|
SCREW 5.0x38 TI ANGULAR STABLE
|
Facility
|
IP
|
$2,751.00
|
|
| Hospital Charge Code |
2966529
|
|
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 5.0x44 ANGULAR STABLE LK
|
Facility
|
OP
|
$2,852.00
|
|
| Hospital Charge Code |
2966531
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$830.50 |
| Max. Negotiated Rate |
$2,728.79 |
| Rate for Payer: Aetna Commercial |
$2,669.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,550.83
|
| Rate for Payer: Aetna Managed Medicare |
$830.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,927.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,483.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,423.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,572.02
|
| Rate for Payer: Cash Price |
$855.60
|
| Rate for Payer: Cigna Commercial |
$2,728.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,659.86
|
| Rate for Payer: Health EOS Commercial |
$2,639.81
|
| Rate for Payer: HFN Commercial |
$2,728.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,224.56
|
| Rate for Payer: Multiplan Commercial |
$2,372.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,779.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,728.79
|
| Rate for Payer: Quartz Beloit One Network |
$1,453.38
|
| Rate for Payer: Quartz Commercial |
$1,927.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,779.65
|
| Rate for Payer: The Alliance Commercial |
$1,483.04
|
| Rate for Payer: WEA Trust Commercial |
$1,631.34
|
| Rate for Payer: WPS Commercial |
$2,196.90
|
|
|
SCREW 5.0x44 ANGULAR STABLE LK
|
Facility
|
IP
|
$2,852.00
|
|
| Hospital Charge Code |
2966531
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,453.38 |
| Max. Negotiated Rate |
$2,728.79 |
| Rate for Payer: Aetna Commercial |
$2,669.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,550.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,572.02
|
| Rate for Payer: Cash Price |
$855.60
|
| Rate for Payer: Cigna Commercial |
$2,728.79
|
| Rate for Payer: Health EOS Commercial |
$2,639.81
|
| Rate for Payer: HFN Commercial |
$2,728.79
|
| Rate for Payer: Multiplan Commercial |
$2,372.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,728.79
|
| Rate for Payer: Quartz Beloit One Network |
$1,453.38
|
| Rate for Payer: Quartz Commercial |
$1,779.65
|
| Rate for Payer: WEA Trust Commercial |
$1,631.34
|
| Rate for Payer: WPS Commercial |
$2,196.90
|
|
|
SCREW 5.0x48 ANGULAR STABLE LK
|
Facility
|
OP
|
$2,751.00
|
|
| Hospital Charge Code |
2966532
|
|
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 5.0x48 ANGULAR STABLE LK
|
Facility
|
IP
|
$2,751.00
|
|
| Hospital Charge Code |
2966532
|
|
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 5.0x65MM CORE LOCKING
|
Facility
|
OP
|
$3,007.00
|
|
| Hospital Charge Code |
2966533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$875.64 |
| Max. Negotiated Rate |
$2,877.10 |
| Rate for Payer: Aetna Commercial |
$2,814.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,689.46
|
| Rate for Payer: Aetna Managed Medicare |
$875.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,032.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,563.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,501.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,657.46
|
| Rate for Payer: Cash Price |
$902.10
|
| Rate for Payer: Cigna Commercial |
$2,877.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,750.07
|
| Rate for Payer: Health EOS Commercial |
$2,783.28
|
| Rate for Payer: HFN Commercial |
$2,877.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,345.46
|
| Rate for Payer: Multiplan Commercial |
$2,501.82
|
| Rate for Payer: NAPHCARE Commercial |
$1,876.37
|
| Rate for Payer: Preferred Network Access Commercial |
$2,877.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,532.37
|
| Rate for Payer: Quartz Commercial |
$2,032.73
|
| Rate for Payer: Quartz Medicare Advantage |
$1,876.37
|
| Rate for Payer: The Alliance Commercial |
$1,563.64
|
| Rate for Payer: WEA Trust Commercial |
$1,720.00
|
| Rate for Payer: WPS Commercial |
$2,316.29
|
|
|
SCREW 5.0x65MM CORE LOCKING
|
Facility
|
IP
|
$3,007.00
|
|
| Hospital Charge Code |
2966533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,532.37 |
| Max. Negotiated Rate |
$2,877.10 |
| Rate for Payer: Aetna Commercial |
$2,814.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,689.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,657.46
|
| Rate for Payer: Cash Price |
$902.10
|
| Rate for Payer: Cigna Commercial |
$2,877.10
|
| Rate for Payer: Health EOS Commercial |
$2,783.28
|
| Rate for Payer: HFN Commercial |
$2,877.10
|
| Rate for Payer: Multiplan Commercial |
$2,501.82
|
| Rate for Payer: Preferred Network Access Commercial |
$2,877.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,532.37
|
| Rate for Payer: Quartz Commercial |
$1,876.37
|
| Rate for Payer: WEA Trust Commercial |
$1,720.00
|
| Rate for Payer: WPS Commercial |
$2,316.29
|
|
|
SCREW 5.0x70MM CORE LOCKING
|
Facility
|
OP
|
$3,007.00
|
|
| Hospital Charge Code |
2966535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$875.64 |
| Max. Negotiated Rate |
$2,877.10 |
| Rate for Payer: Aetna Commercial |
$2,814.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,689.46
|
| Rate for Payer: Aetna Managed Medicare |
$875.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,032.73
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,563.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,501.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,657.46
|
| Rate for Payer: Cash Price |
$902.10
|
| Rate for Payer: Cigna Commercial |
$2,877.10
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,750.07
|
| Rate for Payer: Health EOS Commercial |
$2,783.28
|
| Rate for Payer: HFN Commercial |
$2,877.10
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,345.46
|
| Rate for Payer: Multiplan Commercial |
$2,501.82
|
| Rate for Payer: NAPHCARE Commercial |
$1,876.37
|
| Rate for Payer: Preferred Network Access Commercial |
$2,877.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,532.37
|
| Rate for Payer: Quartz Commercial |
$2,032.73
|
| Rate for Payer: Quartz Medicare Advantage |
$1,876.37
|
| Rate for Payer: The Alliance Commercial |
$1,563.64
|
| Rate for Payer: WEA Trust Commercial |
$1,720.00
|
| Rate for Payer: WPS Commercial |
$2,316.29
|
|
|
SCREW 5.0x70MM CORE LOCKING
|
Facility
|
IP
|
$3,007.00
|
|
| Hospital Charge Code |
2966535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,532.37 |
| Max. Negotiated Rate |
$2,877.10 |
| Rate for Payer: Aetna Commercial |
$2,814.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,689.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,657.46
|
| Rate for Payer: Cash Price |
$902.10
|
| Rate for Payer: Cigna Commercial |
$2,877.10
|
| Rate for Payer: Health EOS Commercial |
$2,783.28
|
| Rate for Payer: HFN Commercial |
$2,877.10
|
| Rate for Payer: Multiplan Commercial |
$2,501.82
|
| Rate for Payer: Preferred Network Access Commercial |
$2,877.10
|
| Rate for Payer: Quartz Beloit One Network |
$1,532.37
|
| Rate for Payer: Quartz Commercial |
$1,876.37
|
| Rate for Payer: WEA Trust Commercial |
$1,720.00
|
| Rate for Payer: WPS Commercial |
$2,316.29
|
|
|
SCREW 5.0x70 TI ANGULAR STABLE
|
Facility
|
OP
|
$2,751.00
|
|
| Hospital Charge Code |
2966534
|
|
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 5.0x70 TI ANGULAR STABLE
|
Facility
|
IP
|
$2,751.00
|
|
| Hospital Charge Code |
2966534
|
|
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 5.0x85 02.205.085 CANN
|
Facility
|
IP
|
$827.00
|
|
| Hospital Charge Code |
3116530
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$421.44 |
| Max. Negotiated Rate |
$791.27 |
| Rate for Payer: Aetna Commercial |
$774.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$739.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$455.84
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cigna Commercial |
$791.27
|
| Rate for Payer: Health EOS Commercial |
$765.47
|
| Rate for Payer: HFN Commercial |
$791.27
|
| Rate for Payer: Multiplan Commercial |
$688.06
|
| Rate for Payer: Preferred Network Access Commercial |
$791.27
|
| Rate for Payer: Quartz Beloit One Network |
$421.44
|
| Rate for Payer: Quartz Commercial |
$516.05
|
| Rate for Payer: WEA Trust Commercial |
$473.04
|
| Rate for Payer: WPS Commercial |
$637.04
|
|
|
SCREW 5.0x85 02.205.085 CANN
|
Facility
|
OP
|
$827.00
|
|
| Hospital Charge Code |
3116530
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$240.82 |
| Max. Negotiated Rate |
$791.27 |
| Rate for Payer: Aetna Commercial |
$774.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$739.67
|
| Rate for Payer: Aetna Managed Medicare |
$240.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$559.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$430.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$412.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$455.84
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cigna Commercial |
$791.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$481.31
|
| Rate for Payer: Health EOS Commercial |
$765.47
|
| Rate for Payer: HFN Commercial |
$791.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$645.06
|
| Rate for Payer: Multiplan Commercial |
$688.06
|
| Rate for Payer: NAPHCARE Commercial |
$516.05
|
| Rate for Payer: Preferred Network Access Commercial |
$791.27
|
| Rate for Payer: Quartz Beloit One Network |
$421.44
|
| Rate for Payer: Quartz Commercial |
$559.05
|
| Rate for Payer: Quartz Medicare Advantage |
$516.05
|
| Rate for Payer: The Alliance Commercial |
$430.04
|
| Rate for Payer: WEA Trust Commercial |
$473.04
|
| Rate for Payer: WPS Commercial |
$637.04
|
|
|
SCREW 7.3X85 CANNULATED
|
Facility
|
IP
|
$3,336.00
|
|
| Hospital Charge Code |
2966541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,700.03 |
| Max. Negotiated Rate |
$3,191.88 |
| Rate for Payer: Aetna Commercial |
$3,122.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,983.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,838.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: Cigna Commercial |
$3,191.88
|
| Rate for Payer: Health EOS Commercial |
$3,087.80
|
| Rate for Payer: HFN Commercial |
$3,191.88
|
| Rate for Payer: Multiplan Commercial |
$2,775.55
|
| Rate for Payer: Preferred Network Access Commercial |
$3,191.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,700.03
|
| Rate for Payer: Quartz Commercial |
$2,081.66
|
| Rate for Payer: WEA Trust Commercial |
$1,908.19
|
| Rate for Payer: WPS Commercial |
$2,569.72
|
|
|
SCREW 7.3X85 CANNULATED
|
Facility
|
OP
|
$3,336.00
|
|
| Hospital Charge Code |
2966541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.44 |
| Max. Negotiated Rate |
$3,191.88 |
| Rate for Payer: Aetna Commercial |
$3,122.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,983.72
|
| Rate for Payer: Aetna Managed Medicare |
$971.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,255.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,734.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,665.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,838.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: Cigna Commercial |
$3,191.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,941.55
|
| Rate for Payer: Health EOS Commercial |
$3,087.80
|
| Rate for Payer: HFN Commercial |
$3,191.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,602.08
|
| Rate for Payer: Multiplan Commercial |
$2,775.55
|
| Rate for Payer: NAPHCARE Commercial |
$2,081.66
|
| Rate for Payer: Preferred Network Access Commercial |
$3,191.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,700.03
|
| Rate for Payer: Quartz Commercial |
$2,255.14
|
| Rate for Payer: Quartz Medicare Advantage |
$2,081.66
|
| Rate for Payer: The Alliance Commercial |
$1,734.72
|
| Rate for Payer: WEA Trust Commercial |
$1,908.19
|
| Rate for Payer: WPS Commercial |
$2,569.72
|
|
|
SCREW 7.3X95 CANNULATED
|
Facility
|
IP
|
$3,336.00
|
|
| Hospital Charge Code |
2969387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,700.03 |
| Max. Negotiated Rate |
$3,191.88 |
| Rate for Payer: Aetna Commercial |
$3,122.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,983.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,838.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: Cigna Commercial |
$3,191.88
|
| Rate for Payer: Health EOS Commercial |
$3,087.80
|
| Rate for Payer: HFN Commercial |
$3,191.88
|
| Rate for Payer: Multiplan Commercial |
$2,775.55
|
| Rate for Payer: Preferred Network Access Commercial |
$3,191.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,700.03
|
| Rate for Payer: Quartz Commercial |
$2,081.66
|
| Rate for Payer: WEA Trust Commercial |
$1,908.19
|
| Rate for Payer: WPS Commercial |
$2,569.72
|
|
|
SCREW 7.3X95 CANNULATED
|
Facility
|
OP
|
$3,336.00
|
|
| Hospital Charge Code |
2969387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.44 |
| Max. Negotiated Rate |
$3,191.88 |
| Rate for Payer: Aetna Commercial |
$3,122.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,983.72
|
| Rate for Payer: Aetna Managed Medicare |
$971.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,255.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,734.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,665.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,838.80
|
| Rate for Payer: Cash Price |
$1,000.80
|
| Rate for Payer: Cigna Commercial |
$3,191.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,941.55
|
| Rate for Payer: Health EOS Commercial |
$3,087.80
|
| Rate for Payer: HFN Commercial |
$3,191.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,602.08
|
| Rate for Payer: Multiplan Commercial |
$2,775.55
|
| Rate for Payer: NAPHCARE Commercial |
$2,081.66
|
| Rate for Payer: Preferred Network Access Commercial |
$3,191.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,700.03
|
| Rate for Payer: Quartz Commercial |
$2,255.14
|
| Rate for Payer: Quartz Medicare Advantage |
$2,081.66
|
| Rate for Payer: The Alliance Commercial |
$1,734.72
|
| Rate for Payer: WEA Trust Commercial |
$1,908.19
|
| Rate for Payer: WPS Commercial |
$2,569.72
|
|
|
SCREW 8X28 BIO COMPOSITE AR-1380TC
|
Facility
|
OP
|
$3,929.00
|
|
| Hospital Charge Code |
2964696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,144.12 |
| Max. Negotiated Rate |
$3,759.27 |
| Rate for Payer: Aetna Commercial |
$3,677.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,514.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,144.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,656.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,043.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,961.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,165.66
|
| Rate for Payer: Cash Price |
$1,178.70
|
| Rate for Payer: Cigna Commercial |
$3,759.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,286.68
|
| Rate for Payer: Health EOS Commercial |
$3,636.68
|
| Rate for Payer: HFN Commercial |
$3,759.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,064.62
|
| Rate for Payer: Multiplan Commercial |
$3,268.93
|
| Rate for Payer: NAPHCARE Commercial |
$2,451.70
|
| Rate for Payer: Preferred Network Access Commercial |
$3,759.27
|
| Rate for Payer: Quartz Beloit One Network |
$2,002.22
|
| Rate for Payer: Quartz Commercial |
$2,656.00
|
| Rate for Payer: Quartz Medicare Advantage |
$2,451.70
|
| Rate for Payer: The Alliance Commercial |
$2,043.08
|
| Rate for Payer: WEA Trust Commercial |
$2,247.39
|
| Rate for Payer: WPS Commercial |
$3,026.51
|
|
|
SCREW 8X28 BIO COMPOSITE AR-1380TC
|
Facility
|
IP
|
$3,929.00
|
|
| Hospital Charge Code |
2964696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,002.22 |
| Max. Negotiated Rate |
$3,759.27 |
| Rate for Payer: Aetna Commercial |
$3,677.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,514.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,165.66
|
| Rate for Payer: Cash Price |
$1,178.70
|
| Rate for Payer: Cigna Commercial |
$3,759.27
|
| Rate for Payer: Health EOS Commercial |
$3,636.68
|
| Rate for Payer: HFN Commercial |
$3,759.27
|
| Rate for Payer: Multiplan Commercial |
$3,268.93
|
| Rate for Payer: Preferred Network Access Commercial |
$3,759.27
|
| Rate for Payer: Quartz Beloit One Network |
$2,002.22
|
| Rate for Payer: Quartz Commercial |
$2,451.70
|
| Rate for Payer: WEA Trust Commercial |
$2,247.39
|
| Rate for Payer: WPS Commercial |
$3,026.51
|
|
|
SCREW 9 X 23MM PEEK INTERFERANCE AR-1390P
|
Facility
|
IP
|
$4,366.00
|
|
| Hospital Charge Code |
4520292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,224.91 |
| Max. Negotiated Rate |
$4,177.39 |
| Rate for Payer: Aetna Commercial |
$4,086.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,904.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,406.54
|
| Rate for Payer: Cash Price |
$1,309.80
|
| Rate for Payer: Cigna Commercial |
$4,177.39
|
| Rate for Payer: Health EOS Commercial |
$4,041.17
|
| Rate for Payer: HFN Commercial |
$4,177.39
|
| Rate for Payer: Multiplan Commercial |
$3,632.51
|
| Rate for Payer: Preferred Network Access Commercial |
$4,177.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,224.91
|
| Rate for Payer: Quartz Commercial |
$2,724.38
|
| Rate for Payer: WEA Trust Commercial |
$2,497.35
|
| Rate for Payer: WPS Commercial |
$3,363.13
|
|
|
SCREW 9 X 23MM PEEK INTERFERANCE AR-1390P
|
Facility
|
OP
|
$4,366.00
|
|
| Hospital Charge Code |
4520292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.38 |
| Max. Negotiated Rate |
$4,177.39 |
| Rate for Payer: Aetna Commercial |
$4,086.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,904.95
|
| Rate for Payer: Aetna Managed Medicare |
$1,271.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,951.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,270.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,179.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,406.54
|
| Rate for Payer: Cash Price |
$1,309.80
|
| Rate for Payer: Cigna Commercial |
$4,177.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,541.01
|
| Rate for Payer: Health EOS Commercial |
$4,041.17
|
| Rate for Payer: HFN Commercial |
$4,177.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,405.48
|
| Rate for Payer: Multiplan Commercial |
$3,632.51
|
| Rate for Payer: NAPHCARE Commercial |
$2,724.38
|
| Rate for Payer: Preferred Network Access Commercial |
$4,177.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,224.91
|
| Rate for Payer: Quartz Commercial |
$2,951.42
|
| Rate for Payer: Quartz Medicare Advantage |
$2,724.38
|
| Rate for Payer: The Alliance Commercial |
$2,270.32
|
| Rate for Payer: WEA Trust Commercial |
$2,497.35
|
| Rate for Payer: WPS Commercial |
$3,363.13
|
|
|
SCREW 9 X 28 TRANSFIX FULLTHREAD AR-1390TC
|
Facility
|
IP
|
$3,929.00
|
|
| Hospital Charge Code |
2964697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,002.22 |
| Max. Negotiated Rate |
$3,759.27 |
| Rate for Payer: Aetna Commercial |
$3,677.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,514.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,165.66
|
| Rate for Payer: Cash Price |
$1,178.70
|
| Rate for Payer: Cigna Commercial |
$3,759.27
|
| Rate for Payer: Health EOS Commercial |
$3,636.68
|
| Rate for Payer: HFN Commercial |
$3,759.27
|
| Rate for Payer: Multiplan Commercial |
$3,268.93
|
| Rate for Payer: Preferred Network Access Commercial |
$3,759.27
|
| Rate for Payer: Quartz Beloit One Network |
$2,002.22
|
| Rate for Payer: Quartz Commercial |
$2,451.70
|
| Rate for Payer: WEA Trust Commercial |
$2,247.39
|
| Rate for Payer: WPS Commercial |
$3,026.51
|
|
|
SCREW 9 X 28 TRANSFIX FULLTHREAD AR-1390TC
|
Facility
|
OP
|
$3,929.00
|
|
| Hospital Charge Code |
2964697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,144.12 |
| Max. Negotiated Rate |
$3,759.27 |
| Rate for Payer: Aetna Commercial |
$3,677.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,514.10
|
| Rate for Payer: Aetna Managed Medicare |
$1,144.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,656.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,043.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,961.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,165.66
|
| Rate for Payer: Cash Price |
$1,178.70
|
| Rate for Payer: Cigna Commercial |
$3,759.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,286.68
|
| Rate for Payer: Health EOS Commercial |
$3,636.68
|
| Rate for Payer: HFN Commercial |
$3,759.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,064.62
|
| Rate for Payer: Multiplan Commercial |
$3,268.93
|
| Rate for Payer: NAPHCARE Commercial |
$2,451.70
|
| Rate for Payer: Preferred Network Access Commercial |
$3,759.27
|
| Rate for Payer: Quartz Beloit One Network |
$2,002.22
|
| Rate for Payer: Quartz Commercial |
$2,656.00
|
| Rate for Payer: Quartz Medicare Advantage |
$2,451.70
|
| Rate for Payer: The Alliance Commercial |
$2,043.08
|
| Rate for Payer: WEA Trust Commercial |
$2,247.39
|
| Rate for Payer: WPS Commercial |
$3,026.51
|
|
|
SCREW ACETABULAR G7 6.5MM X 25MM 010000998
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
6065708
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$301.17 |
| Max. Negotiated Rate |
$565.47 |
| Rate for Payer: Aetna Commercial |
$553.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$528.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$325.76
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cigna Commercial |
$565.47
|
| Rate for Payer: Health EOS Commercial |
$547.03
|
| Rate for Payer: HFN Commercial |
$565.47
|
| Rate for Payer: Multiplan Commercial |
$491.71
|
| Rate for Payer: Preferred Network Access Commercial |
$565.47
|
| Rate for Payer: Quartz Beloit One Network |
$301.17
|
| Rate for Payer: Quartz Commercial |
$368.78
|
| Rate for Payer: WEA Trust Commercial |
$338.05
|
| Rate for Payer: WPS Commercial |
$455.25
|
|
|
SCREW ACETABULAR G7 6.5MM X 25MM 010000998
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
6065708
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.10 |
| Max. Negotiated Rate |
$565.47 |
| Rate for Payer: Aetna Commercial |
$553.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$528.59
|
| Rate for Payer: Aetna Managed Medicare |
$172.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$399.52
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$307.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$295.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$325.76
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cigna Commercial |
$565.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$343.96
|
| Rate for Payer: Health EOS Commercial |
$547.03
|
| Rate for Payer: HFN Commercial |
$565.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$460.98
|
| Rate for Payer: Multiplan Commercial |
$491.71
|
| Rate for Payer: NAPHCARE Commercial |
$368.78
|
| Rate for Payer: Preferred Network Access Commercial |
$565.47
|
| Rate for Payer: Quartz Beloit One Network |
$301.17
|
| Rate for Payer: Quartz Commercial |
$399.52
|
| Rate for Payer: Quartz Medicare Advantage |
$368.78
|
| Rate for Payer: The Alliance Commercial |
$307.32
|
| Rate for Payer: WEA Trust Commercial |
$338.05
|
| Rate for Payer: WPS Commercial |
$455.25
|
|
