|
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 |
$1,447.46 |
| 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 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 |
$1,447.46 |
| 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 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 |
$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 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 |
$1,447.46 |
| 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 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 |
$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 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 |
$1,447.46 |
| 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 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 |
$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 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 |
$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 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 |
$1,447.46 |
| 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 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 |
$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 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 |
$1,447.46 |
| 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 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 |
$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 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 |
$1,447.46 |
| 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 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 |
$1,447.46 |
| 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 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 |
$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 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 |
$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 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 |
$1,447.46 |
| 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 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 |
$1,447.46 |
| 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 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 |
$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 7.3MM X 60MM X 16MM THREAD 208.860
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066479
|
|
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 7.3MM X 60MM X 16MM THREAD 208.860
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066479
|
|
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 7.3MM X 60MM X 32MM THREAD 209.860
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066497
|
|
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 7.3MM X 60MM X 32MM THREAD 209.860
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066497
|
|
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 7.3MM X 65MM X 16MM THREAD 208.865
|
Facility
|
OP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066480
|
|
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 7.3MM X 65MM X 16MM THREAD 208.865
|
Facility
|
IP
|
$2,954.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4066480
|
|
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
|
|
