|
SCREW CORT 2.0 X 6MM 201.356.97
|
Facility
|
OP
|
$563.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.64 |
| Max. Negotiated Rate |
$2,252.00 |
| Rate for Payer: Aetna Commercial |
$506.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.18
|
| Rate for Payer: Aetna Managed Medicare |
$157.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$365.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$281.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$270.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.39
|
| Rate for Payer: Cash Price |
$168.90
|
| Rate for Payer: Cigna Commercial |
$517.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$315.05
|
| Rate for Payer: Health EOS Commercial |
$501.07
|
| Rate for Payer: HFN Commercial |
$517.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$422.25
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: NAPHCARE Commercial |
$337.80
|
| Rate for Payer: Preferred Network Access Commercial |
$517.96
|
| Rate for Payer: Quartz Beloit One Network |
$275.87
|
| Rate for Payer: Quartz Commercial |
$365.95
|
| Rate for Payer: Quartz Medicare Advantage |
$337.80
|
| Rate for Payer: The Alliance Commercial |
$2,252.00
|
| Rate for Payer: WEA Trust Commercial |
$309.65
|
| Rate for Payer: WPS Commercial |
$417.01
|
|
|
SCREW CORT 2.0 X 7MM 201.357.97
|
Facility
|
OP
|
$563.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.64 |
| Max. Negotiated Rate |
$2,252.00 |
| Rate for Payer: Aetna Commercial |
$506.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.18
|
| Rate for Payer: Aetna Managed Medicare |
$157.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$365.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$281.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$270.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.39
|
| Rate for Payer: Cash Price |
$168.90
|
| Rate for Payer: Cigna Commercial |
$517.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$315.05
|
| Rate for Payer: Health EOS Commercial |
$501.07
|
| Rate for Payer: HFN Commercial |
$517.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$422.25
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: NAPHCARE Commercial |
$337.80
|
| Rate for Payer: Preferred Network Access Commercial |
$517.96
|
| Rate for Payer: Quartz Beloit One Network |
$275.87
|
| Rate for Payer: Quartz Commercial |
$365.95
|
| Rate for Payer: Quartz Medicare Advantage |
$337.80
|
| Rate for Payer: The Alliance Commercial |
$2,252.00
|
| Rate for Payer: WEA Trust Commercial |
$309.65
|
| Rate for Payer: WPS Commercial |
$417.01
|
|
|
SCREW CORT 2.0 X 7MM 201.357.97
|
Facility
|
IP
|
$563.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.87 |
| Max. Negotiated Rate |
$517.96 |
| Rate for Payer: Aetna Commercial |
$506.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.39
|
| Rate for Payer: Cash Price |
$168.90
|
| Rate for Payer: Cigna Commercial |
$517.96
|
| Rate for Payer: Health EOS Commercial |
$501.07
|
| Rate for Payer: HFN Commercial |
$517.96
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: NAPHCARE Commercial |
$337.80
|
| Rate for Payer: Preferred Network Access Commercial |
$517.96
|
| Rate for Payer: Quartz Beloit One Network |
$275.87
|
| Rate for Payer: Quartz Commercial |
$337.80
|
| Rate for Payer: WEA Trust Commercial |
$309.65
|
| Rate for Payer: WPS Commercial |
$417.01
|
|
|
SCREW CORT 2.0 X 7MM STARDRVE 401.357.97
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4268740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.40 |
| Max. Negotiated Rate |
$2,920.00 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Aetna Managed Medicare |
$204.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$474.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$365.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$350.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$408.51
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$547.50
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$474.50
|
| Rate for Payer: Quartz Medicare Advantage |
$438.00
|
| Rate for Payer: The Alliance Commercial |
$2,920.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW CORT 2.0 X 7MM STARDRVE 401.357.97
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4268740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.70 |
| Max. Negotiated Rate |
$671.60 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$438.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW-CORT 2.0 X 8 201.008
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.24 |
| Max. Negotiated Rate |
$532.00 |
| Rate for Payer: Aetna Commercial |
$119.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$114.38
|
| Rate for Payer: Aetna Managed Medicare |
$37.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$86.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$66.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$63.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$70.49
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cigna Commercial |
$122.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$74.43
|
| Rate for Payer: Health EOS Commercial |
$118.37
|
| Rate for Payer: HFN Commercial |
$122.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$106.40
|
| Rate for Payer: NAPHCARE Commercial |
$79.80
|
| Rate for Payer: Preferred Network Access Commercial |
$122.36
|
| Rate for Payer: Quartz Beloit One Network |
$65.17
|
| Rate for Payer: Quartz Commercial |
$86.45
|
| Rate for Payer: Quartz Medicare Advantage |
$79.80
|
| Rate for Payer: The Alliance Commercial |
$532.00
|
| Rate for Payer: WEA Trust Commercial |
$73.15
|
| Rate for Payer: WPS Commercial |
$98.51
|
|
|
SCREW-CORT 2.0 X 8 201.008
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2967261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.17 |
| Max. Negotiated Rate |
$122.36 |
| Rate for Payer: Aetna Commercial |
$119.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$114.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$70.49
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cigna Commercial |
$122.36
|
| Rate for Payer: Health EOS Commercial |
$118.37
|
| Rate for Payer: HFN Commercial |
$122.36
|
| Rate for Payer: Multiplan Commercial |
$106.40
|
| Rate for Payer: NAPHCARE Commercial |
$79.80
|
| Rate for Payer: Preferred Network Access Commercial |
$122.36
|
| Rate for Payer: Quartz Beloit One Network |
$65.17
|
| Rate for Payer: Quartz Commercial |
$79.80
|
| Rate for Payer: WEA Trust Commercial |
$73.15
|
| Rate for Payer: WPS Commercial |
$98.51
|
|
|
SCREW CORT 2.0 X 8MM 201.358.97
|
Facility
|
OP
|
$563.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.64 |
| Max. Negotiated Rate |
$2,252.00 |
| Rate for Payer: Aetna Commercial |
$506.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.18
|
| Rate for Payer: Aetna Managed Medicare |
$157.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$365.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$281.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$270.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.39
|
| Rate for Payer: Cash Price |
$168.90
|
| Rate for Payer: Cigna Commercial |
$517.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$315.05
|
| Rate for Payer: Health EOS Commercial |
$501.07
|
| Rate for Payer: HFN Commercial |
$517.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$422.25
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: NAPHCARE Commercial |
$337.80
|
| Rate for Payer: Preferred Network Access Commercial |
$517.96
|
| Rate for Payer: Quartz Beloit One Network |
$275.87
|
| Rate for Payer: Quartz Commercial |
$365.95
|
| Rate for Payer: Quartz Medicare Advantage |
$337.80
|
| Rate for Payer: The Alliance Commercial |
$2,252.00
|
| Rate for Payer: WEA Trust Commercial |
$309.65
|
| Rate for Payer: WPS Commercial |
$417.01
|
|
|
SCREW CORT 2.0 X 8MM 201.358.97
|
Facility
|
IP
|
$563.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.87 |
| Max. Negotiated Rate |
$517.96 |
| Rate for Payer: Aetna Commercial |
$506.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$484.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$298.39
|
| Rate for Payer: Cash Price |
$168.90
|
| Rate for Payer: Cigna Commercial |
$517.96
|
| Rate for Payer: Health EOS Commercial |
$501.07
|
| Rate for Payer: HFN Commercial |
$517.96
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: NAPHCARE Commercial |
$337.80
|
| Rate for Payer: Preferred Network Access Commercial |
$517.96
|
| Rate for Payer: Quartz Beloit One Network |
$275.87
|
| Rate for Payer: Quartz Commercial |
$337.80
|
| Rate for Payer: WEA Trust Commercial |
$309.65
|
| Rate for Payer: WPS Commercial |
$417.01
|
|
|
SCREW CORT 2.0 X 9MM 201.359.97
|
Facility
|
IP
|
$655.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4858888
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$320.95 |
| Max. Negotiated Rate |
$602.60 |
| Rate for Payer: Aetna Commercial |
$589.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$563.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$347.15
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$602.60
|
| Rate for Payer: Health EOS Commercial |
$582.95
|
| Rate for Payer: HFN Commercial |
$602.60
|
| Rate for Payer: Multiplan Commercial |
$524.00
|
| Rate for Payer: NAPHCARE Commercial |
$393.00
|
| Rate for Payer: Preferred Network Access Commercial |
$602.60
|
| Rate for Payer: Quartz Beloit One Network |
$320.95
|
| Rate for Payer: Quartz Commercial |
$393.00
|
| Rate for Payer: WEA Trust Commercial |
$360.25
|
| Rate for Payer: WPS Commercial |
$485.16
|
|
|
SCREW CORT 2.0 X 9MM 201.359.97
|
Facility
|
OP
|
$655.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4858888
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.40 |
| Max. Negotiated Rate |
$2,620.00 |
| Rate for Payer: Aetna Commercial |
$589.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$563.30
|
| Rate for Payer: Aetna Managed Medicare |
$183.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$425.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$327.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$314.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$347.15
|
| Rate for Payer: Cash Price |
$196.50
|
| Rate for Payer: Cigna Commercial |
$602.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$366.54
|
| Rate for Payer: Health EOS Commercial |
$582.95
|
| Rate for Payer: HFN Commercial |
$602.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$491.25
|
| Rate for Payer: Multiplan Commercial |
$524.00
|
| Rate for Payer: NAPHCARE Commercial |
$393.00
|
| Rate for Payer: Preferred Network Access Commercial |
$602.60
|
| Rate for Payer: Quartz Beloit One Network |
$320.95
|
| Rate for Payer: Quartz Commercial |
$425.75
|
| Rate for Payer: Quartz Medicare Advantage |
$393.00
|
| Rate for Payer: The Alliance Commercial |
$2,620.00
|
| Rate for Payer: WEA Trust Commercial |
$360.25
|
| Rate for Payer: WPS Commercial |
$485.16
|
|
|
SCREW CORT 2.0 X 9MM STARDRIVE 401.359.97
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4640856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.40 |
| Max. Negotiated Rate |
$2,920.00 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Aetna Managed Medicare |
$204.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$474.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$365.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$350.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$408.51
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$547.50
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$474.50
|
| Rate for Payer: Quartz Medicare Advantage |
$438.00
|
| Rate for Payer: The Alliance Commercial |
$2,920.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW CORT 2.0 X 9MM STARDRIVE 401.359.97
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4640856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.70 |
| Max. Negotiated Rate |
$671.60 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$627.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$386.90
|
| Rate for Payer: Cash Price |
$219.00
|
| Rate for Payer: Cigna Commercial |
$671.60
|
| Rate for Payer: Health EOS Commercial |
$649.70
|
| Rate for Payer: HFN Commercial |
$671.60
|
| Rate for Payer: Multiplan Commercial |
$584.00
|
| Rate for Payer: NAPHCARE Commercial |
$438.00
|
| Rate for Payer: Preferred Network Access Commercial |
$671.60
|
| Rate for Payer: Quartz Beloit One Network |
$357.70
|
| Rate for Payer: Quartz Commercial |
$438.00
|
| Rate for Payer: WEA Trust Commercial |
$401.50
|
| Rate for Payer: WPS Commercial |
$540.71
|
|
|
SCREW CORT 2.3 X 14 NON-TOGGLE CO-N2314
|
Facility
|
IP
|
$1,536.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$752.64 |
| Max. Negotiated Rate |
$1,413.12 |
| Rate for Payer: Aetna Commercial |
$1,382.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$814.08
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cigna Commercial |
$1,413.12
|
| Rate for Payer: Health EOS Commercial |
$1,367.04
|
| Rate for Payer: HFN Commercial |
$1,413.12
|
| Rate for Payer: Multiplan Commercial |
$1,228.80
|
| Rate for Payer: NAPHCARE Commercial |
$921.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,413.12
|
| Rate for Payer: Quartz Beloit One Network |
$752.64
|
| Rate for Payer: Quartz Commercial |
$921.60
|
| Rate for Payer: WEA Trust Commercial |
$844.80
|
| Rate for Payer: WPS Commercial |
$1,137.72
|
|
|
SCREW CORT 2.3 X 14 NON-TOGGLE CO-N2314
|
Facility
|
OP
|
$1,536.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.08 |
| Max. Negotiated Rate |
$6,144.00 |
| Rate for Payer: Aetna Commercial |
$1,382.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,320.96
|
| Rate for Payer: Aetna Managed Medicare |
$430.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$998.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$768.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$737.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$814.08
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cigna Commercial |
$1,413.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$859.55
|
| Rate for Payer: Health EOS Commercial |
$1,367.04
|
| Rate for Payer: HFN Commercial |
$1,413.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,152.00
|
| Rate for Payer: Multiplan Commercial |
$1,228.80
|
| Rate for Payer: NAPHCARE Commercial |
$921.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,413.12
|
| Rate for Payer: Quartz Beloit One Network |
$752.64
|
| Rate for Payer: Quartz Commercial |
$998.40
|
| Rate for Payer: Quartz Medicare Advantage |
$921.60
|
| Rate for Payer: The Alliance Commercial |
$6,144.00
|
| Rate for Payer: WEA Trust Commercial |
$844.80
|
| Rate for Payer: WPS Commercial |
$1,137.72
|
|
|
SCREW CORT 2.3 X 16 NON-TOGGLE CO-N2316
|
Facility
|
OP
|
$1,429.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.12 |
| Max. Negotiated Rate |
$5,716.00 |
| Rate for Payer: Aetna Commercial |
$1,286.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.94
|
| Rate for Payer: Aetna Managed Medicare |
$400.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$928.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$714.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$685.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.37
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,314.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$799.67
|
| Rate for Payer: Health EOS Commercial |
$1,271.81
|
| Rate for Payer: HFN Commercial |
$1,314.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,071.75
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: NAPHCARE Commercial |
$857.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.68
|
| Rate for Payer: Quartz Beloit One Network |
$700.21
|
| Rate for Payer: Quartz Commercial |
$928.85
|
| Rate for Payer: Quartz Medicare Advantage |
$857.40
|
| Rate for Payer: The Alliance Commercial |
$5,716.00
|
| Rate for Payer: WEA Trust Commercial |
$785.95
|
| Rate for Payer: WPS Commercial |
$1,058.46
|
|
|
SCREW CORT 2.3 X 16 NON-TOGGLE CO-N2316
|
Facility
|
IP
|
$1,429.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.21 |
| Max. Negotiated Rate |
$1,314.68 |
| Rate for Payer: Aetna Commercial |
$1,286.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.37
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,314.68
|
| Rate for Payer: Health EOS Commercial |
$1,271.81
|
| Rate for Payer: HFN Commercial |
$1,314.68
|
| Rate for Payer: Multiplan Commercial |
$1,143.20
|
| Rate for Payer: NAPHCARE Commercial |
$857.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.68
|
| Rate for Payer: Quartz Beloit One Network |
$700.21
|
| Rate for Payer: Quartz Commercial |
$857.40
|
| Rate for Payer: WEA Trust Commercial |
$785.95
|
| Rate for Payer: WPS Commercial |
$1,058.46
|
|
|
SCREW CORT 2.3 X 18 NON-TOGGLE CO-N2318
|
Facility
|
IP
|
$1,536.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632656
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$752.64 |
| Max. Negotiated Rate |
$1,413.12 |
| Rate for Payer: Aetna Commercial |
$1,382.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,320.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$814.08
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cigna Commercial |
$1,413.12
|
| Rate for Payer: Health EOS Commercial |
$1,367.04
|
| Rate for Payer: HFN Commercial |
$1,413.12
|
| Rate for Payer: Multiplan Commercial |
$1,228.80
|
| Rate for Payer: NAPHCARE Commercial |
$921.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,413.12
|
| Rate for Payer: Quartz Beloit One Network |
$752.64
|
| Rate for Payer: Quartz Commercial |
$921.60
|
| Rate for Payer: WEA Trust Commercial |
$844.80
|
| Rate for Payer: WPS Commercial |
$1,137.72
|
|
|
SCREW CORT 2.3 X 18 NON-TOGGLE CO-N2318
|
Facility
|
OP
|
$1,536.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632656
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$430.08 |
| Max. Negotiated Rate |
$6,144.00 |
| Rate for Payer: Aetna Commercial |
$1,382.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,320.96
|
| Rate for Payer: Aetna Managed Medicare |
$430.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$998.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$768.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$737.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$814.08
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cigna Commercial |
$1,413.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$859.55
|
| Rate for Payer: Health EOS Commercial |
$1,367.04
|
| Rate for Payer: HFN Commercial |
$1,413.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,152.00
|
| Rate for Payer: Multiplan Commercial |
$1,228.80
|
| Rate for Payer: NAPHCARE Commercial |
$921.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,413.12
|
| Rate for Payer: Quartz Beloit One Network |
$752.64
|
| Rate for Payer: Quartz Commercial |
$998.40
|
| Rate for Payer: Quartz Medicare Advantage |
$921.60
|
| Rate for Payer: The Alliance Commercial |
$6,144.00
|
| Rate for Payer: WEA Trust Commercial |
$844.80
|
| Rate for Payer: WPS Commercial |
$1,137.72
|
|
|
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 |
$444.08 |
| Max. Negotiated Rate |
$6,344.00 |
| Rate for Payer: Aetna Commercial |
$1,427.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,363.96
|
| Rate for Payer: Aetna Managed Medicare |
$444.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,030.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$793.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$761.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$840.58
|
| Rate for Payer: Cash Price |
$475.80
|
| Rate for Payer: Cigna Commercial |
$1,459.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$887.53
|
| Rate for Payer: Health EOS Commercial |
$1,411.54
|
| Rate for Payer: HFN Commercial |
$1,459.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,189.50
|
| Rate for Payer: Multiplan Commercial |
$1,268.80
|
| Rate for Payer: NAPHCARE Commercial |
$951.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,459.12
|
| Rate for Payer: Quartz Beloit One Network |
$777.14
|
| Rate for Payer: Quartz Commercial |
$1,030.90
|
| Rate for Payer: Quartz Medicare Advantage |
$951.60
|
| Rate for Payer: The Alliance Commercial |
$6,344.00
|
| Rate for Payer: WEA Trust Commercial |
$872.30
|
| Rate for Payer: WPS Commercial |
$1,174.75
|
|
|
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 |
$777.14 |
| Max. Negotiated Rate |
$1,459.12 |
| Rate for Payer: Aetna Commercial |
$1,427.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,363.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$840.58
|
| Rate for Payer: Cash Price |
$475.80
|
| Rate for Payer: Cigna Commercial |
$1,459.12
|
| Rate for Payer: Health EOS Commercial |
$1,411.54
|
| Rate for Payer: HFN Commercial |
$1,459.12
|
| Rate for Payer: Multiplan Commercial |
$1,268.80
|
| Rate for Payer: NAPHCARE Commercial |
$951.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,459.12
|
| Rate for Payer: Quartz Beloit One Network |
$777.14
|
| Rate for Payer: Quartz Commercial |
$951.60
|
| Rate for Payer: WEA Trust Commercial |
$872.30
|
| Rate for Payer: WPS Commercial |
$1,174.75
|
|
|
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 |
$610.05 |
| Max. Negotiated Rate |
$1,145.40 |
| Rate for Payer: Aetna Commercial |
$1,120.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,070.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$659.85
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Health EOS Commercial |
$1,108.05
|
| Rate for Payer: HFN Commercial |
$1,145.40
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: NAPHCARE Commercial |
$747.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,145.40
|
| Rate for Payer: Quartz Beloit One Network |
$610.05
|
| Rate for Payer: Quartz Commercial |
$747.00
|
| Rate for Payer: WEA Trust Commercial |
$684.75
|
| Rate for Payer: WPS Commercial |
$922.17
|
|
|
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 |
$348.60 |
| Max. Negotiated Rate |
$4,980.00 |
| Rate for Payer: Aetna Commercial |
$1,120.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,070.70
|
| Rate for Payer: Aetna Managed Medicare |
$348.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$809.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$622.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$597.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$659.85
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$696.70
|
| Rate for Payer: Health EOS Commercial |
$1,108.05
|
| Rate for Payer: HFN Commercial |
$1,145.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$933.75
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: NAPHCARE Commercial |
$747.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,145.40
|
| Rate for Payer: Quartz Beloit One Network |
$610.05
|
| Rate for Payer: Quartz Commercial |
$809.25
|
| Rate for Payer: Quartz Medicare Advantage |
$747.00
|
| Rate for Payer: The Alliance Commercial |
$4,980.00
|
| Rate for Payer: WEA Trust Commercial |
$684.75
|
| Rate for Payer: WPS Commercial |
$922.17
|
|
|
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 |
$610.05 |
| Max. Negotiated Rate |
$1,145.40 |
| Rate for Payer: Aetna Commercial |
$1,120.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,070.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$659.85
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Health EOS Commercial |
$1,108.05
|
| Rate for Payer: HFN Commercial |
$1,145.40
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: NAPHCARE Commercial |
$747.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,145.40
|
| Rate for Payer: Quartz Beloit One Network |
$610.05
|
| Rate for Payer: Quartz Commercial |
$747.00
|
| Rate for Payer: WEA Trust Commercial |
$684.75
|
| Rate for Payer: WPS Commercial |
$922.17
|
|
|
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 |
$348.60 |
| Max. Negotiated Rate |
$4,980.00 |
| Rate for Payer: Aetna Commercial |
$1,120.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,070.70
|
| Rate for Payer: Aetna Managed Medicare |
$348.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$809.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$622.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$597.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$659.85
|
| Rate for Payer: Cash Price |
$373.50
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$696.70
|
| Rate for Payer: Health EOS Commercial |
$1,108.05
|
| Rate for Payer: HFN Commercial |
$1,145.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$933.75
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: NAPHCARE Commercial |
$747.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,145.40
|
| Rate for Payer: Quartz Beloit One Network |
$610.05
|
| Rate for Payer: Quartz Commercial |
$809.25
|
| Rate for Payer: Quartz Medicare Advantage |
$747.00
|
| Rate for Payer: The Alliance Commercial |
$4,980.00
|
| Rate for Payer: WEA Trust Commercial |
$684.75
|
| Rate for Payer: WPS Commercial |
$922.17
|
|
