|
SCREW CORT 1.5 X 8MM 02.130.008
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$402.58 |
| Max. Negotiated Rate |
$755.87 |
| Rate for Payer: Aetna Commercial |
$739.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$706.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$435.45
|
| Rate for Payer: Cash Price |
$237.00
|
| Rate for Payer: Cigna Commercial |
$755.87
|
| Rate for Payer: Health EOS Commercial |
$731.22
|
| Rate for Payer: HFN Commercial |
$755.87
|
| Rate for Payer: Multiplan Commercial |
$657.28
|
| Rate for Payer: Preferred Network Access Commercial |
$755.87
|
| Rate for Payer: Quartz Beloit One Network |
$402.58
|
| Rate for Payer: Quartz Commercial |
$492.96
|
| Rate for Payer: WEA Trust Commercial |
$451.88
|
| Rate for Payer: WPS Commercial |
$608.54
|
|
|
SCREW CORT 1.5 X 8MM 02.214.108
|
Facility
|
OP
|
$977.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966419
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.50 |
| Max. Negotiated Rate |
$934.79 |
| Rate for Payer: Aetna Commercial |
$914.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$873.83
|
| Rate for Payer: Aetna Managed Medicare |
$284.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$660.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$508.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$487.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$538.52
|
| Rate for Payer: Cash Price |
$293.10
|
| Rate for Payer: Cigna Commercial |
$934.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$568.61
|
| Rate for Payer: Health EOS Commercial |
$904.31
|
| Rate for Payer: HFN Commercial |
$934.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$762.06
|
| Rate for Payer: Multiplan Commercial |
$812.86
|
| Rate for Payer: NAPHCARE Commercial |
$609.65
|
| Rate for Payer: Preferred Network Access Commercial |
$934.79
|
| Rate for Payer: Quartz Beloit One Network |
$497.88
|
| Rate for Payer: Quartz Commercial |
$660.45
|
| Rate for Payer: Quartz Medicare Advantage |
$609.65
|
| Rate for Payer: The Alliance Commercial |
$508.04
|
| Rate for Payer: WEA Trust Commercial |
$558.84
|
| Rate for Payer: WPS Commercial |
$752.58
|
|
|
SCREW CORT 1.5 X 8MM 02.214.108
|
Facility
|
IP
|
$977.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966419
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$497.88 |
| Max. Negotiated Rate |
$934.79 |
| Rate for Payer: Aetna Commercial |
$914.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$873.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$538.52
|
| Rate for Payer: Cash Price |
$293.10
|
| Rate for Payer: Cigna Commercial |
$934.79
|
| Rate for Payer: Health EOS Commercial |
$904.31
|
| Rate for Payer: HFN Commercial |
$934.79
|
| Rate for Payer: Multiplan Commercial |
$812.86
|
| Rate for Payer: Preferred Network Access Commercial |
$934.79
|
| Rate for Payer: Quartz Beloit One Network |
$497.88
|
| Rate for Payer: Quartz Commercial |
$609.65
|
| Rate for Payer: WEA Trust Commercial |
$558.84
|
| Rate for Payer: WPS Commercial |
$752.58
|
|
|
SCREW CORT 1.5 X 8 ST 200.808
|
Facility
|
OP
|
$388.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.99 |
| Max. Negotiated Rate |
$371.24 |
| Rate for Payer: Aetna Commercial |
$363.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$347.03
|
| Rate for Payer: Aetna Managed Medicare |
$112.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$262.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$201.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$193.69
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$213.87
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cigna Commercial |
$371.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$225.82
|
| Rate for Payer: Health EOS Commercial |
$359.13
|
| Rate for Payer: HFN Commercial |
$371.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$302.64
|
| Rate for Payer: Multiplan Commercial |
$322.82
|
| Rate for Payer: NAPHCARE Commercial |
$242.11
|
| Rate for Payer: Preferred Network Access Commercial |
$371.24
|
| Rate for Payer: Quartz Beloit One Network |
$197.72
|
| Rate for Payer: Quartz Commercial |
$262.29
|
| Rate for Payer: Quartz Medicare Advantage |
$242.11
|
| Rate for Payer: The Alliance Commercial |
$201.76
|
| Rate for Payer: WEA Trust Commercial |
$221.94
|
| Rate for Payer: WPS Commercial |
$298.88
|
|
|
SCREW CORT 1.5 X 8 ST 200.808
|
Facility
|
IP
|
$388.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494538
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.72 |
| Max. Negotiated Rate |
$371.24 |
| Rate for Payer: Aetna Commercial |
$363.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$347.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$213.87
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cigna Commercial |
$371.24
|
| Rate for Payer: Health EOS Commercial |
$359.13
|
| Rate for Payer: HFN Commercial |
$371.24
|
| Rate for Payer: Multiplan Commercial |
$322.82
|
| Rate for Payer: Preferred Network Access Commercial |
$371.24
|
| Rate for Payer: Quartz Beloit One Network |
$197.72
|
| Rate for Payer: Quartz Commercial |
$242.11
|
| Rate for Payer: WEA Trust Commercial |
$221.94
|
| Rate for Payer: WPS Commercial |
$298.88
|
|
|
SCREW-CORT 1.5 X 9 200.009
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$67.78 |
| Max. Negotiated Rate |
$127.25 |
| Rate for Payer: Aetna Commercial |
$124.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$73.31
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cigna Commercial |
$127.25
|
| Rate for Payer: Health EOS Commercial |
$123.10
|
| Rate for Payer: HFN Commercial |
$127.25
|
| Rate for Payer: Multiplan Commercial |
$110.66
|
| Rate for Payer: Preferred Network Access Commercial |
$127.25
|
| Rate for Payer: Quartz Beloit One Network |
$67.78
|
| Rate for Payer: Quartz Commercial |
$82.99
|
| Rate for Payer: WEA Trust Commercial |
$76.08
|
| Rate for Payer: WPS Commercial |
$102.45
|
|
|
SCREW-CORT 1.5 X 9 200.009
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.73 |
| Max. Negotiated Rate |
$127.25 |
| Rate for Payer: Aetna Commercial |
$124.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$118.96
|
| Rate for Payer: Aetna Managed Medicare |
$38.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$89.91
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$69.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$66.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$73.31
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cigna Commercial |
$127.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$77.41
|
| Rate for Payer: Health EOS Commercial |
$123.10
|
| Rate for Payer: HFN Commercial |
$127.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$103.74
|
| Rate for Payer: Multiplan Commercial |
$110.66
|
| Rate for Payer: NAPHCARE Commercial |
$82.99
|
| Rate for Payer: Preferred Network Access Commercial |
$127.25
|
| Rate for Payer: Quartz Beloit One Network |
$67.78
|
| Rate for Payer: Quartz Commercial |
$89.91
|
| Rate for Payer: Quartz Medicare Advantage |
$82.99
|
| Rate for Payer: The Alliance Commercial |
$69.16
|
| Rate for Payer: WEA Trust Commercial |
$76.08
|
| Rate for Payer: WPS Commercial |
$102.45
|
|
|
SCREW CORT 1.5 X 9MM 02.214.109
|
Facility
|
IP
|
$977.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966423
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$497.88 |
| Max. Negotiated Rate |
$934.79 |
| Rate for Payer: Aetna Commercial |
$914.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$873.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$538.52
|
| Rate for Payer: Cash Price |
$293.10
|
| Rate for Payer: Cigna Commercial |
$934.79
|
| Rate for Payer: Health EOS Commercial |
$904.31
|
| Rate for Payer: HFN Commercial |
$934.79
|
| Rate for Payer: Multiplan Commercial |
$812.86
|
| Rate for Payer: Preferred Network Access Commercial |
$934.79
|
| Rate for Payer: Quartz Beloit One Network |
$497.88
|
| Rate for Payer: Quartz Commercial |
$609.65
|
| Rate for Payer: WEA Trust Commercial |
$558.84
|
| Rate for Payer: WPS Commercial |
$752.58
|
|
|
SCREW CORT 1.5 X 9MM 02.214.109
|
Facility
|
OP
|
$977.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966423
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.50 |
| Max. Negotiated Rate |
$934.79 |
| Rate for Payer: Aetna Commercial |
$914.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$873.83
|
| Rate for Payer: Aetna Managed Medicare |
$284.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$660.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$508.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$487.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$538.52
|
| Rate for Payer: Cash Price |
$293.10
|
| Rate for Payer: Cigna Commercial |
$934.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$568.61
|
| Rate for Payer: Health EOS Commercial |
$904.31
|
| Rate for Payer: HFN Commercial |
$934.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$762.06
|
| Rate for Payer: Multiplan Commercial |
$812.86
|
| Rate for Payer: NAPHCARE Commercial |
$609.65
|
| Rate for Payer: Preferred Network Access Commercial |
$934.79
|
| Rate for Payer: Quartz Beloit One Network |
$497.88
|
| Rate for Payer: Quartz Commercial |
$660.45
|
| Rate for Payer: Quartz Medicare Advantage |
$609.65
|
| Rate for Payer: The Alliance Commercial |
$508.04
|
| Rate for Payer: WEA Trust Commercial |
$558.84
|
| Rate for Payer: WPS Commercial |
$752.58
|
|
|
SCREW CORT1.5 X 9MM 400.809.96
|
Facility
|
IP
|
$1,032.00
|
|
| Hospital Charge Code |
2966422
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.91 |
| Max. Negotiated Rate |
$987.42 |
| Rate for Payer: Aetna Commercial |
$965.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$923.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$568.84
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cigna Commercial |
$987.42
|
| Rate for Payer: Health EOS Commercial |
$955.22
|
| Rate for Payer: HFN Commercial |
$987.42
|
| Rate for Payer: Multiplan Commercial |
$858.62
|
| Rate for Payer: Preferred Network Access Commercial |
$987.42
|
| Rate for Payer: Quartz Beloit One Network |
$525.91
|
| Rate for Payer: Quartz Commercial |
$643.97
|
| Rate for Payer: WEA Trust Commercial |
$590.30
|
| Rate for Payer: WPS Commercial |
$794.95
|
|
|
SCREW CORT1.5 X 9MM 400.809.96
|
Facility
|
OP
|
$1,032.00
|
|
| Hospital Charge Code |
2966422
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$300.52 |
| Max. Negotiated Rate |
$987.42 |
| Rate for Payer: Aetna Commercial |
$965.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$923.02
|
| Rate for Payer: Aetna Managed Medicare |
$300.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$697.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$536.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$515.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$568.84
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cigna Commercial |
$987.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$600.62
|
| Rate for Payer: Health EOS Commercial |
$955.22
|
| Rate for Payer: HFN Commercial |
$987.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$804.96
|
| Rate for Payer: Multiplan Commercial |
$858.62
|
| Rate for Payer: NAPHCARE Commercial |
$643.97
|
| Rate for Payer: Preferred Network Access Commercial |
$987.42
|
| Rate for Payer: Quartz Beloit One Network |
$525.91
|
| Rate for Payer: Quartz Commercial |
$697.63
|
| Rate for Payer: Quartz Medicare Advantage |
$643.97
|
| Rate for Payer: The Alliance Commercial |
$536.64
|
| Rate for Payer: WEA Trust Commercial |
$590.30
|
| Rate for Payer: WPS Commercial |
$794.95
|
|
|
SCREW CORT 1.5 X 9 ST 200.809
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494539
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$310.86 |
| Max. Negotiated Rate |
$583.65 |
| Rate for Payer: Aetna Commercial |
$570.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$336.23
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$583.65
|
| Rate for Payer: Health EOS Commercial |
$564.62
|
| Rate for Payer: HFN Commercial |
$583.65
|
| Rate for Payer: Multiplan Commercial |
$507.52
|
| Rate for Payer: Preferred Network Access Commercial |
$583.65
|
| Rate for Payer: Quartz Beloit One Network |
$310.86
|
| Rate for Payer: Quartz Commercial |
$380.64
|
| Rate for Payer: WEA Trust Commercial |
$348.92
|
| Rate for Payer: WPS Commercial |
$469.88
|
|
|
SCREW CORT 1.5 X 9 ST 200.809
|
Facility
|
OP
|
$610.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494539
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.63 |
| Max. Negotiated Rate |
$583.65 |
| Rate for Payer: Aetna Commercial |
$570.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.58
|
| Rate for Payer: Aetna Managed Medicare |
$177.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$412.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$317.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$304.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$336.23
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$583.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$355.02
|
| Rate for Payer: Health EOS Commercial |
$564.62
|
| Rate for Payer: HFN Commercial |
$583.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$475.80
|
| Rate for Payer: Multiplan Commercial |
$507.52
|
| Rate for Payer: NAPHCARE Commercial |
$380.64
|
| Rate for Payer: Preferred Network Access Commercial |
$583.65
|
| Rate for Payer: Quartz Beloit One Network |
$310.86
|
| Rate for Payer: Quartz Commercial |
$412.36
|
| Rate for Payer: Quartz Medicare Advantage |
$380.64
|
| Rate for Payer: The Alliance Commercial |
$317.20
|
| Rate for Payer: WEA Trust Commercial |
$348.92
|
| Rate for Payer: WPS Commercial |
$469.88
|
|
|
SCREW CORT 2.0MM X 10MM SELF TAPPING 201.810
|
Facility
|
OP
|
$610.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508573
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.63 |
| Max. Negotiated Rate |
$583.65 |
| Rate for Payer: Aetna Commercial |
$570.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.58
|
| Rate for Payer: Aetna Managed Medicare |
$177.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$412.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$317.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$304.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$336.23
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$583.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$355.02
|
| Rate for Payer: Health EOS Commercial |
$564.62
|
| Rate for Payer: HFN Commercial |
$583.65
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$475.80
|
| Rate for Payer: Multiplan Commercial |
$507.52
|
| Rate for Payer: NAPHCARE Commercial |
$380.64
|
| Rate for Payer: Preferred Network Access Commercial |
$583.65
|
| Rate for Payer: Quartz Beloit One Network |
$310.86
|
| Rate for Payer: Quartz Commercial |
$412.36
|
| Rate for Payer: Quartz Medicare Advantage |
$380.64
|
| Rate for Payer: The Alliance Commercial |
$317.20
|
| Rate for Payer: WEA Trust Commercial |
$348.92
|
| Rate for Payer: WPS Commercial |
$469.88
|
|
|
SCREW CORT 2.0MM X 10MM SELF TAPPING 201.810
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508573
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$310.86 |
| Max. Negotiated Rate |
$583.65 |
| Rate for Payer: Aetna Commercial |
$570.96
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$545.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$336.23
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$583.65
|
| Rate for Payer: Health EOS Commercial |
$564.62
|
| Rate for Payer: HFN Commercial |
$583.65
|
| Rate for Payer: Multiplan Commercial |
$507.52
|
| Rate for Payer: Preferred Network Access Commercial |
$583.65
|
| Rate for Payer: Quartz Beloit One Network |
$310.86
|
| Rate for Payer: Quartz Commercial |
$380.64
|
| Rate for Payer: WEA Trust Commercial |
$348.92
|
| Rate for Payer: WPS Commercial |
$469.88
|
|
|
SCREW CORT 2.0MM X 11MM SELF TAPPING 201.811
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508574
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Aetna Managed Medicare |
$171.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$397.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$305.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$293.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$342.22
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$458.64
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: NAPHCARE Commercial |
$366.91
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$397.49
|
| Rate for Payer: Quartz Medicare Advantage |
$366.91
|
| Rate for Payer: The Alliance Commercial |
$305.76
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 11MM SELF TAPPING 201.811
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508574
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$299.64 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$366.91
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 12MM SELF TAPPING 201.812
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508575
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$299.64 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$366.91
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 12MM SELF TAPPING 201.812
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508575
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Aetna Managed Medicare |
$171.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$397.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$305.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$293.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$342.22
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$458.64
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: NAPHCARE Commercial |
$366.91
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$397.49
|
| Rate for Payer: Quartz Medicare Advantage |
$366.91
|
| Rate for Payer: The Alliance Commercial |
$305.76
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 13MM SELF TAPPING 201.813
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508576
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Aetna Managed Medicare |
$171.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$397.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$305.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$293.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$342.22
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$458.64
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: NAPHCARE Commercial |
$366.91
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$397.49
|
| Rate for Payer: Quartz Medicare Advantage |
$366.91
|
| Rate for Payer: The Alliance Commercial |
$305.76
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 13MM SELF TAPPING 201.813
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508576
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$299.64 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$366.91
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 14MM SELF TAPPING 201.814
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$299.64 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$366.91
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 14MM SELF TAPPING 201.814
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Aetna Managed Medicare |
$171.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$397.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$305.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$293.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$342.22
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$458.64
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: NAPHCARE Commercial |
$366.91
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$397.49
|
| Rate for Payer: Quartz Medicare Advantage |
$366.91
|
| Rate for Payer: The Alliance Commercial |
$305.76
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 16MM SELF TAPPING 201.816
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508860
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$299.64 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$366.91
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
|
SCREW CORT 2.0MM X 16MM SELF TAPPING 201.816
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508860
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$562.60 |
| Rate for Payer: Aetna Commercial |
$550.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$525.91
|
| Rate for Payer: Aetna Managed Medicare |
$171.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$397.49
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$305.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$293.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.11
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna Commercial |
$562.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$342.22
|
| Rate for Payer: Health EOS Commercial |
$544.25
|
| Rate for Payer: HFN Commercial |
$562.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$458.64
|
| Rate for Payer: Multiplan Commercial |
$489.22
|
| Rate for Payer: NAPHCARE Commercial |
$366.91
|
| Rate for Payer: Preferred Network Access Commercial |
$562.60
|
| Rate for Payer: Quartz Beloit One Network |
$299.64
|
| Rate for Payer: Quartz Commercial |
$397.49
|
| Rate for Payer: Quartz Medicare Advantage |
$366.91
|
| Rate for Payer: The Alliance Commercial |
$305.76
|
| Rate for Payer: WEA Trust Commercial |
$336.34
|
| Rate for Payer: WPS Commercial |
$452.94
|
|
