|
SCREW 3.5 X 20 LOCK CORT COL-3200
|
Facility
|
OP
|
$1,724.00
|
|
| Hospital Charge Code |
2964162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$482.72 |
| Max. Negotiated Rate |
$6,896.00 |
| Rate for Payer: Aetna Commercial |
$1,551.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,482.64
|
| Rate for Payer: Aetna Managed Medicare |
$482.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,120.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$862.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$827.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$913.72
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cigna Commercial |
$1,586.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$964.75
|
| Rate for Payer: Health EOS Commercial |
$1,534.36
|
| Rate for Payer: HFN Commercial |
$1,586.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,293.00
|
| Rate for Payer: Multiplan Commercial |
$1,379.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,034.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,586.08
|
| Rate for Payer: Quartz Beloit One Network |
$844.76
|
| Rate for Payer: Quartz Commercial |
$1,120.60
|
| Rate for Payer: Quartz Medicare Advantage |
$1,034.40
|
| Rate for Payer: The Alliance Commercial |
$6,896.00
|
| Rate for Payer: WEA Trust Commercial |
$948.20
|
| Rate for Payer: WPS Commercial |
$1,276.97
|
|
|
SCREW 3.5 X 20 LOCK CORT COL-3200
|
Facility
|
IP
|
$1,724.00
|
|
| Hospital Charge Code |
2964162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$844.76 |
| Max. Negotiated Rate |
$1,586.08 |
| Rate for Payer: Aetna Commercial |
$1,551.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,482.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$913.72
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cigna Commercial |
$1,586.08
|
| Rate for Payer: Health EOS Commercial |
$1,534.36
|
| Rate for Payer: HFN Commercial |
$1,586.08
|
| Rate for Payer: Multiplan Commercial |
$1,379.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,034.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,586.08
|
| Rate for Payer: Quartz Beloit One Network |
$844.76
|
| Rate for Payer: Quartz Commercial |
$1,034.40
|
| Rate for Payer: WEA Trust Commercial |
$948.20
|
| Rate for Payer: WPS Commercial |
$1,276.97
|
|
|
SCREW 3.5 X 22 CORT C0-3220
|
Facility
|
OP
|
$1,135.00
|
|
| Hospital Charge Code |
2964157
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$317.80 |
| Max. Negotiated Rate |
$4,540.00 |
| Rate for Payer: Aetna Commercial |
$1,021.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$976.10
|
| Rate for Payer: Aetna Managed Medicare |
$317.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$737.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$567.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$544.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$601.55
|
| Rate for Payer: Cash Price |
$340.50
|
| Rate for Payer: Cigna Commercial |
$1,044.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$635.15
|
| Rate for Payer: Health EOS Commercial |
$1,010.15
|
| Rate for Payer: HFN Commercial |
$1,044.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$851.25
|
| Rate for Payer: Multiplan Commercial |
$908.00
|
| Rate for Payer: NAPHCARE Commercial |
$681.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,044.20
|
| Rate for Payer: Quartz Beloit One Network |
$556.15
|
| Rate for Payer: Quartz Commercial |
$737.75
|
| Rate for Payer: Quartz Medicare Advantage |
$681.00
|
| Rate for Payer: The Alliance Commercial |
$4,540.00
|
| Rate for Payer: WEA Trust Commercial |
$624.25
|
| Rate for Payer: WPS Commercial |
$840.69
|
|
|
SCREW 3.5 X 22 CORT C0-3220
|
Facility
|
IP
|
$1,135.00
|
|
| Hospital Charge Code |
2964157
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.15 |
| Max. Negotiated Rate |
$1,044.20 |
| Rate for Payer: Aetna Commercial |
$1,021.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$976.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$601.55
|
| Rate for Payer: Cash Price |
$340.50
|
| Rate for Payer: Cigna Commercial |
$1,044.20
|
| Rate for Payer: Health EOS Commercial |
$1,010.15
|
| Rate for Payer: HFN Commercial |
$1,044.20
|
| Rate for Payer: Multiplan Commercial |
$908.00
|
| Rate for Payer: NAPHCARE Commercial |
$681.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,044.20
|
| Rate for Payer: Quartz Beloit One Network |
$556.15
|
| Rate for Payer: Quartz Commercial |
$681.00
|
| Rate for Payer: WEA Trust Commercial |
$624.25
|
| Rate for Payer: WPS Commercial |
$840.69
|
|
|
SCREW 3.5X24 LOCKING
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.56 |
| Max. Negotiated Rate |
$8,008.00 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Aetna Managed Medicare |
$560.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,301.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,001.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$960.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,120.32
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,501.50
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,301.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,201.20
|
| Rate for Payer: The Alliance Commercial |
$8,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5X24 LOCKING
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.98 |
| Max. Negotiated Rate |
$1,841.84 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,201.20
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5 X 28 LOCK 30-0242
|
Facility
|
IP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,126.02 |
| Max. Negotiated Rate |
$2,114.16 |
| Rate for Payer: Aetna Commercial |
$2,068.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,976.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,217.94
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,114.16
|
| Rate for Payer: Health EOS Commercial |
$2,045.22
|
| Rate for Payer: HFN Commercial |
$2,114.16
|
| Rate for Payer: Multiplan Commercial |
$1,838.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,378.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,114.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,126.02
|
| Rate for Payer: Quartz Commercial |
$1,378.80
|
| Rate for Payer: WEA Trust Commercial |
$1,263.90
|
| Rate for Payer: WPS Commercial |
$1,702.13
|
|
|
SCREW 3.5 X 28 LOCK 30-0242
|
Facility
|
OP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$643.44 |
| Max. Negotiated Rate |
$9,192.00 |
| Rate for Payer: Aetna Commercial |
$2,068.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,976.28
|
| Rate for Payer: Aetna Managed Medicare |
$643.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,493.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,149.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,103.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,217.94
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,114.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,285.96
|
| Rate for Payer: Health EOS Commercial |
$2,045.22
|
| Rate for Payer: HFN Commercial |
$2,114.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,723.50
|
| Rate for Payer: Multiplan Commercial |
$1,838.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,378.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,114.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,126.02
|
| Rate for Payer: Quartz Commercial |
$1,493.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,378.80
|
| Rate for Payer: The Alliance Commercial |
$9,192.00
|
| Rate for Payer: WEA Trust Commercial |
$1,263.90
|
| Rate for Payer: WPS Commercial |
$1,702.13
|
|
|
SCREW 3.5 X 30 LOCKING
|
Facility
|
OP
|
$1,728.00
|
|
| Hospital Charge Code |
2966495
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.84 |
| Max. Negotiated Rate |
$6,912.00 |
| Rate for Payer: Aetna Commercial |
$1,555.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,486.08
|
| Rate for Payer: Aetna Managed Medicare |
$483.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,123.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$864.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$829.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$915.84
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cigna Commercial |
$1,589.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$966.99
|
| Rate for Payer: Health EOS Commercial |
$1,537.92
|
| Rate for Payer: HFN Commercial |
$1,589.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,296.00
|
| Rate for Payer: Multiplan Commercial |
$1,382.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,036.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,589.76
|
| Rate for Payer: Quartz Beloit One Network |
$846.72
|
| Rate for Payer: Quartz Commercial |
$1,123.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,036.80
|
| Rate for Payer: The Alliance Commercial |
$6,912.00
|
| Rate for Payer: WEA Trust Commercial |
$950.40
|
| Rate for Payer: WPS Commercial |
$1,279.93
|
|
|
SCREW 3.5 X 30 LOCKING
|
Facility
|
IP
|
$1,728.00
|
|
| Hospital Charge Code |
2966495
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$846.72 |
| Max. Negotiated Rate |
$1,589.76 |
| Rate for Payer: Aetna Commercial |
$1,555.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,486.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$915.84
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cigna Commercial |
$1,589.76
|
| Rate for Payer: Health EOS Commercial |
$1,537.92
|
| Rate for Payer: HFN Commercial |
$1,589.76
|
| Rate for Payer: Multiplan Commercial |
$1,382.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,036.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,589.76
|
| Rate for Payer: Quartz Beloit One Network |
$846.72
|
| Rate for Payer: Quartz Commercial |
$1,036.80
|
| Rate for Payer: WEA Trust Commercial |
$950.40
|
| Rate for Payer: WPS Commercial |
$1,279.93
|
|
|
SCREW 3.5x32 LOCKING 213.032
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966499
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.56 |
| Max. Negotiated Rate |
$8,008.00 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Aetna Managed Medicare |
$560.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,301.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,001.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$960.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,120.32
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,501.50
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,301.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,201.20
|
| Rate for Payer: The Alliance Commercial |
$8,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5x32 LOCKING 213.032
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966499
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.98 |
| Max. Negotiated Rate |
$1,841.84 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,201.20
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5X34 LOCKING
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.98 |
| Max. Negotiated Rate |
$1,841.84 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,201.20
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5X34 LOCKING
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.56 |
| Max. Negotiated Rate |
$8,008.00 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Aetna Managed Medicare |
$560.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,301.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,001.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$960.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,120.32
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,501.50
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,301.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,201.20
|
| Rate for Payer: The Alliance Commercial |
$8,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5x36 LOCKING 213.036
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.56 |
| Max. Negotiated Rate |
$8,008.00 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Aetna Managed Medicare |
$560.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,301.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,001.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$960.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,120.32
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,501.50
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,301.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,201.20
|
| Rate for Payer: The Alliance Commercial |
$8,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5x36 LOCKING 213.036
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.98 |
| Max. Negotiated Rate |
$1,841.84 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,201.20
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW 3.5 X 40 LOCK 30-0248
|
Facility
|
OP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$643.44 |
| Max. Negotiated Rate |
$9,192.00 |
| Rate for Payer: Aetna Commercial |
$2,068.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,976.28
|
| Rate for Payer: Aetna Managed Medicare |
$643.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,493.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,149.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,103.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,217.94
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,114.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,285.96
|
| Rate for Payer: Health EOS Commercial |
$2,045.22
|
| Rate for Payer: HFN Commercial |
$2,114.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,723.50
|
| Rate for Payer: Multiplan Commercial |
$1,838.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,378.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,114.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,126.02
|
| Rate for Payer: Quartz Commercial |
$1,493.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,378.80
|
| Rate for Payer: The Alliance Commercial |
$9,192.00
|
| Rate for Payer: WEA Trust Commercial |
$1,263.90
|
| Rate for Payer: WPS Commercial |
$1,702.13
|
|
|
SCREW 3.5 X 40 LOCK 30-0248
|
Facility
|
IP
|
$2,298.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,126.02 |
| Max. Negotiated Rate |
$2,114.16 |
| Rate for Payer: Aetna Commercial |
$2,068.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,976.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,217.94
|
| Rate for Payer: Cash Price |
$689.40
|
| Rate for Payer: Cigna Commercial |
$2,114.16
|
| Rate for Payer: Health EOS Commercial |
$2,045.22
|
| Rate for Payer: HFN Commercial |
$2,114.16
|
| Rate for Payer: Multiplan Commercial |
$1,838.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,378.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,114.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,126.02
|
| Rate for Payer: Quartz Commercial |
$1,378.80
|
| Rate for Payer: WEA Trust Commercial |
$1,263.90
|
| Rate for Payer: WPS Commercial |
$1,702.13
|
|
|
SCREW 4.0 CANNULATED 44MM
|
Facility
|
OP
|
$2,747.00
|
|
| Hospital Charge Code |
2965016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$769.16 |
| Max. Negotiated Rate |
$10,988.00 |
| Rate for Payer: Aetna Commercial |
$2,472.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,362.42
|
| Rate for Payer: Aetna Managed Medicare |
$769.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,785.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,373.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,318.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,455.91
|
| Rate for Payer: Cash Price |
$824.10
|
| Rate for Payer: Cigna Commercial |
$2,527.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,537.22
|
| Rate for Payer: Health EOS Commercial |
$2,444.83
|
| Rate for Payer: HFN Commercial |
$2,527.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,060.25
|
| Rate for Payer: Multiplan Commercial |
$2,197.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,648.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,527.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,346.03
|
| Rate for Payer: Quartz Commercial |
$1,785.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,648.20
|
| Rate for Payer: The Alliance Commercial |
$10,988.00
|
| Rate for Payer: WEA Trust Commercial |
$1,510.85
|
| Rate for Payer: WPS Commercial |
$2,034.70
|
|
|
SCREW 4.0 CANNULATED 44MM
|
Facility
|
IP
|
$2,747.00
|
|
| Hospital Charge Code |
2965016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,346.03 |
| Max. Negotiated Rate |
$2,527.24 |
| Rate for Payer: Aetna Commercial |
$2,472.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,362.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,455.91
|
| Rate for Payer: Cash Price |
$824.10
|
| Rate for Payer: Cigna Commercial |
$2,527.24
|
| Rate for Payer: Health EOS Commercial |
$2,444.83
|
| Rate for Payer: HFN Commercial |
$2,527.24
|
| Rate for Payer: Multiplan Commercial |
$2,197.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,648.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,527.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,346.03
|
| Rate for Payer: Quartz Commercial |
$1,648.20
|
| Rate for Payer: WEA Trust Commercial |
$1,510.85
|
| Rate for Payer: WPS Commercial |
$2,034.70
|
|
|
SCREW 4.0x18 TITANIUM CANCELLO
|
Facility
|
OP
|
$472.00
|
|
| Hospital Charge Code |
2966514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$132.16 |
| Max. Negotiated Rate |
$1,888.00 |
| Rate for Payer: Aetna Commercial |
$424.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$405.92
|
| Rate for Payer: Aetna Managed Medicare |
$132.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$306.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$236.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$226.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$250.16
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cigna Commercial |
$434.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$264.13
|
| Rate for Payer: Health EOS Commercial |
$420.08
|
| Rate for Payer: HFN Commercial |
$434.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$354.00
|
| Rate for Payer: Multiplan Commercial |
$377.60
|
| Rate for Payer: NAPHCARE Commercial |
$283.20
|
| Rate for Payer: Preferred Network Access Commercial |
$434.24
|
| Rate for Payer: Quartz Beloit One Network |
$231.28
|
| Rate for Payer: Quartz Commercial |
$306.80
|
| Rate for Payer: Quartz Medicare Advantage |
$283.20
|
| Rate for Payer: The Alliance Commercial |
$1,888.00
|
| Rate for Payer: WEA Trust Commercial |
$259.60
|
| Rate for Payer: WPS Commercial |
$349.61
|
|
|
SCREW 4.0x18 TITANIUM CANCELLO
|
Facility
|
IP
|
$472.00
|
|
| Hospital Charge Code |
2966514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$231.28 |
| Max. Negotiated Rate |
$434.24 |
| Rate for Payer: Aetna Commercial |
$424.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$405.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$250.16
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cigna Commercial |
$434.24
|
| Rate for Payer: Health EOS Commercial |
$420.08
|
| Rate for Payer: HFN Commercial |
$434.24
|
| Rate for Payer: Multiplan Commercial |
$377.60
|
| Rate for Payer: NAPHCARE Commercial |
$283.20
|
| Rate for Payer: Preferred Network Access Commercial |
$434.24
|
| Rate for Payer: Quartz Beloit One Network |
$231.28
|
| Rate for Payer: Quartz Commercial |
$283.20
|
| Rate for Payer: WEA Trust Commercial |
$259.60
|
| Rate for Payer: WPS Commercial |
$349.61
|
|
|
SCREW 4.0 X 20 CORTICAL
|
Facility
|
OP
|
$2,340.00
|
|
| Hospital Charge Code |
2966035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$655.20 |
| Max. Negotiated Rate |
$9,360.00 |
| Rate for Payer: Aetna Commercial |
$2,106.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,012.40
|
| Rate for Payer: Aetna Managed Medicare |
$655.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,521.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,170.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,123.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,240.20
|
| Rate for Payer: Cash Price |
$702.00
|
| Rate for Payer: Cigna Commercial |
$2,152.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,309.46
|
| Rate for Payer: Health EOS Commercial |
$2,082.60
|
| Rate for Payer: HFN Commercial |
$2,152.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,755.00
|
| Rate for Payer: Multiplan Commercial |
$1,872.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,404.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,152.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,146.60
|
| Rate for Payer: Quartz Commercial |
$1,521.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,404.00
|
| Rate for Payer: The Alliance Commercial |
$9,360.00
|
| Rate for Payer: WEA Trust Commercial |
$1,287.00
|
| Rate for Payer: WPS Commercial |
$1,733.24
|
|
|
SCREW 4.0 X 20 CORTICAL
|
Facility
|
IP
|
$2,340.00
|
|
| Hospital Charge Code |
2966035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,146.60 |
| Max. Negotiated Rate |
$2,152.80 |
| Rate for Payer: Aetna Commercial |
$2,106.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,012.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,240.20
|
| Rate for Payer: Cash Price |
$702.00
|
| Rate for Payer: Cigna Commercial |
$2,152.80
|
| Rate for Payer: Health EOS Commercial |
$2,082.60
|
| Rate for Payer: HFN Commercial |
$2,152.80
|
| Rate for Payer: Multiplan Commercial |
$1,872.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,404.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,152.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,146.60
|
| Rate for Payer: Quartz Commercial |
$1,404.00
|
| Rate for Payer: WEA Trust Commercial |
$1,287.00
|
| Rate for Payer: WPS Commercial |
$1,733.24
|
|
|
SCREW 4.0x34 LOCKING TORNIER
|
Facility
|
IP
|
$1,373.00
|
|
| Hospital Charge Code |
2967363
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$672.77 |
| Max. Negotiated Rate |
$1,263.16 |
| Rate for Payer: Aetna Commercial |
$1,235.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,180.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$727.69
|
| Rate for Payer: Cash Price |
$411.90
|
| Rate for Payer: Cigna Commercial |
$1,263.16
|
| Rate for Payer: Health EOS Commercial |
$1,221.97
|
| Rate for Payer: HFN Commercial |
$1,263.16
|
| Rate for Payer: Multiplan Commercial |
$1,098.40
|
| Rate for Payer: NAPHCARE Commercial |
$823.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,263.16
|
| Rate for Payer: Quartz Beloit One Network |
$672.77
|
| Rate for Payer: Quartz Commercial |
$823.80
|
| Rate for Payer: WEA Trust Commercial |
$755.15
|
| Rate for Payer: WPS Commercial |
$1,016.98
|
|
