|
SCREW 2.3x5mm
|
Facility
|
OP
|
$1,172.00
|
|
| Hospital Charge Code |
2965257
|
|
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 2.3x7 KLS MARTIN
|
Facility
|
IP
|
$1,172.00
|
|
| Hospital Charge Code |
2965258
|
|
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 2.3x7 KLS MARTIN
|
Facility
|
OP
|
$1,172.00
|
|
| Hospital Charge Code |
2965258
|
|
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 2.4x10 LOCKING 02.210.110
|
Facility
|
OP
|
$2,196.00
|
|
| Hospital Charge Code |
2990963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$639.48 |
| Max. Negotiated Rate |
$2,101.13 |
| Rate for Payer: Aetna Commercial |
$2,055.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,964.10
|
| Rate for Payer: Aetna Managed Medicare |
$639.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,484.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,141.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,096.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,210.44
|
| Rate for Payer: Cash Price |
$658.80
|
| Rate for Payer: Cigna Commercial |
$2,101.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,278.07
|
| Rate for Payer: Health EOS Commercial |
$2,032.62
|
| Rate for Payer: HFN Commercial |
$2,101.13
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,712.88
|
| Rate for Payer: Multiplan Commercial |
$1,827.07
|
| Rate for Payer: NAPHCARE Commercial |
$1,370.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,101.13
|
| Rate for Payer: Quartz Beloit One Network |
$1,119.08
|
| Rate for Payer: Quartz Commercial |
$1,484.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,370.30
|
| Rate for Payer: The Alliance Commercial |
$1,141.92
|
| Rate for Payer: WEA Trust Commercial |
$1,256.11
|
| Rate for Payer: WPS Commercial |
$1,691.58
|
|
|
SCREW 2.4x10 LOCKING 02.210.110
|
Facility
|
IP
|
$2,196.00
|
|
| Hospital Charge Code |
2990963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,119.08 |
| Max. Negotiated Rate |
$2,101.13 |
| Rate for Payer: Aetna Commercial |
$2,055.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,964.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,210.44
|
| Rate for Payer: Cash Price |
$658.80
|
| Rate for Payer: Cigna Commercial |
$2,101.13
|
| Rate for Payer: Health EOS Commercial |
$2,032.62
|
| Rate for Payer: HFN Commercial |
$2,101.13
|
| Rate for Payer: Multiplan Commercial |
$1,827.07
|
| Rate for Payer: Preferred Network Access Commercial |
$2,101.13
|
| Rate for Payer: Quartz Beloit One Network |
$1,119.08
|
| Rate for Payer: Quartz Commercial |
$1,370.30
|
| Rate for Payer: WEA Trust Commercial |
$1,256.11
|
| Rate for Payer: WPS Commercial |
$1,691.58
|
|
|
SCREW 2.4 X 16 HEADLESS 02.226.216
|
Facility
|
OP
|
$4,066.00
|
|
| Hospital Charge Code |
2966449
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,184.02 |
| Max. Negotiated Rate |
$3,890.35 |
| Rate for Payer: Aetna Commercial |
$3,805.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,636.63
|
| Rate for Payer: Aetna Managed Medicare |
$1,184.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,748.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,114.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,029.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,241.18
|
| Rate for Payer: Cash Price |
$1,219.80
|
| Rate for Payer: Cigna Commercial |
$3,890.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,366.41
|
| Rate for Payer: Health EOS Commercial |
$3,763.49
|
| Rate for Payer: HFN Commercial |
$3,890.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,171.48
|
| Rate for Payer: Multiplan Commercial |
$3,382.91
|
| Rate for Payer: NAPHCARE Commercial |
$2,537.18
|
| Rate for Payer: Preferred Network Access Commercial |
$3,890.35
|
| Rate for Payer: Quartz Beloit One Network |
$2,072.03
|
| Rate for Payer: Quartz Commercial |
$2,748.62
|
| Rate for Payer: Quartz Medicare Advantage |
$2,537.18
|
| Rate for Payer: The Alliance Commercial |
$2,114.32
|
| Rate for Payer: WEA Trust Commercial |
$2,325.75
|
| Rate for Payer: WPS Commercial |
$3,132.04
|
|
|
SCREW 2.4 X 16 HEADLESS 02.226.216
|
Facility
|
IP
|
$4,066.00
|
|
| Hospital Charge Code |
2966449
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,072.03 |
| Max. Negotiated Rate |
$3,890.35 |
| Rate for Payer: Aetna Commercial |
$3,805.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,636.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,241.18
|
| Rate for Payer: Cash Price |
$1,219.80
|
| Rate for Payer: Cigna Commercial |
$3,890.35
|
| Rate for Payer: Health EOS Commercial |
$3,763.49
|
| Rate for Payer: HFN Commercial |
$3,890.35
|
| Rate for Payer: Multiplan Commercial |
$3,382.91
|
| Rate for Payer: Preferred Network Access Commercial |
$3,890.35
|
| Rate for Payer: Quartz Beloit One Network |
$2,072.03
|
| Rate for Payer: Quartz Commercial |
$2,537.18
|
| Rate for Payer: WEA Trust Commercial |
$2,325.75
|
| Rate for Payer: WPS Commercial |
$3,132.04
|
|
|
SCREW 2.4x18 HEADLESS
|
Facility
|
IP
|
$4,066.00
|
|
| Hospital Charge Code |
2966450
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,072.03 |
| Max. Negotiated Rate |
$3,890.35 |
| Rate for Payer: Aetna Commercial |
$3,805.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,636.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,241.18
|
| Rate for Payer: Cash Price |
$1,219.80
|
| Rate for Payer: Cigna Commercial |
$3,890.35
|
| Rate for Payer: Health EOS Commercial |
$3,763.49
|
| Rate for Payer: HFN Commercial |
$3,890.35
|
| Rate for Payer: Multiplan Commercial |
$3,382.91
|
| Rate for Payer: Preferred Network Access Commercial |
$3,890.35
|
| Rate for Payer: Quartz Beloit One Network |
$2,072.03
|
| Rate for Payer: Quartz Commercial |
$2,537.18
|
| Rate for Payer: WEA Trust Commercial |
$2,325.75
|
| Rate for Payer: WPS Commercial |
$3,132.04
|
|
|
SCREW 2.4x18 HEADLESS
|
Facility
|
OP
|
$4,066.00
|
|
| Hospital Charge Code |
2966450
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,184.02 |
| Max. Negotiated Rate |
$3,890.35 |
| Rate for Payer: Aetna Commercial |
$3,805.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,636.63
|
| Rate for Payer: Aetna Managed Medicare |
$1,184.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,748.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,114.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,029.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,241.18
|
| Rate for Payer: Cash Price |
$1,219.80
|
| Rate for Payer: Cigna Commercial |
$3,890.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,366.41
|
| Rate for Payer: Health EOS Commercial |
$3,763.49
|
| Rate for Payer: HFN Commercial |
$3,890.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,171.48
|
| Rate for Payer: Multiplan Commercial |
$3,382.91
|
| Rate for Payer: NAPHCARE Commercial |
$2,537.18
|
| Rate for Payer: Preferred Network Access Commercial |
$3,890.35
|
| Rate for Payer: Quartz Beloit One Network |
$2,072.03
|
| Rate for Payer: Quartz Commercial |
$2,748.62
|
| Rate for Payer: Quartz Medicare Advantage |
$2,537.18
|
| Rate for Payer: The Alliance Commercial |
$2,114.32
|
| Rate for Payer: WEA Trust Commercial |
$2,325.75
|
| Rate for Payer: WPS Commercial |
$3,132.04
|
|
|
SCREW 2.4x20MM COMPRESSION
|
Facility
|
IP
|
$4,428.00
|
|
| Hospital Charge Code |
2966456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,256.51 |
| Max. Negotiated Rate |
$4,236.71 |
| Rate for Payer: Aetna Commercial |
$4,144.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,960.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,440.71
|
| Rate for Payer: Cash Price |
$1,328.40
|
| Rate for Payer: Cigna Commercial |
$4,236.71
|
| Rate for Payer: Health EOS Commercial |
$4,098.56
|
| Rate for Payer: HFN Commercial |
$4,236.71
|
| Rate for Payer: Multiplan Commercial |
$3,684.10
|
| Rate for Payer: Preferred Network Access Commercial |
$4,236.71
|
| Rate for Payer: Quartz Beloit One Network |
$2,256.51
|
| Rate for Payer: Quartz Commercial |
$2,763.07
|
| Rate for Payer: WEA Trust Commercial |
$2,532.82
|
| Rate for Payer: WPS Commercial |
$3,410.89
|
|
|
SCREW 2.4x20MM COMPRESSION
|
Facility
|
OP
|
$4,428.00
|
|
| Hospital Charge Code |
2966456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,289.43 |
| Max. Negotiated Rate |
$4,236.71 |
| Rate for Payer: Aetna Commercial |
$4,144.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,960.40
|
| Rate for Payer: Aetna Managed Medicare |
$1,289.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,993.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,302.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,210.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,440.71
|
| Rate for Payer: Cash Price |
$1,328.40
|
| Rate for Payer: Cigna Commercial |
$4,236.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,577.10
|
| Rate for Payer: Health EOS Commercial |
$4,098.56
|
| Rate for Payer: HFN Commercial |
$4,236.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,453.84
|
| Rate for Payer: Multiplan Commercial |
$3,684.10
|
| Rate for Payer: NAPHCARE Commercial |
$2,763.07
|
| Rate for Payer: Preferred Network Access Commercial |
$4,236.71
|
| Rate for Payer: Quartz Beloit One Network |
$2,256.51
|
| Rate for Payer: Quartz Commercial |
$2,993.33
|
| Rate for Payer: Quartz Medicare Advantage |
$2,763.07
|
| Rate for Payer: The Alliance Commercial |
$2,302.56
|
| Rate for Payer: WEA Trust Commercial |
$2,532.82
|
| Rate for Payer: WPS Commercial |
$3,410.89
|
|
|
SCREW 2.4X24 CORTEX 201.774
|
Facility
|
OP
|
$999.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$290.91 |
| Max. Negotiated Rate |
$955.84 |
| Rate for Payer: Aetna Commercial |
$935.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$893.51
|
| Rate for Payer: Aetna Managed Medicare |
$290.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$675.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$519.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$498.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$550.65
|
| Rate for Payer: Cash Price |
$299.70
|
| Rate for Payer: Cigna Commercial |
$955.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$581.42
|
| Rate for Payer: Health EOS Commercial |
$924.67
|
| Rate for Payer: HFN Commercial |
$955.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$779.22
|
| Rate for Payer: Multiplan Commercial |
$831.17
|
| Rate for Payer: NAPHCARE Commercial |
$623.38
|
| Rate for Payer: Preferred Network Access Commercial |
$955.84
|
| Rate for Payer: Quartz Beloit One Network |
$509.09
|
| Rate for Payer: Quartz Commercial |
$675.32
|
| Rate for Payer: Quartz Medicare Advantage |
$623.38
|
| Rate for Payer: The Alliance Commercial |
$519.48
|
| Rate for Payer: WEA Trust Commercial |
$571.43
|
| Rate for Payer: WPS Commercial |
$769.53
|
|
|
SCREW 2.4X24 CORTEX 201.774
|
Facility
|
IP
|
$999.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.09 |
| Max. Negotiated Rate |
$955.84 |
| Rate for Payer: Aetna Commercial |
$935.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$893.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$550.65
|
| Rate for Payer: Cash Price |
$299.70
|
| Rate for Payer: Cigna Commercial |
$955.84
|
| Rate for Payer: Health EOS Commercial |
$924.67
|
| Rate for Payer: HFN Commercial |
$955.84
|
| Rate for Payer: Multiplan Commercial |
$831.17
|
| Rate for Payer: Preferred Network Access Commercial |
$955.84
|
| Rate for Payer: Quartz Beloit One Network |
$509.09
|
| Rate for Payer: Quartz Commercial |
$623.38
|
| Rate for Payer: WEA Trust Commercial |
$571.43
|
| Rate for Payer: WPS Commercial |
$769.53
|
|
|
SCREW 2.4x26 CORTEX SLF TAP 201.776
|
Facility
|
OP
|
$1,077.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.62 |
| Max. Negotiated Rate |
$1,030.47 |
| Rate for Payer: Aetna Commercial |
$1,008.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$963.27
|
| Rate for Payer: Aetna Managed Medicare |
$313.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$728.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$560.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$537.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$593.64
|
| Rate for Payer: Cash Price |
$323.10
|
| Rate for Payer: Cigna Commercial |
$1,030.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$626.81
|
| Rate for Payer: Health EOS Commercial |
$996.87
|
| Rate for Payer: HFN Commercial |
$1,030.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$840.06
|
| Rate for Payer: Multiplan Commercial |
$896.06
|
| Rate for Payer: NAPHCARE Commercial |
$672.05
|
| Rate for Payer: Preferred Network Access Commercial |
$1,030.47
|
| Rate for Payer: Quartz Beloit One Network |
$548.84
|
| Rate for Payer: Quartz Commercial |
$728.05
|
| Rate for Payer: Quartz Medicare Advantage |
$672.05
|
| Rate for Payer: The Alliance Commercial |
$560.04
|
| Rate for Payer: WEA Trust Commercial |
$616.04
|
| Rate for Payer: WPS Commercial |
$829.61
|
|
|
SCREW 2.4x26 CORTEX SLF TAP 201.776
|
Facility
|
IP
|
$1,077.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$548.84 |
| Max. Negotiated Rate |
$1,030.47 |
| Rate for Payer: Aetna Commercial |
$1,008.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$963.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$593.64
|
| Rate for Payer: Cash Price |
$323.10
|
| Rate for Payer: Cigna Commercial |
$1,030.47
|
| Rate for Payer: Health EOS Commercial |
$996.87
|
| Rate for Payer: HFN Commercial |
$1,030.47
|
| Rate for Payer: Multiplan Commercial |
$896.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,030.47
|
| Rate for Payer: Quartz Beloit One Network |
$548.84
|
| Rate for Payer: Quartz Commercial |
$672.05
|
| Rate for Payer: WEA Trust Commercial |
$616.04
|
| Rate for Payer: WPS Commercial |
$829.61
|
|
|
SCREW 2.4x28 CORTEX SLF-TAP 201.778
|
Facility
|
OP
|
$1,040.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.85 |
| Max. Negotiated Rate |
$995.07 |
| Rate for Payer: Aetna Commercial |
$973.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$930.18
|
| Rate for Payer: Aetna Managed Medicare |
$302.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$703.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$540.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$519.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$573.25
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cigna Commercial |
$995.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$605.28
|
| Rate for Payer: Health EOS Commercial |
$962.62
|
| Rate for Payer: HFN Commercial |
$995.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$811.20
|
| Rate for Payer: Multiplan Commercial |
$865.28
|
| Rate for Payer: NAPHCARE Commercial |
$648.96
|
| Rate for Payer: Preferred Network Access Commercial |
$995.07
|
| Rate for Payer: Quartz Beloit One Network |
$529.98
|
| Rate for Payer: Quartz Commercial |
$703.04
|
| Rate for Payer: Quartz Medicare Advantage |
$648.96
|
| Rate for Payer: The Alliance Commercial |
$540.80
|
| Rate for Payer: WEA Trust Commercial |
$594.88
|
| Rate for Payer: WPS Commercial |
$801.11
|
|
|
SCREW 2.4x28 CORTEX SLF-TAP 201.778
|
Facility
|
IP
|
$1,040.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$529.98 |
| Max. Negotiated Rate |
$995.07 |
| Rate for Payer: Aetna Commercial |
$973.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$930.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$573.25
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cigna Commercial |
$995.07
|
| Rate for Payer: Health EOS Commercial |
$962.62
|
| Rate for Payer: HFN Commercial |
$995.07
|
| Rate for Payer: Multiplan Commercial |
$865.28
|
| Rate for Payer: Preferred Network Access Commercial |
$995.07
|
| Rate for Payer: Quartz Beloit One Network |
$529.98
|
| Rate for Payer: Quartz Commercial |
$648.96
|
| Rate for Payer: WEA Trust Commercial |
$594.88
|
| Rate for Payer: WPS Commercial |
$801.11
|
|
|
SCREW 2.5 X 20MM TI SV20
|
Facility
|
OP
|
$5,270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583410
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,534.62 |
| Max. Negotiated Rate |
$5,042.34 |
| Rate for Payer: Aetna Commercial |
$4,932.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,713.49
|
| Rate for Payer: Aetna Managed Medicare |
$1,534.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,562.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,740.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,630.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,904.82
|
| Rate for Payer: Cash Price |
$1,581.00
|
| Rate for Payer: Cigna Commercial |
$5,042.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,067.14
|
| Rate for Payer: Health EOS Commercial |
$4,877.91
|
| Rate for Payer: HFN Commercial |
$5,042.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,110.60
|
| Rate for Payer: Multiplan Commercial |
$4,384.64
|
| Rate for Payer: NAPHCARE Commercial |
$3,288.48
|
| Rate for Payer: Preferred Network Access Commercial |
$5,042.34
|
| Rate for Payer: Quartz Beloit One Network |
$2,685.59
|
| Rate for Payer: Quartz Commercial |
$3,562.52
|
| Rate for Payer: Quartz Medicare Advantage |
$3,288.48
|
| Rate for Payer: The Alliance Commercial |
$2,740.40
|
| Rate for Payer: WEA Trust Commercial |
$3,014.44
|
| Rate for Payer: WPS Commercial |
$4,059.48
|
|
|
SCREW 2.5 X 20MM TI SV20
|
Facility
|
IP
|
$5,270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583410
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,685.59 |
| Max. Negotiated Rate |
$5,042.34 |
| Rate for Payer: Aetna Commercial |
$4,932.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,713.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,904.82
|
| Rate for Payer: Cash Price |
$1,581.00
|
| Rate for Payer: Cigna Commercial |
$5,042.34
|
| Rate for Payer: Health EOS Commercial |
$4,877.91
|
| Rate for Payer: HFN Commercial |
$5,042.34
|
| Rate for Payer: Multiplan Commercial |
$4,384.64
|
| Rate for Payer: Preferred Network Access Commercial |
$5,042.34
|
| Rate for Payer: Quartz Beloit One Network |
$2,685.59
|
| Rate for Payer: Quartz Commercial |
$3,288.48
|
| Rate for Payer: WEA Trust Commercial |
$3,014.44
|
| Rate for Payer: WPS Commercial |
$4,059.48
|
|
|
SCREW 2.7 X 14MM LOCKING
|
Facility
|
IP
|
$2,670.00
|
|
| Hospital Charge Code |
2964739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,360.63 |
| Max. Negotiated Rate |
$2,554.66 |
| Rate for Payer: Aetna Commercial |
$2,499.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,388.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,471.70
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cigna Commercial |
$2,554.66
|
| Rate for Payer: Health EOS Commercial |
$2,471.35
|
| Rate for Payer: HFN Commercial |
$2,554.66
|
| Rate for Payer: Multiplan Commercial |
$2,221.44
|
| Rate for Payer: Preferred Network Access Commercial |
$2,554.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,360.63
|
| Rate for Payer: Quartz Commercial |
$1,666.08
|
| Rate for Payer: WEA Trust Commercial |
$1,527.24
|
| Rate for Payer: WPS Commercial |
$2,056.70
|
|
|
SCREW 2.7 X 14MM LOCKING
|
Facility
|
OP
|
$2,670.00
|
|
| Hospital Charge Code |
2964739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$777.50 |
| Max. Negotiated Rate |
$2,554.66 |
| Rate for Payer: Aetna Commercial |
$2,499.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,388.05
|
| Rate for Payer: Aetna Managed Medicare |
$777.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,804.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,388.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,332.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,471.70
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cigna Commercial |
$2,554.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,553.94
|
| Rate for Payer: Health EOS Commercial |
$2,471.35
|
| Rate for Payer: HFN Commercial |
$2,554.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,082.60
|
| Rate for Payer: Multiplan Commercial |
$2,221.44
|
| Rate for Payer: NAPHCARE Commercial |
$1,666.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,554.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,360.63
|
| Rate for Payer: Quartz Commercial |
$1,804.92
|
| Rate for Payer: Quartz Medicare Advantage |
$1,666.08
|
| Rate for Payer: The Alliance Commercial |
$1,388.40
|
| Rate for Payer: WEA Trust Commercial |
$1,527.24
|
| Rate for Payer: WPS Commercial |
$2,056.70
|
|
|
SCREW 2.7 X 16MM LOCKING
|
Facility
|
IP
|
$2,670.00
|
|
| Hospital Charge Code |
2964740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,360.63 |
| Max. Negotiated Rate |
$2,554.66 |
| Rate for Payer: Aetna Commercial |
$2,499.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,388.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,471.70
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cigna Commercial |
$2,554.66
|
| Rate for Payer: Health EOS Commercial |
$2,471.35
|
| Rate for Payer: HFN Commercial |
$2,554.66
|
| Rate for Payer: Multiplan Commercial |
$2,221.44
|
| Rate for Payer: Preferred Network Access Commercial |
$2,554.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,360.63
|
| Rate for Payer: Quartz Commercial |
$1,666.08
|
| Rate for Payer: WEA Trust Commercial |
$1,527.24
|
| Rate for Payer: WPS Commercial |
$2,056.70
|
|
|
SCREW 2.7 X 16MM LOCKING
|
Facility
|
OP
|
$2,670.00
|
|
| Hospital Charge Code |
2964740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$777.50 |
| Max. Negotiated Rate |
$2,554.66 |
| Rate for Payer: Aetna Commercial |
$2,499.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,388.05
|
| Rate for Payer: Aetna Managed Medicare |
$777.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,804.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,388.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,332.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,471.70
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cigna Commercial |
$2,554.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,553.94
|
| Rate for Payer: Health EOS Commercial |
$2,471.35
|
| Rate for Payer: HFN Commercial |
$2,554.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,082.60
|
| Rate for Payer: Multiplan Commercial |
$2,221.44
|
| Rate for Payer: NAPHCARE Commercial |
$1,666.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,554.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,360.63
|
| Rate for Payer: Quartz Commercial |
$1,804.92
|
| Rate for Payer: Quartz Medicare Advantage |
$1,666.08
|
| Rate for Payer: The Alliance Commercial |
$1,388.40
|
| Rate for Payer: WEA Trust Commercial |
$1,527.24
|
| Rate for Payer: WPS Commercial |
$2,056.70
|
|
|
SCREW 2.7 X 16MM STD.
|
Facility
|
IP
|
$1,754.00
|
|
| Hospital Charge Code |
2964741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$893.84 |
| Max. Negotiated Rate |
$1,678.23 |
| Rate for Payer: Aetna Commercial |
$1,641.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,568.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.80
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cigna Commercial |
$1,678.23
|
| Rate for Payer: Health EOS Commercial |
$1,623.50
|
| Rate for Payer: HFN Commercial |
$1,678.23
|
| Rate for Payer: Multiplan Commercial |
$1,459.33
|
| Rate for Payer: Preferred Network Access Commercial |
$1,678.23
|
| Rate for Payer: Quartz Beloit One Network |
$893.84
|
| Rate for Payer: Quartz Commercial |
$1,094.50
|
| Rate for Payer: WEA Trust Commercial |
$1,003.29
|
| Rate for Payer: WPS Commercial |
$1,351.11
|
|
|
SCREW 2.7 X 16MM STD.
|
Facility
|
OP
|
$1,754.00
|
|
| Hospital Charge Code |
2964741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$510.76 |
| Max. Negotiated Rate |
$1,678.23 |
| Rate for Payer: Aetna Commercial |
$1,641.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,568.78
|
| Rate for Payer: Aetna Managed Medicare |
$510.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,185.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$912.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$875.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.80
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cigna Commercial |
$1,678.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,020.83
|
| Rate for Payer: Health EOS Commercial |
$1,623.50
|
| Rate for Payer: HFN Commercial |
$1,678.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,368.12
|
| Rate for Payer: Multiplan Commercial |
$1,459.33
|
| Rate for Payer: NAPHCARE Commercial |
$1,094.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,678.23
|
| Rate for Payer: Quartz Beloit One Network |
$893.84
|
| Rate for Payer: Quartz Commercial |
$1,185.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,094.50
|
| Rate for Payer: The Alliance Commercial |
$912.08
|
| Rate for Payer: WEA Trust Commercial |
$1,003.29
|
| Rate for Payer: WPS Commercial |
$1,351.11
|
|
