|
SCREW CORT 2.3 X 20 NON-TOGGLE CO-N2320
|
Facility
|
IP
|
$1,586.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$808.23 |
| Max. Negotiated Rate |
$1,517.48 |
| Rate for Payer: Aetna Commercial |
$1,484.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,418.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$874.20
|
| Rate for Payer: Cash Price |
$475.80
|
| Rate for Payer: Cigna Commercial |
$1,517.48
|
| Rate for Payer: Health EOS Commercial |
$1,468.00
|
| Rate for Payer: HFN Commercial |
$1,517.48
|
| Rate for Payer: Multiplan Commercial |
$1,319.55
|
| Rate for Payer: Preferred Network Access Commercial |
$1,517.48
|
| Rate for Payer: Quartz Beloit One Network |
$808.23
|
| Rate for Payer: Quartz Commercial |
$989.66
|
| Rate for Payer: WEA Trust Commercial |
$907.19
|
| Rate for Payer: WPS Commercial |
$1,221.70
|
|
|
SCREW CORT 2.3 X 20 NON-TOGGLE CO-N2320
|
Facility
|
OP
|
$1,586.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.84 |
| Max. Negotiated Rate |
$1,517.48 |
| Rate for Payer: Aetna Commercial |
$1,484.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,418.52
|
| Rate for Payer: Aetna Managed Medicare |
$461.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,072.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$824.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$791.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$874.20
|
| Rate for Payer: Cash Price |
$475.80
|
| Rate for Payer: Cigna Commercial |
$1,517.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$923.05
|
| Rate for Payer: Health EOS Commercial |
$1,468.00
|
| Rate for Payer: HFN Commercial |
$1,517.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,237.08
|
| Rate for Payer: Multiplan Commercial |
$1,319.55
|
| Rate for Payer: NAPHCARE Commercial |
$989.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,517.48
|
| Rate for Payer: Quartz Beloit One Network |
$808.23
|
| Rate for Payer: Quartz Commercial |
$1,072.14
|
| Rate for Payer: Quartz Medicare Advantage |
$989.66
|
| Rate for Payer: The Alliance Commercial |
$824.72
|
| Rate for Payer: WEA Trust Commercial |
$907.19
|
| Rate for Payer: WPS Commercial |
$1,221.70
|
|
|
SCREW CORT 2.4MM X 10MM SELF TAPPING 201.640
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494554
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 10MM SELF TAPPING 201.640
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494554
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 11MM SELF TAPPING 201.641
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 11MM SELF TAPPING 201.641
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 12MM SELF TAPPING 201.642
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 12MM SELF TAPPING 201.642
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 13MM SELF TAPPING 201.643
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 13MM SELF TAPPING 201.643
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 14MM SELF TAPPING 201.644
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 14MM SELF TAPPING 201.644
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 16MM SELF TAPPING 201.646
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 16MM SELF TAPPING 201.646
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 18MM SELF TAPPING 201.648
|
Facility
|
IP
|
$1,245.00
|
|
| Hospital Charge Code |
4494561
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 18MM SELF TAPPING 201.648
|
Facility
|
OP
|
$1,245.00
|
|
| Hospital Charge Code |
4494561
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 20MM SELF TAPPING 201.650
|
Facility
|
IP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494562
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$658.91 |
| Max. Negotiated Rate |
$1,237.14 |
| Rate for Payer: Aetna Commercial |
$1,210.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,156.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$712.70
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,237.14
|
| Rate for Payer: Health EOS Commercial |
$1,196.80
|
| Rate for Payer: HFN Commercial |
$1,237.14
|
| Rate for Payer: Multiplan Commercial |
$1,075.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,237.14
|
| Rate for Payer: Quartz Beloit One Network |
$658.91
|
| Rate for Payer: Quartz Commercial |
$806.83
|
| Rate for Payer: WEA Trust Commercial |
$739.60
|
| Rate for Payer: WPS Commercial |
$996.00
|
|
|
SCREW CORT 2.4MM X 20MM SELF TAPPING 201.650
|
Facility
|
OP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494562
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.52 |
| Max. Negotiated Rate |
$1,237.14 |
| Rate for Payer: Aetna Commercial |
$1,210.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,156.46
|
| Rate for Payer: Aetna Managed Medicare |
$376.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$874.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$672.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$645.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$712.70
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,237.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$752.53
|
| Rate for Payer: Health EOS Commercial |
$1,196.80
|
| Rate for Payer: HFN Commercial |
$1,237.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,008.54
|
| Rate for Payer: Multiplan Commercial |
$1,075.78
|
| Rate for Payer: NAPHCARE Commercial |
$806.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,237.14
|
| Rate for Payer: Quartz Beloit One Network |
$658.91
|
| Rate for Payer: Quartz Commercial |
$874.07
|
| Rate for Payer: Quartz Medicare Advantage |
$806.83
|
| Rate for Payer: The Alliance Commercial |
$672.36
|
| Rate for Payer: WEA Trust Commercial |
$739.60
|
| Rate for Payer: WPS Commercial |
$996.00
|
|
|
SCREW CORT 2.4MM X 22MM SELF TAPPING 201.652
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.54 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Aetna Managed Medicare |
$362.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$841.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$647.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$621.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$724.59
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$971.10
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: NAPHCARE Commercial |
$776.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$841.62
|
| Rate for Payer: Quartz Medicare Advantage |
$776.88
|
| Rate for Payer: The Alliance Commercial |
$647.40
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 22MM SELF TAPPING 201.652
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$634.45 |
| Max. Negotiated Rate |
$1,191.22 |
| Rate for Payer: Aetna Commercial |
$1,165.32
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,113.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$686.24
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,191.22
|
| Rate for Payer: Health EOS Commercial |
$1,152.37
|
| Rate for Payer: HFN Commercial |
$1,191.22
|
| Rate for Payer: Multiplan Commercial |
$1,035.84
|
| Rate for Payer: Preferred Network Access Commercial |
$1,191.22
|
| Rate for Payer: Quartz Beloit One Network |
$634.45
|
| Rate for Payer: Quartz Commercial |
$776.88
|
| Rate for Payer: WEA Trust Commercial |
$712.14
|
| Rate for Payer: WPS Commercial |
$959.02
|
|
|
SCREW CORT 2.4MM X 24MM SELF TAPPING 201.654
|
Facility
|
IP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$658.91 |
| Max. Negotiated Rate |
$1,237.14 |
| Rate for Payer: Aetna Commercial |
$1,210.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,156.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$712.70
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,237.14
|
| Rate for Payer: Health EOS Commercial |
$1,196.80
|
| Rate for Payer: HFN Commercial |
$1,237.14
|
| Rate for Payer: Multiplan Commercial |
$1,075.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,237.14
|
| Rate for Payer: Quartz Beloit One Network |
$658.91
|
| Rate for Payer: Quartz Commercial |
$806.83
|
| Rate for Payer: WEA Trust Commercial |
$739.60
|
| Rate for Payer: WPS Commercial |
$996.00
|
|
|
SCREW CORT 2.4MM X 24MM SELF TAPPING 201.654
|
Facility
|
OP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.52 |
| Max. Negotiated Rate |
$1,237.14 |
| Rate for Payer: Aetna Commercial |
$1,210.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,156.46
|
| Rate for Payer: Aetna Managed Medicare |
$376.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$874.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$672.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$645.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$712.70
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,237.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$752.53
|
| Rate for Payer: Health EOS Commercial |
$1,196.80
|
| Rate for Payer: HFN Commercial |
$1,237.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,008.54
|
| Rate for Payer: Multiplan Commercial |
$1,075.78
|
| Rate for Payer: NAPHCARE Commercial |
$806.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,237.14
|
| Rate for Payer: Quartz Beloit One Network |
$658.91
|
| Rate for Payer: Quartz Commercial |
$874.07
|
| Rate for Payer: Quartz Medicare Advantage |
$806.83
|
| Rate for Payer: The Alliance Commercial |
$672.36
|
| Rate for Payer: WEA Trust Commercial |
$739.60
|
| Rate for Payer: WPS Commercial |
$996.00
|
|
|
SCREW CORT 2.4MM X 26MM SELF TAPPING 201.656
|
Facility
|
OP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494565
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.52 |
| Max. Negotiated Rate |
$1,237.14 |
| Rate for Payer: Aetna Commercial |
$1,210.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,156.46
|
| Rate for Payer: Aetna Managed Medicare |
$376.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$874.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$672.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$645.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$712.70
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,237.14
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$752.53
|
| Rate for Payer: Health EOS Commercial |
$1,196.80
|
| Rate for Payer: HFN Commercial |
$1,237.14
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,008.54
|
| Rate for Payer: Multiplan Commercial |
$1,075.78
|
| Rate for Payer: NAPHCARE Commercial |
$806.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,237.14
|
| Rate for Payer: Quartz Beloit One Network |
$658.91
|
| Rate for Payer: Quartz Commercial |
$874.07
|
| Rate for Payer: Quartz Medicare Advantage |
$806.83
|
| Rate for Payer: The Alliance Commercial |
$672.36
|
| Rate for Payer: WEA Trust Commercial |
$739.60
|
| Rate for Payer: WPS Commercial |
$996.00
|
|
|
SCREW CORT 2.4MM X 26MM SELF TAPPING 201.656
|
Facility
|
IP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494565
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$658.91 |
| Max. Negotiated Rate |
$1,237.14 |
| Rate for Payer: Aetna Commercial |
$1,210.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,156.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$712.70
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,237.14
|
| Rate for Payer: Health EOS Commercial |
$1,196.80
|
| Rate for Payer: HFN Commercial |
$1,237.14
|
| Rate for Payer: Multiplan Commercial |
$1,075.78
|
| Rate for Payer: Preferred Network Access Commercial |
$1,237.14
|
| Rate for Payer: Quartz Beloit One Network |
$658.91
|
| Rate for Payer: Quartz Commercial |
$806.83
|
| Rate for Payer: WEA Trust Commercial |
$739.60
|
| Rate for Payer: WPS Commercial |
$996.00
|
|
|
SCREW CORT 2.4MM X 28MM SELF TAPPING 201.658
|
Facility
|
IP
|
$773.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$393.92 |
| Max. Negotiated Rate |
$739.61 |
| Rate for Payer: Aetna Commercial |
$723.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$691.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$426.08
|
| Rate for Payer: Cash Price |
$231.90
|
| Rate for Payer: Cigna Commercial |
$739.61
|
| Rate for Payer: Health EOS Commercial |
$715.49
|
| Rate for Payer: HFN Commercial |
$739.61
|
| Rate for Payer: Multiplan Commercial |
$643.14
|
| Rate for Payer: Preferred Network Access Commercial |
$739.61
|
| Rate for Payer: Quartz Beloit One Network |
$393.92
|
| Rate for Payer: Quartz Commercial |
$482.35
|
| Rate for Payer: WEA Trust Commercial |
$442.16
|
| Rate for Payer: WPS Commercial |
$595.44
|
|
