|
SCREW 4.5X16 214.816
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966921
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.65 |
| Max. Negotiated Rate |
$463.09 |
| Rate for Payer: Aetna Commercial |
$453.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$432.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$266.78
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$463.09
|
| Rate for Payer: Health EOS Commercial |
$447.99
|
| Rate for Payer: HFN Commercial |
$463.09
|
| Rate for Payer: Multiplan Commercial |
$402.69
|
| Rate for Payer: Preferred Network Access Commercial |
$463.09
|
| Rate for Payer: Quartz Beloit One Network |
$246.65
|
| Rate for Payer: Quartz Commercial |
$302.02
|
| Rate for Payer: WEA Trust Commercial |
$276.85
|
| Rate for Payer: WPS Commercial |
$372.83
|
|
|
SCREW 4.5X16 214.816
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966921
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.94 |
| Max. Negotiated Rate |
$463.09 |
| Rate for Payer: Aetna Commercial |
$453.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$432.89
|
| Rate for Payer: Aetna Managed Medicare |
$140.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$327.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$251.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$241.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$266.78
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$463.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$281.69
|
| Rate for Payer: Health EOS Commercial |
$447.99
|
| Rate for Payer: HFN Commercial |
$463.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$377.52
|
| Rate for Payer: Multiplan Commercial |
$402.69
|
| Rate for Payer: NAPHCARE Commercial |
$302.02
|
| Rate for Payer: Preferred Network Access Commercial |
$463.09
|
| Rate for Payer: Quartz Beloit One Network |
$246.65
|
| Rate for Payer: Quartz Commercial |
$327.18
|
| Rate for Payer: Quartz Medicare Advantage |
$302.02
|
| Rate for Payer: The Alliance Commercial |
$251.68
|
| Rate for Payer: WEA Trust Commercial |
$276.85
|
| Rate for Payer: WPS Commercial |
$372.83
|
|
|
SCREW 4.5X18 214.818
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966922
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.70 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Aetna Managed Medicare |
$135.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$315.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$242.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$232.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$271.21
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$363.48
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: NAPHCARE Commercial |
$290.78
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$315.02
|
| Rate for Payer: Quartz Medicare Advantage |
$290.78
|
| Rate for Payer: The Alliance Commercial |
$242.32
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X18 214.818
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966922
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$237.47 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$290.78
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X20 214.820
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966923
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.70 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Aetna Managed Medicare |
$135.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$315.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$242.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$232.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$271.21
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$363.48
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: NAPHCARE Commercial |
$290.78
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$315.02
|
| Rate for Payer: Quartz Medicare Advantage |
$290.78
|
| Rate for Payer: The Alliance Commercial |
$242.32
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X20 214.820
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966923
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$237.47 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$290.78
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X22 214.822
|
Facility
|
OP
|
$466.00
|
|
| Hospital Charge Code |
2966924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.70 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Aetna Managed Medicare |
$135.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$315.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$242.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$232.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$271.21
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$363.48
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: NAPHCARE Commercial |
$290.78
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$315.02
|
| Rate for Payer: Quartz Medicare Advantage |
$290.78
|
| Rate for Payer: The Alliance Commercial |
$242.32
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X22 214.822
|
Facility
|
IP
|
$466.00
|
|
| Hospital Charge Code |
2966924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$237.47 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$290.78
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X24 214.824
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.94 |
| Max. Negotiated Rate |
$463.09 |
| Rate for Payer: Aetna Commercial |
$453.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$432.89
|
| Rate for Payer: Aetna Managed Medicare |
$140.94
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$327.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$251.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$241.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$266.78
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$463.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$281.69
|
| Rate for Payer: Health EOS Commercial |
$447.99
|
| Rate for Payer: HFN Commercial |
$463.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$377.52
|
| Rate for Payer: Multiplan Commercial |
$402.69
|
| Rate for Payer: NAPHCARE Commercial |
$302.02
|
| Rate for Payer: Preferred Network Access Commercial |
$463.09
|
| Rate for Payer: Quartz Beloit One Network |
$246.65
|
| Rate for Payer: Quartz Commercial |
$327.18
|
| Rate for Payer: Quartz Medicare Advantage |
$302.02
|
| Rate for Payer: The Alliance Commercial |
$251.68
|
| Rate for Payer: WEA Trust Commercial |
$276.85
|
| Rate for Payer: WPS Commercial |
$372.83
|
|
|
SCREW 4.5X24 214.824
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.65 |
| Max. Negotiated Rate |
$463.09 |
| Rate for Payer: Aetna Commercial |
$453.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$432.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$266.78
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cigna Commercial |
$463.09
|
| Rate for Payer: Health EOS Commercial |
$447.99
|
| Rate for Payer: HFN Commercial |
$463.09
|
| Rate for Payer: Multiplan Commercial |
$402.69
|
| Rate for Payer: Preferred Network Access Commercial |
$463.09
|
| Rate for Payer: Quartz Beloit One Network |
$246.65
|
| Rate for Payer: Quartz Commercial |
$302.02
|
| Rate for Payer: WEA Trust Commercial |
$276.85
|
| Rate for Payer: WPS Commercial |
$372.83
|
|
|
SCREW 4.5X26 214.826
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966926
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.70 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Aetna Managed Medicare |
$135.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$315.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$242.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$232.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$271.21
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$363.48
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: NAPHCARE Commercial |
$290.78
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$315.02
|
| Rate for Payer: Quartz Medicare Advantage |
$290.78
|
| Rate for Payer: The Alliance Commercial |
$242.32
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5X26 214.826
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966926
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$237.47 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$290.78
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
SCREW 4.5x38 MULTILOC
|
Facility
|
IP
|
$3,651.00
|
|
| Hospital Charge Code |
2966521
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,860.55 |
| Max. Negotiated Rate |
$3,493.28 |
| Rate for Payer: Aetna Commercial |
$3,417.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,265.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,012.43
|
| Rate for Payer: Cash Price |
$1,095.30
|
| Rate for Payer: Cigna Commercial |
$3,493.28
|
| Rate for Payer: Health EOS Commercial |
$3,379.37
|
| Rate for Payer: HFN Commercial |
$3,493.28
|
| Rate for Payer: Multiplan Commercial |
$3,037.63
|
| Rate for Payer: Preferred Network Access Commercial |
$3,493.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,860.55
|
| Rate for Payer: Quartz Commercial |
$2,278.22
|
| Rate for Payer: WEA Trust Commercial |
$2,088.37
|
| Rate for Payer: WPS Commercial |
$2,812.37
|
|
|
SCREW 4.5x38 MULTILOC
|
Facility
|
OP
|
$3,651.00
|
|
| Hospital Charge Code |
2966521
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,063.17 |
| Max. Negotiated Rate |
$3,493.28 |
| Rate for Payer: Aetna Commercial |
$3,417.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,265.45
|
| Rate for Payer: Aetna Managed Medicare |
$1,063.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,468.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,898.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,822.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,012.43
|
| Rate for Payer: Cash Price |
$1,095.30
|
| Rate for Payer: Cigna Commercial |
$3,493.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,124.88
|
| Rate for Payer: Health EOS Commercial |
$3,379.37
|
| Rate for Payer: HFN Commercial |
$3,493.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,847.78
|
| Rate for Payer: Multiplan Commercial |
$3,037.63
|
| Rate for Payer: NAPHCARE Commercial |
$2,278.22
|
| Rate for Payer: Preferred Network Access Commercial |
$3,493.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,860.55
|
| Rate for Payer: Quartz Commercial |
$2,468.08
|
| Rate for Payer: Quartz Medicare Advantage |
$2,278.22
|
| Rate for Payer: The Alliance Commercial |
$1,898.52
|
| Rate for Payer: WEA Trust Commercial |
$2,088.37
|
| Rate for Payer: WPS Commercial |
$2,812.37
|
|
|
SCREW 4.5x40 MULTILOC
|
Facility
|
IP
|
$3,651.00
|
|
| Hospital Charge Code |
2966522
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,860.55 |
| Max. Negotiated Rate |
$3,493.28 |
| Rate for Payer: Aetna Commercial |
$3,417.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,265.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,012.43
|
| Rate for Payer: Cash Price |
$1,095.30
|
| Rate for Payer: Cigna Commercial |
$3,493.28
|
| Rate for Payer: Health EOS Commercial |
$3,379.37
|
| Rate for Payer: HFN Commercial |
$3,493.28
|
| Rate for Payer: Multiplan Commercial |
$3,037.63
|
| Rate for Payer: Preferred Network Access Commercial |
$3,493.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,860.55
|
| Rate for Payer: Quartz Commercial |
$2,278.22
|
| Rate for Payer: WEA Trust Commercial |
$2,088.37
|
| Rate for Payer: WPS Commercial |
$2,812.37
|
|
|
SCREW 4.5x40 MULTILOC
|
Facility
|
OP
|
$3,651.00
|
|
| Hospital Charge Code |
2966522
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,063.17 |
| Max. Negotiated Rate |
$3,493.28 |
| Rate for Payer: Aetna Commercial |
$3,417.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,265.45
|
| Rate for Payer: Aetna Managed Medicare |
$1,063.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,468.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,898.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,822.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,012.43
|
| Rate for Payer: Cash Price |
$1,095.30
|
| Rate for Payer: Cigna Commercial |
$3,493.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,124.88
|
| Rate for Payer: Health EOS Commercial |
$3,379.37
|
| Rate for Payer: HFN Commercial |
$3,493.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,847.78
|
| Rate for Payer: Multiplan Commercial |
$3,037.63
|
| Rate for Payer: NAPHCARE Commercial |
$2,278.22
|
| Rate for Payer: Preferred Network Access Commercial |
$3,493.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,860.55
|
| Rate for Payer: Quartz Commercial |
$2,468.08
|
| Rate for Payer: Quartz Medicare Advantage |
$2,278.22
|
| Rate for Payer: The Alliance Commercial |
$1,898.52
|
| Rate for Payer: WEA Trust Commercial |
$2,088.37
|
| Rate for Payer: WPS Commercial |
$2,812.37
|
|
|
SCREW 4.O CANNULATED SPIDER
|
Facility
|
OP
|
$3,008.00
|
|
| Hospital Charge Code |
2965018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$875.93 |
| Max. Negotiated Rate |
$2,878.05 |
| Rate for Payer: Aetna Commercial |
$2,815.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,690.36
|
| Rate for Payer: Aetna Managed Medicare |
$875.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,033.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,564.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,501.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,658.01
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cigna Commercial |
$2,878.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,750.66
|
| Rate for Payer: Health EOS Commercial |
$2,784.20
|
| Rate for Payer: HFN Commercial |
$2,878.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,346.24
|
| Rate for Payer: Multiplan Commercial |
$2,502.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,876.99
|
| Rate for Payer: Preferred Network Access Commercial |
$2,878.05
|
| Rate for Payer: Quartz Beloit One Network |
$1,532.88
|
| Rate for Payer: Quartz Commercial |
$2,033.41
|
| Rate for Payer: Quartz Medicare Advantage |
$1,876.99
|
| Rate for Payer: The Alliance Commercial |
$1,564.16
|
| Rate for Payer: WEA Trust Commercial |
$1,720.58
|
| Rate for Payer: WPS Commercial |
$2,317.06
|
|
|
SCREW 4.O CANNULATED SPIDER
|
Facility
|
IP
|
$3,008.00
|
|
| Hospital Charge Code |
2965018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,532.88 |
| Max. Negotiated Rate |
$2,878.05 |
| Rate for Payer: Aetna Commercial |
$2,815.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,690.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,658.01
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cigna Commercial |
$2,878.05
|
| Rate for Payer: Health EOS Commercial |
$2,784.20
|
| Rate for Payer: HFN Commercial |
$2,878.05
|
| Rate for Payer: Multiplan Commercial |
$2,502.66
|
| Rate for Payer: Preferred Network Access Commercial |
$2,878.05
|
| Rate for Payer: Quartz Beloit One Network |
$1,532.88
|
| Rate for Payer: Quartz Commercial |
$1,876.99
|
| Rate for Payer: WEA Trust Commercial |
$1,720.58
|
| Rate for Payer: WPS Commercial |
$2,317.06
|
|
|
SCREW 5.0x10MM PERIPROSTHETIC
|
Facility
|
IP
|
$2,630.00
|
|
| Hospital Charge Code |
2966523
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.25 |
| Max. Negotiated Rate |
$2,516.38 |
| Rate for Payer: Aetna Commercial |
$2,461.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,352.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,449.66
|
| Rate for Payer: Cash Price |
$789.00
|
| Rate for Payer: Cigna Commercial |
$2,516.38
|
| Rate for Payer: Health EOS Commercial |
$2,434.33
|
| Rate for Payer: HFN Commercial |
$2,516.38
|
| Rate for Payer: Multiplan Commercial |
$2,188.16
|
| Rate for Payer: Preferred Network Access Commercial |
$2,516.38
|
| Rate for Payer: Quartz Beloit One Network |
$1,340.25
|
| Rate for Payer: Quartz Commercial |
$1,641.12
|
| Rate for Payer: WEA Trust Commercial |
$1,504.36
|
| Rate for Payer: WPS Commercial |
$2,025.89
|
|
|
SCREW 5.0x10MM PERIPROSTHETIC
|
Facility
|
OP
|
$2,630.00
|
|
| Hospital Charge Code |
2966523
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$765.86 |
| Max. Negotiated Rate |
$2,516.38 |
| Rate for Payer: Aetna Commercial |
$2,461.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,352.27
|
| Rate for Payer: Aetna Managed Medicare |
$765.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,777.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,367.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,312.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,449.66
|
| Rate for Payer: Cash Price |
$789.00
|
| Rate for Payer: Cigna Commercial |
$2,516.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,530.66
|
| Rate for Payer: Health EOS Commercial |
$2,434.33
|
| Rate for Payer: HFN Commercial |
$2,516.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,051.40
|
| Rate for Payer: Multiplan Commercial |
$2,188.16
|
| Rate for Payer: NAPHCARE Commercial |
$1,641.12
|
| Rate for Payer: Preferred Network Access Commercial |
$2,516.38
|
| Rate for Payer: Quartz Beloit One Network |
$1,340.25
|
| Rate for Payer: Quartz Commercial |
$1,777.88
|
| Rate for Payer: Quartz Medicare Advantage |
$1,641.12
|
| Rate for Payer: The Alliance Commercial |
$1,367.60
|
| Rate for Payer: WEA Trust Commercial |
$1,504.36
|
| Rate for Payer: WPS Commercial |
$2,025.89
|
|
|
SCREW 5.0 X 26 CANCELLOUS 71755026
|
Facility
|
OP
|
$2,260.00
|
|
| Hospital Charge Code |
2966036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$658.11 |
| Max. Negotiated Rate |
$2,162.37 |
| Rate for Payer: Aetna Commercial |
$2,115.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,021.34
|
| Rate for Payer: Aetna Managed Medicare |
$658.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,527.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,175.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,128.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,245.71
|
| Rate for Payer: Cash Price |
$678.00
|
| Rate for Payer: Cigna Commercial |
$2,162.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,315.32
|
| Rate for Payer: Health EOS Commercial |
$2,091.86
|
| Rate for Payer: HFN Commercial |
$2,162.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,762.80
|
| Rate for Payer: Multiplan Commercial |
$1,880.32
|
| Rate for Payer: NAPHCARE Commercial |
$1,410.24
|
| Rate for Payer: Preferred Network Access Commercial |
$2,162.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,151.70
|
| Rate for Payer: Quartz Commercial |
$1,527.76
|
| Rate for Payer: Quartz Medicare Advantage |
$1,410.24
|
| Rate for Payer: The Alliance Commercial |
$1,175.20
|
| Rate for Payer: WEA Trust Commercial |
$1,292.72
|
| Rate for Payer: WPS Commercial |
$1,740.88
|
|
|
SCREW 5.0 X 26 CANCELLOUS 71755026
|
Facility
|
IP
|
$2,260.00
|
|
| Hospital Charge Code |
2966036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,151.70 |
| Max. Negotiated Rate |
$2,162.37 |
| Rate for Payer: Aetna Commercial |
$2,115.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,021.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,245.71
|
| Rate for Payer: Cash Price |
$678.00
|
| Rate for Payer: Cigna Commercial |
$2,162.37
|
| Rate for Payer: Health EOS Commercial |
$2,091.86
|
| Rate for Payer: HFN Commercial |
$2,162.37
|
| Rate for Payer: Multiplan Commercial |
$1,880.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,162.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,151.70
|
| Rate for Payer: Quartz Commercial |
$1,410.24
|
| Rate for Payer: WEA Trust Commercial |
$1,292.72
|
| Rate for Payer: WPS Commercial |
$1,740.88
|
|
|
SCREW 5.0x36 ANGULAR STABLE LK
|
Facility
|
IP
|
$2,751.00
|
|
| Hospital Charge Code |
2966527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,401.91 |
| Max. Negotiated Rate |
$2,632.16 |
| Rate for Payer: Aetna Commercial |
$2,574.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,460.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,516.35
|
| Rate for Payer: Cash Price |
$825.30
|
| Rate for Payer: Cigna Commercial |
$2,632.16
|
| Rate for Payer: Health EOS Commercial |
$2,546.33
|
| Rate for Payer: HFN Commercial |
$2,632.16
|
| Rate for Payer: Multiplan Commercial |
$2,288.83
|
| Rate for Payer: Preferred Network Access Commercial |
$2,632.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,401.91
|
| Rate for Payer: Quartz Commercial |
$1,716.62
|
| Rate for Payer: WEA Trust Commercial |
$1,573.57
|
| Rate for Payer: WPS Commercial |
$2,119.10
|
|
|
SCREW 5.0x36 ANGULAR STABLE LK
|
Facility
|
OP
|
$2,751.00
|
|
| Hospital Charge Code |
2966527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$801.09 |
| Max. Negotiated Rate |
$2,632.16 |
| Rate for Payer: Aetna Commercial |
$2,574.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,460.49
|
| Rate for Payer: Aetna Managed Medicare |
$801.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,859.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,430.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,373.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,516.35
|
| Rate for Payer: Cash Price |
$825.30
|
| Rate for Payer: Cigna Commercial |
$2,632.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,601.08
|
| Rate for Payer: Health EOS Commercial |
$2,546.33
|
| Rate for Payer: HFN Commercial |
$2,632.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,145.78
|
| Rate for Payer: Multiplan Commercial |
$2,288.83
|
| Rate for Payer: NAPHCARE Commercial |
$1,716.62
|
| Rate for Payer: Preferred Network Access Commercial |
$2,632.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,401.91
|
| Rate for Payer: Quartz Commercial |
$1,859.68
|
| Rate for Payer: Quartz Medicare Advantage |
$1,716.62
|
| Rate for Payer: The Alliance Commercial |
$1,430.52
|
| Rate for Payer: WEA Trust Commercial |
$1,573.57
|
| Rate for Payer: WPS Commercial |
$2,119.10
|
|
|
SCREW 5.0x38 TI ANGULAR STABLE
|
Facility
|
OP
|
$2,751.00
|
|
| Hospital Charge Code |
2966529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$801.09 |
| Max. Negotiated Rate |
$2,632.16 |
| Rate for Payer: Aetna Commercial |
$2,574.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,460.49
|
| Rate for Payer: Aetna Managed Medicare |
$801.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,859.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,430.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,373.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,516.35
|
| Rate for Payer: Cash Price |
$825.30
|
| Rate for Payer: Cigna Commercial |
$2,632.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,601.08
|
| Rate for Payer: Health EOS Commercial |
$2,546.33
|
| Rate for Payer: HFN Commercial |
$2,632.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,145.78
|
| Rate for Payer: Multiplan Commercial |
$2,288.83
|
| Rate for Payer: NAPHCARE Commercial |
$1,716.62
|
| Rate for Payer: Preferred Network Access Commercial |
$2,632.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,401.91
|
| Rate for Payer: Quartz Commercial |
$1,859.68
|
| Rate for Payer: Quartz Medicare Advantage |
$1,716.62
|
| Rate for Payer: The Alliance Commercial |
$1,430.52
|
| Rate for Payer: WEA Trust Commercial |
$1,573.57
|
| Rate for Payer: WPS Commercial |
$2,119.10
|
|
