|
SCREW BIO-COMPOSITE 3 X 22MM AR-5025B-22
|
Facility
|
OP
|
$3,885.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6177697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,131.31 |
| Max. Negotiated Rate |
$3,717.17 |
| Rate for Payer: Aetna Commercial |
$3,636.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,474.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,131.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,626.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,020.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,939.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,141.41
|
| Rate for Payer: Cash Price |
$1,165.50
|
| Rate for Payer: Cigna Commercial |
$3,717.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,261.07
|
| Rate for Payer: Health EOS Commercial |
$3,595.96
|
| Rate for Payer: HFN Commercial |
$3,717.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,030.30
|
| Rate for Payer: Multiplan Commercial |
$3,232.32
|
| Rate for Payer: NAPHCARE Commercial |
$2,424.24
|
| Rate for Payer: Preferred Network Access Commercial |
$3,717.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,979.80
|
| Rate for Payer: Quartz Commercial |
$2,626.26
|
| Rate for Payer: Quartz Medicare Advantage |
$2,424.24
|
| Rate for Payer: The Alliance Commercial |
$2,020.20
|
| Rate for Payer: WEA Trust Commercial |
$2,222.22
|
| Rate for Payer: WPS Commercial |
$2,992.62
|
|
|
SCREW BIO-COMPOSITE 3 X 22MM AR-5025B-22
|
Facility
|
IP
|
$3,885.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6177697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,979.80 |
| Max. Negotiated Rate |
$3,717.17 |
| Rate for Payer: Aetna Commercial |
$3,636.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,474.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,141.41
|
| Rate for Payer: Cash Price |
$1,165.50
|
| Rate for Payer: Cigna Commercial |
$3,717.17
|
| Rate for Payer: Health EOS Commercial |
$3,595.96
|
| Rate for Payer: HFN Commercial |
$3,717.17
|
| Rate for Payer: Multiplan Commercial |
$3,232.32
|
| Rate for Payer: Preferred Network Access Commercial |
$3,717.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,979.80
|
| Rate for Payer: Quartz Commercial |
$2,424.24
|
| Rate for Payer: WEA Trust Commercial |
$2,222.22
|
| Rate for Payer: WPS Commercial |
$2,992.62
|
|
|
SCREW BIOMET LOCK 2.4 X 10MM ST GREEN 76-2410
|
Facility
|
OP
|
$2,182.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.40 |
| Max. Negotiated Rate |
$2,087.74 |
| Rate for Payer: Aetna Commercial |
$2,042.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,951.58
|
| Rate for Payer: Aetna Managed Medicare |
$635.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,475.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,134.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,089.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,202.72
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cigna Commercial |
$2,087.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,269.92
|
| Rate for Payer: Health EOS Commercial |
$2,019.66
|
| Rate for Payer: HFN Commercial |
$2,087.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,701.96
|
| Rate for Payer: Multiplan Commercial |
$1,815.42
|
| Rate for Payer: NAPHCARE Commercial |
$1,361.57
|
| Rate for Payer: Preferred Network Access Commercial |
$2,087.74
|
| Rate for Payer: Quartz Beloit One Network |
$1,111.95
|
| Rate for Payer: Quartz Commercial |
$1,475.03
|
| Rate for Payer: Quartz Medicare Advantage |
$1,361.57
|
| Rate for Payer: The Alliance Commercial |
$1,134.64
|
| Rate for Payer: WEA Trust Commercial |
$1,248.10
|
| Rate for Payer: WPS Commercial |
$1,680.79
|
|
|
SCREW BIOMET LOCK 2.4 X 10MM ST GREEN 76-2410
|
Facility
|
IP
|
$2,182.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,111.95 |
| Max. Negotiated Rate |
$2,087.74 |
| Rate for Payer: Aetna Commercial |
$2,042.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,951.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,202.72
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cigna Commercial |
$2,087.74
|
| Rate for Payer: Health EOS Commercial |
$2,019.66
|
| Rate for Payer: HFN Commercial |
$2,087.74
|
| Rate for Payer: Multiplan Commercial |
$1,815.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,087.74
|
| Rate for Payer: Quartz Beloit One Network |
$1,111.95
|
| Rate for Payer: Quartz Commercial |
$1,361.57
|
| Rate for Payer: WEA Trust Commercial |
$1,248.10
|
| Rate for Payer: WPS Commercial |
$1,680.79
|
|
|
SCREW BIOMET LOCK 2.4 X 12MM ST GREEN 76-2412
|
Facility
|
OP
|
$1,971.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$573.96 |
| Max. Negotiated Rate |
$1,885.85 |
| Rate for Payer: Aetna Commercial |
$1,844.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,762.86
|
| Rate for Payer: Aetna Managed Medicare |
$573.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,024.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$983.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,086.42
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cigna Commercial |
$1,885.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,147.12
|
| Rate for Payer: Health EOS Commercial |
$1,824.36
|
| Rate for Payer: HFN Commercial |
$1,885.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,537.38
|
| Rate for Payer: Multiplan Commercial |
$1,639.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,229.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,885.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,004.42
|
| Rate for Payer: Quartz Commercial |
$1,332.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,229.90
|
| Rate for Payer: The Alliance Commercial |
$1,024.92
|
| Rate for Payer: WEA Trust Commercial |
$1,127.41
|
| Rate for Payer: WPS Commercial |
$1,518.26
|
|
|
SCREW BIOMET LOCK 2.4 X 12MM ST GREEN 76-2412
|
Facility
|
IP
|
$1,971.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,004.42 |
| Max. Negotiated Rate |
$1,885.85 |
| Rate for Payer: Aetna Commercial |
$1,844.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,762.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,086.42
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cigna Commercial |
$1,885.85
|
| Rate for Payer: Health EOS Commercial |
$1,824.36
|
| Rate for Payer: HFN Commercial |
$1,885.85
|
| Rate for Payer: Multiplan Commercial |
$1,639.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,885.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,004.42
|
| Rate for Payer: Quartz Commercial |
$1,229.90
|
| Rate for Payer: WEA Trust Commercial |
$1,127.41
|
| Rate for Payer: WPS Commercial |
$1,518.26
|
|
|
SCREW BIOMET LOCK 2.4 X 14MM ST GREEN 76-2414
|
Facility
|
IP
|
$1,971.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,004.42 |
| Max. Negotiated Rate |
$1,885.85 |
| Rate for Payer: Aetna Commercial |
$1,844.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,762.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,086.42
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cigna Commercial |
$1,885.85
|
| Rate for Payer: Health EOS Commercial |
$1,824.36
|
| Rate for Payer: HFN Commercial |
$1,885.85
|
| Rate for Payer: Multiplan Commercial |
$1,639.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,885.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,004.42
|
| Rate for Payer: Quartz Commercial |
$1,229.90
|
| Rate for Payer: WEA Trust Commercial |
$1,127.41
|
| Rate for Payer: WPS Commercial |
$1,518.26
|
|
|
SCREW BIOMET LOCK 2.4 X 14MM ST GREEN 76-2414
|
Facility
|
OP
|
$1,971.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$573.96 |
| Max. Negotiated Rate |
$1,885.85 |
| Rate for Payer: Aetna Commercial |
$1,844.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,762.86
|
| Rate for Payer: Aetna Managed Medicare |
$573.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,332.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,024.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$983.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,086.42
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cigna Commercial |
$1,885.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,147.12
|
| Rate for Payer: Health EOS Commercial |
$1,824.36
|
| Rate for Payer: HFN Commercial |
$1,885.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,537.38
|
| Rate for Payer: Multiplan Commercial |
$1,639.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,229.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,885.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,004.42
|
| Rate for Payer: Quartz Commercial |
$1,332.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,229.90
|
| Rate for Payer: The Alliance Commercial |
$1,024.92
|
| Rate for Payer: WEA Trust Commercial |
$1,127.41
|
| Rate for Payer: WPS Commercial |
$1,518.26
|
|
|
SCREW BIOMET LOCK 2.4 X 16MM ST GREEN 76-2416
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.87 |
| Max. Negotiated Rate |
$873.56 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Aetna Managed Medicare |
$265.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$617.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$474.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$531.37
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$712.14
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: NAPHCARE Commercial |
$569.71
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$617.19
|
| Rate for Payer: Quartz Medicare Advantage |
$569.71
|
| Rate for Payer: The Alliance Commercial |
$474.76
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
|
SCREW BIOMET LOCK 2.4 X 16MM ST GREEN 76-2416
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.26 |
| Max. Negotiated Rate |
$873.56 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$569.71
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
|
SCREW BIOMET LOCK 2.4 X 7MM ST GREEN 76-2407
|
Facility
|
IP
|
$2,622.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563318
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,336.17 |
| Max. Negotiated Rate |
$2,508.73 |
| Rate for Payer: Aetna Commercial |
$2,454.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,345.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,445.25
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cigna Commercial |
$2,508.73
|
| Rate for Payer: Health EOS Commercial |
$2,426.92
|
| Rate for Payer: HFN Commercial |
$2,508.73
|
| Rate for Payer: Multiplan Commercial |
$2,181.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,508.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,336.17
|
| Rate for Payer: Quartz Commercial |
$1,636.13
|
| Rate for Payer: WEA Trust Commercial |
$1,499.78
|
| Rate for Payer: WPS Commercial |
$2,019.73
|
|
|
SCREW BIOMET LOCK 2.4 X 7MM ST GREEN 76-2407
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563318
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$763.53 |
| Max. Negotiated Rate |
$2,508.73 |
| Rate for Payer: Aetna Commercial |
$2,454.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,345.12
|
| Rate for Payer: Aetna Managed Medicare |
$763.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,772.47
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,363.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,308.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,445.25
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cigna Commercial |
$2,508.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,526.00
|
| Rate for Payer: Health EOS Commercial |
$2,426.92
|
| Rate for Payer: HFN Commercial |
$2,508.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,045.16
|
| Rate for Payer: Multiplan Commercial |
$2,181.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,636.13
|
| Rate for Payer: Preferred Network Access Commercial |
$2,508.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,336.17
|
| Rate for Payer: Quartz Commercial |
$1,772.47
|
| Rate for Payer: Quartz Medicare Advantage |
$1,636.13
|
| Rate for Payer: The Alliance Commercial |
$1,363.44
|
| Rate for Payer: WEA Trust Commercial |
$1,499.78
|
| Rate for Payer: WPS Commercial |
$2,019.73
|
|
|
SCREW BIOMET LOCK 2.4 X 8MM ST GREEN 76-2408
|
Facility
|
OP
|
$2,182.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.40 |
| Max. Negotiated Rate |
$2,087.74 |
| Rate for Payer: Aetna Commercial |
$2,042.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,951.58
|
| Rate for Payer: Aetna Managed Medicare |
$635.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,475.03
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,134.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,089.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,202.72
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cigna Commercial |
$2,087.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,269.92
|
| Rate for Payer: Health EOS Commercial |
$2,019.66
|
| Rate for Payer: HFN Commercial |
$2,087.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,701.96
|
| Rate for Payer: Multiplan Commercial |
$1,815.42
|
| Rate for Payer: NAPHCARE Commercial |
$1,361.57
|
| Rate for Payer: Preferred Network Access Commercial |
$2,087.74
|
| Rate for Payer: Quartz Beloit One Network |
$1,111.95
|
| Rate for Payer: Quartz Commercial |
$1,475.03
|
| Rate for Payer: Quartz Medicare Advantage |
$1,361.57
|
| Rate for Payer: The Alliance Commercial |
$1,134.64
|
| Rate for Payer: WEA Trust Commercial |
$1,248.10
|
| Rate for Payer: WPS Commercial |
$1,680.79
|
|
|
SCREW BIOMET LOCK 2.4 X 8MM ST GREEN 76-2408
|
Facility
|
IP
|
$2,182.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,111.95 |
| Max. Negotiated Rate |
$2,087.74 |
| Rate for Payer: Aetna Commercial |
$2,042.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,951.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,202.72
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cigna Commercial |
$2,087.74
|
| Rate for Payer: Health EOS Commercial |
$2,019.66
|
| Rate for Payer: HFN Commercial |
$2,087.74
|
| Rate for Payer: Multiplan Commercial |
$1,815.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,087.74
|
| Rate for Payer: Quartz Beloit One Network |
$1,111.95
|
| Rate for Payer: Quartz Commercial |
$1,361.57
|
| Rate for Payer: WEA Trust Commercial |
$1,248.10
|
| Rate for Payer: WPS Commercial |
$1,680.79
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 10MM GOLD 73-2410
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415896
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.26 |
| Max. Negotiated Rate |
$873.56 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$569.71
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 10MM GOLD 73-2410
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415896
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.87 |
| Max. Negotiated Rate |
$873.56 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Aetna Managed Medicare |
$265.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$617.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$474.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$531.37
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$712.14
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: NAPHCARE Commercial |
$569.71
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$617.19
|
| Rate for Payer: Quartz Medicare Advantage |
$569.71
|
| Rate for Payer: The Alliance Commercial |
$474.76
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 12MM GOLD 73-2412
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4205987
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.06 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Aetna Managed Medicare |
$276.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$640.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$492.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$473.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$551.74
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$739.44
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: NAPHCARE Commercial |
$591.55
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$640.85
|
| Rate for Payer: Quartz Medicare Advantage |
$591.55
|
| Rate for Payer: The Alliance Commercial |
$492.96
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 12MM GOLD 73-2412
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4205987
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$591.55
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 14MM GOLD 73-2414
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.06 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Aetna Managed Medicare |
$276.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$640.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$492.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$473.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$551.74
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$739.44
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: NAPHCARE Commercial |
$591.55
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$640.85
|
| Rate for Payer: Quartz Medicare Advantage |
$591.55
|
| Rate for Payer: The Alliance Commercial |
$492.96
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 14MM GOLD 73-2414
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$591.55
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 16MM GOLD 73-2416
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4205997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$591.55
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 16MM GOLD 73-2416
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4205997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.06 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Aetna Managed Medicare |
$276.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$640.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$492.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$473.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$551.74
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$739.44
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: NAPHCARE Commercial |
$591.55
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$640.85
|
| Rate for Payer: Quartz Medicare Advantage |
$591.55
|
| Rate for Payer: The Alliance Commercial |
$492.96
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 18MM GOLD 73-2418
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4205999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$591.55
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 18MM GOLD 73-2418
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4205999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.06 |
| Max. Negotiated Rate |
$907.05 |
| Rate for Payer: Aetna Commercial |
$887.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$847.89
|
| Rate for Payer: Aetna Managed Medicare |
$276.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$640.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$492.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$473.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$522.54
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$907.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$551.74
|
| Rate for Payer: Health EOS Commercial |
$877.47
|
| Rate for Payer: HFN Commercial |
$907.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$739.44
|
| Rate for Payer: Multiplan Commercial |
$788.74
|
| Rate for Payer: NAPHCARE Commercial |
$591.55
|
| Rate for Payer: Preferred Network Access Commercial |
$907.05
|
| Rate for Payer: Quartz Beloit One Network |
$483.10
|
| Rate for Payer: Quartz Commercial |
$640.85
|
| Rate for Payer: Quartz Medicare Advantage |
$591.55
|
| Rate for Payer: The Alliance Commercial |
$492.96
|
| Rate for Payer: WEA Trust Commercial |
$542.26
|
| Rate for Payer: WPS Commercial |
$730.24
|
|
|
SCREW BIOMET LOCK CANC 2.4 X 20MM GOLD 73-2420
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.87 |
| Max. Negotiated Rate |
$873.56 |
| Rate for Payer: Aetna Commercial |
$854.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$816.59
|
| Rate for Payer: Aetna Managed Medicare |
$265.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$617.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$474.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$503.25
|
| Rate for Payer: Cash Price |
$273.90
|
| Rate for Payer: Cigna Commercial |
$873.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$531.37
|
| Rate for Payer: Health EOS Commercial |
$845.07
|
| Rate for Payer: HFN Commercial |
$873.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$712.14
|
| Rate for Payer: Multiplan Commercial |
$759.62
|
| Rate for Payer: NAPHCARE Commercial |
$569.71
|
| Rate for Payer: Preferred Network Access Commercial |
$873.56
|
| Rate for Payer: Quartz Beloit One Network |
$465.26
|
| Rate for Payer: Quartz Commercial |
$617.19
|
| Rate for Payer: Quartz Medicare Advantage |
$569.71
|
| Rate for Payer: The Alliance Commercial |
$474.76
|
| Rate for Payer: WEA Trust Commercial |
$522.24
|
| Rate for Payer: WPS Commercial |
$703.28
|
|
