|
SCREW CORT FT 3.5 X 24MM 58913524
|
Facility
|
IP
|
$1,751.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$892.31 |
| Max. Negotiated Rate |
$1,675.36 |
| Rate for Payer: Aetna Commercial |
$1,638.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,566.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$965.15
|
| Rate for Payer: Cash Price |
$525.30
|
| Rate for Payer: Cigna Commercial |
$1,675.36
|
| Rate for Payer: Health EOS Commercial |
$1,620.73
|
| Rate for Payer: HFN Commercial |
$1,675.36
|
| Rate for Payer: Multiplan Commercial |
$1,456.83
|
| Rate for Payer: Preferred Network Access Commercial |
$1,675.36
|
| Rate for Payer: Quartz Beloit One Network |
$892.31
|
| Rate for Payer: Quartz Commercial |
$1,092.62
|
| Rate for Payer: WEA Trust Commercial |
$1,001.57
|
| Rate for Payer: WPS Commercial |
$1,348.80
|
|
|
SCREW CORT FT 3.5 X 24MM 58913524
|
Facility
|
OP
|
$1,751.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.89 |
| Max. Negotiated Rate |
$1,675.36 |
| Rate for Payer: Aetna Commercial |
$1,638.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,566.09
|
| Rate for Payer: Aetna Managed Medicare |
$509.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,183.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$910.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$874.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$965.15
|
| Rate for Payer: Cash Price |
$525.30
|
| Rate for Payer: Cigna Commercial |
$1,675.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,019.08
|
| Rate for Payer: Health EOS Commercial |
$1,620.73
|
| Rate for Payer: HFN Commercial |
$1,675.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,365.78
|
| Rate for Payer: Multiplan Commercial |
$1,456.83
|
| Rate for Payer: NAPHCARE Commercial |
$1,092.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,675.36
|
| Rate for Payer: Quartz Beloit One Network |
$892.31
|
| Rate for Payer: Quartz Commercial |
$1,183.68
|
| Rate for Payer: Quartz Medicare Advantage |
$1,092.62
|
| Rate for Payer: The Alliance Commercial |
$910.52
|
| Rate for Payer: WEA Trust Commercial |
$1,001.57
|
| Rate for Payer: WPS Commercial |
$1,348.80
|
|
|
SCREW CORT FT 3.5 X 26MM 58913526
|
Facility
|
OP
|
$2,068.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6149649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$602.20 |
| Max. Negotiated Rate |
$1,978.66 |
| Rate for Payer: Aetna Commercial |
$1,935.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,849.62
|
| Rate for Payer: Aetna Managed Medicare |
$602.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,397.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,075.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,032.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,139.88
|
| Rate for Payer: Cash Price |
$620.40
|
| Rate for Payer: Cigna Commercial |
$1,978.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,203.58
|
| Rate for Payer: Health EOS Commercial |
$1,914.14
|
| Rate for Payer: HFN Commercial |
$1,978.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,613.04
|
| Rate for Payer: Multiplan Commercial |
$1,720.58
|
| Rate for Payer: NAPHCARE Commercial |
$1,290.43
|
| Rate for Payer: Preferred Network Access Commercial |
$1,978.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,053.85
|
| Rate for Payer: Quartz Commercial |
$1,397.97
|
| Rate for Payer: Quartz Medicare Advantage |
$1,290.43
|
| Rate for Payer: The Alliance Commercial |
$1,075.36
|
| Rate for Payer: WEA Trust Commercial |
$1,182.90
|
| Rate for Payer: WPS Commercial |
$1,592.98
|
|
|
SCREW CORT FT 3.5 X 26MM 58913526
|
Facility
|
IP
|
$2,068.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6149649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,053.85 |
| Max. Negotiated Rate |
$1,978.66 |
| Rate for Payer: Aetna Commercial |
$1,935.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,849.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,139.88
|
| Rate for Payer: Cash Price |
$620.40
|
| Rate for Payer: Cigna Commercial |
$1,978.66
|
| Rate for Payer: Health EOS Commercial |
$1,914.14
|
| Rate for Payer: HFN Commercial |
$1,978.66
|
| Rate for Payer: Multiplan Commercial |
$1,720.58
|
| Rate for Payer: Preferred Network Access Commercial |
$1,978.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,053.85
|
| Rate for Payer: Quartz Commercial |
$1,290.43
|
| Rate for Payer: WEA Trust Commercial |
$1,182.90
|
| Rate for Payer: WPS Commercial |
$1,592.98
|
|
|
SCREW CORT FT 4.0 X 42MM 58924042
|
Facility
|
IP
|
$2,234.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6171781
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,138.45 |
| Max. Negotiated Rate |
$2,137.49 |
| Rate for Payer: Aetna Commercial |
$2,091.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,998.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,231.38
|
| Rate for Payer: Cash Price |
$670.20
|
| Rate for Payer: Cigna Commercial |
$2,137.49
|
| Rate for Payer: Health EOS Commercial |
$2,067.79
|
| Rate for Payer: HFN Commercial |
$2,137.49
|
| Rate for Payer: Multiplan Commercial |
$1,858.69
|
| Rate for Payer: Preferred Network Access Commercial |
$2,137.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,138.45
|
| Rate for Payer: Quartz Commercial |
$1,394.02
|
| Rate for Payer: WEA Trust Commercial |
$1,277.85
|
| Rate for Payer: WPS Commercial |
$1,720.85
|
|
|
SCREW CORT FT 4.0 X 42MM 58924042
|
Facility
|
OP
|
$2,234.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6171781
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$650.54 |
| Max. Negotiated Rate |
$2,137.49 |
| Rate for Payer: Aetna Commercial |
$2,091.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,998.09
|
| Rate for Payer: Aetna Managed Medicare |
$650.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,510.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,161.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,115.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,231.38
|
| Rate for Payer: Cash Price |
$670.20
|
| Rate for Payer: Cigna Commercial |
$2,137.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,300.19
|
| Rate for Payer: Health EOS Commercial |
$2,067.79
|
| Rate for Payer: HFN Commercial |
$2,137.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,742.52
|
| Rate for Payer: Multiplan Commercial |
$1,858.69
|
| Rate for Payer: NAPHCARE Commercial |
$1,394.02
|
| Rate for Payer: Preferred Network Access Commercial |
$2,137.49
|
| Rate for Payer: Quartz Beloit One Network |
$1,138.45
|
| Rate for Payer: Quartz Commercial |
$1,510.18
|
| Rate for Payer: Quartz Medicare Advantage |
$1,394.02
|
| Rate for Payer: The Alliance Commercial |
$1,161.68
|
| Rate for Payer: WEA Trust Commercial |
$1,277.85
|
| Rate for Payer: WPS Commercial |
$1,720.85
|
|
|
SCREW CORT FT 4.0 X 48MM 58924048
|
Facility
|
OP
|
$1,792.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.83 |
| Max. Negotiated Rate |
$1,714.59 |
| Rate for Payer: Aetna Commercial |
$1,677.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,602.76
|
| Rate for Payer: Aetna Managed Medicare |
$521.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,211.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$931.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$894.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$987.75
|
| Rate for Payer: Cash Price |
$537.60
|
| Rate for Payer: Cigna Commercial |
$1,714.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,042.94
|
| Rate for Payer: Health EOS Commercial |
$1,658.68
|
| Rate for Payer: HFN Commercial |
$1,714.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,397.76
|
| Rate for Payer: Multiplan Commercial |
$1,490.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,118.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,714.59
|
| Rate for Payer: Quartz Beloit One Network |
$913.20
|
| Rate for Payer: Quartz Commercial |
$1,211.39
|
| Rate for Payer: Quartz Medicare Advantage |
$1,118.21
|
| Rate for Payer: The Alliance Commercial |
$931.84
|
| Rate for Payer: WEA Trust Commercial |
$1,025.02
|
| Rate for Payer: WPS Commercial |
$1,380.38
|
|
|
SCREW CORT FT 4.0 X 48MM 58924048
|
Facility
|
IP
|
$1,792.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$913.20 |
| Max. Negotiated Rate |
$1,714.59 |
| Rate for Payer: Aetna Commercial |
$1,677.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,602.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$987.75
|
| Rate for Payer: Cash Price |
$537.60
|
| Rate for Payer: Cigna Commercial |
$1,714.59
|
| Rate for Payer: Health EOS Commercial |
$1,658.68
|
| Rate for Payer: HFN Commercial |
$1,714.59
|
| Rate for Payer: Multiplan Commercial |
$1,490.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,714.59
|
| Rate for Payer: Quartz Beloit One Network |
$913.20
|
| Rate for Payer: Quartz Commercial |
$1,118.21
|
| Rate for Payer: WEA Trust Commercial |
$1,025.02
|
| Rate for Payer: WPS Commercial |
$1,380.38
|
|
|
SCREW CORT FT 4.0 X 52MM 58924052
|
Facility
|
OP
|
$1,792.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729844
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.83 |
| Max. Negotiated Rate |
$1,714.59 |
| Rate for Payer: Aetna Commercial |
$1,677.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,602.76
|
| Rate for Payer: Aetna Managed Medicare |
$521.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,211.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$931.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$894.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$987.75
|
| Rate for Payer: Cash Price |
$537.60
|
| Rate for Payer: Cigna Commercial |
$1,714.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,042.94
|
| Rate for Payer: Health EOS Commercial |
$1,658.68
|
| Rate for Payer: HFN Commercial |
$1,714.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,397.76
|
| Rate for Payer: Multiplan Commercial |
$1,490.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,118.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,714.59
|
| Rate for Payer: Quartz Beloit One Network |
$913.20
|
| Rate for Payer: Quartz Commercial |
$1,211.39
|
| Rate for Payer: Quartz Medicare Advantage |
$1,118.21
|
| Rate for Payer: The Alliance Commercial |
$931.84
|
| Rate for Payer: WEA Trust Commercial |
$1,025.02
|
| Rate for Payer: WPS Commercial |
$1,380.38
|
|
|
SCREW CORT FT 4.0 X 52MM 58924052
|
Facility
|
IP
|
$1,792.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729844
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$913.20 |
| Max. Negotiated Rate |
$1,714.59 |
| Rate for Payer: Aetna Commercial |
$1,677.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,602.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$987.75
|
| Rate for Payer: Cash Price |
$537.60
|
| Rate for Payer: Cigna Commercial |
$1,714.59
|
| Rate for Payer: Health EOS Commercial |
$1,658.68
|
| Rate for Payer: HFN Commercial |
$1,714.59
|
| Rate for Payer: Multiplan Commercial |
$1,490.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,714.59
|
| Rate for Payer: Quartz Beloit One Network |
$913.20
|
| Rate for Payer: Quartz Commercial |
$1,118.21
|
| Rate for Payer: WEA Trust Commercial |
$1,025.02
|
| Rate for Payer: WPS Commercial |
$1,380.38
|
|
|
SCREW CORTICAL 2.4 X 10 MS-2410
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$821.98 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,006.51
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 10 MS-2410
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264780
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$469.71 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Aetna Managed Medicare |
$469.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,090.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$838.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$805.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$938.77
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,258.14
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,006.51
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,090.39
|
| Rate for Payer: Quartz Medicare Advantage |
$1,006.51
|
| Rate for Payer: The Alliance Commercial |
$838.76
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 12 MS-2412
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264779
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$469.71 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Aetna Managed Medicare |
$469.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,090.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$838.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$805.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$938.77
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,258.14
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,006.51
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,090.39
|
| Rate for Payer: Quartz Medicare Advantage |
$1,006.51
|
| Rate for Payer: The Alliance Commercial |
$838.76
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 12 MS-2412
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5264779
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$821.98 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,006.51
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 14 MS-2414
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$469.71 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Aetna Managed Medicare |
$469.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,090.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$838.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$805.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$938.77
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,258.14
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,006.51
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,090.39
|
| Rate for Payer: Quartz Medicare Advantage |
$1,006.51
|
| Rate for Payer: The Alliance Commercial |
$838.76
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 14 MS-2414
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$821.98 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,006.51
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 16 MS-2416
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5510697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$469.71 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Aetna Managed Medicare |
$469.71
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,090.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$838.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$805.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$938.77
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,258.14
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,006.51
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,090.39
|
| Rate for Payer: Quartz Medicare Advantage |
$1,006.51
|
| Rate for Payer: The Alliance Commercial |
$838.76
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 2.4 X 16 MS-2416
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5510697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$821.98 |
| Max. Negotiated Rate |
$1,543.32 |
| Rate for Payer: Aetna Commercial |
$1,509.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,442.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$889.09
|
| Rate for Payer: Cash Price |
$483.90
|
| Rate for Payer: Cigna Commercial |
$1,543.32
|
| Rate for Payer: Health EOS Commercial |
$1,492.99
|
| Rate for Payer: HFN Commercial |
$1,543.32
|
| Rate for Payer: Multiplan Commercial |
$1,342.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,543.32
|
| Rate for Payer: Quartz Beloit One Network |
$821.98
|
| Rate for Payer: Quartz Commercial |
$1,006.51
|
| Rate for Payer: WEA Trust Commercial |
$922.64
|
| Rate for Payer: WPS Commercial |
$1,242.49
|
|
|
SCREW CORTICAL 3.5MM X 30MM 338630
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3983340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Aetna Managed Medicare |
$120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$279.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$215.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$206.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$240.95
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$322.92
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: NAPHCARE Commercial |
$258.34
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$279.86
|
| Rate for Payer: Quartz Medicare Advantage |
$258.34
|
| Rate for Payer: The Alliance Commercial |
$215.28
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
SCREW CORTICAL 3.5MM X 30MM 338630
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3983340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.97 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$258.34
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
SCREW CORTICAL 3.5MM X 36MM 338636
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6198980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.97 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$258.34
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
SCREW CORTICAL 3.5MM X 36MM 338636
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6198980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Aetna Managed Medicare |
$120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$279.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$215.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$206.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$240.95
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$322.92
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: NAPHCARE Commercial |
$258.34
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$279.86
|
| Rate for Payer: Quartz Medicare Advantage |
$258.34
|
| Rate for Payer: The Alliance Commercial |
$215.28
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
SCREW CORTICAL 3.5MM X 38MM 338638
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3983341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Aetna Managed Medicare |
$120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$279.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$215.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$206.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$240.95
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$322.92
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: NAPHCARE Commercial |
$258.34
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$279.86
|
| Rate for Payer: Quartz Medicare Advantage |
$258.34
|
| Rate for Payer: The Alliance Commercial |
$215.28
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
SCREW CORTICAL 3.5MM X 38MM 338638
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3983341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.97 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$258.34
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
|
SCREW CORTICAL 3.5MM X 46MM 338646
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6198981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$396.12 |
| Rate for Payer: Aetna Commercial |
$387.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$370.28
|
| Rate for Payer: Aetna Managed Medicare |
$120.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$279.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$215.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$206.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$228.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$396.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$240.95
|
| Rate for Payer: Health EOS Commercial |
$383.20
|
| Rate for Payer: HFN Commercial |
$396.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$322.92
|
| Rate for Payer: Multiplan Commercial |
$344.45
|
| Rate for Payer: NAPHCARE Commercial |
$258.34
|
| Rate for Payer: Preferred Network Access Commercial |
$396.12
|
| Rate for Payer: Quartz Beloit One Network |
$210.97
|
| Rate for Payer: Quartz Commercial |
$279.86
|
| Rate for Payer: Quartz Medicare Advantage |
$258.34
|
| Rate for Payer: The Alliance Commercial |
$215.28
|
| Rate for Payer: WEA Trust Commercial |
$236.81
|
| Rate for Payer: WPS Commercial |
$318.90
|
|
