|
SCREW 1.5x22MM LOCKING 02.214.022
|
Facility
|
OP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$653.80 |
| Max. Negotiated Rate |
$9,340.00 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Aetna Managed Medicare |
$653.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,517.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,167.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,120.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,306.67
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,751.25
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,517.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,401.00
|
| Rate for Payer: The Alliance Commercial |
$9,340.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x24MM LOCKING 02.214.024
|
Facility
|
OP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4519462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$653.80 |
| Max. Negotiated Rate |
$9,340.00 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Aetna Managed Medicare |
$653.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,517.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,167.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,120.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,306.67
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,751.25
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,517.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,401.00
|
| Rate for Payer: The Alliance Commercial |
$9,340.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x24MM LOCKING 02.214.024
|
Facility
|
IP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4519462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,144.15 |
| Max. Negotiated Rate |
$2,148.20 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,401.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x6MM LOCKING SYNTHES 02.214.006
|
Facility
|
OP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$653.80 |
| Max. Negotiated Rate |
$9,340.00 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Aetna Managed Medicare |
$653.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,517.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,167.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,120.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,306.67
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,751.25
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,517.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,401.00
|
| Rate for Payer: The Alliance Commercial |
$9,340.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x6MM LOCKING SYNTHES 02.214.006
|
Facility
|
IP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,144.15 |
| Max. Negotiated Rate |
$2,148.20 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,401.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x7MM LOCKING SYNTHES 02.214.007
|
Facility
|
IP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508906
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,144.15 |
| Max. Negotiated Rate |
$2,148.20 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,401.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x7MM LOCKING SYNTHES 02.214.007
|
Facility
|
OP
|
$2,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508906
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$653.80 |
| Max. Negotiated Rate |
$9,340.00 |
| Rate for Payer: Aetna Commercial |
$2,101.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,008.10
|
| Rate for Payer: Aetna Managed Medicare |
$653.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,517.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,167.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,120.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,237.55
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$2,148.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,306.67
|
| Rate for Payer: Health EOS Commercial |
$2,078.15
|
| Rate for Payer: HFN Commercial |
$2,148.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,751.25
|
| Rate for Payer: Multiplan Commercial |
$1,868.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,401.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,148.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,144.15
|
| Rate for Payer: Quartz Commercial |
$1,517.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,401.00
|
| Rate for Payer: The Alliance Commercial |
$9,340.00
|
| Rate for Payer: WEA Trust Commercial |
$1,284.25
|
| Rate for Payer: WPS Commercial |
$1,729.53
|
|
|
SCREW 1.5x8MM CORTEX SELF 400.808.96
|
Facility
|
IP
|
$1,032.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$505.68 |
| Max. Negotiated Rate |
$949.44 |
| Rate for Payer: Aetna Commercial |
$928.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$887.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$546.96
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cigna Commercial |
$949.44
|
| Rate for Payer: Health EOS Commercial |
$918.48
|
| Rate for Payer: HFN Commercial |
$949.44
|
| Rate for Payer: Multiplan Commercial |
$825.60
|
| Rate for Payer: NAPHCARE Commercial |
$619.20
|
| Rate for Payer: Preferred Network Access Commercial |
$949.44
|
| Rate for Payer: Quartz Beloit One Network |
$505.68
|
| Rate for Payer: Quartz Commercial |
$619.20
|
| Rate for Payer: WEA Trust Commercial |
$567.60
|
| Rate for Payer: WPS Commercial |
$764.40
|
|
|
SCREW 1.5x8MM CORTEX SELF 400.808.96
|
Facility
|
OP
|
$1,032.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.96 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$928.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$887.52
|
| Rate for Payer: Aetna Managed Medicare |
$288.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$670.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$516.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$495.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$546.96
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cigna Commercial |
$949.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$577.51
|
| Rate for Payer: Health EOS Commercial |
$918.48
|
| Rate for Payer: HFN Commercial |
$949.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$774.00
|
| Rate for Payer: Multiplan Commercial |
$825.60
|
| Rate for Payer: NAPHCARE Commercial |
$619.20
|
| Rate for Payer: Preferred Network Access Commercial |
$949.44
|
| Rate for Payer: Quartz Beloit One Network |
$505.68
|
| Rate for Payer: Quartz Commercial |
$670.80
|
| Rate for Payer: Quartz Medicare Advantage |
$619.20
|
| Rate for Payer: The Alliance Commercial |
$4,128.00
|
| Rate for Payer: WEA Trust Commercial |
$567.60
|
| Rate for Payer: WPS Commercial |
$764.40
|
|
|
SCREW 2.0x12 LCK SF TAP TI
|
Facility
|
IP
|
$1,823.00
|
|
| Hospital Charge Code |
2966429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$893.27 |
| Max. Negotiated Rate |
$1,677.16 |
| Rate for Payer: Aetna Commercial |
$1,640.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,567.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.19
|
| Rate for Payer: Cash Price |
$546.90
|
| Rate for Payer: Cigna Commercial |
$1,677.16
|
| Rate for Payer: Health EOS Commercial |
$1,622.47
|
| Rate for Payer: HFN Commercial |
$1,677.16
|
| Rate for Payer: Multiplan Commercial |
$1,458.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,093.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,677.16
|
| Rate for Payer: Quartz Beloit One Network |
$893.27
|
| Rate for Payer: Quartz Commercial |
$1,093.80
|
| Rate for Payer: WEA Trust Commercial |
$1,002.65
|
| Rate for Payer: WPS Commercial |
$1,350.30
|
|
|
SCREW 2.0x12 LCK SF TAP TI
|
Facility
|
OP
|
$1,823.00
|
|
| Hospital Charge Code |
2966429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$510.44 |
| Max. Negotiated Rate |
$7,292.00 |
| Rate for Payer: Aetna Commercial |
$1,640.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,567.78
|
| Rate for Payer: Aetna Managed Medicare |
$510.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,184.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$911.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$875.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$966.19
|
| Rate for Payer: Cash Price |
$546.90
|
| Rate for Payer: Cigna Commercial |
$1,677.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,020.15
|
| Rate for Payer: Health EOS Commercial |
$1,622.47
|
| Rate for Payer: HFN Commercial |
$1,677.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,367.25
|
| Rate for Payer: Multiplan Commercial |
$1,458.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,093.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,677.16
|
| Rate for Payer: Quartz Beloit One Network |
$893.27
|
| Rate for Payer: Quartz Commercial |
$1,184.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,093.80
|
| Rate for Payer: The Alliance Commercial |
$7,292.00
|
| Rate for Payer: WEA Trust Commercial |
$1,002.65
|
| Rate for Payer: WPS Commercial |
$1,350.30
|
|
|
SCREW 2.0x22 CANN 319-2022
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2975072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$644.84 |
| Max. Negotiated Rate |
$9,212.00 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Aetna Managed Medicare |
$644.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,496.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,151.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,105.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,288.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,727.25
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,496.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,381.80
|
| Rate for Payer: The Alliance Commercial |
$9,212.00
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW 2.0x22 CANN 319-2022
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2975072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.47 |
| Max. Negotiated Rate |
$2,118.76 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,381.80
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW 2.0x6 CANN 319-2006
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2975071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.47 |
| Max. Negotiated Rate |
$2,118.76 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,381.80
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW 2.0x6 CANN 319-2006
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2975071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$644.84 |
| Max. Negotiated Rate |
$9,212.00 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Aetna Managed Medicare |
$644.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,496.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,151.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,105.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,288.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,727.25
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,496.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,381.80
|
| Rate for Payer: The Alliance Commercial |
$9,212.00
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW 2.0x7 KLS MARTIN
|
Facility
|
OP
|
$988.00
|
|
| Hospital Charge Code |
2965253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.64 |
| Max. Negotiated Rate |
$3,952.00 |
| Rate for Payer: Aetna Commercial |
$889.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$849.68
|
| Rate for Payer: Aetna Managed Medicare |
$276.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$642.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$494.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$474.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$523.64
|
| Rate for Payer: Cash Price |
$296.40
|
| Rate for Payer: Cigna Commercial |
$908.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$552.88
|
| Rate for Payer: Health EOS Commercial |
$879.32
|
| Rate for Payer: HFN Commercial |
$908.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$741.00
|
| Rate for Payer: Multiplan Commercial |
$790.40
|
| Rate for Payer: NAPHCARE Commercial |
$592.80
|
| Rate for Payer: Preferred Network Access Commercial |
$908.96
|
| Rate for Payer: Quartz Beloit One Network |
$484.12
|
| Rate for Payer: Quartz Commercial |
$642.20
|
| Rate for Payer: Quartz Medicare Advantage |
$592.80
|
| Rate for Payer: The Alliance Commercial |
$3,952.00
|
| Rate for Payer: WEA Trust Commercial |
$543.40
|
| Rate for Payer: WPS Commercial |
$731.81
|
|
|
SCREW 2.0x7 KLS MARTIN
|
Facility
|
IP
|
$988.00
|
|
| Hospital Charge Code |
2965253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$484.12 |
| Max. Negotiated Rate |
$908.96 |
| Rate for Payer: Aetna Commercial |
$889.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$849.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$523.64
|
| Rate for Payer: Cash Price |
$296.40
|
| Rate for Payer: Cigna Commercial |
$908.96
|
| Rate for Payer: Health EOS Commercial |
$879.32
|
| Rate for Payer: HFN Commercial |
$908.96
|
| Rate for Payer: Multiplan Commercial |
$790.40
|
| Rate for Payer: NAPHCARE Commercial |
$592.80
|
| Rate for Payer: Preferred Network Access Commercial |
$908.96
|
| Rate for Payer: Quartz Beloit One Network |
$484.12
|
| Rate for Payer: Quartz Commercial |
$592.80
|
| Rate for Payer: WEA Trust Commercial |
$543.40
|
| Rate for Payer: WPS Commercial |
$731.81
|
|
|
SCREW 2.0x9 KLS MARTIN
|
Facility
|
OP
|
$915.00
|
|
| Hospital Charge Code |
2965254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.20 |
| Max. Negotiated Rate |
$3,660.00 |
| Rate for Payer: Aetna Commercial |
$823.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$786.90
|
| Rate for Payer: Aetna Managed Medicare |
$256.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$594.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$457.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$439.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$484.95
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cigna Commercial |
$841.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$512.03
|
| Rate for Payer: Health EOS Commercial |
$814.35
|
| Rate for Payer: HFN Commercial |
$841.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$686.25
|
| Rate for Payer: Multiplan Commercial |
$732.00
|
| Rate for Payer: NAPHCARE Commercial |
$549.00
|
| Rate for Payer: Preferred Network Access Commercial |
$841.80
|
| Rate for Payer: Quartz Beloit One Network |
$448.35
|
| Rate for Payer: Quartz Commercial |
$594.75
|
| Rate for Payer: Quartz Medicare Advantage |
$549.00
|
| Rate for Payer: The Alliance Commercial |
$3,660.00
|
| Rate for Payer: WEA Trust Commercial |
$503.25
|
| Rate for Payer: WPS Commercial |
$677.74
|
|
|
SCREW 2.0x9 KLS MARTIN
|
Facility
|
IP
|
$915.00
|
|
| Hospital Charge Code |
2965254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$448.35 |
| Max. Negotiated Rate |
$841.80 |
| Rate for Payer: Aetna Commercial |
$823.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$786.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$484.95
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cigna Commercial |
$841.80
|
| Rate for Payer: Health EOS Commercial |
$814.35
|
| Rate for Payer: HFN Commercial |
$841.80
|
| Rate for Payer: Multiplan Commercial |
$732.00
|
| Rate for Payer: NAPHCARE Commercial |
$549.00
|
| Rate for Payer: Preferred Network Access Commercial |
$841.80
|
| Rate for Payer: Quartz Beloit One Network |
$448.35
|
| Rate for Payer: Quartz Commercial |
$549.00
|
| Rate for Payer: WEA Trust Commercial |
$503.25
|
| Rate for Payer: WPS Commercial |
$677.74
|
|
|
SCREW 2.3 X 10 LOCK CO-T2310
|
Facility
|
IP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.25 |
| Max. Negotiated Rate |
$1,587.00 |
| Rate for Payer: Aetna Commercial |
$1,552.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,483.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$914.25
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,587.00
|
| Rate for Payer: Health EOS Commercial |
$1,535.25
|
| Rate for Payer: HFN Commercial |
$1,587.00
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,035.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,587.00
|
| Rate for Payer: Quartz Beloit One Network |
$845.25
|
| Rate for Payer: Quartz Commercial |
$1,035.00
|
| Rate for Payer: WEA Trust Commercial |
$948.75
|
| Rate for Payer: WPS Commercial |
$1,277.71
|
|
|
SCREW 2.3 X 10 LOCK CO-T2310
|
Facility
|
OP
|
$1,725.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$6,900.00 |
| Rate for Payer: Aetna Commercial |
$1,552.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,483.50
|
| Rate for Payer: Aetna Managed Medicare |
$483.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,121.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$862.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$828.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$914.25
|
| Rate for Payer: Cash Price |
$517.50
|
| Rate for Payer: Cigna Commercial |
$1,587.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$965.31
|
| Rate for Payer: Health EOS Commercial |
$1,535.25
|
| Rate for Payer: HFN Commercial |
$1,587.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,293.75
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,035.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,587.00
|
| Rate for Payer: Quartz Beloit One Network |
$845.25
|
| Rate for Payer: Quartz Commercial |
$1,121.25
|
| Rate for Payer: Quartz Medicare Advantage |
$1,035.00
|
| Rate for Payer: The Alliance Commercial |
$6,900.00
|
| Rate for Payer: WEA Trust Commercial |
$948.75
|
| Rate for Payer: WPS Commercial |
$1,277.71
|
|
|
SCREW 2.3 X 12 LOCK CO-T2312
|
Facility
|
IP
|
$1,429.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415919
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.21 |
| Max. Negotiated Rate |
$1,314.68 |
| Rate for Payer: Aetna Commercial |
$1,286.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.37
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,314.68
|
| Rate for Payer: Health EOS Commercial |
$1,271.81
|
| Rate for Payer: HFN Commercial |
$1,314.68
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: NAPHCARE Commercial |
$857.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.68
|
| Rate for Payer: Quartz Beloit One Network |
$700.21
|
| Rate for Payer: Quartz Commercial |
$857.40
|
| Rate for Payer: WEA Trust Commercial |
$785.95
|
| Rate for Payer: WPS Commercial |
$1,058.46
|
|
|
SCREW 2.3 X 12 LOCK CO-T2312
|
Facility
|
OP
|
$1,429.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415919
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.12 |
| Max. Negotiated Rate |
$5,716.00 |
| Rate for Payer: Aetna Commercial |
$1,286.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.94
|
| Rate for Payer: Aetna Managed Medicare |
$400.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$928.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$714.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$685.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.37
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,314.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$799.67
|
| Rate for Payer: Health EOS Commercial |
$1,271.81
|
| Rate for Payer: HFN Commercial |
$1,314.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,071.75
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: NAPHCARE Commercial |
$857.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.68
|
| Rate for Payer: Quartz Beloit One Network |
$700.21
|
| Rate for Payer: Quartz Commercial |
$928.85
|
| Rate for Payer: Quartz Medicare Advantage |
$857.40
|
| Rate for Payer: The Alliance Commercial |
$5,716.00
|
| Rate for Payer: WEA Trust Commercial |
$785.95
|
| Rate for Payer: WPS Commercial |
$1,058.46
|
|
|
SCREW 2.3x13 MAX DRIVE
|
Facility
|
OP
|
$1,172.00
|
|
| Hospital Charge Code |
2965255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$328.16 |
| Max. Negotiated Rate |
$4,688.00 |
| Rate for Payer: Aetna Commercial |
$1,054.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,007.92
|
| Rate for Payer: Aetna Managed Medicare |
$328.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$761.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$586.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$562.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$621.16
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,078.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$655.85
|
| Rate for Payer: Health EOS Commercial |
$1,043.08
|
| Rate for Payer: HFN Commercial |
$1,078.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$879.00
|
| Rate for Payer: Multiplan Commercial |
$937.60
|
| Rate for Payer: NAPHCARE Commercial |
$703.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,078.24
|
| Rate for Payer: Quartz Beloit One Network |
$574.28
|
| Rate for Payer: Quartz Commercial |
$761.80
|
| Rate for Payer: Quartz Medicare Advantage |
$703.20
|
| Rate for Payer: The Alliance Commercial |
$4,688.00
|
| Rate for Payer: WEA Trust Commercial |
$644.60
|
| Rate for Payer: WPS Commercial |
$868.10
|
|
|
SCREW 2.3x13 MAX DRIVE
|
Facility
|
IP
|
$1,172.00
|
|
| Hospital Charge Code |
2965255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$574.28 |
| Max. Negotiated Rate |
$1,078.24 |
| Rate for Payer: Aetna Commercial |
$1,054.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,007.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$621.16
|
| Rate for Payer: Cash Price |
$351.60
|
| Rate for Payer: Cigna Commercial |
$1,078.24
|
| Rate for Payer: Health EOS Commercial |
$1,043.08
|
| Rate for Payer: HFN Commercial |
$1,078.24
|
| Rate for Payer: Multiplan Commercial |
$937.60
|
| Rate for Payer: NAPHCARE Commercial |
$703.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,078.24
|
| Rate for Payer: Quartz Beloit One Network |
$574.28
|
| Rate for Payer: Quartz Commercial |
$703.20
|
| Rate for Payer: WEA Trust Commercial |
$644.60
|
| Rate for Payer: WPS Commercial |
$868.10
|
|
