|
SCREW CORT 2.0MM X 18MM SELF TAPPING 201.818
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508577
|
|
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 18MM SELF TAPPING 201.818
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508577
|
|
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 20MM SELF TAPPING 201.820
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508578
|
|
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 20MM SELF TAPPING 201.820
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508578
|
|
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 22MM SELF TAPPING 201.822
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508579
|
|
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 22MM SELF TAPPING 201.822
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508579
|
|
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 24MM SELF TAPPING 201.824
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508580
|
|
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 24MM SELF TAPPING 201.824
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508580
|
|
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 26MM SELF TAPPING 201.826
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508581
|
|
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 26MM SELF TAPPING 201.826
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508581
|
|
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 28MM SELF TAPPING 201.828
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508582
|
|
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 28MM SELF TAPPING 201.828
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508582
|
|
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 30MM SELF TAPPING 201.830
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508584
|
|
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 30MM SELF TAPPING 201.830
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508584
|
|
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 32MM SELF TAPPING 201.832
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508585
|
|
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 32MM SELF TAPPING 201.832
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508585
|
|
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 6MM SELF TAPPING 201.806
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494569
|
|
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 6MM SELF TAPPING 201.806
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494569
|
|
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 7MM SELF TAPPING 201.807
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494570
|
|
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 7MM SELF TAPPING 201.807
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494570
|
|
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 8MM SELF TAPPING 201.808
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494571
|
|
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 8MM SELF TAPPING 201.808
|
Facility
|
OP
|
$610.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494571
|
|
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 9MM SELF TAPPING 201.809
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494572
|
|
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 9MM SELF TAPPING 201.809
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494572
|
|
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 2.0 X 10 201.010
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967254
|
|
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
|
|
