|
SCREW CORT 3.5 X 38MM LP 02.206.238
|
Facility
|
IP
|
$519.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4317102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$264.48 |
| Max. Negotiated Rate |
$496.58 |
| Rate for Payer: Aetna Commercial |
$485.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$464.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$286.07
|
| Rate for Payer: Cash Price |
$155.70
|
| Rate for Payer: Cigna Commercial |
$496.58
|
| Rate for Payer: Health EOS Commercial |
$480.39
|
| Rate for Payer: HFN Commercial |
$496.58
|
| Rate for Payer: Multiplan Commercial |
$431.81
|
| Rate for Payer: Preferred Network Access Commercial |
$496.58
|
| Rate for Payer: Quartz Beloit One Network |
$264.48
|
| Rate for Payer: Quartz Commercial |
$323.86
|
| Rate for Payer: WEA Trust Commercial |
$296.87
|
| Rate for Payer: WPS Commercial |
$399.79
|
|
|
SCREW CORT 3.5 X 38MM LP AR-8835-38
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.90 |
| Max. Negotiated Rate |
$554.94 |
| Rate for Payer: Aetna Commercial |
$542.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.75
|
| Rate for Payer: Aetna Managed Medicare |
$168.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$392.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$301.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$289.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.70
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cigna Commercial |
$554.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$337.56
|
| Rate for Payer: Health EOS Commercial |
$536.85
|
| Rate for Payer: HFN Commercial |
$554.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$452.40
|
| Rate for Payer: Multiplan Commercial |
$482.56
|
| Rate for Payer: NAPHCARE Commercial |
$361.92
|
| Rate for Payer: Preferred Network Access Commercial |
$554.94
|
| Rate for Payer: Quartz Beloit One Network |
$295.57
|
| Rate for Payer: Quartz Commercial |
$392.08
|
| Rate for Payer: Quartz Medicare Advantage |
$361.92
|
| Rate for Payer: The Alliance Commercial |
$301.60
|
| Rate for Payer: WEA Trust Commercial |
$331.76
|
| Rate for Payer: WPS Commercial |
$446.77
|
|
|
SCREW CORT 3.5 X 38MM LP AR-8835-38
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.57 |
| Max. Negotiated Rate |
$554.94 |
| Rate for Payer: Aetna Commercial |
$542.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.70
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cigna Commercial |
$554.94
|
| Rate for Payer: Health EOS Commercial |
$536.85
|
| Rate for Payer: HFN Commercial |
$554.94
|
| Rate for Payer: Multiplan Commercial |
$482.56
|
| Rate for Payer: Preferred Network Access Commercial |
$554.94
|
| Rate for Payer: Quartz Beloit One Network |
$295.57
|
| Rate for Payer: Quartz Commercial |
$361.92
|
| Rate for Payer: WEA Trust Commercial |
$331.76
|
| Rate for Payer: WPS Commercial |
$446.77
|
|
|
SCREW-CORT 3.5 X 40 204.840
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.11 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$116.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Aetna Managed Medicare |
$36.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$83.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$64.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$61.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.35
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$118.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$72.17
|
| Rate for Payer: Health EOS Commercial |
$114.77
|
| Rate for Payer: HFN Commercial |
$118.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$96.72
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: NAPHCARE Commercial |
$77.38
|
| Rate for Payer: Preferred Network Access Commercial |
$118.64
|
| Rate for Payer: Quartz Beloit One Network |
$63.19
|
| Rate for Payer: Quartz Commercial |
$83.82
|
| Rate for Payer: Quartz Medicare Advantage |
$77.38
|
| Rate for Payer: The Alliance Commercial |
$64.48
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$95.52
|
|
|
SCREW-CORT 3.5 X 40 204.840
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$116.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.35
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$118.64
|
| Rate for Payer: Health EOS Commercial |
$114.77
|
| Rate for Payer: HFN Commercial |
$118.64
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: Preferred Network Access Commercial |
$118.64
|
| Rate for Payer: Quartz Beloit One Network |
$63.19
|
| Rate for Payer: Quartz Commercial |
$77.38
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$95.52
|
|
|
SCREW CORT 3.5 X 40MM LP AR-8835-40
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5977644
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.29 |
| Max. Negotiated Rate |
$576.95 |
| Rate for Payer: Aetna Commercial |
$564.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$539.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$332.37
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Cigna Commercial |
$576.95
|
| Rate for Payer: Health EOS Commercial |
$558.14
|
| Rate for Payer: HFN Commercial |
$576.95
|
| Rate for Payer: Multiplan Commercial |
$501.70
|
| Rate for Payer: Preferred Network Access Commercial |
$576.95
|
| Rate for Payer: Quartz Beloit One Network |
$307.29
|
| Rate for Payer: Quartz Commercial |
$376.27
|
| Rate for Payer: WEA Trust Commercial |
$344.92
|
| Rate for Payer: WPS Commercial |
$464.49
|
|
|
SCREW CORT 3.5 X 40MM LP AR-8835-40
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5977644
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.59 |
| Max. Negotiated Rate |
$576.95 |
| Rate for Payer: Aetna Commercial |
$564.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$539.32
|
| Rate for Payer: Aetna Managed Medicare |
$175.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$407.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$313.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$301.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$332.37
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Cigna Commercial |
$576.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$350.95
|
| Rate for Payer: Health EOS Commercial |
$558.14
|
| Rate for Payer: HFN Commercial |
$576.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$470.34
|
| Rate for Payer: Multiplan Commercial |
$501.70
|
| Rate for Payer: NAPHCARE Commercial |
$376.27
|
| Rate for Payer: Preferred Network Access Commercial |
$576.95
|
| Rate for Payer: Quartz Beloit One Network |
$307.29
|
| Rate for Payer: Quartz Commercial |
$407.63
|
| Rate for Payer: Quartz Medicare Advantage |
$376.27
|
| Rate for Payer: The Alliance Commercial |
$313.56
|
| Rate for Payer: WEA Trust Commercial |
$344.92
|
| Rate for Payer: WPS Commercial |
$464.49
|
|
|
SCREW CORT 3.5 X 40MM ST 661440
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5458969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.31 |
| Max. Negotiated Rate |
$727.17 |
| Rate for Payer: Aetna Commercial |
$711.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$679.74
|
| Rate for Payer: Aetna Managed Medicare |
$221.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$513.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$395.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$379.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$418.91
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$727.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$442.32
|
| Rate for Payer: Health EOS Commercial |
$703.46
|
| Rate for Payer: HFN Commercial |
$727.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$592.80
|
| Rate for Payer: Multiplan Commercial |
$632.32
|
| Rate for Payer: NAPHCARE Commercial |
$474.24
|
| Rate for Payer: Preferred Network Access Commercial |
$727.17
|
| Rate for Payer: Quartz Beloit One Network |
$387.30
|
| Rate for Payer: Quartz Commercial |
$513.76
|
| Rate for Payer: Quartz Medicare Advantage |
$474.24
|
| Rate for Payer: The Alliance Commercial |
$395.20
|
| Rate for Payer: WEA Trust Commercial |
$434.72
|
| Rate for Payer: WPS Commercial |
$585.43
|
|
|
SCREW CORT 3.5 X 40MM ST 661440
|
Facility
|
IP
|
$760.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5458969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$727.17 |
| Rate for Payer: Aetna Commercial |
$711.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$679.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$418.91
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$727.17
|
| Rate for Payer: Health EOS Commercial |
$703.46
|
| Rate for Payer: HFN Commercial |
$727.17
|
| Rate for Payer: Multiplan Commercial |
$632.32
|
| Rate for Payer: Preferred Network Access Commercial |
$727.17
|
| Rate for Payer: Quartz Beloit One Network |
$387.30
|
| Rate for Payer: Quartz Commercial |
$474.24
|
| Rate for Payer: WEA Trust Commercial |
$434.72
|
| Rate for Payer: WPS Commercial |
$585.43
|
|
|
SCREW CORT 3.5 X 42MM LP AR-8835-42
|
Facility
|
OP
|
$652.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.86 |
| Max. Negotiated Rate |
$623.83 |
| Rate for Payer: Aetna Commercial |
$610.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$583.15
|
| Rate for Payer: Aetna Managed Medicare |
$189.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$440.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$339.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$325.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$359.38
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$623.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$379.46
|
| Rate for Payer: Health EOS Commercial |
$603.49
|
| Rate for Payer: HFN Commercial |
$623.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$508.56
|
| Rate for Payer: Multiplan Commercial |
$542.46
|
| Rate for Payer: NAPHCARE Commercial |
$406.85
|
| Rate for Payer: Preferred Network Access Commercial |
$623.83
|
| Rate for Payer: Quartz Beloit One Network |
$332.26
|
| Rate for Payer: Quartz Commercial |
$440.75
|
| Rate for Payer: Quartz Medicare Advantage |
$406.85
|
| Rate for Payer: The Alliance Commercial |
$339.04
|
| Rate for Payer: WEA Trust Commercial |
$372.94
|
| Rate for Payer: WPS Commercial |
$502.24
|
|
|
SCREW CORT 3.5 X 42MM LP AR-8835-42
|
Facility
|
IP
|
$652.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$332.26 |
| Max. Negotiated Rate |
$623.83 |
| Rate for Payer: Aetna Commercial |
$610.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$583.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$359.38
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$623.83
|
| Rate for Payer: Health EOS Commercial |
$603.49
|
| Rate for Payer: HFN Commercial |
$623.83
|
| Rate for Payer: Multiplan Commercial |
$542.46
|
| Rate for Payer: Preferred Network Access Commercial |
$623.83
|
| Rate for Payer: Quartz Beloit One Network |
$332.26
|
| Rate for Payer: Quartz Commercial |
$406.85
|
| Rate for Payer: WEA Trust Commercial |
$372.94
|
| Rate for Payer: WPS Commercial |
$502.24
|
|
|
SCREW CORT 3.5 X 42MM ST 661442
|
Facility
|
OP
|
$731.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5627655
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$699.42 |
| Rate for Payer: Aetna Commercial |
$684.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$653.81
|
| Rate for Payer: Aetna Managed Medicare |
$212.87
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$494.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$380.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$364.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.93
|
| Rate for Payer: Cash Price |
$219.30
|
| Rate for Payer: Cigna Commercial |
$699.42
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$425.44
|
| Rate for Payer: Health EOS Commercial |
$676.61
|
| Rate for Payer: HFN Commercial |
$699.42
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$570.18
|
| Rate for Payer: Multiplan Commercial |
$608.19
|
| Rate for Payer: NAPHCARE Commercial |
$456.14
|
| Rate for Payer: Preferred Network Access Commercial |
$699.42
|
| Rate for Payer: Quartz Beloit One Network |
$372.52
|
| Rate for Payer: Quartz Commercial |
$494.16
|
| Rate for Payer: Quartz Medicare Advantage |
$456.14
|
| Rate for Payer: The Alliance Commercial |
$380.12
|
| Rate for Payer: WEA Trust Commercial |
$418.13
|
| Rate for Payer: WPS Commercial |
$563.09
|
|
|
SCREW CORT 3.5 X 42MM ST 661442
|
Facility
|
IP
|
$731.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5627655
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$372.52 |
| Max. Negotiated Rate |
$699.42 |
| Rate for Payer: Aetna Commercial |
$684.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$653.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.93
|
| Rate for Payer: Cash Price |
$219.30
|
| Rate for Payer: Cigna Commercial |
$699.42
|
| Rate for Payer: Health EOS Commercial |
$676.61
|
| Rate for Payer: HFN Commercial |
$699.42
|
| Rate for Payer: Multiplan Commercial |
$608.19
|
| Rate for Payer: Preferred Network Access Commercial |
$699.42
|
| Rate for Payer: Quartz Beloit One Network |
$372.52
|
| Rate for Payer: Quartz Commercial |
$456.14
|
| Rate for Payer: WEA Trust Commercial |
$418.13
|
| Rate for Payer: WPS Commercial |
$563.09
|
|
|
SCREW-CORT 3.5 X 44 204.844
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.46 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Aetna Managed Medicare |
$206.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$479.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$368.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$353.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$412.64
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$553.02
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: NAPHCARE Commercial |
$442.42
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$479.28
|
| Rate for Payer: Quartz Medicare Advantage |
$442.42
|
| Rate for Payer: The Alliance Commercial |
$368.68
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-CORT 3.5 X 44 204.844
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$361.31 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$442.42
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW CORT 3.5 X 44MM LP AR-8835-44
|
Facility
|
OP
|
$627.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5885648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.58 |
| Max. Negotiated Rate |
$599.91 |
| Rate for Payer: Aetna Commercial |
$586.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.79
|
| Rate for Payer: Aetna Managed Medicare |
$182.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$326.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$313.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.60
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna Commercial |
$599.91
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$364.91
|
| Rate for Payer: Health EOS Commercial |
$580.35
|
| Rate for Payer: HFN Commercial |
$599.91
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$489.06
|
| Rate for Payer: Multiplan Commercial |
$521.66
|
| Rate for Payer: NAPHCARE Commercial |
$391.25
|
| Rate for Payer: Preferred Network Access Commercial |
$599.91
|
| Rate for Payer: Quartz Beloit One Network |
$319.52
|
| Rate for Payer: Quartz Commercial |
$423.85
|
| Rate for Payer: Quartz Medicare Advantage |
$391.25
|
| Rate for Payer: The Alliance Commercial |
$326.04
|
| Rate for Payer: WEA Trust Commercial |
$358.64
|
| Rate for Payer: WPS Commercial |
$482.98
|
|
|
SCREW CORT 3.5 X 44MM LP AR-8835-44
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5885648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$319.52 |
| Max. Negotiated Rate |
$599.91 |
| Rate for Payer: Aetna Commercial |
$586.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.60
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cigna Commercial |
$599.91
|
| Rate for Payer: Health EOS Commercial |
$580.35
|
| Rate for Payer: HFN Commercial |
$599.91
|
| Rate for Payer: Multiplan Commercial |
$521.66
|
| Rate for Payer: Preferred Network Access Commercial |
$599.91
|
| Rate for Payer: Quartz Beloit One Network |
$319.52
|
| Rate for Payer: Quartz Commercial |
$391.25
|
| Rate for Payer: WEA Trust Commercial |
$358.64
|
| Rate for Payer: WPS Commercial |
$482.98
|
|
|
SCREW CORT 3.5 X 44MM ST 661444
|
Facility
|
IP
|
$760.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599552
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$727.17 |
| Rate for Payer: Aetna Commercial |
$711.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$679.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$418.91
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$727.17
|
| Rate for Payer: Health EOS Commercial |
$703.46
|
| Rate for Payer: HFN Commercial |
$727.17
|
| Rate for Payer: Multiplan Commercial |
$632.32
|
| Rate for Payer: Preferred Network Access Commercial |
$727.17
|
| Rate for Payer: Quartz Beloit One Network |
$387.30
|
| Rate for Payer: Quartz Commercial |
$474.24
|
| Rate for Payer: WEA Trust Commercial |
$434.72
|
| Rate for Payer: WPS Commercial |
$585.43
|
|
|
SCREW CORT 3.5 X 44MM ST 661444
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599552
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.31 |
| Max. Negotiated Rate |
$727.17 |
| Rate for Payer: Aetna Commercial |
$711.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$679.74
|
| Rate for Payer: Aetna Managed Medicare |
$221.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$513.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$395.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$379.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$418.91
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cigna Commercial |
$727.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$442.32
|
| Rate for Payer: Health EOS Commercial |
$703.46
|
| Rate for Payer: HFN Commercial |
$727.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$592.80
|
| Rate for Payer: Multiplan Commercial |
$632.32
|
| Rate for Payer: NAPHCARE Commercial |
$474.24
|
| Rate for Payer: Preferred Network Access Commercial |
$727.17
|
| Rate for Payer: Quartz Beloit One Network |
$387.30
|
| Rate for Payer: Quartz Commercial |
$513.76
|
| Rate for Payer: Quartz Medicare Advantage |
$474.24
|
| Rate for Payer: The Alliance Commercial |
$395.20
|
| Rate for Payer: WEA Trust Commercial |
$434.72
|
| Rate for Payer: WPS Commercial |
$585.43
|
|
|
SCREW-CORT 3.5 X 45 204.845
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.11 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$116.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Aetna Managed Medicare |
$36.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$83.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$64.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$61.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.35
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$118.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$72.17
|
| Rate for Payer: Health EOS Commercial |
$114.77
|
| Rate for Payer: HFN Commercial |
$118.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$96.72
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: NAPHCARE Commercial |
$77.38
|
| Rate for Payer: Preferred Network Access Commercial |
$118.64
|
| Rate for Payer: Quartz Beloit One Network |
$63.19
|
| Rate for Payer: Quartz Commercial |
$83.82
|
| Rate for Payer: Quartz Medicare Advantage |
$77.38
|
| Rate for Payer: The Alliance Commercial |
$64.48
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$95.52
|
|
|
SCREW-CORT 3.5 X 45 204.845
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$116.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$110.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$68.35
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cigna Commercial |
$118.64
|
| Rate for Payer: Health EOS Commercial |
$114.77
|
| Rate for Payer: HFN Commercial |
$118.64
|
| Rate for Payer: Multiplan Commercial |
$103.17
|
| Rate for Payer: Preferred Network Access Commercial |
$118.64
|
| Rate for Payer: Quartz Beloit One Network |
$63.19
|
| Rate for Payer: Quartz Commercial |
$77.38
|
| Rate for Payer: WEA Trust Commercial |
$70.93
|
| Rate for Payer: WPS Commercial |
$95.52
|
|
|
SCREW CORT 3.5 X 45MM LP AR-8835-45
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6001665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.29 |
| Max. Negotiated Rate |
$576.95 |
| Rate for Payer: Aetna Commercial |
$564.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$539.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$332.37
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Cigna Commercial |
$576.95
|
| Rate for Payer: Health EOS Commercial |
$558.14
|
| Rate for Payer: HFN Commercial |
$576.95
|
| Rate for Payer: Multiplan Commercial |
$501.70
|
| Rate for Payer: Preferred Network Access Commercial |
$576.95
|
| Rate for Payer: Quartz Beloit One Network |
$307.29
|
| Rate for Payer: Quartz Commercial |
$376.27
|
| Rate for Payer: WEA Trust Commercial |
$344.92
|
| Rate for Payer: WPS Commercial |
$464.49
|
|
|
SCREW CORT 3.5 X 45MM LP AR-8835-45
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6001665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.59 |
| Max. Negotiated Rate |
$576.95 |
| Rate for Payer: Aetna Commercial |
$564.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$539.32
|
| Rate for Payer: Aetna Managed Medicare |
$175.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$407.63
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$313.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$301.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$332.37
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Cigna Commercial |
$576.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$350.95
|
| Rate for Payer: Health EOS Commercial |
$558.14
|
| Rate for Payer: HFN Commercial |
$576.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$470.34
|
| Rate for Payer: Multiplan Commercial |
$501.70
|
| Rate for Payer: NAPHCARE Commercial |
$376.27
|
| Rate for Payer: Preferred Network Access Commercial |
$576.95
|
| Rate for Payer: Quartz Beloit One Network |
$307.29
|
| Rate for Payer: Quartz Commercial |
$407.63
|
| Rate for Payer: Quartz Medicare Advantage |
$376.27
|
| Rate for Payer: The Alliance Commercial |
$313.56
|
| Rate for Payer: WEA Trust Commercial |
$344.92
|
| Rate for Payer: WPS Commercial |
$464.49
|
|
|
SCREW CORT 3.5 X 46MM LP AR-8835-46
|
Facility
|
IP
|
$652.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5416038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$332.26 |
| Max. Negotiated Rate |
$623.83 |
| Rate for Payer: Aetna Commercial |
$610.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$583.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$359.38
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$623.83
|
| Rate for Payer: Health EOS Commercial |
$603.49
|
| Rate for Payer: HFN Commercial |
$623.83
|
| Rate for Payer: Multiplan Commercial |
$542.46
|
| Rate for Payer: Preferred Network Access Commercial |
$623.83
|
| Rate for Payer: Quartz Beloit One Network |
$332.26
|
| Rate for Payer: Quartz Commercial |
$406.85
|
| Rate for Payer: WEA Trust Commercial |
$372.94
|
| Rate for Payer: WPS Commercial |
$502.24
|
|
|
SCREW CORT 3.5 X 46MM LP AR-8835-46
|
Facility
|
OP
|
$652.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5416038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.86 |
| Max. Negotiated Rate |
$623.83 |
| Rate for Payer: Aetna Commercial |
$610.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$583.15
|
| Rate for Payer: Aetna Managed Medicare |
$189.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$440.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$339.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$325.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$359.38
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$623.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$379.46
|
| Rate for Payer: Health EOS Commercial |
$603.49
|
| Rate for Payer: HFN Commercial |
$623.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$508.56
|
| Rate for Payer: Multiplan Commercial |
$542.46
|
| Rate for Payer: NAPHCARE Commercial |
$406.85
|
| Rate for Payer: Preferred Network Access Commercial |
$623.83
|
| Rate for Payer: Quartz Beloit One Network |
$332.26
|
| Rate for Payer: Quartz Commercial |
$440.75
|
| Rate for Payer: Quartz Medicare Advantage |
$406.85
|
| Rate for Payer: The Alliance Commercial |
$339.04
|
| Rate for Payer: WEA Trust Commercial |
$372.94
|
| Rate for Payer: WPS Commercial |
$502.24
|
|
