|
SCREW-CANC 6.5 X 50 218.050 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967067
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.97 |
| Max. Negotiated Rate |
$508.76 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$331.80
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW-CANC 6.5 X 55 217.055 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.89 |
| Max. Negotiated Rate |
$424.12 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$276.60
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 55 217.055 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$1,844.00 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Aetna Managed Medicare |
$129.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$299.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$230.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$257.98
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$345.75
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$299.65
|
| Rate for Payer: Quartz Medicare Advantage |
$276.60
|
| Rate for Payer: The Alliance Commercial |
$1,844.00
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 55 218.055 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967070
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.97 |
| Max. Negotiated Rate |
$508.76 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$331.80
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW-CANC 6.5 X 55 218.055 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967070
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$2,212.00 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Aetna Managed Medicare |
$154.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$359.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$276.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$265.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$309.46
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$414.75
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$359.45
|
| Rate for Payer: Quartz Medicare Advantage |
$331.80
|
| Rate for Payer: The Alliance Commercial |
$2,212.00
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW CANC 6.5 X 55 SHORT THREAD 16MM 216.055
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.57 |
| Max. Negotiated Rate |
$269.56 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$175.80
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW CANC 6.5 X 55 SHORT THREAD 16MM 216.055
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.04 |
| Max. Negotiated Rate |
$1,172.00 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Aetna Managed Medicare |
$82.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$190.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$146.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$140.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.96
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$190.45
|
| Rate for Payer: Quartz Medicare Advantage |
$175.80
|
| Rate for Payer: The Alliance Commercial |
$1,172.00
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW-CANC 6.5 X 60 217.060 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$1,844.00 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Aetna Managed Medicare |
$129.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$299.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$230.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$257.98
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$345.75
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$299.65
|
| Rate for Payer: Quartz Medicare Advantage |
$276.60
|
| Rate for Payer: The Alliance Commercial |
$1,844.00
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 60 217.060 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.89 |
| Max. Negotiated Rate |
$424.12 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$276.60
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 60 218.060 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.97 |
| Max. Negotiated Rate |
$508.76 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$331.80
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW-CANC 6.5 X 60 218.060 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$2,212.00 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Aetna Managed Medicare |
$154.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$359.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$276.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$265.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$309.46
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$414.75
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$359.45
|
| Rate for Payer: Quartz Medicare Advantage |
$331.80
|
| Rate for Payer: The Alliance Commercial |
$2,212.00
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW CANC 6.5 X 60 SHORT THREAD 16MM 216.060
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.57 |
| Max. Negotiated Rate |
$269.56 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$175.80
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW CANC 6.5 X 60 SHORT THREAD 16MM 216.060
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.04 |
| Max. Negotiated Rate |
$1,172.00 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Aetna Managed Medicare |
$82.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$190.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$146.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$140.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.96
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$190.45
|
| Rate for Payer: Quartz Medicare Advantage |
$175.80
|
| Rate for Payer: The Alliance Commercial |
$1,172.00
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW-CANC 6.5 X 65 216.065 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.57 |
| Max. Negotiated Rate |
$269.56 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$175.80
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW-CANC 6.5 X 65 216.065 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.04 |
| Max. Negotiated Rate |
$1,172.00 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Aetna Managed Medicare |
$82.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$190.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$146.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$140.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.96
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$190.45
|
| Rate for Payer: Quartz Medicare Advantage |
$175.80
|
| Rate for Payer: The Alliance Commercial |
$1,172.00
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW-CANC 6.5 X 65 217.065 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.89 |
| Max. Negotiated Rate |
$424.12 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$276.60
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 65 217.065 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$1,844.00 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Aetna Managed Medicare |
$129.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$299.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$230.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$257.98
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$345.75
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$299.65
|
| Rate for Payer: Quartz Medicare Advantage |
$276.60
|
| Rate for Payer: The Alliance Commercial |
$1,844.00
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 65 218.065 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$2,212.00 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Aetna Managed Medicare |
$154.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$359.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$276.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$265.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$309.46
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$414.75
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$359.45
|
| Rate for Payer: Quartz Medicare Advantage |
$331.80
|
| Rate for Payer: The Alliance Commercial |
$2,212.00
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW-CANC 6.5 X 65 218.065 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.97 |
| Max. Negotiated Rate |
$508.76 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$331.80
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW-CANC 6.5 X 70 216.070 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.57 |
| Max. Negotiated Rate |
$269.56 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$175.80
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW-CANC 6.5 X 70 216.070 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.04 |
| Max. Negotiated Rate |
$1,172.00 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$251.98
|
| Rate for Payer: Aetna Managed Medicare |
$82.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$190.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$146.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$140.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$155.29
|
| Rate for Payer: Cash Price |
$87.90
|
| Rate for Payer: Cigna Commercial |
$269.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$163.96
|
| Rate for Payer: Health EOS Commercial |
$260.77
|
| Rate for Payer: HFN Commercial |
$269.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: NAPHCARE Commercial |
$175.80
|
| Rate for Payer: Preferred Network Access Commercial |
$269.56
|
| Rate for Payer: Quartz Beloit One Network |
$143.57
|
| Rate for Payer: Quartz Commercial |
$190.45
|
| Rate for Payer: Quartz Medicare Advantage |
$175.80
|
| Rate for Payer: The Alliance Commercial |
$1,172.00
|
| Rate for Payer: WEA Trust Commercial |
$161.15
|
| Rate for Payer: WPS Commercial |
$217.03
|
|
|
SCREW-CANC 6.5 X 70 217.070 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$1,844.00 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Aetna Managed Medicare |
$129.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$299.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$230.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$221.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$257.98
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$345.75
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$299.65
|
| Rate for Payer: Quartz Medicare Advantage |
$276.60
|
| Rate for Payer: The Alliance Commercial |
$1,844.00
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 70 217.070 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967078
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.89 |
| Max. Negotiated Rate |
$424.12 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$396.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$244.33
|
| Rate for Payer: Cash Price |
$138.30
|
| Rate for Payer: Cigna Commercial |
$424.12
|
| Rate for Payer: Health EOS Commercial |
$410.29
|
| Rate for Payer: HFN Commercial |
$424.12
|
| Rate for Payer: Multiplan Commercial |
$368.80
|
| Rate for Payer: NAPHCARE Commercial |
$276.60
|
| Rate for Payer: Preferred Network Access Commercial |
$424.12
|
| Rate for Payer: Quartz Beloit One Network |
$225.89
|
| Rate for Payer: Quartz Commercial |
$276.60
|
| Rate for Payer: WEA Trust Commercial |
$253.55
|
| Rate for Payer: WPS Commercial |
$341.46
|
|
|
SCREW-CANC 6.5 X 70 218.070 FULL THREAD
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
2967079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$2,212.00 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Aetna Managed Medicare |
$154.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$359.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$276.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$265.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$309.46
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$414.75
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$359.45
|
| Rate for Payer: Quartz Medicare Advantage |
$331.80
|
| Rate for Payer: The Alliance Commercial |
$2,212.00
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
|
SCREW-CANC 6.5 X 70 218.070 FULL THREAD
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
2967079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.97 |
| Max. Negotiated Rate |
$508.76 |
| Rate for Payer: Aetna Commercial |
$497.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$475.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$293.09
|
| Rate for Payer: Cash Price |
$165.90
|
| Rate for Payer: Cigna Commercial |
$508.76
|
| Rate for Payer: Health EOS Commercial |
$492.17
|
| Rate for Payer: HFN Commercial |
$508.76
|
| Rate for Payer: Multiplan Commercial |
$442.40
|
| Rate for Payer: NAPHCARE Commercial |
$331.80
|
| Rate for Payer: Preferred Network Access Commercial |
$508.76
|
| Rate for Payer: Quartz Beloit One Network |
$270.97
|
| Rate for Payer: Quartz Commercial |
$331.80
|
| Rate for Payer: WEA Trust Commercial |
$304.15
|
| Rate for Payer: WPS Commercial |
$409.61
|
|
