|
SCREW CANN 3.75 X 32MM FULLY THREAD AR-7000-32FT
|
Facility
|
OP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4264789
|
|
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 32MM FULLY THREAD AR-7000-32FT
|
Facility
|
IP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4264789
|
|
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 34MM FULLY THREAD AR-7000-34FT
|
Facility
|
OP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595505
|
|
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 34MM FULLY THREAD AR-7000-34FT
|
Facility
|
IP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4595505
|
|
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 34MM PARTIAL THREAD AR-7000-34
|
Facility
|
IP
|
$2,046.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508886
|
|
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 34MM PARTIAL THREAD AR-7000-34
|
Facility
|
OP
|
$2,046.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508886
|
|
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
|
|
|
SCREW CANN 3.75 X 36MM FULLY THREAD AR-7000-36FT
|
Facility
|
OP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4124778
|
|
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 36MM FULLY THREAD AR-7000-36FT
|
Facility
|
IP
|
$2,926.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4124778
|
|
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 36MM PARTIAL THREAD AR-7000-36
|
Facility
|
OP
|
$2,046.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508887
|
|
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
|
|
|
SCREW CANN 3.75 X 36MM PARTIAL THREAD AR-7000-36
|
Facility
|
IP
|
$2,046.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508887
|
|
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 4.0 X 10 207.610
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,170.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 10 207.610
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$546.00 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Aetna Managed Medicare |
$546.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,267.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$975.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$936.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,091.25
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,462.50
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,170.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,267.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,170.00
|
| Rate for Payer: The Alliance Commercial |
$975.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 12 207.612
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$546.00 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Aetna Managed Medicare |
$546.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,267.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$975.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$936.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,091.25
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,462.50
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,170.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,267.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,170.00
|
| Rate for Payer: The Alliance Commercial |
$975.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 12 207.612
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,170.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 14 207.614
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,170.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 14 207.614
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$546.00 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Aetna Managed Medicare |
$546.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,267.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$975.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$936.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,091.25
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,462.50
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,170.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,267.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,170.00
|
| Rate for Payer: The Alliance Commercial |
$975.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 16 207.616
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,170.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 16 207.616
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$546.00 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Aetna Managed Medicare |
$546.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,267.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$975.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$936.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,091.25
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,462.50
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,170.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,267.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,170.00
|
| Rate for Payer: The Alliance Commercial |
$975.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 16 207.716
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967132
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$546.00 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Aetna Managed Medicare |
$546.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,267.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$975.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$936.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,091.25
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,462.50
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,170.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,267.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,170.00
|
| Rate for Payer: The Alliance Commercial |
$975.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW-CANN 4.0 X 16 207.716
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967132
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,170.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
|
SCREW CANN 4.0 X 16MM TRILLIANT 200-40-016
|
Facility
|
IP
|
$1,997.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599586
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,017.67 |
| Max. Negotiated Rate |
$1,910.73 |
| Rate for Payer: Aetna Commercial |
$1,869.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,786.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,100.75
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,910.73
|
| Rate for Payer: Health EOS Commercial |
$1,848.42
|
| Rate for Payer: HFN Commercial |
$1,910.73
|
| Rate for Payer: Multiplan Commercial |
$1,661.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,910.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,017.67
|
| Rate for Payer: Quartz Commercial |
$1,246.13
|
| Rate for Payer: WEA Trust Commercial |
$1,142.28
|
| Rate for Payer: WPS Commercial |
$1,538.29
|
|
|
SCREW CANN 4.0 X 16MM TRILLIANT 200-40-016
|
Facility
|
OP
|
$1,997.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599586
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$581.53 |
| Max. Negotiated Rate |
$1,910.73 |
| Rate for Payer: Aetna Commercial |
$1,869.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,786.12
|
| Rate for Payer: Aetna Managed Medicare |
$581.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,349.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,038.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$996.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,100.75
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,910.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,162.25
|
| Rate for Payer: Health EOS Commercial |
$1,848.42
|
| Rate for Payer: HFN Commercial |
$1,910.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,557.66
|
| Rate for Payer: Multiplan Commercial |
$1,661.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,246.13
|
| Rate for Payer: Preferred Network Access Commercial |
$1,910.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,017.67
|
| Rate for Payer: Quartz Commercial |
$1,349.97
|
| Rate for Payer: Quartz Medicare Advantage |
$1,246.13
|
| Rate for Payer: The Alliance Commercial |
$1,038.44
|
| Rate for Payer: WEA Trust Commercial |
$1,142.28
|
| Rate for Payer: WPS Commercial |
$1,538.29
|
|
|
SCREW-CANN 4.0 X 18 207.618
|
Facility
|
OP
|
$1,947.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967133
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.97 |
| Max. Negotiated Rate |
$1,862.89 |
| Rate for Payer: Aetna Commercial |
$1,822.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,741.40
|
| Rate for Payer: Aetna Managed Medicare |
$566.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,316.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,012.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$971.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,073.19
|
| Rate for Payer: Cash Price |
$584.10
|
| Rate for Payer: Cigna Commercial |
$1,862.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,133.15
|
| Rate for Payer: Health EOS Commercial |
$1,802.14
|
| Rate for Payer: HFN Commercial |
$1,862.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,518.66
|
| Rate for Payer: Multiplan Commercial |
$1,619.90
|
| Rate for Payer: NAPHCARE Commercial |
$1,214.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,862.89
|
| Rate for Payer: Quartz Beloit One Network |
$992.19
|
| Rate for Payer: Quartz Commercial |
$1,316.17
|
| Rate for Payer: Quartz Medicare Advantage |
$1,214.93
|
| Rate for Payer: The Alliance Commercial |
$1,012.44
|
| Rate for Payer: WEA Trust Commercial |
$1,113.68
|
| Rate for Payer: WPS Commercial |
$1,499.77
|
|
|
SCREW-CANN 4.0 X 18 207.618
|
Facility
|
IP
|
$1,947.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967133
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$992.19 |
| Max. Negotiated Rate |
$1,862.89 |
| Rate for Payer: Aetna Commercial |
$1,822.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,741.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,073.19
|
| Rate for Payer: Cash Price |
$584.10
|
| Rate for Payer: Cigna Commercial |
$1,862.89
|
| Rate for Payer: Health EOS Commercial |
$1,802.14
|
| Rate for Payer: HFN Commercial |
$1,862.89
|
| Rate for Payer: Multiplan Commercial |
$1,619.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,862.89
|
| Rate for Payer: Quartz Beloit One Network |
$992.19
|
| Rate for Payer: Quartz Commercial |
$1,214.93
|
| Rate for Payer: WEA Trust Commercial |
$1,113.68
|
| Rate for Payer: WPS Commercial |
$1,499.77
|
|
|
SCREW-CANN 4.0 X 18 207.718
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$1,794.00 |
| Rate for Payer: Aetna Commercial |
$1,755.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,677.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,033.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$1,794.00
|
| Rate for Payer: Health EOS Commercial |
$1,735.50
|
| Rate for Payer: HFN Commercial |
$1,794.00
|
| Rate for Payer: Multiplan Commercial |
$1,560.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,794.00
|
| Rate for Payer: Quartz Beloit One Network |
$955.50
|
| Rate for Payer: Quartz Commercial |
$1,170.00
|
| Rate for Payer: WEA Trust Commercial |
$1,072.50
|
| Rate for Payer: WPS Commercial |
$1,444.31
|
|
