|
SCREW CANN 7.3MM X 90MM X 16MM THREAD 208.890
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966542
|
|
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 90MM X 32MM THREAD 209.890
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066503
|
|
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 90MM X 32MM THREAD 209.890
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066503
|
|
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 95MM X 16MM THREAD 208.895
|
Facility
|
IP
|
$3,067.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966550
|
|
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 95MM X 16MM THREAD 208.895
|
Facility
|
OP
|
$3,067.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966550
|
|
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 95MM X 32MM THREAD 209.895
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2969338
|
|
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 95MM X 32MM THREAD 209.895
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2969338
|
|
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 7.3 X 30 02.207.030
|
Facility
|
OP
|
$3,623.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,055.02 |
| Max. Negotiated Rate |
$3,466.49 |
| Rate for Payer: Aetna Commercial |
$3,391.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,240.41
|
| Rate for Payer: Aetna Managed Medicare |
$1,055.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,449.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,883.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,808.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,997.00
|
| Rate for Payer: Cash Price |
$1,086.90
|
| Rate for Payer: Cigna Commercial |
$3,466.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,108.59
|
| Rate for Payer: Health EOS Commercial |
$3,353.45
|
| Rate for Payer: HFN Commercial |
$3,466.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,825.94
|
| Rate for Payer: Multiplan Commercial |
$3,014.34
|
| Rate for Payer: NAPHCARE Commercial |
$2,260.75
|
| Rate for Payer: Preferred Network Access Commercial |
$3,466.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,846.28
|
| Rate for Payer: Quartz Commercial |
$2,449.15
|
| Rate for Payer: Quartz Medicare Advantage |
$2,260.75
|
| Rate for Payer: The Alliance Commercial |
$1,883.96
|
| Rate for Payer: WEA Trust Commercial |
$2,072.36
|
| Rate for Payer: WPS Commercial |
$2,790.80
|
|
|
SCREW-CANN 7.3 X 30 02.207.030
|
Facility
|
IP
|
$3,623.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,846.28 |
| Max. Negotiated Rate |
$3,466.49 |
| Rate for Payer: Aetna Commercial |
$3,391.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,240.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,997.00
|
| Rate for Payer: Cash Price |
$1,086.90
|
| Rate for Payer: Cigna Commercial |
$3,466.49
|
| Rate for Payer: Health EOS Commercial |
$3,353.45
|
| Rate for Payer: HFN Commercial |
$3,466.49
|
| Rate for Payer: Multiplan Commercial |
$3,014.34
|
| Rate for Payer: Preferred Network Access Commercial |
$3,466.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,846.28
|
| Rate for Payer: Quartz Commercial |
$2,260.75
|
| Rate for Payer: WEA Trust Commercial |
$2,072.36
|
| Rate for Payer: WPS Commercial |
$2,790.80
|
|
|
SCREW-CANN 7.3 X 45 02.207.045
|
Facility
|
OP
|
$3,623.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966540
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,055.02 |
| Max. Negotiated Rate |
$3,466.49 |
| Rate for Payer: Aetna Commercial |
$3,391.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,240.41
|
| Rate for Payer: Aetna Managed Medicare |
$1,055.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,449.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,883.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,808.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,997.00
|
| Rate for Payer: Cash Price |
$1,086.90
|
| Rate for Payer: Cigna Commercial |
$3,466.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,108.59
|
| Rate for Payer: Health EOS Commercial |
$3,353.45
|
| Rate for Payer: HFN Commercial |
$3,466.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,825.94
|
| Rate for Payer: Multiplan Commercial |
$3,014.34
|
| Rate for Payer: NAPHCARE Commercial |
$2,260.75
|
| Rate for Payer: Preferred Network Access Commercial |
$3,466.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,846.28
|
| Rate for Payer: Quartz Commercial |
$2,449.15
|
| Rate for Payer: Quartz Medicare Advantage |
$2,260.75
|
| Rate for Payer: The Alliance Commercial |
$1,883.96
|
| Rate for Payer: WEA Trust Commercial |
$2,072.36
|
| Rate for Payer: WPS Commercial |
$2,790.80
|
|
|
SCREW-CANN 7.3 X 45 02.207.045
|
Facility
|
IP
|
$3,623.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966540
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,846.28 |
| Max. Negotiated Rate |
$3,466.49 |
| Rate for Payer: Aetna Commercial |
$3,391.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,240.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,997.00
|
| Rate for Payer: Cash Price |
$1,086.90
|
| Rate for Payer: Cigna Commercial |
$3,466.49
|
| Rate for Payer: Health EOS Commercial |
$3,353.45
|
| Rate for Payer: HFN Commercial |
$3,466.49
|
| Rate for Payer: Multiplan Commercial |
$3,014.34
|
| Rate for Payer: Preferred Network Access Commercial |
$3,466.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,846.28
|
| Rate for Payer: Quartz Commercial |
$2,260.75
|
| Rate for Payer: WEA Trust Commercial |
$2,072.36
|
| Rate for Payer: WPS Commercial |
$2,790.80
|
|
|
SCREW-CANN 7.3 X 50 02.207.050
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$628.34 |
| Max. Negotiated Rate |
$1,179.73 |
| Rate for Payer: Aetna Commercial |
$1,154.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,102.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$679.63
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,179.73
|
| Rate for Payer: Health EOS Commercial |
$1,141.26
|
| Rate for Payer: HFN Commercial |
$1,179.73
|
| Rate for Payer: Multiplan Commercial |
$1,025.86
|
| Rate for Payer: Preferred Network Access Commercial |
$1,179.73
|
| Rate for Payer: Quartz Beloit One Network |
$628.34
|
| Rate for Payer: Quartz Commercial |
$769.39
|
| Rate for Payer: WEA Trust Commercial |
$705.28
|
| Rate for Payer: WPS Commercial |
$949.78
|
|
|
SCREW-CANN 7.3 X 50 02.207.050
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$359.05 |
| Max. Negotiated Rate |
$1,179.73 |
| Rate for Payer: Aetna Commercial |
$1,154.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,102.80
|
| Rate for Payer: Aetna Managed Medicare |
$359.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$833.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$641.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$615.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$679.63
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,179.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$717.61
|
| Rate for Payer: Health EOS Commercial |
$1,141.26
|
| Rate for Payer: HFN Commercial |
$1,179.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$961.74
|
| Rate for Payer: Multiplan Commercial |
$1,025.86
|
| Rate for Payer: NAPHCARE Commercial |
$769.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,179.73
|
| Rate for Payer: Quartz Beloit One Network |
$628.34
|
| Rate for Payer: Quartz Commercial |
$833.51
|
| Rate for Payer: Quartz Medicare Advantage |
$769.39
|
| Rate for Payer: The Alliance Commercial |
$641.16
|
| Rate for Payer: WEA Trust Commercial |
$705.28
|
| Rate for Payer: WPS Commercial |
$949.78
|
|
|
SCREW-CANN 7.3 X 50 02.207.250
|
Facility
|
OP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.07 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Aetna Managed Medicare |
$891.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,068.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,591.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,527.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,780.92
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,386.80
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: NAPHCARE Commercial |
$1,909.44
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$2,068.56
|
| Rate for Payer: Quartz Medicare Advantage |
$1,909.44
|
| Rate for Payer: The Alliance Commercial |
$1,591.20
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 50 02.207.250
|
Facility
|
IP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,559.38 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$1,909.44
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 50 02.207.450
|
Facility
|
IP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,559.38 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$1,909.44
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 50 02.207.450
|
Facility
|
OP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.07 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Aetna Managed Medicare |
$891.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,068.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,591.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,527.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,780.92
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,386.80
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: NAPHCARE Commercial |
$1,909.44
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$2,068.56
|
| Rate for Payer: Quartz Medicare Advantage |
$1,909.44
|
| Rate for Payer: The Alliance Commercial |
$1,591.20
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 55 02.207.055
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$359.05 |
| Max. Negotiated Rate |
$1,179.73 |
| Rate for Payer: Aetna Commercial |
$1,154.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,102.80
|
| Rate for Payer: Aetna Managed Medicare |
$359.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$833.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$641.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$615.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$679.63
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,179.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$717.61
|
| Rate for Payer: Health EOS Commercial |
$1,141.26
|
| Rate for Payer: HFN Commercial |
$1,179.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$961.74
|
| Rate for Payer: Multiplan Commercial |
$1,025.86
|
| Rate for Payer: NAPHCARE Commercial |
$769.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,179.73
|
| Rate for Payer: Quartz Beloit One Network |
$628.34
|
| Rate for Payer: Quartz Commercial |
$833.51
|
| Rate for Payer: Quartz Medicare Advantage |
$769.39
|
| Rate for Payer: The Alliance Commercial |
$641.16
|
| Rate for Payer: WEA Trust Commercial |
$705.28
|
| Rate for Payer: WPS Commercial |
$949.78
|
|
|
SCREW-CANN 7.3 X 55 02.207.055
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$628.34 |
| Max. Negotiated Rate |
$1,179.73 |
| Rate for Payer: Aetna Commercial |
$1,154.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,102.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$679.63
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,179.73
|
| Rate for Payer: Health EOS Commercial |
$1,141.26
|
| Rate for Payer: HFN Commercial |
$1,179.73
|
| Rate for Payer: Multiplan Commercial |
$1,025.86
|
| Rate for Payer: Preferred Network Access Commercial |
$1,179.73
|
| Rate for Payer: Quartz Beloit One Network |
$628.34
|
| Rate for Payer: Quartz Commercial |
$769.39
|
| Rate for Payer: WEA Trust Commercial |
$705.28
|
| Rate for Payer: WPS Commercial |
$949.78
|
|
|
SCREW-CANN 7.3 X 55 02.207.255
|
Facility
|
OP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.07 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Aetna Managed Medicare |
$891.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,068.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,591.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,527.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,780.92
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,386.80
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: NAPHCARE Commercial |
$1,909.44
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$2,068.56
|
| Rate for Payer: Quartz Medicare Advantage |
$1,909.44
|
| Rate for Payer: The Alliance Commercial |
$1,591.20
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 55 02.207.255
|
Facility
|
IP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,559.38 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$1,909.44
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 55 02.207.455
|
Facility
|
OP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.07 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Aetna Managed Medicare |
$891.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,068.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,591.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,527.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,780.92
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,386.80
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: NAPHCARE Commercial |
$1,909.44
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$2,068.56
|
| Rate for Payer: Quartz Medicare Advantage |
$1,909.44
|
| Rate for Payer: The Alliance Commercial |
$1,591.20
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 55 02.207.455
|
Facility
|
IP
|
$3,060.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,559.38 |
| Max. Negotiated Rate |
$2,927.81 |
| Rate for Payer: Aetna Commercial |
$2,864.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,736.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,686.67
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$2,927.81
|
| Rate for Payer: Health EOS Commercial |
$2,832.34
|
| Rate for Payer: HFN Commercial |
$2,927.81
|
| Rate for Payer: Multiplan Commercial |
$2,545.92
|
| Rate for Payer: Preferred Network Access Commercial |
$2,927.81
|
| Rate for Payer: Quartz Beloit One Network |
$1,559.38
|
| Rate for Payer: Quartz Commercial |
$1,909.44
|
| Rate for Payer: WEA Trust Commercial |
$1,750.32
|
| Rate for Payer: WPS Commercial |
$2,357.12
|
|
|
SCREW-CANN 7.3 X 60 02.207.060
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$628.34 |
| Max. Negotiated Rate |
$1,179.73 |
| Rate for Payer: Aetna Commercial |
$1,154.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,102.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$679.63
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,179.73
|
| Rate for Payer: Health EOS Commercial |
$1,141.26
|
| Rate for Payer: HFN Commercial |
$1,179.73
|
| Rate for Payer: Multiplan Commercial |
$1,025.86
|
| Rate for Payer: Preferred Network Access Commercial |
$1,179.73
|
| Rate for Payer: Quartz Beloit One Network |
$628.34
|
| Rate for Payer: Quartz Commercial |
$769.39
|
| Rate for Payer: WEA Trust Commercial |
$705.28
|
| Rate for Payer: WPS Commercial |
$949.78
|
|
|
SCREW-CANN 7.3 X 60 02.207.060
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$359.05 |
| Max. Negotiated Rate |
$1,179.73 |
| Rate for Payer: Aetna Commercial |
$1,154.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,102.80
|
| Rate for Payer: Aetna Managed Medicare |
$359.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$833.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$641.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$615.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$679.63
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna Commercial |
$1,179.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$717.61
|
| Rate for Payer: Health EOS Commercial |
$1,141.26
|
| Rate for Payer: HFN Commercial |
$1,179.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$961.74
|
| Rate for Payer: Multiplan Commercial |
$1,025.86
|
| Rate for Payer: NAPHCARE Commercial |
$769.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,179.73
|
| Rate for Payer: Quartz Beloit One Network |
$628.34
|
| Rate for Payer: Quartz Commercial |
$833.51
|
| Rate for Payer: Quartz Medicare Advantage |
$769.39
|
| Rate for Payer: The Alliance Commercial |
$641.16
|
| Rate for Payer: WEA Trust Commercial |
$705.28
|
| Rate for Payer: WPS Commercial |
$949.78
|
|
