|
SCREW-CANN 5.0 X 80 02.205.280
|
Facility
|
IP
|
$2,022.00
|
|
| Hospital Charge Code |
2967219
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$990.78 |
| Max. Negotiated Rate |
$1,860.24 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,213.20
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW-CANN 5.0 X 85 02.205.285
|
Facility
|
OP
|
$2,022.00
|
|
| Hospital Charge Code |
2967220
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.16 |
| Max. Negotiated Rate |
$8,088.00 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Aetna Managed Medicare |
$566.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,314.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,011.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$970.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,131.51
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,516.50
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,314.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,213.20
|
| Rate for Payer: The Alliance Commercial |
$8,088.00
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW-CANN 5.0 X 85 02.205.285
|
Facility
|
IP
|
$2,022.00
|
|
| Hospital Charge Code |
2967220
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$990.78 |
| Max. Negotiated Rate |
$1,860.24 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,213.20
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW-CANN 5.0 X 90 02.205.090
|
Facility
|
OP
|
$827.00
|
|
| Hospital Charge Code |
2967009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$231.56 |
| Max. Negotiated Rate |
$3,308.00 |
| Rate for Payer: Aetna Commercial |
$744.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$711.22
|
| Rate for Payer: Aetna Managed Medicare |
$231.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$537.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$413.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$396.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$438.31
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cigna Commercial |
$760.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$462.79
|
| Rate for Payer: Health EOS Commercial |
$736.03
|
| Rate for Payer: HFN Commercial |
$760.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$620.25
|
| Rate for Payer: Multiplan Commercial |
$661.60
|
| Rate for Payer: NAPHCARE Commercial |
$496.20
|
| Rate for Payer: Preferred Network Access Commercial |
$760.84
|
| Rate for Payer: Quartz Beloit One Network |
$405.23
|
| Rate for Payer: Quartz Commercial |
$537.55
|
| Rate for Payer: Quartz Medicare Advantage |
$496.20
|
| Rate for Payer: The Alliance Commercial |
$3,308.00
|
| Rate for Payer: WEA Trust Commercial |
$454.85
|
| Rate for Payer: WPS Commercial |
$612.56
|
|
|
SCREW-CANN 5.0 X 90 02.205.090
|
Facility
|
IP
|
$827.00
|
|
| Hospital Charge Code |
2967009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.23 |
| Max. Negotiated Rate |
$760.84 |
| Rate for Payer: Aetna Commercial |
$744.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$711.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$438.31
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cigna Commercial |
$760.84
|
| Rate for Payer: Health EOS Commercial |
$736.03
|
| Rate for Payer: HFN Commercial |
$760.84
|
| Rate for Payer: Multiplan Commercial |
$661.60
|
| Rate for Payer: NAPHCARE Commercial |
$496.20
|
| Rate for Payer: Preferred Network Access Commercial |
$760.84
|
| Rate for Payer: Quartz Beloit One Network |
$405.23
|
| Rate for Payer: Quartz Commercial |
$496.20
|
| Rate for Payer: WEA Trust Commercial |
$454.85
|
| Rate for Payer: WPS Commercial |
$612.56
|
|
|
SCREW-CANN 5.0 X 90 02.205.290
|
Facility
|
IP
|
$2,022.00
|
|
| Hospital Charge Code |
2967221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$990.78 |
| Max. Negotiated Rate |
$1,860.24 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,213.20
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW-CANN 5.0 X 90 02.205.290
|
Facility
|
OP
|
$2,022.00
|
|
| Hospital Charge Code |
2967221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.16 |
| Max. Negotiated Rate |
$8,088.00 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Aetna Managed Medicare |
$566.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,314.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,011.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$970.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,131.51
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,516.50
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,314.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,213.20
|
| Rate for Payer: The Alliance Commercial |
$8,088.00
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW-CANN 5.0 X 95 02.205.295
|
Facility
|
OP
|
$2,022.00
|
|
| Hospital Charge Code |
2967222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.16 |
| Max. Negotiated Rate |
$8,088.00 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Aetna Managed Medicare |
$566.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,314.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,011.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$970.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,131.51
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,516.50
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,314.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,213.20
|
| Rate for Payer: The Alliance Commercial |
$8,088.00
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW-CANN 5.0 X 95 02.205.295
|
Facility
|
IP
|
$2,022.00
|
|
| Hospital Charge Code |
2967222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$990.78 |
| Max. Negotiated Rate |
$1,860.24 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.66
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cigna Commercial |
$1,860.24
|
| Rate for Payer: Health EOS Commercial |
$1,799.58
|
| Rate for Payer: HFN Commercial |
$1,860.24
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,213.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,860.24
|
| Rate for Payer: Quartz Beloit One Network |
$990.78
|
| Rate for Payer: Quartz Commercial |
$1,213.20
|
| Rate for Payer: WEA Trust Commercial |
$1,112.10
|
| Rate for Payer: WPS Commercial |
$1,497.70
|
|
|
SCREW CANN 6.5MM X 100MM X 16MM THREAD 208.415
|
Facility
|
IP
|
$3,067.00
|
|
| Hospital Charge Code |
4065102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,502.83 |
| Max. Negotiated Rate |
$2,821.64 |
| Rate for Payer: Aetna Commercial |
$2,760.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,637.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,625.51
|
| Rate for Payer: Cash Price |
$920.10
|
| Rate for Payer: Cigna Commercial |
$2,821.64
|
| Rate for Payer: Health EOS Commercial |
$2,729.63
|
| Rate for Payer: HFN Commercial |
$2,821.64
|
| Rate for Payer: Multiplan Commercial |
$2,453.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,840.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,821.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,502.83
|
| Rate for Payer: Quartz Commercial |
$1,840.20
|
| Rate for Payer: WEA Trust Commercial |
$1,686.85
|
| Rate for Payer: WPS Commercial |
$2,271.73
|
|
|
SCREW CANN 6.5MM X 100MM X 16MM THREAD 208.415
|
Facility
|
OP
|
$3,067.00
|
|
| Hospital Charge Code |
4065102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$858.76 |
| Max. Negotiated Rate |
$12,268.00 |
| Rate for Payer: Aetna Commercial |
$2,760.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,637.62
|
| Rate for Payer: Aetna Managed Medicare |
$858.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,993.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,533.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,472.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,625.51
|
| Rate for Payer: Cash Price |
$920.10
|
| Rate for Payer: Cigna Commercial |
$2,821.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,716.29
|
| Rate for Payer: Health EOS Commercial |
$2,729.63
|
| Rate for Payer: HFN Commercial |
$2,821.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,300.25
|
| Rate for Payer: Multiplan Commercial |
$2,453.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,840.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,821.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,502.83
|
| Rate for Payer: Quartz Commercial |
$1,993.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,840.20
|
| Rate for Payer: The Alliance Commercial |
$12,268.00
|
| Rate for Payer: WEA Trust Commercial |
$1,686.85
|
| Rate for Payer: WPS Commercial |
$2,271.73
|
|
|
SCREW CANN 6.5MM X 100MM X 32 THREAD 208.442
|
Facility
|
OP
|
$3,067.00
|
|
| Hospital Charge Code |
4066460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$858.76 |
| Max. Negotiated Rate |
$12,268.00 |
| Rate for Payer: Aetna Commercial |
$2,760.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,637.62
|
| Rate for Payer: Aetna Managed Medicare |
$858.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,993.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,533.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,472.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,625.51
|
| Rate for Payer: Cash Price |
$920.10
|
| Rate for Payer: Cigna Commercial |
$2,821.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,716.29
|
| Rate for Payer: Health EOS Commercial |
$2,729.63
|
| Rate for Payer: HFN Commercial |
$2,821.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,300.25
|
| Rate for Payer: Multiplan Commercial |
$2,453.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,840.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,821.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,502.83
|
| Rate for Payer: Quartz Commercial |
$1,993.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,840.20
|
| Rate for Payer: The Alliance Commercial |
$12,268.00
|
| Rate for Payer: WEA Trust Commercial |
$1,686.85
|
| Rate for Payer: WPS Commercial |
$2,271.73
|
|
|
SCREW CANN 6.5MM X 100MM X 32 THREAD 208.442
|
Facility
|
IP
|
$3,067.00
|
|
| Hospital Charge Code |
4066460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,502.83 |
| Max. Negotiated Rate |
$2,821.64 |
| Rate for Payer: Aetna Commercial |
$2,760.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,637.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,625.51
|
| Rate for Payer: Cash Price |
$920.10
|
| Rate for Payer: Cigna Commercial |
$2,821.64
|
| Rate for Payer: Health EOS Commercial |
$2,729.63
|
| Rate for Payer: HFN Commercial |
$2,821.64
|
| Rate for Payer: Multiplan Commercial |
$2,453.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,840.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,821.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,502.83
|
| Rate for Payer: Quartz Commercial |
$1,840.20
|
| Rate for Payer: WEA Trust Commercial |
$1,686.85
|
| Rate for Payer: WPS Commercial |
$2,271.73
|
|
|
SCREW CANN 6.5MM X 105MM X 16MM THREAD 208.416
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4065103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$827.12 |
| Max. Negotiated Rate |
$11,816.00 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Aetna Managed Medicare |
$827.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,920.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,477.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,653.06
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,215.50
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,920.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,772.40
|
| Rate for Payer: The Alliance Commercial |
$11,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 105MM X 16MM THREAD 208.416
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4065103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$2,717.68 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,772.40
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 105MM X 32 THREAD 208.443
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4066461
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$827.12 |
| Max. Negotiated Rate |
$11,816.00 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Aetna Managed Medicare |
$827.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,920.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,477.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,653.06
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,215.50
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,920.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,772.40
|
| Rate for Payer: The Alliance Commercial |
$11,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 105MM X 32 THREAD 208.443
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4066461
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$2,717.68 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,772.40
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 110MM X 16MM THREAD 208.417
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4065104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$2,717.68 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,772.40
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 110MM X 16MM THREAD 208.417
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4065104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$827.12 |
| Max. Negotiated Rate |
$11,816.00 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Aetna Managed Medicare |
$827.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,920.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,477.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,653.06
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,215.50
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,920.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,772.40
|
| Rate for Payer: The Alliance Commercial |
$11,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 110MM X 32 THREAD 208.444
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4066462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$827.12 |
| Max. Negotiated Rate |
$11,816.00 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Aetna Managed Medicare |
$827.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,920.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,477.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,653.06
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,215.50
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,920.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,772.40
|
| Rate for Payer: The Alliance Commercial |
$11,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 110MM X 32 THREAD 208.444
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4066462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$2,717.68 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,772.40
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 115MM 208.418
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4065105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$2,717.68 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,772.40
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 115MM 208.418
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4065105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$827.12 |
| Max. Negotiated Rate |
$11,816.00 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Aetna Managed Medicare |
$827.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,920.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,477.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,653.06
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,215.50
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,920.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,772.40
|
| Rate for Payer: The Alliance Commercial |
$11,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 115MM X 32 THREAD 208.445
|
Facility
|
OP
|
$2,954.00
|
|
| Hospital Charge Code |
4066464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$827.12 |
| Max. Negotiated Rate |
$11,816.00 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Aetna Managed Medicare |
$827.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,920.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,477.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,653.06
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,215.50
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,920.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,772.40
|
| Rate for Payer: The Alliance Commercial |
$11,816.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
|
SCREW CANN 6.5MM X 115MM X 32 THREAD 208.445
|
Facility
|
IP
|
$2,954.00
|
|
| Hospital Charge Code |
4066464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.46 |
| Max. Negotiated Rate |
$2,717.68 |
| Rate for Payer: Aetna Commercial |
$2,658.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,540.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.62
|
| Rate for Payer: Cash Price |
$886.20
|
| Rate for Payer: Cigna Commercial |
$2,717.68
|
| Rate for Payer: Health EOS Commercial |
$2,629.06
|
| Rate for Payer: HFN Commercial |
$2,717.68
|
| Rate for Payer: Multiplan Commercial |
$2,363.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,772.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,717.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,447.46
|
| Rate for Payer: Quartz Commercial |
$1,772.40
|
| Rate for Payer: WEA Trust Commercial |
$1,624.70
|
| Rate for Payer: WPS Commercial |
$2,188.03
|
|
