|
SCREW CORT 1.3 X 10 ST 200.690
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494528
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 11 ST 200.691
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 11 ST 200.691
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 12MM TITANIUM 400.692
|
Facility
|
IP
|
$1,454.00
|
|
| Hospital Charge Code |
2966399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$740.96 |
| Max. Negotiated Rate |
$1,391.19 |
| Rate for Payer: Aetna Commercial |
$1,360.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,300.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$801.44
|
| Rate for Payer: Cash Price |
$436.20
|
| Rate for Payer: Cigna Commercial |
$1,391.19
|
| Rate for Payer: Health EOS Commercial |
$1,345.82
|
| Rate for Payer: HFN Commercial |
$1,391.19
|
| Rate for Payer: Multiplan Commercial |
$1,209.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,391.19
|
| Rate for Payer: Quartz Beloit One Network |
$740.96
|
| Rate for Payer: Quartz Commercial |
$907.30
|
| Rate for Payer: WEA Trust Commercial |
$831.69
|
| Rate for Payer: WPS Commercial |
$1,120.02
|
|
|
SCREW CORT 1.3 X 12MM TITANIUM 400.692
|
Facility
|
OP
|
$1,454.00
|
|
| Hospital Charge Code |
2966399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$423.40 |
| Max. Negotiated Rate |
$1,391.19 |
| Rate for Payer: Aetna Commercial |
$1,360.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,300.46
|
| Rate for Payer: Aetna Managed Medicare |
$423.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$982.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$756.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$725.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$801.44
|
| Rate for Payer: Cash Price |
$436.20
|
| Rate for Payer: Cigna Commercial |
$1,391.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$846.23
|
| Rate for Payer: Health EOS Commercial |
$1,345.82
|
| Rate for Payer: HFN Commercial |
$1,391.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,134.12
|
| Rate for Payer: Multiplan Commercial |
$1,209.73
|
| Rate for Payer: NAPHCARE Commercial |
$907.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,391.19
|
| Rate for Payer: Quartz Beloit One Network |
$740.96
|
| Rate for Payer: Quartz Commercial |
$982.90
|
| Rate for Payer: Quartz Medicare Advantage |
$907.30
|
| Rate for Payer: The Alliance Commercial |
$756.08
|
| Rate for Payer: WEA Trust Commercial |
$831.69
|
| Rate for Payer: WPS Commercial |
$1,120.02
|
|
|
SCREW CORT 1.3 X 12 ST 200.692
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494530
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 12 ST 200.692
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494530
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 14MM 400.694
|
Facility
|
OP
|
$1,454.00
|
|
| Hospital Charge Code |
2966400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$423.40 |
| Max. Negotiated Rate |
$1,391.19 |
| Rate for Payer: Aetna Commercial |
$1,360.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,300.46
|
| Rate for Payer: Aetna Managed Medicare |
$423.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$982.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$756.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$725.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$801.44
|
| Rate for Payer: Cash Price |
$436.20
|
| Rate for Payer: Cigna Commercial |
$1,391.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$846.23
|
| Rate for Payer: Health EOS Commercial |
$1,345.82
|
| Rate for Payer: HFN Commercial |
$1,391.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,134.12
|
| Rate for Payer: Multiplan Commercial |
$1,209.73
|
| Rate for Payer: NAPHCARE Commercial |
$907.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,391.19
|
| Rate for Payer: Quartz Beloit One Network |
$740.96
|
| Rate for Payer: Quartz Commercial |
$982.90
|
| Rate for Payer: Quartz Medicare Advantage |
$907.30
|
| Rate for Payer: The Alliance Commercial |
$756.08
|
| Rate for Payer: WEA Trust Commercial |
$831.69
|
| Rate for Payer: WPS Commercial |
$1,120.02
|
|
|
SCREW CORT 1.3 X 14MM 400.694
|
Facility
|
IP
|
$1,454.00
|
|
| Hospital Charge Code |
2966400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$740.96 |
| Max. Negotiated Rate |
$1,391.19 |
| Rate for Payer: Aetna Commercial |
$1,360.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,300.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$801.44
|
| Rate for Payer: Cash Price |
$436.20
|
| Rate for Payer: Cigna Commercial |
$1,391.19
|
| Rate for Payer: Health EOS Commercial |
$1,345.82
|
| Rate for Payer: HFN Commercial |
$1,391.19
|
| Rate for Payer: Multiplan Commercial |
$1,209.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,391.19
|
| Rate for Payer: Quartz Beloit One Network |
$740.96
|
| Rate for Payer: Quartz Commercial |
$907.30
|
| Rate for Payer: WEA Trust Commercial |
$831.69
|
| Rate for Payer: WPS Commercial |
$1,120.02
|
|
|
SCREW CORT 1.3 X 14 ST 200.694
|
Facility
|
IP
|
$953.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$485.65 |
| Max. Negotiated Rate |
$911.83 |
| Rate for Payer: Aetna Commercial |
$892.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.29
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$911.83
|
| Rate for Payer: Health EOS Commercial |
$882.10
|
| Rate for Payer: HFN Commercial |
$911.83
|
| Rate for Payer: Multiplan Commercial |
$792.90
|
| Rate for Payer: Preferred Network Access Commercial |
$911.83
|
| Rate for Payer: Quartz Beloit One Network |
$485.65
|
| Rate for Payer: Quartz Commercial |
$594.67
|
| Rate for Payer: WEA Trust Commercial |
$545.12
|
| Rate for Payer: WPS Commercial |
$734.10
|
|
|
SCREW CORT 1.3 X 14 ST 200.694
|
Facility
|
OP
|
$953.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.51 |
| Max. Negotiated Rate |
$911.83 |
| Rate for Payer: Aetna Commercial |
$892.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.36
|
| Rate for Payer: Aetna Managed Medicare |
$277.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.29
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$911.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.65
|
| Rate for Payer: Health EOS Commercial |
$882.10
|
| Rate for Payer: HFN Commercial |
$911.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.34
|
| Rate for Payer: Multiplan Commercial |
$792.90
|
| Rate for Payer: NAPHCARE Commercial |
$594.67
|
| Rate for Payer: Preferred Network Access Commercial |
$911.83
|
| Rate for Payer: Quartz Beloit One Network |
$485.65
|
| Rate for Payer: Quartz Commercial |
$644.23
|
| Rate for Payer: Quartz Medicare Advantage |
$594.67
|
| Rate for Payer: The Alliance Commercial |
$495.56
|
| Rate for Payer: WEA Trust Commercial |
$545.12
|
| Rate for Payer: WPS Commercial |
$734.10
|
|
|
SCREW CORT 1.3 X 15 ST 200.695
|
Facility
|
IP
|
$953.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$485.65 |
| Max. Negotiated Rate |
$911.83 |
| Rate for Payer: Aetna Commercial |
$892.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.29
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$911.83
|
| Rate for Payer: Health EOS Commercial |
$882.10
|
| Rate for Payer: HFN Commercial |
$911.83
|
| Rate for Payer: Multiplan Commercial |
$792.90
|
| Rate for Payer: Preferred Network Access Commercial |
$911.83
|
| Rate for Payer: Quartz Beloit One Network |
$485.65
|
| Rate for Payer: Quartz Commercial |
$594.67
|
| Rate for Payer: WEA Trust Commercial |
$545.12
|
| Rate for Payer: WPS Commercial |
$734.10
|
|
|
SCREW CORT 1.3 X 15 ST 200.695
|
Facility
|
OP
|
$953.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.51 |
| Max. Negotiated Rate |
$911.83 |
| Rate for Payer: Aetna Commercial |
$892.01
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.36
|
| Rate for Payer: Aetna Managed Medicare |
$277.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.29
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cigna Commercial |
$911.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.65
|
| Rate for Payer: Health EOS Commercial |
$882.10
|
| Rate for Payer: HFN Commercial |
$911.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.34
|
| Rate for Payer: Multiplan Commercial |
$792.90
|
| Rate for Payer: NAPHCARE Commercial |
$594.67
|
| Rate for Payer: Preferred Network Access Commercial |
$911.83
|
| Rate for Payer: Quartz Beloit One Network |
$485.65
|
| Rate for Payer: Quartz Commercial |
$644.23
|
| Rate for Payer: Quartz Medicare Advantage |
$594.67
|
| Rate for Payer: The Alliance Commercial |
$495.56
|
| Rate for Payer: WEA Trust Commercial |
$545.12
|
| Rate for Payer: WPS Commercial |
$734.10
|
|
|
SCREW CORT 1.3 X 16 ST 200.696
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 16 ST 200.696
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 18 ST 200.698
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494534
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 18 ST 200.698
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494534
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 6 ST 200.686
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 6 ST 200.686
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 7 ST 200.687
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494525
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 7 ST 200.687
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494525
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 8MM TITANIUM 400.688
|
Facility
|
IP
|
$1,454.00
|
|
| Hospital Charge Code |
2966401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$740.96 |
| Max. Negotiated Rate |
$1,391.19 |
| Rate for Payer: Aetna Commercial |
$1,360.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,300.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$801.44
|
| Rate for Payer: Cash Price |
$436.20
|
| Rate for Payer: Cigna Commercial |
$1,391.19
|
| Rate for Payer: Health EOS Commercial |
$1,345.82
|
| Rate for Payer: HFN Commercial |
$1,391.19
|
| Rate for Payer: Multiplan Commercial |
$1,209.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,391.19
|
| Rate for Payer: Quartz Beloit One Network |
$740.96
|
| Rate for Payer: Quartz Commercial |
$907.30
|
| Rate for Payer: WEA Trust Commercial |
$831.69
|
| Rate for Payer: WPS Commercial |
$1,120.02
|
|
|
SCREW CORT 1.3 X 8MM TITANIUM 400.688
|
Facility
|
OP
|
$1,454.00
|
|
| Hospital Charge Code |
2966401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$423.40 |
| Max. Negotiated Rate |
$1,391.19 |
| Rate for Payer: Aetna Commercial |
$1,360.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,300.46
|
| Rate for Payer: Aetna Managed Medicare |
$423.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$982.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$756.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$725.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$801.44
|
| Rate for Payer: Cash Price |
$436.20
|
| Rate for Payer: Cigna Commercial |
$1,391.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$846.23
|
| Rate for Payer: Health EOS Commercial |
$1,345.82
|
| Rate for Payer: HFN Commercial |
$1,391.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,134.12
|
| Rate for Payer: Multiplan Commercial |
$1,209.73
|
| Rate for Payer: NAPHCARE Commercial |
$907.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,391.19
|
| Rate for Payer: Quartz Beloit One Network |
$740.96
|
| Rate for Payer: Quartz Commercial |
$982.90
|
| Rate for Payer: Quartz Medicare Advantage |
$907.30
|
| Rate for Payer: The Alliance Commercial |
$756.08
|
| Rate for Payer: WEA Trust Commercial |
$831.69
|
| Rate for Payer: WPS Commercial |
$1,120.02
|
|
|
SCREW CORT 1.3 X 8 ST 200.688
|
Facility
|
OP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494526
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.58 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Aetna Managed Medicare |
$311.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.74
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.60
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: NAPHCARE Commercial |
$667.68
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$723.32
|
| Rate for Payer: Quartz Medicare Advantage |
$667.68
|
| Rate for Payer: The Alliance Commercial |
$556.40
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
|
SCREW CORT 1.3 X 8 ST 200.688
|
Facility
|
IP
|
$1,070.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494526
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$545.27 |
| Max. Negotiated Rate |
$1,023.78 |
| Rate for Payer: Aetna Commercial |
$1,001.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.78
|
| Rate for Payer: Cash Price |
$321.00
|
| Rate for Payer: Cigna Commercial |
$1,023.78
|
| Rate for Payer: Health EOS Commercial |
$990.39
|
| Rate for Payer: HFN Commercial |
$1,023.78
|
| Rate for Payer: Multiplan Commercial |
$890.24
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.78
|
| Rate for Payer: Quartz Beloit One Network |
$545.27
|
| Rate for Payer: Quartz Commercial |
$667.68
|
| Rate for Payer: WEA Trust Commercial |
$612.04
|
| Rate for Payer: WPS Commercial |
$824.22
|
|
