|
SCREW 3.5 X 10 LOCKING
|
Facility
|
IP
|
$1,777.00
|
|
| Hospital Charge Code |
2967392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$905.56 |
| Max. Negotiated Rate |
$1,700.23 |
| Rate for Payer: Aetna Commercial |
$1,663.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,589.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$979.48
|
| Rate for Payer: Cash Price |
$533.10
|
| Rate for Payer: Cigna Commercial |
$1,700.23
|
| Rate for Payer: Health EOS Commercial |
$1,644.79
|
| Rate for Payer: HFN Commercial |
$1,700.23
|
| Rate for Payer: Multiplan Commercial |
$1,478.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,700.23
|
| Rate for Payer: Quartz Beloit One Network |
$905.56
|
| Rate for Payer: Quartz Commercial |
$1,108.85
|
| Rate for Payer: WEA Trust Commercial |
$1,016.44
|
| Rate for Payer: WPS Commercial |
$1,368.82
|
|
|
SCREW 3.5 X 10 NON-LOCKING C0-3100
|
Facility
|
OP
|
$1,611.00
|
|
| Hospital Charge Code |
2964158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$469.12 |
| Max. Negotiated Rate |
$1,541.40 |
| Rate for Payer: Aetna Commercial |
$1,507.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,440.88
|
| Rate for Payer: Aetna Managed Medicare |
$469.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,089.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$837.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$804.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$887.98
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cigna Commercial |
$1,541.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$937.60
|
| Rate for Payer: Health EOS Commercial |
$1,491.14
|
| Rate for Payer: HFN Commercial |
$1,541.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,256.58
|
| Rate for Payer: Multiplan Commercial |
$1,340.35
|
| Rate for Payer: NAPHCARE Commercial |
$1,005.26
|
| Rate for Payer: Preferred Network Access Commercial |
$1,541.40
|
| Rate for Payer: Quartz Beloit One Network |
$820.97
|
| Rate for Payer: Quartz Commercial |
$1,089.04
|
| Rate for Payer: Quartz Medicare Advantage |
$1,005.26
|
| Rate for Payer: The Alliance Commercial |
$837.72
|
| Rate for Payer: WEA Trust Commercial |
$921.49
|
| Rate for Payer: WPS Commercial |
$1,240.95
|
|
|
SCREW 3.5 X 10 NON-LOCKING C0-3100
|
Facility
|
IP
|
$1,611.00
|
|
| Hospital Charge Code |
2964158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$820.97 |
| Max. Negotiated Rate |
$1,541.40 |
| Rate for Payer: Aetna Commercial |
$1,507.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,440.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$887.98
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cigna Commercial |
$1,541.40
|
| Rate for Payer: Health EOS Commercial |
$1,491.14
|
| Rate for Payer: HFN Commercial |
$1,541.40
|
| Rate for Payer: Multiplan Commercial |
$1,340.35
|
| Rate for Payer: Preferred Network Access Commercial |
$1,541.40
|
| Rate for Payer: Quartz Beloit One Network |
$820.97
|
| Rate for Payer: Quartz Commercial |
$1,005.26
|
| Rate for Payer: WEA Trust Commercial |
$921.49
|
| Rate for Payer: WPS Commercial |
$1,240.95
|
|
|
SCREW 3.5 X 12 C0-3120
|
Facility
|
OP
|
$1,099.00
|
|
| Hospital Charge Code |
2964159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$320.03 |
| Max. Negotiated Rate |
$1,051.52 |
| Rate for Payer: Aetna Commercial |
$1,028.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$982.95
|
| Rate for Payer: Aetna Managed Medicare |
$320.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$742.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$571.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$548.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$605.77
|
| Rate for Payer: Cash Price |
$329.70
|
| Rate for Payer: Cigna Commercial |
$1,051.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$639.62
|
| Rate for Payer: Health EOS Commercial |
$1,017.23
|
| Rate for Payer: HFN Commercial |
$1,051.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$857.22
|
| Rate for Payer: Multiplan Commercial |
$914.37
|
| Rate for Payer: NAPHCARE Commercial |
$685.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,051.52
|
| Rate for Payer: Quartz Beloit One Network |
$560.05
|
| Rate for Payer: Quartz Commercial |
$742.92
|
| Rate for Payer: Quartz Medicare Advantage |
$685.78
|
| Rate for Payer: The Alliance Commercial |
$571.48
|
| Rate for Payer: WEA Trust Commercial |
$628.63
|
| Rate for Payer: WPS Commercial |
$846.56
|
|
|
SCREW 3.5 X 12 C0-3120
|
Facility
|
IP
|
$1,099.00
|
|
| Hospital Charge Code |
2964159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.05 |
| Max. Negotiated Rate |
$1,051.52 |
| Rate for Payer: Aetna Commercial |
$1,028.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$982.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$605.77
|
| Rate for Payer: Cash Price |
$329.70
|
| Rate for Payer: Cigna Commercial |
$1,051.52
|
| Rate for Payer: Health EOS Commercial |
$1,017.23
|
| Rate for Payer: HFN Commercial |
$1,051.52
|
| Rate for Payer: Multiplan Commercial |
$914.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,051.52
|
| Rate for Payer: Quartz Beloit One Network |
$560.05
|
| Rate for Payer: Quartz Commercial |
$685.78
|
| Rate for Payer: WEA Trust Commercial |
$628.63
|
| Rate for Payer: WPS Commercial |
$846.56
|
|
|
SCREW 3.5 X 12 CORT 30-0257
|
Facility
|
OP
|
$1,708.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494363
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$497.37 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Aetna Managed Medicare |
$497.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,154.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$888.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$852.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$994.06
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,332.24
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: NAPHCARE Commercial |
$1,065.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,154.61
|
| Rate for Payer: Quartz Medicare Advantage |
$1,065.79
|
| Rate for Payer: The Alliance Commercial |
$888.16
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
SCREW 3.5 X 12 CORT 30-0257
|
Facility
|
IP
|
$1,708.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494363
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$870.40 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,065.79
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
SCREW 3.5 X 12 LOCK 30-0234
|
Facility
|
OP
|
$2,386.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3529508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$694.80 |
| Max. Negotiated Rate |
$2,282.92 |
| Rate for Payer: Aetna Commercial |
$2,233.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,134.04
|
| Rate for Payer: Aetna Managed Medicare |
$694.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,612.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,240.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,191.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,315.16
|
| Rate for Payer: Cash Price |
$715.80
|
| Rate for Payer: Cigna Commercial |
$2,282.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,388.65
|
| Rate for Payer: Health EOS Commercial |
$2,208.48
|
| Rate for Payer: HFN Commercial |
$2,282.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,861.08
|
| Rate for Payer: Multiplan Commercial |
$1,985.15
|
| Rate for Payer: NAPHCARE Commercial |
$1,488.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,282.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,215.91
|
| Rate for Payer: Quartz Commercial |
$1,612.94
|
| Rate for Payer: Quartz Medicare Advantage |
$1,488.86
|
| Rate for Payer: The Alliance Commercial |
$1,240.72
|
| Rate for Payer: WEA Trust Commercial |
$1,364.79
|
| Rate for Payer: WPS Commercial |
$1,837.94
|
|
|
SCREW 3.5 X 12 LOCK 30-0234
|
Facility
|
IP
|
$2,386.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3529508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,215.91 |
| Max. Negotiated Rate |
$2,282.92 |
| Rate for Payer: Aetna Commercial |
$2,233.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,134.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,315.16
|
| Rate for Payer: Cash Price |
$715.80
|
| Rate for Payer: Cigna Commercial |
$2,282.92
|
| Rate for Payer: Health EOS Commercial |
$2,208.48
|
| Rate for Payer: HFN Commercial |
$2,282.92
|
| Rate for Payer: Multiplan Commercial |
$1,985.15
|
| Rate for Payer: Preferred Network Access Commercial |
$2,282.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,215.91
|
| Rate for Payer: Quartz Commercial |
$1,488.86
|
| Rate for Payer: WEA Trust Commercial |
$1,364.79
|
| Rate for Payer: WPS Commercial |
$1,837.94
|
|
|
SCREW 3.5 X 12 LOCKING COL-3120
|
Facility
|
OP
|
$1,281.00
|
|
| Hospital Charge Code |
2964156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$373.03 |
| Max. Negotiated Rate |
$1,225.66 |
| Rate for Payer: Aetna Commercial |
$1,199.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,145.73
|
| Rate for Payer: Aetna Managed Medicare |
$373.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$865.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$666.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$639.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$706.09
|
| Rate for Payer: Cash Price |
$384.30
|
| Rate for Payer: Cigna Commercial |
$1,225.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$745.54
|
| Rate for Payer: Health EOS Commercial |
$1,185.69
|
| Rate for Payer: HFN Commercial |
$1,225.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$999.18
|
| Rate for Payer: Multiplan Commercial |
$1,065.79
|
| Rate for Payer: NAPHCARE Commercial |
$799.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,225.66
|
| Rate for Payer: Quartz Beloit One Network |
$652.80
|
| Rate for Payer: Quartz Commercial |
$865.96
|
| Rate for Payer: Quartz Medicare Advantage |
$799.34
|
| Rate for Payer: The Alliance Commercial |
$666.12
|
| Rate for Payer: WEA Trust Commercial |
$732.73
|
| Rate for Payer: WPS Commercial |
$986.75
|
|
|
SCREW 3.5 X 12 LOCKING COL-3120
|
Facility
|
IP
|
$1,281.00
|
|
| Hospital Charge Code |
2964156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$652.80 |
| Max. Negotiated Rate |
$1,225.66 |
| Rate for Payer: Aetna Commercial |
$1,199.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,145.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$706.09
|
| Rate for Payer: Cash Price |
$384.30
|
| Rate for Payer: Cigna Commercial |
$1,225.66
|
| Rate for Payer: Health EOS Commercial |
$1,185.69
|
| Rate for Payer: HFN Commercial |
$1,225.66
|
| Rate for Payer: Multiplan Commercial |
$1,065.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,225.66
|
| Rate for Payer: Quartz Beloit One Network |
$652.80
|
| Rate for Payer: Quartz Commercial |
$799.34
|
| Rate for Payer: WEA Trust Commercial |
$732.73
|
| Rate for Payer: WPS Commercial |
$986.75
|
|
|
SCREW 3.5x12 TI SF TAP CORTEX
|
Facility
|
IP
|
$523.00
|
|
| Hospital Charge Code |
2966496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$266.52 |
| Max. Negotiated Rate |
$500.41 |
| Rate for Payer: Aetna Commercial |
$489.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$467.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$288.28
|
| Rate for Payer: Cash Price |
$156.90
|
| Rate for Payer: Cigna Commercial |
$500.41
|
| Rate for Payer: Health EOS Commercial |
$484.09
|
| Rate for Payer: HFN Commercial |
$500.41
|
| Rate for Payer: Multiplan Commercial |
$435.14
|
| Rate for Payer: Preferred Network Access Commercial |
$500.41
|
| Rate for Payer: Quartz Beloit One Network |
$266.52
|
| Rate for Payer: Quartz Commercial |
$326.35
|
| Rate for Payer: WEA Trust Commercial |
$299.16
|
| Rate for Payer: WPS Commercial |
$402.87
|
|
|
SCREW 3.5x12 TI SF TAP CORTEX
|
Facility
|
OP
|
$523.00
|
|
| Hospital Charge Code |
2966496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$500.41 |
| Rate for Payer: Aetna Commercial |
$489.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$467.77
|
| Rate for Payer: Aetna Managed Medicare |
$152.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$353.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$271.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$261.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$288.28
|
| Rate for Payer: Cash Price |
$156.90
|
| Rate for Payer: Cigna Commercial |
$500.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$304.39
|
| Rate for Payer: Health EOS Commercial |
$484.09
|
| Rate for Payer: HFN Commercial |
$500.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$407.94
|
| Rate for Payer: Multiplan Commercial |
$435.14
|
| Rate for Payer: NAPHCARE Commercial |
$326.35
|
| Rate for Payer: Preferred Network Access Commercial |
$500.41
|
| Rate for Payer: Quartz Beloit One Network |
$266.52
|
| Rate for Payer: Quartz Commercial |
$353.55
|
| Rate for Payer: Quartz Medicare Advantage |
$326.35
|
| Rate for Payer: The Alliance Commercial |
$271.96
|
| Rate for Payer: WEA Trust Commercial |
$299.16
|
| Rate for Payer: WPS Commercial |
$402.87
|
|
|
SCREW 3.5 X 14 CORT 30-0258
|
Facility
|
OP
|
$1,708.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$497.37 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Aetna Managed Medicare |
$497.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,154.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$888.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$852.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$994.06
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,332.24
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: NAPHCARE Commercial |
$1,065.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,154.61
|
| Rate for Payer: Quartz Medicare Advantage |
$1,065.79
|
| Rate for Payer: The Alliance Commercial |
$888.16
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
SCREW 3.5 X 14 CORT 30-0258
|
Facility
|
IP
|
$1,708.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$870.40 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,065.79
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
SCREW 3.5 X 14 LOCK 30-0235
|
Facility
|
OP
|
$2,386.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$694.80 |
| Max. Negotiated Rate |
$2,282.92 |
| Rate for Payer: Aetna Commercial |
$2,233.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,134.04
|
| Rate for Payer: Aetna Managed Medicare |
$694.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,612.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,240.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,191.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,315.16
|
| Rate for Payer: Cash Price |
$715.80
|
| Rate for Payer: Cigna Commercial |
$2,282.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,388.65
|
| Rate for Payer: Health EOS Commercial |
$2,208.48
|
| Rate for Payer: HFN Commercial |
$2,282.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,861.08
|
| Rate for Payer: Multiplan Commercial |
$1,985.15
|
| Rate for Payer: NAPHCARE Commercial |
$1,488.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,282.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,215.91
|
| Rate for Payer: Quartz Commercial |
$1,612.94
|
| Rate for Payer: Quartz Medicare Advantage |
$1,488.86
|
| Rate for Payer: The Alliance Commercial |
$1,240.72
|
| Rate for Payer: WEA Trust Commercial |
$1,364.79
|
| Rate for Payer: WPS Commercial |
$1,837.94
|
|
|
SCREW 3.5 X 14 LOCK 30-0235
|
Facility
|
IP
|
$2,386.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,215.91 |
| Max. Negotiated Rate |
$2,282.92 |
| Rate for Payer: Aetna Commercial |
$2,233.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,134.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,315.16
|
| Rate for Payer: Cash Price |
$715.80
|
| Rate for Payer: Cigna Commercial |
$2,282.92
|
| Rate for Payer: Health EOS Commercial |
$2,208.48
|
| Rate for Payer: HFN Commercial |
$2,282.92
|
| Rate for Payer: Multiplan Commercial |
$1,985.15
|
| Rate for Payer: Preferred Network Access Commercial |
$2,282.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,215.91
|
| Rate for Payer: Quartz Commercial |
$1,488.86
|
| Rate for Payer: WEA Trust Commercial |
$1,364.79
|
| Rate for Payer: WPS Commercial |
$1,837.94
|
|
|
SCREW 3.5 X 14MM CORT C0-3140
|
Facility
|
IP
|
$1,135.00
|
|
| Hospital Charge Code |
2964160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$578.40 |
| Max. Negotiated Rate |
$1,085.97 |
| Rate for Payer: Aetna Commercial |
$1,062.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,015.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$625.61
|
| Rate for Payer: Cash Price |
$340.50
|
| Rate for Payer: Cigna Commercial |
$1,085.97
|
| Rate for Payer: Health EOS Commercial |
$1,050.56
|
| Rate for Payer: HFN Commercial |
$1,085.97
|
| Rate for Payer: Multiplan Commercial |
$944.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,085.97
|
| Rate for Payer: Quartz Beloit One Network |
$578.40
|
| Rate for Payer: Quartz Commercial |
$708.24
|
| Rate for Payer: WEA Trust Commercial |
$649.22
|
| Rate for Payer: WPS Commercial |
$874.29
|
|
|
SCREW 3.5 X 14MM CORT C0-3140
|
Facility
|
OP
|
$1,135.00
|
|
| Hospital Charge Code |
2964160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.51 |
| Max. Negotiated Rate |
$1,085.97 |
| Rate for Payer: Aetna Commercial |
$1,062.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,015.14
|
| Rate for Payer: Aetna Managed Medicare |
$330.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$767.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$590.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$566.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$625.61
|
| Rate for Payer: Cash Price |
$340.50
|
| Rate for Payer: Cigna Commercial |
$1,085.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$660.57
|
| Rate for Payer: Health EOS Commercial |
$1,050.56
|
| Rate for Payer: HFN Commercial |
$1,085.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$885.30
|
| Rate for Payer: Multiplan Commercial |
$944.32
|
| Rate for Payer: NAPHCARE Commercial |
$708.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,085.97
|
| Rate for Payer: Quartz Beloit One Network |
$578.40
|
| Rate for Payer: Quartz Commercial |
$767.26
|
| Rate for Payer: Quartz Medicare Advantage |
$708.24
|
| Rate for Payer: The Alliance Commercial |
$590.20
|
| Rate for Payer: WEA Trust Commercial |
$649.22
|
| Rate for Payer: WPS Commercial |
$874.29
|
|
|
SCREW 3.5x14 TI SF TAP CORTEX
|
Facility
|
OP
|
$523.00
|
|
| Hospital Charge Code |
2966497
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$500.41 |
| Rate for Payer: Aetna Commercial |
$489.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$467.77
|
| Rate for Payer: Aetna Managed Medicare |
$152.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$353.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$271.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$261.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$288.28
|
| Rate for Payer: Cash Price |
$156.90
|
| Rate for Payer: Cigna Commercial |
$500.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$304.39
|
| Rate for Payer: Health EOS Commercial |
$484.09
|
| Rate for Payer: HFN Commercial |
$500.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$407.94
|
| Rate for Payer: Multiplan Commercial |
$435.14
|
| Rate for Payer: NAPHCARE Commercial |
$326.35
|
| Rate for Payer: Preferred Network Access Commercial |
$500.41
|
| Rate for Payer: Quartz Beloit One Network |
$266.52
|
| Rate for Payer: Quartz Commercial |
$353.55
|
| Rate for Payer: Quartz Medicare Advantage |
$326.35
|
| Rate for Payer: The Alliance Commercial |
$271.96
|
| Rate for Payer: WEA Trust Commercial |
$299.16
|
| Rate for Payer: WPS Commercial |
$402.87
|
|
|
SCREW 3.5x14 TI SF TAP CORTEX
|
Facility
|
IP
|
$523.00
|
|
| Hospital Charge Code |
2966497
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$266.52 |
| Max. Negotiated Rate |
$500.41 |
| Rate for Payer: Aetna Commercial |
$489.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$467.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$288.28
|
| Rate for Payer: Cash Price |
$156.90
|
| Rate for Payer: Cigna Commercial |
$500.41
|
| Rate for Payer: Health EOS Commercial |
$484.09
|
| Rate for Payer: HFN Commercial |
$500.41
|
| Rate for Payer: Multiplan Commercial |
$435.14
|
| Rate for Payer: Preferred Network Access Commercial |
$500.41
|
| Rate for Payer: Quartz Beloit One Network |
$266.52
|
| Rate for Payer: Quartz Commercial |
$326.35
|
| Rate for Payer: WEA Trust Commercial |
$299.16
|
| Rate for Payer: WPS Commercial |
$402.87
|
|
|
SCREW 3.5 X 16 CORT 30-0259
|
Facility
|
OP
|
$1,708.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$497.37 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Aetna Managed Medicare |
$497.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,154.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$888.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$852.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$994.06
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,332.24
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: NAPHCARE Commercial |
$1,065.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,154.61
|
| Rate for Payer: Quartz Medicare Advantage |
$1,065.79
|
| Rate for Payer: The Alliance Commercial |
$888.16
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
SCREW 3.5 X 16 CORT 30-0259
|
Facility
|
IP
|
$1,708.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$870.40 |
| Max. Negotiated Rate |
$1,634.21 |
| Rate for Payer: Aetna Commercial |
$1,598.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,527.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$941.45
|
| Rate for Payer: Cash Price |
$512.40
|
| Rate for Payer: Cigna Commercial |
$1,634.21
|
| Rate for Payer: Health EOS Commercial |
$1,580.92
|
| Rate for Payer: HFN Commercial |
$1,634.21
|
| Rate for Payer: Multiplan Commercial |
$1,421.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,634.21
|
| Rate for Payer: Quartz Beloit One Network |
$870.40
|
| Rate for Payer: Quartz Commercial |
$1,065.79
|
| Rate for Payer: WEA Trust Commercial |
$976.98
|
| Rate for Payer: WPS Commercial |
$1,315.67
|
|
|
SCREW 3.5 X 16 LOCK 30-0236
|
Facility
|
OP
|
$2,386.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4594905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$694.80 |
| Max. Negotiated Rate |
$2,282.92 |
| Rate for Payer: Aetna Commercial |
$2,233.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,134.04
|
| Rate for Payer: Aetna Managed Medicare |
$694.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,612.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,240.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,191.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,315.16
|
| Rate for Payer: Cash Price |
$715.80
|
| Rate for Payer: Cigna Commercial |
$2,282.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,388.65
|
| Rate for Payer: Health EOS Commercial |
$2,208.48
|
| Rate for Payer: HFN Commercial |
$2,282.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,861.08
|
| Rate for Payer: Multiplan Commercial |
$1,985.15
|
| Rate for Payer: NAPHCARE Commercial |
$1,488.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,282.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,215.91
|
| Rate for Payer: Quartz Commercial |
$1,612.94
|
| Rate for Payer: Quartz Medicare Advantage |
$1,488.86
|
| Rate for Payer: The Alliance Commercial |
$1,240.72
|
| Rate for Payer: WEA Trust Commercial |
$1,364.79
|
| Rate for Payer: WPS Commercial |
$1,837.94
|
|
|
SCREW 3.5 X 16 LOCK 30-0236
|
Facility
|
IP
|
$2,386.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4594905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,215.91 |
| Max. Negotiated Rate |
$2,282.92 |
| Rate for Payer: Aetna Commercial |
$2,233.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,134.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,315.16
|
| Rate for Payer: Cash Price |
$715.80
|
| Rate for Payer: Cigna Commercial |
$2,282.92
|
| Rate for Payer: Health EOS Commercial |
$2,208.48
|
| Rate for Payer: HFN Commercial |
$2,282.92
|
| Rate for Payer: Multiplan Commercial |
$1,985.15
|
| Rate for Payer: Preferred Network Access Commercial |
$2,282.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,215.91
|
| Rate for Payer: Quartz Commercial |
$1,488.86
|
| Rate for Payer: WEA Trust Commercial |
$1,364.79
|
| Rate for Payer: WPS Commercial |
$1,837.94
|
|
