|
SCREW CORT 2.4MM X 28MM SELF TAPPING 201.658
|
Facility
|
OP
|
$773.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.10 |
| Max. Negotiated Rate |
$739.61 |
| Rate for Payer: Aetna Commercial |
$723.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$691.37
|
| Rate for Payer: Aetna Managed Medicare |
$225.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$522.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$401.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$385.88
|
| 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: Dean Health DHI/DHP/ASO |
$449.89
|
| Rate for Payer: Health EOS Commercial |
$715.49
|
| Rate for Payer: HFN Commercial |
$739.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$602.94
|
| Rate for Payer: Multiplan Commercial |
$643.14
|
| Rate for Payer: NAPHCARE Commercial |
$482.35
|
| Rate for Payer: Preferred Network Access Commercial |
$739.61
|
| Rate for Payer: Quartz Beloit One Network |
$393.92
|
| Rate for Payer: Quartz Commercial |
$522.55
|
| Rate for Payer: Quartz Medicare Advantage |
$482.35
|
| Rate for Payer: The Alliance Commercial |
$401.96
|
| Rate for Payer: WEA Trust Commercial |
$442.16
|
| Rate for Payer: WPS Commercial |
$595.44
|
|
|
SCREW CORT 2.4MM X 30MM SELF TAPPING 201.660
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494567
|
|
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 30MM SELF TAPPING 201.660
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494567
|
|
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 32MM SELF TAPPING 201.662
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494568
|
|
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 32MM SELF TAPPING 201.662
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494568
|
|
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 6MM SELF TAPPING 201.636
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494550
|
|
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 6MM SELF TAPPING 201.636
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494550
|
|
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 7MM SELF TAPPING 201.637
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494551
|
|
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 7MM SELF TAPPING 201.637
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494551
|
|
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 8MM SELF TAPPING 201.638
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494552
|
|
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 8MM SELF TAPPING 201.638
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494552
|
|
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 9MM SELF TAPPING 201.639
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494553
|
|
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 9MM SELF TAPPING 201.639
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494553
|
|
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 2.4 X 10 401.760
|
Facility
|
IP
|
$478.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.59 |
| Max. Negotiated Rate |
$457.35 |
| Rate for Payer: Aetna Commercial |
$447.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$427.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$263.47
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$457.35
|
| Rate for Payer: Health EOS Commercial |
$442.44
|
| Rate for Payer: HFN Commercial |
$457.35
|
| Rate for Payer: Multiplan Commercial |
$397.70
|
| Rate for Payer: Preferred Network Access Commercial |
$457.35
|
| Rate for Payer: Quartz Beloit One Network |
$243.59
|
| Rate for Payer: Quartz Commercial |
$298.27
|
| Rate for Payer: WEA Trust Commercial |
$273.42
|
| Rate for Payer: WPS Commercial |
$368.20
|
|
|
SCREW-CORT 2.4 X 10 401.760
|
Facility
|
OP
|
$478.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.19 |
| Max. Negotiated Rate |
$457.35 |
| Rate for Payer: Aetna Commercial |
$447.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$427.52
|
| Rate for Payer: Aetna Managed Medicare |
$139.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$323.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$248.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$238.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$263.47
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$457.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$278.20
|
| Rate for Payer: Health EOS Commercial |
$442.44
|
| Rate for Payer: HFN Commercial |
$457.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$372.84
|
| Rate for Payer: Multiplan Commercial |
$397.70
|
| Rate for Payer: NAPHCARE Commercial |
$298.27
|
| Rate for Payer: Preferred Network Access Commercial |
$457.35
|
| Rate for Payer: Quartz Beloit One Network |
$243.59
|
| Rate for Payer: Quartz Commercial |
$323.13
|
| Rate for Payer: Quartz Medicare Advantage |
$298.27
|
| Rate for Payer: The Alliance Commercial |
$248.56
|
| Rate for Payer: WEA Trust Commercial |
$273.42
|
| Rate for Payer: WPS Commercial |
$368.20
|
|
|
SCREW CORT 2.4 X 10MM AR-8956-10
|
Facility
|
IP
|
$1,464.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5286716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$746.05 |
| Max. Negotiated Rate |
$1,400.76 |
| Rate for Payer: Aetna Commercial |
$1,370.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,309.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.96
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cigna Commercial |
$1,400.76
|
| Rate for Payer: Health EOS Commercial |
$1,355.08
|
| Rate for Payer: HFN Commercial |
$1,400.76
|
| Rate for Payer: Multiplan Commercial |
$1,218.05
|
| Rate for Payer: Preferred Network Access Commercial |
$1,400.76
|
| Rate for Payer: Quartz Beloit One Network |
$746.05
|
| Rate for Payer: Quartz Commercial |
$913.54
|
| Rate for Payer: WEA Trust Commercial |
$837.41
|
| Rate for Payer: WPS Commercial |
$1,127.72
|
|
|
SCREW CORT 2.4 X 10MM AR-8956-10
|
Facility
|
OP
|
$1,464.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5286716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.32 |
| Max. Negotiated Rate |
$1,400.76 |
| Rate for Payer: Aetna Commercial |
$1,370.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,309.40
|
| Rate for Payer: Aetna Managed Medicare |
$426.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$989.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$761.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$730.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.96
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cigna Commercial |
$1,400.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$852.05
|
| Rate for Payer: Health EOS Commercial |
$1,355.08
|
| Rate for Payer: HFN Commercial |
$1,400.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,141.92
|
| Rate for Payer: Multiplan Commercial |
$1,218.05
|
| Rate for Payer: NAPHCARE Commercial |
$913.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,400.76
|
| Rate for Payer: Quartz Beloit One Network |
$746.05
|
| Rate for Payer: Quartz Commercial |
$989.66
|
| Rate for Payer: Quartz Medicare Advantage |
$913.54
|
| Rate for Payer: The Alliance Commercial |
$761.28
|
| Rate for Payer: WEA Trust Commercial |
$837.41
|
| Rate for Payer: WPS Commercial |
$1,127.72
|
|
|
SCREW CORT 2.4 X 10MM LP TI AR-8724-10
|
Facility
|
OP
|
$1,464.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5286788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.32 |
| Max. Negotiated Rate |
$1,400.76 |
| Rate for Payer: Aetna Commercial |
$1,370.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,309.40
|
| Rate for Payer: Aetna Managed Medicare |
$426.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$989.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$761.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$730.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.96
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cigna Commercial |
$1,400.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$852.05
|
| Rate for Payer: Health EOS Commercial |
$1,355.08
|
| Rate for Payer: HFN Commercial |
$1,400.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,141.92
|
| Rate for Payer: Multiplan Commercial |
$1,218.05
|
| Rate for Payer: NAPHCARE Commercial |
$913.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,400.76
|
| Rate for Payer: Quartz Beloit One Network |
$746.05
|
| Rate for Payer: Quartz Commercial |
$989.66
|
| Rate for Payer: Quartz Medicare Advantage |
$913.54
|
| Rate for Payer: The Alliance Commercial |
$761.28
|
| Rate for Payer: WEA Trust Commercial |
$837.41
|
| Rate for Payer: WPS Commercial |
$1,127.72
|
|
|
SCREW CORT 2.4 X 10MM LP TI AR-8724-10
|
Facility
|
IP
|
$1,464.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5286788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$746.05 |
| Max. Negotiated Rate |
$1,400.76 |
| Rate for Payer: Aetna Commercial |
$1,370.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,309.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.96
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cigna Commercial |
$1,400.76
|
| Rate for Payer: Health EOS Commercial |
$1,355.08
|
| Rate for Payer: HFN Commercial |
$1,400.76
|
| Rate for Payer: Multiplan Commercial |
$1,218.05
|
| Rate for Payer: Preferred Network Access Commercial |
$1,400.76
|
| Rate for Payer: Quartz Beloit One Network |
$746.05
|
| Rate for Payer: Quartz Commercial |
$913.54
|
| Rate for Payer: WEA Trust Commercial |
$837.41
|
| Rate for Payer: WPS Commercial |
$1,127.72
|
|
|
SCREW-CORT 2.4 X 12 401.762
|
Facility
|
IP
|
$497.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966798
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$253.27 |
| Max. Negotiated Rate |
$475.53 |
| Rate for Payer: Aetna Commercial |
$465.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$444.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$273.95
|
| Rate for Payer: Cash Price |
$149.10
|
| Rate for Payer: Cigna Commercial |
$475.53
|
| Rate for Payer: Health EOS Commercial |
$460.02
|
| Rate for Payer: HFN Commercial |
$475.53
|
| Rate for Payer: Multiplan Commercial |
$413.50
|
| Rate for Payer: Preferred Network Access Commercial |
$475.53
|
| Rate for Payer: Quartz Beloit One Network |
$253.27
|
| Rate for Payer: Quartz Commercial |
$310.13
|
| Rate for Payer: WEA Trust Commercial |
$284.28
|
| Rate for Payer: WPS Commercial |
$382.84
|
|
|
SCREW-CORT 2.4 X 12 401.762
|
Facility
|
OP
|
$497.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966798
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.73 |
| Max. Negotiated Rate |
$475.53 |
| Rate for Payer: Aetna Commercial |
$465.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$444.52
|
| Rate for Payer: Aetna Managed Medicare |
$144.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$335.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$258.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$248.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$273.95
|
| Rate for Payer: Cash Price |
$149.10
|
| Rate for Payer: Cigna Commercial |
$475.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$289.25
|
| Rate for Payer: Health EOS Commercial |
$460.02
|
| Rate for Payer: HFN Commercial |
$475.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$387.66
|
| Rate for Payer: Multiplan Commercial |
$413.50
|
| Rate for Payer: NAPHCARE Commercial |
$310.13
|
| Rate for Payer: Preferred Network Access Commercial |
$475.53
|
| Rate for Payer: Quartz Beloit One Network |
$253.27
|
| Rate for Payer: Quartz Commercial |
$335.97
|
| Rate for Payer: Quartz Medicare Advantage |
$310.13
|
| Rate for Payer: The Alliance Commercial |
$258.44
|
| Rate for Payer: WEA Trust Commercial |
$284.28
|
| Rate for Payer: WPS Commercial |
$382.84
|
|
|
SCREW CORT 2.4 X 12MM AR-8956-12
|
Facility
|
IP
|
$1,464.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5286717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$746.05 |
| Max. Negotiated Rate |
$1,400.76 |
| Rate for Payer: Aetna Commercial |
$1,370.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,309.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.96
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cigna Commercial |
$1,400.76
|
| Rate for Payer: Health EOS Commercial |
$1,355.08
|
| Rate for Payer: HFN Commercial |
$1,400.76
|
| Rate for Payer: Multiplan Commercial |
$1,218.05
|
| Rate for Payer: Preferred Network Access Commercial |
$1,400.76
|
| Rate for Payer: Quartz Beloit One Network |
$746.05
|
| Rate for Payer: Quartz Commercial |
$913.54
|
| Rate for Payer: WEA Trust Commercial |
$837.41
|
| Rate for Payer: WPS Commercial |
$1,127.72
|
|
|
SCREW CORT 2.4 X 12MM AR-8956-12
|
Facility
|
OP
|
$1,464.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5286717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.32 |
| Max. Negotiated Rate |
$1,400.76 |
| Rate for Payer: Aetna Commercial |
$1,370.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,309.40
|
| Rate for Payer: Aetna Managed Medicare |
$426.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$989.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$761.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$730.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.96
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cigna Commercial |
$1,400.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$852.05
|
| Rate for Payer: Health EOS Commercial |
$1,355.08
|
| Rate for Payer: HFN Commercial |
$1,400.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,141.92
|
| Rate for Payer: Multiplan Commercial |
$1,218.05
|
| Rate for Payer: NAPHCARE Commercial |
$913.54
|
| Rate for Payer: Preferred Network Access Commercial |
$1,400.76
|
| Rate for Payer: Quartz Beloit One Network |
$746.05
|
| Rate for Payer: Quartz Commercial |
$989.66
|
| Rate for Payer: Quartz Medicare Advantage |
$913.54
|
| Rate for Payer: The Alliance Commercial |
$761.28
|
| Rate for Payer: WEA Trust Commercial |
$837.41
|
| Rate for Payer: WPS Commercial |
$1,127.72
|
|
|
SCREW CORT 2.4 X 12MM LP TI AR-8724-12
|
Facility
|
IP
|
$1,463.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5200623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$745.54 |
| Max. Negotiated Rate |
$1,399.80 |
| Rate for Payer: Aetna Commercial |
$1,369.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,308.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.41
|
| Rate for Payer: Cash Price |
$438.90
|
| Rate for Payer: Cigna Commercial |
$1,399.80
|
| Rate for Payer: Health EOS Commercial |
$1,354.15
|
| Rate for Payer: HFN Commercial |
$1,399.80
|
| Rate for Payer: Multiplan Commercial |
$1,217.22
|
| Rate for Payer: Preferred Network Access Commercial |
$1,399.80
|
| Rate for Payer: Quartz Beloit One Network |
$745.54
|
| Rate for Payer: Quartz Commercial |
$912.91
|
| Rate for Payer: WEA Trust Commercial |
$836.84
|
| Rate for Payer: WPS Commercial |
$1,126.95
|
|
|
SCREW CORT 2.4 X 12MM LP TI AR-8724-12
|
Facility
|
OP
|
$1,463.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5200623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.03 |
| Max. Negotiated Rate |
$1,399.80 |
| Rate for Payer: Aetna Commercial |
$1,369.37
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,308.51
|
| Rate for Payer: Aetna Managed Medicare |
$426.03
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$988.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$760.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$730.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$806.41
|
| Rate for Payer: Cash Price |
$438.90
|
| Rate for Payer: Cigna Commercial |
$1,399.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$851.47
|
| Rate for Payer: Health EOS Commercial |
$1,354.15
|
| Rate for Payer: HFN Commercial |
$1,399.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,141.14
|
| Rate for Payer: Multiplan Commercial |
$1,217.22
|
| Rate for Payer: NAPHCARE Commercial |
$912.91
|
| Rate for Payer: Preferred Network Access Commercial |
$1,399.80
|
| Rate for Payer: Quartz Beloit One Network |
$745.54
|
| Rate for Payer: Quartz Commercial |
$988.99
|
| Rate for Payer: Quartz Medicare Advantage |
$912.91
|
| Rate for Payer: The Alliance Commercial |
$760.76
|
| Rate for Payer: WEA Trust Commercial |
$836.84
|
| Rate for Payer: WPS Commercial |
$1,126.95
|
|
