|
SCREW CANN 7.3MM X 145MM X 16MM THREAD 208.945
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066493
|
|
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 32MM THREAD 209.945
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067876
|
|
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 145MM X 32MM THREAD 209.945
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067876
|
|
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 150MM X 16MM THREAD 208.950
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066494
|
|
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 150MM X 16MM THREAD 208.950
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066494
|
|
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 150MM X 32MM THREAD 209.950
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067877
|
|
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 150MM X 32MM THREAD 209.950
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4067877
|
|
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 30MM X 16MM THREAD 208.830
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066473
|
|
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 30MM X 16MM THREAD 208.830
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066473
|
|
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 35MM X 16MM THREAD 208.835
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066474
|
|
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 35MM X 16MM THREAD 208.835
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066474
|
|
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 40MM X 16MM THREAD 208.840
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066475
|
|
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 40MM X 16MM THREAD 208.840
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066475
|
|
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 45MM X 16MM THREAD 208.845
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066476
|
|
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 45MM X 16MM THREAD 208.845
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066476
|
|
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 45MM X 32MM THREAD 209.845
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966539
|
|
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 45MM X 32MM THREAD 209.845
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966539
|
|
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 50MM X 16MM THREAD 208.850
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066477
|
|
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 50MM X 16MM THREAD 208.850
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066477
|
|
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 50MM X 32MM THREAD 209.850
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066495
|
|
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 50MM X 32MM THREAD 209.850
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066495
|
|
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 55MM X 16MM THREAD 208.855
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066478
|
|
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 55MM X 16MM THREAD 208.855
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066478
|
|
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 55MM X 32MM THREAD 209.855
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066496
|
|
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 55MM X 32MM THREAD 209.855
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066496
|
|
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
|
|
