|
SCREW-CANN 2.4 X 18 319-2418
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.61 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,437.07
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW CANN 2.4 X 18 TIGER 200-24-018
|
Facility
|
IP
|
$2,139.00
|
|
| Hospital Charge Code |
3333541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.03 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,334.74
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW CANN 2.4 X 18 TIGER 200-24-018
|
Facility
|
OP
|
$2,139.00
|
|
| Hospital Charge Code |
3333541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.88 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Aetna Managed Medicare |
$622.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,445.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,112.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,067.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,244.90
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,668.42
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,334.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,445.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,334.74
|
| Rate for Payer: The Alliance Commercial |
$1,112.28
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW-CANN 2.4 X 20 319-2420
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.61 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,437.07
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW-CANN 2.4 X 20 319-2420
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.63 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Aetna Managed Medicare |
$670.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,556.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,197.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,149.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,340.35
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,796.34
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,437.07
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,556.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,437.07
|
| Rate for Payer: The Alliance Commercial |
$1,197.56
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW CANN 2.4 X 20 PART THREAD LP TI AR-8724-20
|
Facility
|
OP
|
$2,213.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415810
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$644.43 |
| Max. Negotiated Rate |
$2,117.40 |
| Rate for Payer: Aetna Commercial |
$2,071.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,979.31
|
| Rate for Payer: Aetna Managed Medicare |
$644.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,495.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,150.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,104.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,219.81
|
| Rate for Payer: Cash Price |
$663.90
|
| Rate for Payer: Cigna Commercial |
$2,117.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,287.97
|
| Rate for Payer: Health EOS Commercial |
$2,048.35
|
| Rate for Payer: HFN Commercial |
$2,117.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,726.14
|
| Rate for Payer: Multiplan Commercial |
$1,841.22
|
| Rate for Payer: NAPHCARE Commercial |
$1,380.91
|
| Rate for Payer: Preferred Network Access Commercial |
$2,117.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,127.74
|
| Rate for Payer: Quartz Commercial |
$1,495.99
|
| Rate for Payer: Quartz Medicare Advantage |
$1,380.91
|
| Rate for Payer: The Alliance Commercial |
$1,150.76
|
| Rate for Payer: WEA Trust Commercial |
$1,265.84
|
| Rate for Payer: WPS Commercial |
$1,704.67
|
|
|
SCREW CANN 2.4 X 20 PART THREAD LP TI AR-8724-20
|
Facility
|
IP
|
$2,213.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415810
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,127.74 |
| Max. Negotiated Rate |
$2,117.40 |
| Rate for Payer: Aetna Commercial |
$2,071.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,979.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,219.81
|
| Rate for Payer: Cash Price |
$663.90
|
| Rate for Payer: Cigna Commercial |
$2,117.40
|
| Rate for Payer: Health EOS Commercial |
$2,048.35
|
| Rate for Payer: HFN Commercial |
$2,117.40
|
| Rate for Payer: Multiplan Commercial |
$1,841.22
|
| Rate for Payer: Preferred Network Access Commercial |
$2,117.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,127.74
|
| Rate for Payer: Quartz Commercial |
$1,380.91
|
| Rate for Payer: WEA Trust Commercial |
$1,265.84
|
| Rate for Payer: WPS Commercial |
$1,704.67
|
|
|
SCREW CANN 2.4 X 20 TIGER 200-24-020
|
Facility
|
IP
|
$2,139.00
|
|
| Hospital Charge Code |
3444826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.03 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,334.74
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW CANN 2.4 X 20 TIGER 200-24-020
|
Facility
|
OP
|
$2,139.00
|
|
| Hospital Charge Code |
3444826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.88 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Aetna Managed Medicare |
$622.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,445.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,112.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,067.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,244.90
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,668.42
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,334.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,445.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,334.74
|
| Rate for Payer: The Alliance Commercial |
$1,112.28
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW-CANN 2.4 X 22 319-2422
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965483
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.63 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Aetna Managed Medicare |
$670.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,556.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,197.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,149.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,340.35
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,796.34
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,437.07
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,556.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,437.07
|
| Rate for Payer: The Alliance Commercial |
$1,197.56
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW-CANN 2.4 X 22 319-2422
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965483
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.61 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,437.07
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW CANN 2.4 X 22 TIGER 200-24-022
|
Facility
|
IP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3333542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.03 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,334.74
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW CANN 2.4 X 22 TIGER 200-24-022
|
Facility
|
OP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3333542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.88 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Aetna Managed Medicare |
$622.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,445.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,112.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,067.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,244.90
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,668.42
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,334.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,445.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,334.74
|
| Rate for Payer: The Alliance Commercial |
$1,112.28
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW-CANN 2.4 X 24 319-2424
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965485
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.63 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Aetna Managed Medicare |
$670.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,556.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,197.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,149.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,340.35
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,796.34
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,437.07
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,556.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,437.07
|
| Rate for Payer: The Alliance Commercial |
$1,197.56
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW-CANN 2.4 X 24 319-2424
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965485
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.61 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,437.07
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW CANN 2.4 X 24 TIGER 200-24-024
|
Facility
|
OP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3782769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.88 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Aetna Managed Medicare |
$622.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,445.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,112.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,067.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,244.90
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,668.42
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,334.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,445.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,334.74
|
| Rate for Payer: The Alliance Commercial |
$1,112.28
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW CANN 2.4 X 24 TIGER 200-24-024
|
Facility
|
IP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3782769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.03 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,334.74
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW-CANN 2.4 X 26 319-2426
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.63 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Aetna Managed Medicare |
$670.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,556.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,197.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,149.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,340.35
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,796.34
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,437.07
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,556.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,437.07
|
| Rate for Payer: The Alliance Commercial |
$1,197.56
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW-CANN 2.4 X 26 319-2426
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.61 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,437.07
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW CANN 2.4 X 26 HEADLESS 02.226.326
|
Facility
|
OP
|
$4,242.00
|
|
| Hospital Charge Code |
3072551
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,235.27 |
| Max. Negotiated Rate |
$4,058.75 |
| Rate for Payer: Aetna Commercial |
$3,970.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,794.04
|
| Rate for Payer: Aetna Managed Medicare |
$1,235.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,867.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,205.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,117.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,338.19
|
| Rate for Payer: Cash Price |
$1,272.60
|
| Rate for Payer: Cigna Commercial |
$4,058.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,468.84
|
| Rate for Payer: Health EOS Commercial |
$3,926.40
|
| Rate for Payer: HFN Commercial |
$4,058.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,308.76
|
| Rate for Payer: Multiplan Commercial |
$3,529.34
|
| Rate for Payer: NAPHCARE Commercial |
$2,647.01
|
| Rate for Payer: Preferred Network Access Commercial |
$4,058.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,161.72
|
| Rate for Payer: Quartz Commercial |
$2,867.59
|
| Rate for Payer: Quartz Medicare Advantage |
$2,647.01
|
| Rate for Payer: The Alliance Commercial |
$2,205.84
|
| Rate for Payer: WEA Trust Commercial |
$2,426.42
|
| Rate for Payer: WPS Commercial |
$3,267.61
|
|
|
SCREW CANN 2.4 X 26 HEADLESS 02.226.326
|
Facility
|
IP
|
$4,242.00
|
|
| Hospital Charge Code |
3072551
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,161.72 |
| Max. Negotiated Rate |
$4,058.75 |
| Rate for Payer: Aetna Commercial |
$3,970.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,794.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,338.19
|
| Rate for Payer: Cash Price |
$1,272.60
|
| Rate for Payer: Cigna Commercial |
$4,058.75
|
| Rate for Payer: Health EOS Commercial |
$3,926.40
|
| Rate for Payer: HFN Commercial |
$4,058.75
|
| Rate for Payer: Multiplan Commercial |
$3,529.34
|
| Rate for Payer: Preferred Network Access Commercial |
$4,058.75
|
| Rate for Payer: Quartz Beloit One Network |
$2,161.72
|
| Rate for Payer: Quartz Commercial |
$2,647.01
|
| Rate for Payer: WEA Trust Commercial |
$2,426.42
|
| Rate for Payer: WPS Commercial |
$3,267.61
|
|
|
SCREW CANN 2.4 X 26 TIGER 200-24-026
|
Facility
|
IP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3457511
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.03 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,334.74
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW CANN 2.4 X 26 TIGER 200-24-026
|
Facility
|
OP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3457511
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.88 |
| Max. Negotiated Rate |
$2,046.60 |
| Rate for Payer: Aetna Commercial |
$2,002.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,913.12
|
| Rate for Payer: Aetna Managed Medicare |
$622.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,445.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,112.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,067.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,179.02
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$2,046.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,244.90
|
| Rate for Payer: Health EOS Commercial |
$1,979.86
|
| Rate for Payer: HFN Commercial |
$2,046.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,668.42
|
| Rate for Payer: Multiplan Commercial |
$1,779.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,334.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,046.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,090.03
|
| Rate for Payer: Quartz Commercial |
$1,445.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,334.74
|
| Rate for Payer: The Alliance Commercial |
$1,112.28
|
| Rate for Payer: WEA Trust Commercial |
$1,223.51
|
| Rate for Payer: WPS Commercial |
$1,647.67
|
|
|
SCREW-CANN 2.4 X 28 319-2428
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.63 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Aetna Managed Medicare |
$670.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,556.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,197.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,149.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,340.35
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,796.34
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,437.07
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,556.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,437.07
|
| Rate for Payer: The Alliance Commercial |
$1,197.56
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
|
SCREW-CANN 2.4 X 28 319-2428
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.61 |
| Max. Negotiated Rate |
$2,203.51 |
| Rate for Payer: Aetna Commercial |
$2,155.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,059.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,269.41
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,203.51
|
| Rate for Payer: Health EOS Commercial |
$2,131.66
|
| Rate for Payer: HFN Commercial |
$2,203.51
|
| Rate for Payer: Multiplan Commercial |
$1,916.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,203.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.61
|
| Rate for Payer: Quartz Commercial |
$1,437.07
|
| Rate for Payer: WEA Trust Commercial |
$1,317.32
|
| Rate for Payer: WPS Commercial |
$1,774.00
|
|
