|
SCREW-CANN 3.0 X 36 202.736
|
Facility
|
OP
|
$2,121.00
|
|
| Hospital Charge Code |
2967121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$617.64 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Aetna Managed Medicare |
$617.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,433.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,058.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,234.42
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,654.38
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,323.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,433.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,323.50
|
| Rate for Payer: The Alliance Commercial |
$1,102.92
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW CANN 3.0 X 36 TIGER 200-30-036
|
Facility
|
IP
|
$2,059.00
|
|
| Hospital Charge Code |
3784159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,049.27 |
| Max. Negotiated Rate |
$1,970.05 |
| Rate for Payer: Aetna Commercial |
$1,927.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,841.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,134.92
|
| Rate for Payer: Cash Price |
$617.70
|
| Rate for Payer: Cigna Commercial |
$1,970.05
|
| Rate for Payer: Health EOS Commercial |
$1,905.81
|
| Rate for Payer: HFN Commercial |
$1,970.05
|
| Rate for Payer: Multiplan Commercial |
$1,713.09
|
| Rate for Payer: Preferred Network Access Commercial |
$1,970.05
|
| Rate for Payer: Quartz Beloit One Network |
$1,049.27
|
| Rate for Payer: Quartz Commercial |
$1,284.82
|
| Rate for Payer: WEA Trust Commercial |
$1,177.75
|
| Rate for Payer: WPS Commercial |
$1,586.05
|
|
|
SCREW CANN 3.0 X 36 TIGER 200-30-036
|
Facility
|
OP
|
$2,059.00
|
|
| Hospital Charge Code |
3784159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$599.58 |
| Max. Negotiated Rate |
$1,970.05 |
| Rate for Payer: Aetna Commercial |
$1,927.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,841.57
|
| Rate for Payer: Aetna Managed Medicare |
$599.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,391.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,070.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,027.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,134.92
|
| Rate for Payer: Cash Price |
$617.70
|
| Rate for Payer: Cigna Commercial |
$1,970.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,198.34
|
| Rate for Payer: Health EOS Commercial |
$1,905.81
|
| Rate for Payer: HFN Commercial |
$1,970.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,606.02
|
| Rate for Payer: Multiplan Commercial |
$1,713.09
|
| Rate for Payer: NAPHCARE Commercial |
$1,284.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,970.05
|
| Rate for Payer: Quartz Beloit One Network |
$1,049.27
|
| Rate for Payer: Quartz Commercial |
$1,391.88
|
| Rate for Payer: Quartz Medicare Advantage |
$1,284.82
|
| Rate for Payer: The Alliance Commercial |
$1,070.68
|
| Rate for Payer: WEA Trust Commercial |
$1,177.75
|
| Rate for Payer: WPS Commercial |
$1,586.05
|
|
|
SCREW-CANN 3.0 X 38 202.638
|
Facility
|
OP
|
$2,121.00
|
|
| Hospital Charge Code |
2967122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$617.64 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Aetna Managed Medicare |
$617.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,433.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,058.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,234.42
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,654.38
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,323.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,433.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,323.50
|
| Rate for Payer: The Alliance Commercial |
$1,102.92
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 38 202.638
|
Facility
|
IP
|
$2,121.00
|
|
| Hospital Charge Code |
2967122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,080.86 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,323.50
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 38 202.738
|
Facility
|
IP
|
$2,202.00
|
|
| Hospital Charge Code |
2967123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,122.14 |
| Max. Negotiated Rate |
$2,106.87 |
| Rate for Payer: Aetna Commercial |
$2,061.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,969.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,213.74
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cigna Commercial |
$2,106.87
|
| Rate for Payer: Health EOS Commercial |
$2,038.17
|
| Rate for Payer: HFN Commercial |
$2,106.87
|
| Rate for Payer: Multiplan Commercial |
$1,832.06
|
| Rate for Payer: Preferred Network Access Commercial |
$2,106.87
|
| Rate for Payer: Quartz Beloit One Network |
$1,122.14
|
| Rate for Payer: Quartz Commercial |
$1,374.05
|
| Rate for Payer: WEA Trust Commercial |
$1,259.54
|
| Rate for Payer: WPS Commercial |
$1,696.20
|
|
|
SCREW-CANN 3.0 X 38 202.738
|
Facility
|
OP
|
$2,202.00
|
|
| Hospital Charge Code |
2967123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.22 |
| Max. Negotiated Rate |
$2,106.87 |
| Rate for Payer: Aetna Commercial |
$2,061.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,969.47
|
| Rate for Payer: Aetna Managed Medicare |
$641.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,488.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,145.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,099.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,213.74
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cigna Commercial |
$2,106.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,281.56
|
| Rate for Payer: Health EOS Commercial |
$2,038.17
|
| Rate for Payer: HFN Commercial |
$2,106.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,717.56
|
| Rate for Payer: Multiplan Commercial |
$1,832.06
|
| Rate for Payer: NAPHCARE Commercial |
$1,374.05
|
| Rate for Payer: Preferred Network Access Commercial |
$2,106.87
|
| Rate for Payer: Quartz Beloit One Network |
$1,122.14
|
| Rate for Payer: Quartz Commercial |
$1,488.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,374.05
|
| Rate for Payer: The Alliance Commercial |
$1,145.04
|
| Rate for Payer: WEA Trust Commercial |
$1,259.54
|
| Rate for Payer: WPS Commercial |
$1,696.20
|
|
|
SCREW CANN 3.0 X 38 TIGER 200-30-038
|
Facility
|
IP
|
$2,059.00
|
|
| Hospital Charge Code |
3784160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,049.27 |
| Max. Negotiated Rate |
$1,970.05 |
| Rate for Payer: Aetna Commercial |
$1,927.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,841.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,134.92
|
| Rate for Payer: Cash Price |
$617.70
|
| Rate for Payer: Cigna Commercial |
$1,970.05
|
| Rate for Payer: Health EOS Commercial |
$1,905.81
|
| Rate for Payer: HFN Commercial |
$1,970.05
|
| Rate for Payer: Multiplan Commercial |
$1,713.09
|
| Rate for Payer: Preferred Network Access Commercial |
$1,970.05
|
| Rate for Payer: Quartz Beloit One Network |
$1,049.27
|
| Rate for Payer: Quartz Commercial |
$1,284.82
|
| Rate for Payer: WEA Trust Commercial |
$1,177.75
|
| Rate for Payer: WPS Commercial |
$1,586.05
|
|
|
SCREW CANN 3.0 X 38 TIGER 200-30-038
|
Facility
|
OP
|
$2,059.00
|
|
| Hospital Charge Code |
3784160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$599.58 |
| Max. Negotiated Rate |
$1,970.05 |
| Rate for Payer: Aetna Commercial |
$1,927.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,841.57
|
| Rate for Payer: Aetna Managed Medicare |
$599.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,391.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,070.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,027.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,134.92
|
| Rate for Payer: Cash Price |
$617.70
|
| Rate for Payer: Cigna Commercial |
$1,970.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,198.34
|
| Rate for Payer: Health EOS Commercial |
$1,905.81
|
| Rate for Payer: HFN Commercial |
$1,970.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,606.02
|
| Rate for Payer: Multiplan Commercial |
$1,713.09
|
| Rate for Payer: NAPHCARE Commercial |
$1,284.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,970.05
|
| Rate for Payer: Quartz Beloit One Network |
$1,049.27
|
| Rate for Payer: Quartz Commercial |
$1,391.88
|
| Rate for Payer: Quartz Medicare Advantage |
$1,284.82
|
| Rate for Payer: The Alliance Commercial |
$1,070.68
|
| Rate for Payer: WEA Trust Commercial |
$1,177.75
|
| Rate for Payer: WPS Commercial |
$1,586.05
|
|
|
SCREW-CANN 3.0 X 40 202.640
|
Facility
|
OP
|
$2,121.00
|
|
| Hospital Charge Code |
2967124
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$617.64 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Aetna Managed Medicare |
$617.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,433.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,058.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,234.42
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,654.38
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,323.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,433.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,323.50
|
| Rate for Payer: The Alliance Commercial |
$1,102.92
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 40 202.640
|
Facility
|
IP
|
$2,121.00
|
|
| Hospital Charge Code |
2967124
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,080.86 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,323.50
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 40 202.740
|
Facility
|
OP
|
$2,121.00
|
|
| Hospital Charge Code |
2967125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$617.64 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Aetna Managed Medicare |
$617.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,433.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,058.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,234.42
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,654.38
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,323.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,433.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,323.50
|
| Rate for Payer: The Alliance Commercial |
$1,102.92
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 40 202.740
|
Facility
|
IP
|
$2,121.00
|
|
| Hospital Charge Code |
2967125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,080.86 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,323.50
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW CANN 3.0 X 40 TIGER 200-30-040
|
Facility
|
IP
|
$2,139.00
|
|
| Hospital Charge Code |
3784161
|
|
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 3.0 X 40 TIGER 200-30-040
|
Facility
|
OP
|
$2,139.00
|
|
| Hospital Charge Code |
3784161
|
|
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 3.0 X 55MM LONG THREAD TI 04.354.255TS
|
Facility
|
IP
|
$3,948.83
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6248160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,012.32 |
| Max. Negotiated Rate |
$3,778.24 |
| Rate for Payer: Aetna Commercial |
$3,696.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,531.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,176.60
|
| Rate for Payer: Cash Price |
$1,184.65
|
| Rate for Payer: Cigna Commercial |
$3,778.24
|
| Rate for Payer: Health EOS Commercial |
$3,655.04
|
| Rate for Payer: HFN Commercial |
$3,778.24
|
| Rate for Payer: Multiplan Commercial |
$3,285.43
|
| Rate for Payer: Preferred Network Access Commercial |
$3,778.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,012.32
|
| Rate for Payer: Quartz Commercial |
$2,464.07
|
| Rate for Payer: WEA Trust Commercial |
$2,258.73
|
| Rate for Payer: WPS Commercial |
$3,041.78
|
|
|
SCREW CANN 3.0 X 55MM LONG THREAD TI 04.354.255TS
|
Facility
|
OP
|
$3,948.83
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6248160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,149.90 |
| Max. Negotiated Rate |
$3,778.24 |
| Rate for Payer: Aetna Commercial |
$3,696.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,531.83
|
| Rate for Payer: Aetna Managed Medicare |
$1,149.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,669.41
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,053.39
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,971.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,176.60
|
| Rate for Payer: Cash Price |
$1,184.65
|
| Rate for Payer: Cigna Commercial |
$3,778.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,298.22
|
| Rate for Payer: Health EOS Commercial |
$3,655.04
|
| Rate for Payer: HFN Commercial |
$3,778.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,080.09
|
| Rate for Payer: Multiplan Commercial |
$3,285.43
|
| Rate for Payer: NAPHCARE Commercial |
$2,464.07
|
| Rate for Payer: Preferred Network Access Commercial |
$3,778.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,012.32
|
| Rate for Payer: Quartz Commercial |
$2,669.41
|
| Rate for Payer: Quartz Medicare Advantage |
$2,464.07
|
| Rate for Payer: The Alliance Commercial |
$2,053.39
|
| Rate for Payer: WEA Trust Commercial |
$2,258.73
|
| Rate for Payer: WPS Commercial |
$3,041.78
|
|
|
SCREW-CANN 3.0 X 8 202.608
|
Facility
|
OP
|
$2,121.00
|
|
| Hospital Charge Code |
2967126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$617.64 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Aetna Managed Medicare |
$617.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,433.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,058.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,234.42
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,654.38
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,323.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,433.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,323.50
|
| Rate for Payer: The Alliance Commercial |
$1,102.92
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 8 202.608
|
Facility
|
IP
|
$2,121.00
|
|
| Hospital Charge Code |
2967126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,080.86 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,323.50
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 9 202.609
|
Facility
|
OP
|
$2,121.00
|
|
| Hospital Charge Code |
2967127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$617.64 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Aetna Managed Medicare |
$617.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,433.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,102.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,058.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,234.42
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,654.38
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,323.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,433.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,323.50
|
| Rate for Payer: The Alliance Commercial |
$1,102.92
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW-CANN 3.0 X 9 202.609
|
Facility
|
IP
|
$2,121.00
|
|
| Hospital Charge Code |
2967127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,080.86 |
| Max. Negotiated Rate |
$2,029.37 |
| Rate for Payer: Aetna Commercial |
$1,985.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,897.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,169.10
|
| Rate for Payer: Cash Price |
$636.30
|
| Rate for Payer: Cigna Commercial |
$2,029.37
|
| Rate for Payer: Health EOS Commercial |
$1,963.20
|
| Rate for Payer: HFN Commercial |
$2,029.37
|
| Rate for Payer: Multiplan Commercial |
$1,764.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,029.37
|
| Rate for Payer: Quartz Beloit One Network |
$1,080.86
|
| Rate for Payer: Quartz Commercial |
$1,323.50
|
| Rate for Payer: WEA Trust Commercial |
$1,213.21
|
| Rate for Payer: WPS Commercial |
$1,633.81
|
|
|
SCREW CANN 3.75 X 30MM FULL THREAD AR-7000-30FT
|
Facility
|
IP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.09 |
| Max. Negotiated Rate |
$2,799.60 |
| Rate for Payer: Aetna Commercial |
$2,738.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,612.81
|
| Rate for Payer: Cash Price |
$877.80
|
| Rate for Payer: Cigna Commercial |
$2,799.60
|
| Rate for Payer: Health EOS Commercial |
$2,708.31
|
| Rate for Payer: HFN Commercial |
$2,799.60
|
| Rate for Payer: Multiplan Commercial |
$2,434.43
|
| Rate for Payer: Preferred Network Access Commercial |
$2,799.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.09
|
| Rate for Payer: Quartz Commercial |
$1,825.82
|
| Rate for Payer: WEA Trust Commercial |
$1,673.67
|
| Rate for Payer: WPS Commercial |
$2,253.90
|
|
|
SCREW CANN 3.75 X 30MM FULL THREAD AR-7000-30FT
|
Facility
|
OP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.05 |
| Max. Negotiated Rate |
$2,799.60 |
| Rate for Payer: Aetna Commercial |
$2,738.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.01
|
| Rate for Payer: Aetna Managed Medicare |
$852.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,977.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,521.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,460.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,612.81
|
| Rate for Payer: Cash Price |
$877.80
|
| Rate for Payer: Cigna Commercial |
$2,799.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,702.93
|
| Rate for Payer: Health EOS Commercial |
$2,708.31
|
| Rate for Payer: HFN Commercial |
$2,799.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,282.28
|
| Rate for Payer: Multiplan Commercial |
$2,434.43
|
| Rate for Payer: NAPHCARE Commercial |
$1,825.82
|
| Rate for Payer: Preferred Network Access Commercial |
$2,799.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.09
|
| Rate for Payer: Quartz Commercial |
$1,977.98
|
| Rate for Payer: Quartz Medicare Advantage |
$1,825.82
|
| Rate for Payer: The Alliance Commercial |
$1,521.52
|
| Rate for Payer: WEA Trust Commercial |
$1,673.67
|
| Rate for Payer: WPS Commercial |
$2,253.90
|
|
|
SCREW CANN 3.75 X 30MM PARTIAL THREAD AR-7000-30
|
Facility
|
IP
|
$2,046.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,042.64 |
| Max. Negotiated Rate |
$1,957.61 |
| Rate for Payer: Aetna Commercial |
$1,915.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,829.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,127.76
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cigna Commercial |
$1,957.61
|
| Rate for Payer: Health EOS Commercial |
$1,893.78
|
| Rate for Payer: HFN Commercial |
$1,957.61
|
| Rate for Payer: Multiplan Commercial |
$1,702.27
|
| Rate for Payer: Preferred Network Access Commercial |
$1,957.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,042.64
|
| Rate for Payer: Quartz Commercial |
$1,276.70
|
| Rate for Payer: WEA Trust Commercial |
$1,170.31
|
| Rate for Payer: WPS Commercial |
$1,576.03
|
|
|
SCREW CANN 3.75 X 30MM PARTIAL THREAD AR-7000-30
|
Facility
|
OP
|
$2,046.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$595.80 |
| Max. Negotiated Rate |
$1,957.61 |
| Rate for Payer: Aetna Commercial |
$1,915.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,829.94
|
| Rate for Payer: Aetna Managed Medicare |
$595.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,383.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,063.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,021.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,127.76
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cigna Commercial |
$1,957.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,190.77
|
| Rate for Payer: Health EOS Commercial |
$1,893.78
|
| Rate for Payer: HFN Commercial |
$1,957.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,595.88
|
| Rate for Payer: Multiplan Commercial |
$1,702.27
|
| Rate for Payer: NAPHCARE Commercial |
$1,276.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,957.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,042.64
|
| Rate for Payer: Quartz Commercial |
$1,383.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,276.70
|
| Rate for Payer: The Alliance Commercial |
$1,063.92
|
| Rate for Payer: WEA Trust Commercial |
$1,170.31
|
| Rate for Payer: WPS Commercial |
$1,576.03
|
|
