$2,044.68 |
| Rate for Payer: Aetna Commercial |
$2,000.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,911.33
|
| Rate for Payer: Aetna Managed Medicare |
$622.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,444.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,111.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,066.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,177.91
|
| Rate for Payer: Cash Price |
$641.10
|
| Rate for Payer: Cigna Commercial |
$2,044.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,243.73
|
| Rate for Payer: Health EOS Commercial |
$1,978.01
|
| Rate for Payer: HFN Commercial |
$2,044.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,666.86
|
| Rate for Payer: Multiplan Commercial |
$1,777.98
|
| Rate for Payer: NAPHCARE Commercial |
$1,333.49
|
| Rate for Payer: Preferred Network Access Commercial |
$2,044.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,089.02
|
| Rate for Payer: Quartz Commercial |
$1,444.61
|
| Rate for Payer: Quartz Medicare Advantage |
$1,333.49
|
| Rate for Payer: The Alliance Commercial |
$1,111.24
|
| Rate for Payer: WEA Trust Commercial |
$1,222.36
|
| Rate for Payer: WPS Commercial |
$1,646.13
|
|
|
SCREW 2.3 X 26 LOCK CO-T2326
|
Facility
|
IP
|
$1,661.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$846.45 |
| Max. Negotiated Rate |
$1,589.24 |
| Rate for Payer: Aetna Commercial |
$1,554.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,485.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$915.54
|
| Rate for Payer: Cash Price |
$498.30
|
| Rate for Payer: Cigna Commercial |
$1,589.24
|
| Rate for Payer: Health EOS Commercial |
$1,537.42
|
| Rate for Payer: HFN Commercial |
$1,589.24
|
| Rate for Payer: Multiplan Commercial |
$1,381.95
|
| Rate for Payer: Preferred Network Access Commercial |
$1,589.24
|
| Rate for Payer: Quartz Beloit One Network |
$846.45
|
| Rate for Payer: Quartz Commercial |
$1,036.46
|
| Rate for Payer: WEA Trust Commercial |
$950.09
|
| Rate for Payer: WPS Commercial |
$1,279.47
|
|
|
SCREW 2.3 X 26 LOCK CO-T2326
|
Facility
|
OP
|
$1,661.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.68 |
| Max. Negotiated Rate |
$1,589.24 |
| Rate for Payer: Aetna Commercial |
$1,554.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,485.60
|
| Rate for Payer: Aetna Managed Medicare |
$483.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,122.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$863.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$829.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$915.54
|
| Rate for Payer: Cash Price |
$498.30
|
| Rate for Payer: Cigna Commercial |
$1,589.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$966.70
|
| Rate for Payer: Health EOS Commercial |
$1,537.42
|
| Rate for Payer: HFN Commercial |
$1,589.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,295.58
|
| Rate for Payer: Multiplan Commercial |
$1,381.95
|
| Rate for Payer: NAPHCARE Commercial |
$1,036.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,589.24
|
| Rate for Payer: Quartz Beloit One Network |
$846.45
|
| Rate for Payer: Quartz Commercial |
$1,122.84
|
| Rate for Payer: Quartz Medicare Advantage |
$1,036.46
|
| Rate for Payer: The Alliance Commercial |
$863.72
|
| Rate for Payer: WEA Trust Commercial |
$950.09
|
| Rate for Payer: WPS Commercial |
$1,279.47
|
|
|
SCREW 2.3x5mm
|
Facility
|
IP
|
$1,172.00
|
|
| Hospital Charge Code |
2965257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,121.37 |
| Rate for Payer: Aetna Commercial |
$1,096.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,048.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$646.01
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,121.37
|
| Rate for Payer: Health EOS Commercial |
$1,084.80
|
| Rate for Payer: HFN Commercial |
$1,121.37
|
| Rate for Payer: Multiplan Commercial |
$975.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,121.37
|
| Rate for Payer: Quartz Beloit One Network |
$597.25
|
| Rate for Payer: Quartz Commercial |
$731.33
|
| Rate for Payer: WEA Trust Commercial |
$670.38
|
| Rate for Payer: WPS Commercial |
$902.79
|
|
