|
SCREW-CANC 6.5 X 75 216.075 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967080
|
|
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 75 216.075 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967080
|
|
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 75 217.075 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967081
|
|
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 75 217.075 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967081
|
|
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 80 216.080 SHORT THREAD
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
2967082
|
|
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 80 216.080 SHORT THREAD
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
2967082
|
|
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 80 217.080 LONG THREAD
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
2967083
|
|
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 80 217.080 LONG THREAD
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
2967083
|
|
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 85 216.085 SHORT THREAD
|
Facility
|
OP
|
$730.00
|
|
| Hospital Charge Code |
2967084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.40 |
| Max. Negotiated Rate |
$2,920.00 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Aetna Managed Medicare |
$204.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$474.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$365.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$350.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$408.51
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$547.50
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$474.50
|
| Rate for Payer: Quartz Medicare Advantage |
$438.00
|
| Rate for Payer: The Alliance Commercial |
$2,920.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW-CANC 6.5 X 85 216.085 SHORT THREAD
|
Facility
|
IP
|
$730.00
|
|
| Hospital Charge Code |
2967084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.70 |
| Max. Negotiated Rate |
$671.60 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$438.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW-CANC 6.5 X 90 216.090 SHORT THREAD
|
Facility
|
IP
|
$730.00
|
|
| Hospital Charge Code |
2967085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.70 |
| Max. Negotiated Rate |
$671.60 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$438.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW-CANC 6.5 X 90 216.090 SHORT THREAD
|
Facility
|
OP
|
$730.00
|
|
| Hospital Charge Code |
2967085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.40 |
| Max. Negotiated Rate |
$2,920.00 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Aetna Managed Medicare |
$204.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$474.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$365.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$350.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$408.51
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$547.50
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$474.50
|
| Rate for Payer: Quartz Medicare Advantage |
$438.00
|
| Rate for Payer: The Alliance Commercial |
$2,920.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW-CANC 6.5 X 95 216.095 SHORT THREAD
|
Facility
|
OP
|
$730.00
|
|
| Hospital Charge Code |
2967086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.40 |
| Max. Negotiated Rate |
$2,920.00 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Aetna Managed Medicare |
$204.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$474.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$365.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$350.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$408.51
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$547.50
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$474.50
|
| Rate for Payer: Quartz Medicare Advantage |
$438.00
|
| Rate for Payer: The Alliance Commercial |
$2,920.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW-CANC 6.5 X 95 216.095 SHORT THREAD
|
Facility
|
IP
|
$730.00
|
|
| Hospital Charge Code |
2967086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.70 |
| Max. Negotiated Rate |
$671.60 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$438.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW CANCELLOUS 5.0X30 71755030
|
Facility
|
IP
|
$2,340.00
|
|
| Hospital Charge Code |
2966037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,146.60 |
| Max. Negotiated Rate |
$2,152.80 |
| Rate for Payer: Aetna Commercial |
$2,106.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,012.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,240.20
|
| Rate for Payer: Cash Price |
$702.00
|
| Rate for Payer: Cigna Commercial |
$2,152.80
|
| Rate for Payer: Health EOS Commercial |
$2,082.60
|
| Rate for Payer: HFN Commercial |
$2,152.80
|
| Rate for Payer: Multiplan Commercial |
$1,872.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,404.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,152.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,146.60
|
| Rate for Payer: Quartz Commercial |
$1,404.00
|
| Rate for Payer: WEA Trust Commercial |
$1,287.00
|
| Rate for Payer: WPS Commercial |
$1,733.24
|
|
|
SCREW CANCELLOUS 5.0X30 71755030
|
Facility
|
OP
|
$2,340.00
|
|
| Hospital Charge Code |
2966037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$655.20 |
| Max. Negotiated Rate |
$9,360.00 |
| Rate for Payer: Aetna Commercial |
$2,106.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,012.40
|
| Rate for Payer: Aetna Managed Medicare |
$655.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,521.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,170.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,123.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,240.20
|
| Rate for Payer: Cash Price |
$702.00
|
| Rate for Payer: Cigna Commercial |
$2,152.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,309.46
|
| Rate for Payer: Health EOS Commercial |
$2,082.60
|
| Rate for Payer: HFN Commercial |
$2,152.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,755.00
|
| Rate for Payer: Multiplan Commercial |
$1,872.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,404.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,152.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,146.60
|
| Rate for Payer: Quartz Commercial |
$1,521.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,404.00
|
| Rate for Payer: The Alliance Commercial |
$9,360.00
|
| Rate for Payer: WEA Trust Commercial |
$1,287.00
|
| Rate for Payer: WPS Commercial |
$1,733.24
|
|
|
SCREW CANCELLOUS HALF THREAD #407.045
|
Facility
|
OP
|
$456.00
|
|
| Hospital Charge Code |
2966546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.68 |
| Max. Negotiated Rate |
$1,824.00 |
| Rate for Payer: Aetna Commercial |
$410.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$392.16
|
| Rate for Payer: Aetna Managed Medicare |
$127.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$296.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$228.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$218.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$241.68
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cigna Commercial |
$419.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$255.18
|
| Rate for Payer: Health EOS Commercial |
$405.84
|
| Rate for Payer: HFN Commercial |
$419.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$342.00
|
| Rate for Payer: Multiplan Commercial |
$364.80
|
| Rate for Payer: NAPHCARE Commercial |
$273.60
|
| Rate for Payer: Preferred Network Access Commercial |
$419.52
|
| Rate for Payer: Quartz Beloit One Network |
$223.44
|
| Rate for Payer: Quartz Commercial |
$296.40
|
| Rate for Payer: Quartz Medicare Advantage |
$273.60
|
| Rate for Payer: The Alliance Commercial |
$1,824.00
|
| Rate for Payer: WEA Trust Commercial |
$250.80
|
| Rate for Payer: WPS Commercial |
$337.76
|
|
|
SCREW CANCELLOUS HALF THREAD #407.045
|
Facility
|
IP
|
$456.00
|
|
| Hospital Charge Code |
2966546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$223.44 |
| Max. Negotiated Rate |
$419.52 |
| Rate for Payer: Aetna Commercial |
$410.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$392.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$241.68
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cigna Commercial |
$419.52
|
| Rate for Payer: Health EOS Commercial |
$405.84
|
| Rate for Payer: HFN Commercial |
$419.52
|
| Rate for Payer: Multiplan Commercial |
$364.80
|
| Rate for Payer: NAPHCARE Commercial |
$273.60
|
| Rate for Payer: Preferred Network Access Commercial |
$419.52
|
| Rate for Payer: Quartz Beloit One Network |
$223.44
|
| Rate for Payer: Quartz Commercial |
$273.60
|
| Rate for Payer: WEA Trust Commercial |
$250.80
|
| Rate for Payer: WPS Commercial |
$337.76
|
|
|
SCREW-CANN 2.0 X 10 319-2010
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$644.84 |
| Max. Negotiated Rate |
$9,212.00 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Aetna Managed Medicare |
$644.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,496.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,151.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,105.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,288.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,727.25
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,496.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,381.80
|
| Rate for Payer: The Alliance Commercial |
$9,212.00
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW-CANN 2.0 X 10 319-2010
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.47 |
| Max. Negotiated Rate |
$2,118.76 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,381.80
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW CANN 2.0 X 10 TIGER 200-20-010
|
Facility
|
OP
|
$2,059.00
|
|
| Hospital Charge Code |
3782752
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$576.52 |
| Max. Negotiated Rate |
$8,236.00 |
| Rate for Payer: Aetna Commercial |
$1,853.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,770.74
|
| Rate for Payer: Aetna Managed Medicare |
$576.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,338.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,029.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$988.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,091.27
|
| Rate for Payer: Cash Price |
$617.70
|
| Rate for Payer: Cigna Commercial |
$1,894.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,152.22
|
| Rate for Payer: Health EOS Commercial |
$1,832.51
|
| Rate for Payer: HFN Commercial |
$1,894.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,544.25
|
| Rate for Payer: Multiplan Commercial |
$1,647.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,235.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,894.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,008.91
|
| Rate for Payer: Quartz Commercial |
$1,338.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,235.40
|
| Rate for Payer: The Alliance Commercial |
$8,236.00
|
| Rate for Payer: WEA Trust Commercial |
$1,132.45
|
| Rate for Payer: WPS Commercial |
$1,525.10
|
|
|
SCREW CANN 2.0 X 10 TIGER 200-20-010
|
Facility
|
IP
|
$2,059.00
|
|
| Hospital Charge Code |
3782752
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,008.91 |
| Max. Negotiated Rate |
$1,894.28 |
| Rate for Payer: Aetna Commercial |
$1,853.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,770.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,091.27
|
| Rate for Payer: Cash Price |
$617.70
|
| Rate for Payer: Cigna Commercial |
$1,894.28
|
| Rate for Payer: Health EOS Commercial |
$1,832.51
|
| Rate for Payer: HFN Commercial |
$1,894.28
|
| Rate for Payer: Multiplan Commercial |
$1,647.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,235.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,894.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,008.91
|
| Rate for Payer: Quartz Commercial |
$1,235.40
|
| Rate for Payer: WEA Trust Commercial |
$1,132.45
|
| Rate for Payer: WPS Commercial |
$1,525.10
|
|
|
SCREW-CANN 2.0 X 12 319-2012
|
Facility
|
IP
|
$2,303.00
|
|
| Hospital Charge Code |
2965455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.47 |
| Max. Negotiated Rate |
$2,118.76 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,381.80
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW-CANN 2.0 X 12 319-2012
|
Facility
|
OP
|
$2,303.00
|
|
| Hospital Charge Code |
2965455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$644.84 |
| Max. Negotiated Rate |
$9,212.00 |
| Rate for Payer: Aetna Commercial |
$2,072.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,980.58
|
| Rate for Payer: Aetna Managed Medicare |
$644.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,496.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,151.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,105.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,220.59
|
| Rate for Payer: Cash Price |
$690.90
|
| Rate for Payer: Cigna Commercial |
$2,118.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,288.76
|
| Rate for Payer: Health EOS Commercial |
$2,049.67
|
| Rate for Payer: HFN Commercial |
$2,118.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,727.25
|
| Rate for Payer: Multiplan Commercial |
$1,842.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,381.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,118.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,128.47
|
| Rate for Payer: Quartz Commercial |
$1,496.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,381.80
|
| Rate for Payer: The Alliance Commercial |
$9,212.00
|
| Rate for Payer: WEA Trust Commercial |
$1,266.65
|
| Rate for Payer: WPS Commercial |
$1,705.83
|
|
|
SCREW CANN 2.0 X 12 TIGER 200-20-012
|
Facility
|
OP
|
$2,139.00
|
|
| Hospital Charge Code |
3487501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$598.92 |
| Max. Negotiated Rate |
$8,556.00 |
| Rate for Payer: Aetna Commercial |
$1,925.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,839.54
|
| Rate for Payer: Aetna Managed Medicare |
$598.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,390.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,069.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,026.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,133.67
|
| Rate for Payer: Cash Price |
$641.70
|
| Rate for Payer: Cigna Commercial |
$1,967.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,196.98
|
| Rate for Payer: Health EOS Commercial |
$1,903.71
|
| Rate for Payer: HFN Commercial |
$1,967.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,604.25
|
| Rate for Payer: Multiplan Commercial |
$1,711.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,283.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,967.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,048.11
|
| Rate for Payer: Quartz Commercial |
$1,390.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,283.40
|
| Rate for Payer: The Alliance Commercial |
$8,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,176.45
|
| Rate for Payer: WPS Commercial |
$1,584.36
|
|
