|
SCREW CANC 4.0 X 60 FULL THREAD 206.060
|
Facility
|
IP
|
$496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494438
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.76 |
| Max. Negotiated Rate |
$474.57 |
| Rate for Payer: Aetna Commercial |
$464.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$443.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$273.40
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cigna Commercial |
$474.57
|
| Rate for Payer: Health EOS Commercial |
$459.10
|
| Rate for Payer: HFN Commercial |
$474.57
|
| Rate for Payer: Multiplan Commercial |
$412.67
|
| Rate for Payer: Preferred Network Access Commercial |
$474.57
|
| Rate for Payer: Quartz Beloit One Network |
$252.76
|
| Rate for Payer: Quartz Commercial |
$309.50
|
| Rate for Payer: WEA Trust Commercial |
$283.71
|
| Rate for Payer: WPS Commercial |
$382.07
|
|
|
SCREW CANC 4.0 X 60 FULL THREAD 206.060
|
Facility
|
OP
|
$496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494438
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.44 |
| Max. Negotiated Rate |
$474.57 |
| Rate for Payer: Aetna Commercial |
$464.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$443.62
|
| Rate for Payer: Aetna Managed Medicare |
$144.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$335.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$257.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$247.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$273.40
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cigna Commercial |
$474.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$288.67
|
| Rate for Payer: Health EOS Commercial |
$459.10
|
| Rate for Payer: HFN Commercial |
$474.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$386.88
|
| Rate for Payer: Multiplan Commercial |
$412.67
|
| Rate for Payer: NAPHCARE Commercial |
$309.50
|
| Rate for Payer: Preferred Network Access Commercial |
$474.57
|
| Rate for Payer: Quartz Beloit One Network |
$252.76
|
| Rate for Payer: Quartz Commercial |
$335.30
|
| Rate for Payer: Quartz Medicare Advantage |
$309.50
|
| Rate for Payer: The Alliance Commercial |
$257.92
|
| Rate for Payer: WEA Trust Commercial |
$283.71
|
| Rate for Payer: WPS Commercial |
$382.07
|
|
|
SCREW CANC 4.0 X 80 FULL THREAD 206.080
|
Facility
|
OP
|
$423.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264967
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.18 |
| Max. Negotiated Rate |
$404.73 |
| Rate for Payer: Aetna Commercial |
$395.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$378.33
|
| Rate for Payer: Aetna Managed Medicare |
$123.18
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$285.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$219.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$211.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$233.16
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cigna Commercial |
$404.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$246.19
|
| Rate for Payer: Health EOS Commercial |
$391.53
|
| Rate for Payer: HFN Commercial |
$404.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$329.94
|
| Rate for Payer: Multiplan Commercial |
$351.94
|
| Rate for Payer: NAPHCARE Commercial |
$263.95
|
| Rate for Payer: Preferred Network Access Commercial |
$404.73
|
| Rate for Payer: Quartz Beloit One Network |
$215.56
|
| Rate for Payer: Quartz Commercial |
$285.95
|
| Rate for Payer: Quartz Medicare Advantage |
$263.95
|
| Rate for Payer: The Alliance Commercial |
$219.96
|
| Rate for Payer: WEA Trust Commercial |
$241.96
|
| Rate for Payer: WPS Commercial |
$325.84
|
|
|
SCREW CANC 4.0 X 80 FULL THREAD 206.080
|
Facility
|
IP
|
$423.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264967
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.56 |
| Max. Negotiated Rate |
$404.73 |
| Rate for Payer: Aetna Commercial |
$395.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$378.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$233.16
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cigna Commercial |
$404.73
|
| Rate for Payer: Health EOS Commercial |
$391.53
|
| Rate for Payer: HFN Commercial |
$404.73
|
| Rate for Payer: Multiplan Commercial |
$351.94
|
| Rate for Payer: Preferred Network Access Commercial |
$404.73
|
| Rate for Payer: Quartz Beloit One Network |
$215.56
|
| Rate for Payer: Quartz Commercial |
$263.95
|
| Rate for Payer: WEA Trust Commercial |
$241.96
|
| Rate for Payer: WPS Commercial |
$325.84
|
|
|
SCREW CANC 5.5 X 60MM LP TI AR-8555-60
|
Facility
|
OP
|
$1,198.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.86 |
| Max. Negotiated Rate |
$1,146.25 |
| Rate for Payer: Aetna Commercial |
$1,121.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,071.49
|
| Rate for Payer: Aetna Managed Medicare |
$348.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$809.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$622.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$598.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$660.34
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cigna Commercial |
$1,146.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$697.24
|
| Rate for Payer: Health EOS Commercial |
$1,108.87
|
| Rate for Payer: HFN Commercial |
$1,146.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$934.44
|
| Rate for Payer: Multiplan Commercial |
$996.74
|
| Rate for Payer: NAPHCARE Commercial |
$747.55
|
| Rate for Payer: Preferred Network Access Commercial |
$1,146.25
|
| Rate for Payer: Quartz Beloit One Network |
$610.50
|
| Rate for Payer: Quartz Commercial |
$809.85
|
| Rate for Payer: Quartz Medicare Advantage |
$747.55
|
| Rate for Payer: The Alliance Commercial |
$622.96
|
| Rate for Payer: WEA Trust Commercial |
$685.26
|
| Rate for Payer: WPS Commercial |
$922.82
|
|
|
SCREW CANC 5.5 X 60MM LP TI AR-8555-60
|
Facility
|
IP
|
$1,198.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$610.50 |
| Max. Negotiated Rate |
$1,146.25 |
| Rate for Payer: Aetna Commercial |
$1,121.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,071.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$660.34
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cigna Commercial |
$1,146.25
|
| Rate for Payer: Health EOS Commercial |
$1,108.87
|
| Rate for Payer: HFN Commercial |
$1,146.25
|
| Rate for Payer: Multiplan Commercial |
$996.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,146.25
|
| Rate for Payer: Quartz Beloit One Network |
$610.50
|
| Rate for Payer: Quartz Commercial |
$747.55
|
| Rate for Payer: WEA Trust Commercial |
$685.26
|
| Rate for Payer: WPS Commercial |
$922.82
|
|
|
SCREW-CANC 6.5 X 25 218.025 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Aetna Managed Medicare |
$161.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$373.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$287.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$276.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$321.85
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$431.34
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: NAPHCARE Commercial |
$345.07
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$373.83
|
| Rate for Payer: Quartz Medicare Advantage |
$345.07
|
| Rate for Payer: The Alliance Commercial |
$287.56
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 25 218.025 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.81 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$345.07
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 30 216.030 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967056
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Aetna Managed Medicare |
$85.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$198.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$152.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$146.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$170.53
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$228.54
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: NAPHCARE Commercial |
$182.83
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$198.07
|
| Rate for Payer: Quartz Medicare Advantage |
$182.83
|
| Rate for Payer: The Alliance Commercial |
$152.36
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 30 216.030 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967056
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$182.83
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 30 218.030 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.81 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$345.07
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 30 218.030 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Aetna Managed Medicare |
$161.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$373.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$287.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$276.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$321.85
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$431.34
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: NAPHCARE Commercial |
$345.07
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$373.83
|
| Rate for Payer: Quartz Medicare Advantage |
$345.07
|
| Rate for Payer: The Alliance Commercial |
$287.56
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 35 216.035 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$182.83
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 35 216.035 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Aetna Managed Medicare |
$85.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$198.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$152.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$146.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$170.53
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$228.54
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: NAPHCARE Commercial |
$182.83
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$198.07
|
| Rate for Payer: Quartz Medicare Advantage |
$182.83
|
| Rate for Payer: The Alliance Commercial |
$152.36
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 35 218.035 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Aetna Managed Medicare |
$161.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$373.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$287.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$276.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$321.85
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$431.34
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: NAPHCARE Commercial |
$345.07
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$373.83
|
| Rate for Payer: Quartz Medicare Advantage |
$345.07
|
| Rate for Payer: The Alliance Commercial |
$287.56
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 35 218.035 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.81 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$345.07
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 40 216.040 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$182.83
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 40 216.040 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Aetna Managed Medicare |
$85.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$198.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$152.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$146.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$170.53
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$228.54
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: NAPHCARE Commercial |
$182.83
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$198.07
|
| Rate for Payer: Quartz Medicare Advantage |
$182.83
|
| Rate for Payer: The Alliance Commercial |
$152.36
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 40 218.040 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Aetna Managed Medicare |
$161.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$373.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$287.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$276.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$321.85
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$431.34
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: NAPHCARE Commercial |
$345.07
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$373.83
|
| Rate for Payer: Quartz Medicare Advantage |
$345.07
|
| Rate for Payer: The Alliance Commercial |
$287.56
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 40 218.040 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.81 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$345.07
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
|
SCREW-CANC 6.5 X 45 216.045 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Aetna Managed Medicare |
$85.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$198.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$152.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$146.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$170.53
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$228.54
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: NAPHCARE Commercial |
$182.83
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$198.07
|
| Rate for Payer: Quartz Medicare Advantage |
$182.83
|
| Rate for Payer: The Alliance Commercial |
$152.36
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 45 216.045 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$280.34 |
| Rate for Payer: Aetna Commercial |
$274.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$161.50
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$280.34
|
| Rate for Payer: Health EOS Commercial |
$271.20
|
| Rate for Payer: HFN Commercial |
$280.34
|
| Rate for Payer: Multiplan Commercial |
$243.78
|
| Rate for Payer: Preferred Network Access Commercial |
$280.34
|
| Rate for Payer: Quartz Beloit One Network |
$149.31
|
| Rate for Payer: Quartz Commercial |
$182.83
|
| Rate for Payer: WEA Trust Commercial |
$167.60
|
| Rate for Payer: WPS Commercial |
$225.70
|
|
|
SCREW-CANC 6.5 X 45 217.045 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.93 |
| Max. Negotiated Rate |
$441.08 |
| Rate for Payer: Aetna Commercial |
$431.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$412.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$254.10
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$441.08
|
| Rate for Payer: Health EOS Commercial |
$426.70
|
| Rate for Payer: HFN Commercial |
$441.08
|
| Rate for Payer: Multiplan Commercial |
$383.55
|
| Rate for Payer: Preferred Network Access Commercial |
$441.08
|
| Rate for Payer: Quartz Beloit One Network |
$234.93
|
| Rate for Payer: Quartz Commercial |
$287.66
|
| Rate for Payer: WEA Trust Commercial |
$263.69
|
| Rate for Payer: WPS Commercial |
$355.11
|
|
|
SCREW-CANC 6.5 X 45 217.045 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.24 |
| Max. Negotiated Rate |
$441.08 |
| Rate for Payer: Aetna Commercial |
$431.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$412.32
|
| Rate for Payer: Aetna Managed Medicare |
$134.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$311.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$239.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$230.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$254.10
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$441.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$268.30
|
| Rate for Payer: Health EOS Commercial |
$426.70
|
| Rate for Payer: HFN Commercial |
$441.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$359.58
|
| Rate for Payer: Multiplan Commercial |
$383.55
|
| Rate for Payer: NAPHCARE Commercial |
$287.66
|
| Rate for Payer: Preferred Network Access Commercial |
$441.08
|
| Rate for Payer: Quartz Beloit One Network |
$234.93
|
| Rate for Payer: Quartz Commercial |
$311.64
|
| Rate for Payer: Quartz Medicare Advantage |
$287.66
|
| Rate for Payer: The Alliance Commercial |
$239.72
|
| Rate for Payer: WEA Trust Commercial |
$263.69
|
| Rate for Payer: WPS Commercial |
$355.11
|
|
|
SCREW-CANC 6.5 X 45 218.045 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.81 |
| Max. Negotiated Rate |
$529.11 |
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$494.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$304.81
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$529.11
|
| Rate for Payer: Health EOS Commercial |
$511.86
|
| Rate for Payer: HFN Commercial |
$529.11
|
| Rate for Payer: Multiplan Commercial |
$460.10
|
| Rate for Payer: Preferred Network Access Commercial |
$529.11
|
| Rate for Payer: Quartz Beloit One Network |
$281.81
|
| Rate for Payer: Quartz Commercial |
$345.07
|
| Rate for Payer: WEA Trust Commercial |
$316.32
|
| Rate for Payer: WPS Commercial |
$425.98
|
|
