|
SCREW BIOMET LOCK CANC 2.4 X 20MM GOLD 73-2420
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415897
|
|
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 8MM GOLD 73-2408
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415895
|
|
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 8MM GOLD 73-2408
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415895
|
|
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 2.7 X 10MM MAGENTA 73-2710
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415899
|
|
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 2.7 X 10MM MAGENTA 73-2710
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415899
|
|
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 2.7 X 12MM MAGENTA 73-2712
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415900
|
|
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 2.7 X 12MM MAGENTA 73-2712
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415900
|
|
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 2.7 X 14MM MAGENTA 73-2714
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415901
|
|
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 2.7 X 14MM MAGENTA 73-2714
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415901
|
|
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 2.7 X 16MM MAGENTA 73-2716
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415902
|
|
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 2.7 X 16MM MAGENTA 73-2716
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415902
|
|
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 2.7 X 18MM MAGENTA 73-2718
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415903
|
|
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 2.7 X 18MM MAGENTA 73-2718
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415903
|
|
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 2.7 X 20MM MAGENTA 73-2720
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415904
|
|
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 2.7 X 20MM MAGENTA 73-2720
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415904
|
|
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 2.7 X 8MM MAGENTA 73-2708
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415898
|
|
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 2.7 X 8MM MAGENTA 73-2708
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415898
|
|
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 RESCUE LOCK 2.7 X 10MM PURPLE 76-2710
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583274
|
|
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 RESCUE LOCK 2.7 X 10MM PURPLE 76-2710
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583274
|
|
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 RESCUE LOCK 2.7 X 12MM PURPLE 76-2712
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583275
|
|
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 RESCUE LOCK 2.7 X 12MM PURPLE 76-2712
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583275
|
|
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 RESCUE LOCK 2.7 X 16MM PURPLE 76-2716
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583277
|
|
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 RESCUE LOCK 2.7 X 16MM PURPLE 76-2716
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583277
|
|
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 RESCUE LOCK 2.7 X 8MM PURPLE 76-2708
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583273
|
|
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 RESCUE LOCK 2.7 X 8MM PURPLE 76-2708
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583273
|
|
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
|
|
