|
SCREW 3.5x16 LOCK CORTICAL
|
Facility
|
IP
|
$1,724.00
|
|
| Hospital Charge Code |
2964161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$878.55 |
| Max. Negotiated Rate |
$1,649.52 |
| Rate for Payer: Aetna Commercial |
$1,613.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,541.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.27
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cigna Commercial |
$1,649.52
|
| Rate for Payer: Health EOS Commercial |
$1,595.73
|
| Rate for Payer: HFN Commercial |
$1,649.52
|
| Rate for Payer: Multiplan Commercial |
$1,434.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,649.52
|
| Rate for Payer: Quartz Beloit One Network |
$878.55
|
| Rate for Payer: Quartz Commercial |
$1,075.78
|
| Rate for Payer: WEA Trust Commercial |
$986.13
|
| Rate for Payer: WPS Commercial |
$1,328.00
|
|
|
SCREW 3.5x16 LOCK CORTICAL
|
Facility
|
OP
|
$1,724.00
|
|
| Hospital Charge Code |
2964161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.03 |
| Max. Negotiated Rate |
$1,649.52 |
| Rate for Payer: Aetna Commercial |
$1,613.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,541.95
|
| Rate for Payer: Aetna Managed Medicare |
$502.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,165.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$896.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$860.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.27
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cigna Commercial |
$1,649.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,003.37
|
| Rate for Payer: Health EOS Commercial |
$1,595.73
|
| Rate for Payer: HFN Commercial |
$1,649.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,344.72
|
| Rate for Payer: Multiplan Commercial |
$1,434.37
|
| Rate for Payer: NAPHCARE Commercial |
$1,075.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,649.52
|
| Rate for Payer: Quartz Beloit One Network |
$878.55
|
| Rate for Payer: Quartz Commercial |
$1,165.42
|
| Rate for Payer: Quartz Medicare Advantage |
$1,075.78
|
| Rate for Payer: The Alliance Commercial |
$896.48
|
| Rate for Payer: WEA Trust Commercial |
$986.13
|
| Rate for Payer: WPS Commercial |
$1,328.00
|
|
|
SCREW 3.5 X 18 LOCK 30-0237
|
Facility
|
IP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,171.06 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,433.95
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
SCREW 3.5 X 18 LOCK 30-0237
|
Facility
|
OP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$669.18 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Aetna Managed Medicare |
$669.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,553.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,194.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,147.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,337.44
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,792.44
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,433.95
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,553.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,433.95
|
| Rate for Payer: The Alliance Commercial |
$1,194.96
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
SCREW 3.5 X 18MM TI CS18A
|
Facility
|
OP
|
$5,270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583412
|
|
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 3.5 X 18MM TI CS18A
|
Facility
|
IP
|
$5,270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583412
|
|
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 3.5 X 20 LOCK CORT COL-3200
|
Facility
|
OP
|
$1,724.00
|
|
| Hospital Charge Code |
2964162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.03 |
| Max. Negotiated Rate |
$1,649.52 |
| Rate for Payer: Aetna Commercial |
$1,613.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,541.95
|
| Rate for Payer: Aetna Managed Medicare |
$502.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,165.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$896.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$860.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.27
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cigna Commercial |
$1,649.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,003.37
|
| Rate for Payer: Health EOS Commercial |
$1,595.73
|
| Rate for Payer: HFN Commercial |
$1,649.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,344.72
|
| Rate for Payer: Multiplan Commercial |
$1,434.37
|
| Rate for Payer: NAPHCARE Commercial |
$1,075.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,649.52
|
| Rate for Payer: Quartz Beloit One Network |
$878.55
|
| Rate for Payer: Quartz Commercial |
$1,165.42
|
| Rate for Payer: Quartz Medicare Advantage |
$1,075.78
|
| Rate for Payer: The Alliance Commercial |
$896.48
|
| Rate for Payer: WEA Trust Commercial |
$986.13
|
| Rate for Payer: WPS Commercial |
$1,328.00
|
|
|
SCREW 3.5 X 20 LOCK CORT COL-3200
|
Facility
|
IP
|
$1,724.00
|
|
| Hospital Charge Code |
2964162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$878.55 |
| Max. Negotiated Rate |
$1,649.52 |
| Rate for Payer: Aetna Commercial |
$1,613.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,541.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$950.27
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cigna Commercial |
$1,649.52
|
| Rate for Payer: Health EOS Commercial |
$1,595.73
|
| Rate for Payer: HFN Commercial |
$1,649.52
|
| Rate for Payer: Multiplan Commercial |
$1,434.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,649.52
|
| Rate for Payer: Quartz Beloit One Network |
$878.55
|
| Rate for Payer: Quartz Commercial |
$1,075.78
|
| Rate for Payer: WEA Trust Commercial |
$986.13
|
| Rate for Payer: WPS Commercial |
$1,328.00
|
|
|
SCREW 3.5 X 22 CORT C0-3220
|
Facility
|
IP
|
$1,135.00
|
|
| Hospital Charge Code |
2964157
|
|
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 22 CORT C0-3220
|
Facility
|
OP
|
$1,135.00
|
|
| Hospital Charge Code |
2964157
|
|
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 3.5X24 LOCKING
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,249.25
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5X24 LOCKING
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Aetna Managed Medicare |
$582.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,353.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,041.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$999.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,165.16
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,561.56
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,249.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,353.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,249.25
|
| Rate for Payer: The Alliance Commercial |
$1,041.04
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5 X 28 LOCK 30-0242
|
Facility
|
OP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$669.18 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Aetna Managed Medicare |
$669.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,553.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,194.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,147.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,337.44
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,792.44
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,433.95
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,553.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,433.95
|
| Rate for Payer: The Alliance Commercial |
$1,194.96
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
SCREW 3.5 X 28 LOCK 30-0242
|
Facility
|
IP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,171.06 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,433.95
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
SCREW 3.5 X 30 LOCKING
|
Facility
|
OP
|
$1,728.00
|
|
| Hospital Charge Code |
2966495
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$503.19 |
| Max. Negotiated Rate |
$1,653.35 |
| Rate for Payer: Aetna Commercial |
$1,617.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,545.52
|
| Rate for Payer: Aetna Managed Medicare |
$503.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,168.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$898.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$862.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$952.47
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cigna Commercial |
$1,653.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,005.70
|
| Rate for Payer: Health EOS Commercial |
$1,599.44
|
| Rate for Payer: HFN Commercial |
$1,653.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,347.84
|
| Rate for Payer: Multiplan Commercial |
$1,437.70
|
| Rate for Payer: NAPHCARE Commercial |
$1,078.27
|
| Rate for Payer: Preferred Network Access Commercial |
$1,653.35
|
| Rate for Payer: Quartz Beloit One Network |
$880.59
|
| Rate for Payer: Quartz Commercial |
$1,168.13
|
| Rate for Payer: Quartz Medicare Advantage |
$1,078.27
|
| Rate for Payer: The Alliance Commercial |
$898.56
|
| Rate for Payer: WEA Trust Commercial |
$988.42
|
| Rate for Payer: WPS Commercial |
$1,331.08
|
|
|
SCREW 3.5 X 30 LOCKING
|
Facility
|
IP
|
$1,728.00
|
|
| Hospital Charge Code |
2966495
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$880.59 |
| Max. Negotiated Rate |
$1,653.35 |
| Rate for Payer: Aetna Commercial |
$1,617.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,545.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$952.47
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cigna Commercial |
$1,653.35
|
| Rate for Payer: Health EOS Commercial |
$1,599.44
|
| Rate for Payer: HFN Commercial |
$1,653.35
|
| Rate for Payer: Multiplan Commercial |
$1,437.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,653.35
|
| Rate for Payer: Quartz Beloit One Network |
$880.59
|
| Rate for Payer: Quartz Commercial |
$1,078.27
|
| Rate for Payer: WEA Trust Commercial |
$988.42
|
| Rate for Payer: WPS Commercial |
$1,331.08
|
|
|
SCREW 3.5x32 LOCKING 213.032
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966499
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,249.25
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5x32 LOCKING 213.032
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966499
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Aetna Managed Medicare |
$582.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,353.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,041.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$999.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,165.16
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,561.56
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,249.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,353.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,249.25
|
| Rate for Payer: The Alliance Commercial |
$1,041.04
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5X34 LOCKING
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,249.25
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5X34 LOCKING
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Aetna Managed Medicare |
$582.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,353.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,041.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$999.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,165.16
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,561.56
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,249.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,353.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,249.25
|
| Rate for Payer: The Alliance Commercial |
$1,041.04
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5x36 LOCKING 213.036
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Aetna Managed Medicare |
$582.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,353.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,041.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$999.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,165.16
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,561.56
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,249.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,353.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,249.25
|
| Rate for Payer: The Alliance Commercial |
$1,041.04
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5x36 LOCKING 213.036
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,249.25
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW 3.5 X 40 LOCK 30-0248
|
Facility
|
IP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,171.06 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,433.95
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
SCREW 3.5 X 40 LOCK 30-0248
|
Facility
|
OP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$669.18 |
| Max. Negotiated Rate |
$2,198.73 |
| Rate for Payer: Aetna Commercial |
$2,150.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,055.33
|
| Rate for Payer: Aetna Managed Medicare |
$669.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,553.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,194.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,147.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,266.66
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,198.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,337.44
|
| Rate for Payer: Health EOS Commercial |
$2,127.03
|
| Rate for Payer: HFN Commercial |
$2,198.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,792.44
|
| Rate for Payer: Multiplan Commercial |
$1,911.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,433.95
|
| Rate for Payer: Preferred Network Access Commercial |
$2,198.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,171.06
|
| Rate for Payer: Quartz Commercial |
$1,553.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,433.95
|
| Rate for Payer: The Alliance Commercial |
$1,194.96
|
| Rate for Payer: WEA Trust Commercial |
$1,314.46
|
| Rate for Payer: WPS Commercial |
$1,770.15
|
|
|
SCREW 4.0 CANNULATED 44MM
|
Facility
|
OP
|
$2,747.00
|
|
| Hospital Charge Code |
2965016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$799.93 |
| Max. Negotiated Rate |
$2,628.33 |
| Rate for Payer: Aetna Commercial |
$2,571.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,456.92
|
| Rate for Payer: Aetna Managed Medicare |
$799.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,856.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,428.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,371.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,514.15
|
| Rate for Payer: Cash Price |
$824.10
|
| Rate for Payer: Cigna Commercial |
$2,628.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,598.75
|
| Rate for Payer: Health EOS Commercial |
$2,542.62
|
| Rate for Payer: HFN Commercial |
$2,628.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,142.66
|
| Rate for Payer: Multiplan Commercial |
$2,285.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,714.13
|
| Rate for Payer: Preferred Network Access Commercial |
$2,628.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,399.87
|
| Rate for Payer: Quartz Commercial |
$1,856.97
|
| Rate for Payer: Quartz Medicare Advantage |
$1,714.13
|
| Rate for Payer: The Alliance Commercial |
$1,428.44
|
| Rate for Payer: WEA Trust Commercial |
$1,571.28
|
| Rate for Payer: WPS Commercial |
$2,116.01
|
|
