|
SCREW CANN LOCK 3.7 X 16MM 02.240.016
|
Facility
|
IP
|
$2,953.00
|
|
| Hospital Charge Code |
3072507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,446.97 |
| Max. Negotiated Rate |
$2,716.76 |
| Rate for Payer: Aetna Commercial |
$2,657.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,539.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.09
|
| Rate for Payer: Cash Price |
$885.90
|
| Rate for Payer: Cigna Commercial |
$2,716.76
|
| Rate for Payer: Health EOS Commercial |
$2,628.17
|
| Rate for Payer: HFN Commercial |
$2,716.76
|
| Rate for Payer: Multiplan Commercial |
$2,362.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,771.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,716.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,446.97
|
| Rate for Payer: Quartz Commercial |
$1,771.80
|
| Rate for Payer: WEA Trust Commercial |
$1,624.15
|
| Rate for Payer: WPS Commercial |
$2,187.29
|
|
|
SCREW CANN LOCK 3.7 X 24MM 02.240.024
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
3072509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 24MM 02.240.024
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
3072509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 28MM 02.240.028
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
3072472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 28MM 02.240.028
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
3072472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 30MM 02.240.030
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 30MM 02.240.030
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 32MM 02.240.032
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966503
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 32MM 02.240.032
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966503
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 34MM 02.240.034
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
3072473
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 34MM 02.240.034
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
3072473
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 36MM 02.240.036
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
3072510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 36MM 02.240.036
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
3072510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 38MM 02.240.038
|
Facility
|
IP
|
$2,953.00
|
|
| Hospital Charge Code |
2966504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,446.97 |
| Max. Negotiated Rate |
$2,716.76 |
| Rate for Payer: Aetna Commercial |
$2,657.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,539.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.09
|
| Rate for Payer: Cash Price |
$885.90
|
| Rate for Payer: Cigna Commercial |
$2,716.76
|
| Rate for Payer: Health EOS Commercial |
$2,628.17
|
| Rate for Payer: HFN Commercial |
$2,716.76
|
| Rate for Payer: Multiplan Commercial |
$2,362.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,771.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,716.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,446.97
|
| Rate for Payer: Quartz Commercial |
$1,771.80
|
| Rate for Payer: WEA Trust Commercial |
$1,624.15
|
| Rate for Payer: WPS Commercial |
$2,187.29
|
|
|
SCREW CANN LOCK 3.7 X 38MM 02.240.038
|
Facility
|
OP
|
$2,953.00
|
|
| Hospital Charge Code |
2966504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$826.84 |
| Max. Negotiated Rate |
$11,812.00 |
| Rate for Payer: Aetna Commercial |
$2,657.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,539.58
|
| Rate for Payer: Aetna Managed Medicare |
$826.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,919.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,476.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,417.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,565.09
|
| Rate for Payer: Cash Price |
$885.90
|
| Rate for Payer: Cigna Commercial |
$2,716.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,652.50
|
| Rate for Payer: Health EOS Commercial |
$2,628.17
|
| Rate for Payer: HFN Commercial |
$2,716.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,214.75
|
| Rate for Payer: Multiplan Commercial |
$2,362.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,771.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,716.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,446.97
|
| Rate for Payer: Quartz Commercial |
$1,919.45
|
| Rate for Payer: Quartz Medicare Advantage |
$1,771.80
|
| Rate for Payer: The Alliance Commercial |
$11,812.00
|
| Rate for Payer: WEA Trust Commercial |
$1,624.15
|
| Rate for Payer: WPS Commercial |
$2,187.29
|
|
|
SCREW CANN LOCK 3.7 X 40MM 02.240.040
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 40MM 02.240.040
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 42MM 02.240.042
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 42MM 02.240.042
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 44MM 02.240.044
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 44MM 02.240.044
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 46MM 02.240.046
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 46MM 02.240.046
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 48MM 02.240.048
|
Facility
|
OP
|
$2,752.00
|
|
| Hospital Charge Code |
2966509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$770.56 |
| Max. Negotiated Rate |
$11,008.00 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Aetna Managed Medicare |
$770.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,788.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,540.02
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,064.00
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,788.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,651.20
|
| Rate for Payer: The Alliance Commercial |
$11,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
|
SCREW CANN LOCK 3.7 X 48MM 02.240.048
|
Facility
|
IP
|
$2,752.00
|
|
| Hospital Charge Code |
2966509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,348.48 |
| Max. Negotiated Rate |
$2,531.84 |
| Rate for Payer: Aetna Commercial |
$2,476.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,366.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,458.56
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cigna Commercial |
$2,531.84
|
| Rate for Payer: Health EOS Commercial |
$2,449.28
|
| Rate for Payer: HFN Commercial |
$2,531.84
|
| Rate for Payer: Multiplan Commercial |
$2,201.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,651.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,531.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,348.48
|
| Rate for Payer: Quartz Commercial |
$1,651.20
|
| Rate for Payer: WEA Trust Commercial |
$1,513.60
|
| Rate for Payer: WPS Commercial |
$2,038.41
|
|
