|
SCREW CANN 7.3MM X 115MM X 16MM THREAD 208.915
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 115MM X 16MM THREAD 208.915
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 115MM X 32MM THREAD 209.915
|
Facility
|
OP
|
$3,067.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067870
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$893.11 |
| Max. Negotiated Rate |
$2,934.51 |
| Rate for Payer: Aetna Commercial |
$2,870.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,743.12
|
| Rate for Payer: Aetna Managed Medicare |
$893.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,073.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,594.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,531.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,690.53
|
| Rate for Payer: Cash Price |
$920.10
|
| Rate for Payer: Cigna Commercial |
$2,934.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,784.99
|
| Rate for Payer: Health EOS Commercial |
$2,838.82
|
| Rate for Payer: HFN Commercial |
$2,934.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,392.26
|
| Rate for Payer: Multiplan Commercial |
$2,551.74
|
| Rate for Payer: NAPHCARE Commercial |
$1,913.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,934.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,562.94
|
| Rate for Payer: Quartz Commercial |
$2,073.29
|
| Rate for Payer: Quartz Medicare Advantage |
$1,913.81
|
| Rate for Payer: The Alliance Commercial |
$1,594.84
|
| Rate for Payer: WEA Trust Commercial |
$1,754.32
|
| Rate for Payer: WPS Commercial |
$2,362.51
|
|
|
SCREW CANN 7.3MM X 115MM X 32MM THREAD 209.915
|
Facility
|
IP
|
$3,067.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067870
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,562.94 |
| Max. Negotiated Rate |
$2,934.51 |
| Rate for Payer: Aetna Commercial |
$2,870.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,743.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,690.53
|
| Rate for Payer: Cash Price |
$920.10
|
| Rate for Payer: Cigna Commercial |
$2,934.51
|
| Rate for Payer: Health EOS Commercial |
$2,838.82
|
| Rate for Payer: HFN Commercial |
$2,934.51
|
| Rate for Payer: Multiplan Commercial |
$2,551.74
|
| Rate for Payer: Preferred Network Access Commercial |
$2,934.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,562.94
|
| Rate for Payer: Quartz Commercial |
$1,913.81
|
| Rate for Payer: WEA Trust Commercial |
$1,754.32
|
| Rate for Payer: WPS Commercial |
$2,362.51
|
|
|
SCREW CANN 7.3MM X 120MM X 16MM THREAD 208.920
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 120MM X 16MM THREAD 208.920
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 120MM X 32MM THREAD 209.920
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067871
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 120MM X 32MM THREAD 209.920
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067871
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 125MM X 16MM THREAD 208.925
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 125MM X 16MM THREAD 208.925
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 125MM X 32MM THREAD 209.925
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067872
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 125MM X 32MM THREAD 209.925
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067872
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 130MM X 16MM THREAD 208.930
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 130MM X 16MM THREAD 208.930
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 130MM X 32MM THREAD 209.930
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067873
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 130MM X 32MM THREAD 209.930
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067873
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 135MM X 16MM THREAD 208.935
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4066491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 135MM X 16MM THREAD 208.935
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4066491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 135MM X 32MM THREAD 209.935
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067874
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 135MM X 32MM THREAD 209.935
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067874
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 140MM X 16MM THREAD 208.940
|
Facility
|
IP
|
$2,354.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,199.60 |
| Max. Negotiated Rate |
$2,252.31 |
| Rate for Payer: Aetna Commercial |
$2,203.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,105.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,297.52
|
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cigna Commercial |
$2,252.31
|
| Rate for Payer: Health EOS Commercial |
$2,178.86
|
| Rate for Payer: HFN Commercial |
$2,252.31
|
| Rate for Payer: Multiplan Commercial |
$1,958.53
|
| Rate for Payer: Preferred Network Access Commercial |
$2,252.31
|
| Rate for Payer: Quartz Beloit One Network |
$1,199.60
|
| Rate for Payer: Quartz Commercial |
$1,468.90
|
| Rate for Payer: WEA Trust Commercial |
$1,346.49
|
| Rate for Payer: WPS Commercial |
$1,813.29
|
|
|
SCREW CANN 7.3MM X 140MM X 16MM THREAD 208.940
|
Facility
|
OP
|
$2,354.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$685.48 |
| Max. Negotiated Rate |
$2,252.31 |
| Rate for Payer: Aetna Commercial |
$2,203.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,105.42
|
| Rate for Payer: Aetna Managed Medicare |
$685.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,591.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,224.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,175.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,297.52
|
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cigna Commercial |
$2,252.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,370.03
|
| Rate for Payer: Health EOS Commercial |
$2,178.86
|
| Rate for Payer: HFN Commercial |
$2,252.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,836.12
|
| Rate for Payer: Multiplan Commercial |
$1,958.53
|
| Rate for Payer: NAPHCARE Commercial |
$1,468.90
|
| Rate for Payer: Preferred Network Access Commercial |
$2,252.31
|
| Rate for Payer: Quartz Beloit One Network |
$1,199.60
|
| Rate for Payer: Quartz Commercial |
$1,591.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,468.90
|
| Rate for Payer: The Alliance Commercial |
$1,224.08
|
| Rate for Payer: WEA Trust Commercial |
$1,346.49
|
| Rate for Payer: WPS Commercial |
$1,813.29
|
|
|
SCREW CANN 7.3MM X 140MM X 32MM THREAD 209.940
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 140MM X 32MM THREAD 209.940
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$860.20 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Aetna Managed Medicare |
$860.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,996.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,536.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,474.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,719.23
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,304.12
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,843.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,996.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,843.30
|
| Rate for Payer: The Alliance Commercial |
$1,536.08
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
|
SCREW CANN 7.3MM X 145MM X 16MM THREAD 208.945
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066493
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,505.36 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,764.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,642.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,628.24
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,826.39
|
| Rate for Payer: Health EOS Commercial |
$2,734.22
|
| Rate for Payer: HFN Commercial |
$2,826.39
|
| Rate for Payer: Multiplan Commercial |
$2,457.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,826.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,505.36
|
| Rate for Payer: Quartz Commercial |
$1,843.30
|
| Rate for Payer: WEA Trust Commercial |
$1,689.69
|
| Rate for Payer: WPS Commercial |
$2,275.47
|
|
