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 |
$295.47 |
Max. Negotiated Rate |
$554.76 |
Rate for Payer: Aetna Commercial |
$542.70
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.58
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.59
|
Rate for Payer: Cash Price |
$180.90
|
Rate for Payer: Cigna Commercial |
$554.76
|
Rate for Payer: Health EOS Commercial |
$536.67
|
Rate for Payer: HFN Commercial |
$554.76
|
Rate for Payer: Multiplan Commercial |
$482.40
|
Rate for Payer: NAPHCARE Commercial |
$361.80
|
Rate for Payer: Preferred Network Access Commercial |
$554.76
|
Rate for Payer: Quartz Beloit One Network |
$295.47
|
Rate for Payer: Quartz Commercial |
$361.80
|
Rate for Payer: WEA Trust Commercial |
$331.65
|
Rate for Payer: WPS Commercial |
$446.64
|
|
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 |
$372.40 |
Max. Negotiated Rate |
$699.20 |
Rate for Payer: Aetna Commercial |
$684.00
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$653.60
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.80
|
Rate for Payer: Cash Price |
$228.00
|
Rate for Payer: Cigna Commercial |
$699.20
|
Rate for Payer: Health EOS Commercial |
$676.40
|
Rate for Payer: HFN Commercial |
$699.20
|
Rate for Payer: Multiplan Commercial |
$608.00
|
Rate for Payer: NAPHCARE Commercial |
$456.00
|
Rate for Payer: Preferred Network Access Commercial |
$699.20
|
Rate for Payer: Quartz Beloit One Network |
$372.40
|
Rate for Payer: Quartz Commercial |
$456.00
|
Rate for Payer: WEA Trust Commercial |
$418.00
|
Rate for Payer: WPS Commercial |
$562.93
|
|
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 |
$212.80 |
Max. Negotiated Rate |
$3,040.00 |
Rate for Payer: Aetna Commercial |
$684.00
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$653.60
|
Rate for Payer: Aetna Managed Medicare |
$212.80
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$494.00
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$380.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$364.80
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.80
|
Rate for Payer: Cash Price |
$228.00
|
Rate for Payer: Cigna Commercial |
$699.20
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$425.30
|
Rate for Payer: Health EOS Commercial |
$676.40
|
Rate for Payer: HFN Commercial |
$699.20
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$570.00
|
Rate for Payer: Multiplan Commercial |
$608.00
|
Rate for Payer: NAPHCARE Commercial |
$456.00
|
Rate for Payer: Preferred Network Access Commercial |
$699.20
|
Rate for Payer: Quartz Beloit One Network |
$372.40
|
Rate for Payer: Quartz Commercial |
$494.00
|
Rate for Payer: Quartz Medicare Advantage |
$456.00
|
Rate for Payer: The Alliance Commercial |
$3,040.00
|
Rate for Payer: WEA Trust Commercial |
$418.00
|
Rate for Payer: WPS Commercial |
$562.93
|
|
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 |
$182.56 |
Max. Negotiated Rate |
$2,608.00 |
Rate for Payer: Aetna Commercial |
$586.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.72
|
Rate for Payer: Aetna Managed Medicare |
$182.56
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.80
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$326.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$312.96
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.56
|
Rate for Payer: Cash Price |
$195.60
|
Rate for Payer: Cigna Commercial |
$599.84
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$364.86
|
Rate for Payer: Health EOS Commercial |
$580.28
|
Rate for Payer: HFN Commercial |
$599.84
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$489.00
|
Rate for Payer: Multiplan Commercial |
$521.60
|
Rate for Payer: NAPHCARE Commercial |
$391.20
|
Rate for Payer: Preferred Network Access Commercial |
$599.84
|
Rate for Payer: Quartz Beloit One Network |
$319.48
|
Rate for Payer: Quartz Commercial |
$423.80
|
Rate for Payer: Quartz Medicare Advantage |
$391.20
|
Rate for Payer: The Alliance Commercial |
$2,608.00
|
Rate for Payer: WEA Trust Commercial |
$358.60
|
Rate for Payer: WPS Commercial |
$482.94
|
|
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 |
$319.48 |
Max. Negotiated Rate |
$599.84 |
Rate for Payer: Aetna Commercial |
$586.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.72
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.56
|
Rate for Payer: Cash Price |
$195.60
|
Rate for Payer: Cigna Commercial |
$599.84
|
Rate for Payer: Health EOS Commercial |
$580.28
|
Rate for Payer: HFN Commercial |
$599.84
|
Rate for Payer: Multiplan Commercial |
$521.60
|
Rate for Payer: NAPHCARE Commercial |
$391.20
|
Rate for Payer: Preferred Network Access Commercial |
$599.84
|
Rate for Payer: Quartz Beloit One Network |
$319.48
|
Rate for Payer: Quartz Commercial |
$391.20
|
Rate for Payer: WEA Trust Commercial |
$358.60
|
Rate for Payer: WPS Commercial |
$482.94
|
|
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 |
$204.68 |
Max. Negotiated Rate |
$2,924.00 |
Rate for Payer: Aetna Commercial |
$657.90
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$628.66
|
Rate for Payer: Aetna Managed Medicare |
$204.68
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$475.15
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$365.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$350.88
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$387.43
|
Rate for Payer: Cash Price |
$219.30
|
Rate for Payer: Cigna Commercial |
$672.52
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$409.07
|
Rate for Payer: Health EOS Commercial |
$650.59
|
Rate for Payer: HFN Commercial |
$672.52
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$548.25
|
Rate for Payer: Multiplan Commercial |
$584.80
|
Rate for Payer: NAPHCARE Commercial |
$438.60
|
Rate for Payer: Preferred Network Access Commercial |
$672.52
|
Rate for Payer: Quartz Beloit One Network |
$358.19
|
Rate for Payer: Quartz Commercial |
$475.15
|
Rate for Payer: Quartz Medicare Advantage |
$438.60
|
Rate for Payer: The Alliance Commercial |
$2,924.00
|
Rate for Payer: WEA Trust Commercial |
$402.05
|
Rate for Payer: WPS Commercial |
$541.45
|
|
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 |
$358.19 |
Max. Negotiated Rate |
$672.52 |
Rate for Payer: Aetna Commercial |
$657.90
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$628.66
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$387.43
|
Rate for Payer: Cash Price |
$219.30
|
Rate for Payer: Cigna Commercial |
$672.52
|
Rate for Payer: Health EOS Commercial |
$650.59
|
Rate for Payer: HFN Commercial |
$672.52
|
Rate for Payer: Multiplan Commercial |
$584.80
|
Rate for Payer: NAPHCARE Commercial |
$438.60
|
Rate for Payer: Preferred Network Access Commercial |
$672.52
|
Rate for Payer: Quartz Beloit One Network |
$358.19
|
Rate for Payer: Quartz Commercial |
$438.60
|
Rate for Payer: WEA Trust Commercial |
$402.05
|
Rate for Payer: WPS Commercial |
$541.45
|
|
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 |
$198.52 |
Max. Negotiated Rate |
$2,836.00 |
Rate for Payer: Aetna Commercial |
$638.10
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$609.74
|
Rate for Payer: Aetna Managed Medicare |
$198.52
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$460.85
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$354.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$340.32
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$375.77
|
Rate for Payer: Cash Price |
$212.70
|
Rate for Payer: Cigna Commercial |
$652.28
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$396.76
|
Rate for Payer: Health EOS Commercial |
$631.01
|
Rate for Payer: HFN Commercial |
$652.28
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$531.75
|
Rate for Payer: Multiplan Commercial |
$567.20
|
Rate for Payer: NAPHCARE Commercial |
$425.40
|
Rate for Payer: Preferred Network Access Commercial |
$652.28
|
Rate for Payer: Quartz Beloit One Network |
$347.41
|
Rate for Payer: Quartz Commercial |
$460.85
|
Rate for Payer: Quartz Medicare Advantage |
$425.40
|
Rate for Payer: The Alliance Commercial |
$2,836.00
|
Rate for Payer: WEA Trust Commercial |
$389.95
|
Rate for Payer: WPS Commercial |
$525.16
|
|
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 |
$347.41 |
Max. Negotiated Rate |
$652.28 |
Rate for Payer: Aetna Commercial |
$638.10
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$609.74
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$375.77
|
Rate for Payer: Cash Price |
$212.70
|
Rate for Payer: Cigna Commercial |
$652.28
|
Rate for Payer: Health EOS Commercial |
$631.01
|
Rate for Payer: HFN Commercial |
$652.28
|
Rate for Payer: Multiplan Commercial |
$567.20
|
Rate for Payer: NAPHCARE Commercial |
$425.40
|
Rate for Payer: Preferred Network Access Commercial |
$652.28
|
Rate for Payer: Quartz Beloit One Network |
$347.41
|
Rate for Payer: Quartz Commercial |
$425.40
|
Rate for Payer: WEA Trust Commercial |
$389.95
|
Rate for Payer: WPS Commercial |
$525.16
|
|
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 |
$175.56 |
Max. Negotiated Rate |
$2,508.00 |
Rate for Payer: Aetna Commercial |
$564.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$539.22
|
Rate for Payer: Aetna Managed Medicare |
$175.56
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$407.55
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$313.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$300.96
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$332.31
|
Rate for Payer: Cash Price |
$188.10
|
Rate for Payer: Cigna Commercial |
$576.84
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$350.87
|
Rate for Payer: Health EOS Commercial |
$558.03
|
Rate for Payer: HFN Commercial |
$576.84
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$470.25
|
Rate for Payer: Multiplan Commercial |
$501.60
|
Rate for Payer: NAPHCARE Commercial |
$376.20
|
Rate for Payer: Preferred Network Access Commercial |
$576.84
|
Rate for Payer: Quartz Beloit One Network |
$307.23
|
Rate for Payer: Quartz Commercial |
$407.55
|
Rate for Payer: Quartz Medicare Advantage |
$376.20
|
Rate for Payer: The Alliance Commercial |
$2,508.00
|
Rate for Payer: WEA Trust Commercial |
$344.85
|
Rate for Payer: WPS Commercial |
$464.42
|
|
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 |
$307.23 |
Max. Negotiated Rate |
$576.84 |
Rate for Payer: Aetna Commercial |
$564.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$539.22
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$332.31
|
Rate for Payer: Cash Price |
$188.10
|
Rate for Payer: Cigna Commercial |
$576.84
|
Rate for Payer: Health EOS Commercial |
$558.03
|
Rate for Payer: HFN Commercial |
$576.84
|
Rate for Payer: Multiplan Commercial |
$501.60
|
Rate for Payer: NAPHCARE Commercial |
$376.20
|
Rate for Payer: Preferred Network Access Commercial |
$576.84
|
Rate for Payer: Quartz Beloit One Network |
$307.23
|
Rate for Payer: Quartz Commercial |
$376.20
|
Rate for Payer: WEA Trust Commercial |
$344.85
|
Rate for Payer: WPS Commercial |
$464.42
|
|
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 |
$372.40 |
Max. Negotiated Rate |
$699.20 |
Rate for Payer: Aetna Commercial |
$684.00
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$653.60
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.80
|
Rate for Payer: Cash Price |
$228.00
|
Rate for Payer: Cigna Commercial |
$699.20
|
Rate for Payer: Health EOS Commercial |
$676.40
|
Rate for Payer: HFN Commercial |
$699.20
|
Rate for Payer: Multiplan Commercial |
$608.00
|
Rate for Payer: NAPHCARE Commercial |
$456.00
|
Rate for Payer: Preferred Network Access Commercial |
$699.20
|
Rate for Payer: Quartz Beloit One Network |
$372.40
|
Rate for Payer: Quartz Commercial |
$456.00
|
Rate for Payer: WEA Trust Commercial |
$418.00
|
Rate for Payer: WPS Commercial |
$562.93
|
|
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 |
$212.80 |
Max. Negotiated Rate |
$3,040.00 |
Rate for Payer: Aetna Commercial |
$684.00
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$653.60
|
Rate for Payer: Aetna Managed Medicare |
$212.80
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$494.00
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$380.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$364.80
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$402.80
|
Rate for Payer: Cash Price |
$228.00
|
Rate for Payer: Cigna Commercial |
$699.20
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$425.30
|
Rate for Payer: Health EOS Commercial |
$676.40
|
Rate for Payer: HFN Commercial |
$699.20
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$570.00
|
Rate for Payer: Multiplan Commercial |
$608.00
|
Rate for Payer: NAPHCARE Commercial |
$456.00
|
Rate for Payer: Preferred Network Access Commercial |
$699.20
|
Rate for Payer: Quartz Beloit One Network |
$372.40
|
Rate for Payer: Quartz Commercial |
$494.00
|
Rate for Payer: Quartz Medicare Advantage |
$456.00
|
Rate for Payer: The Alliance Commercial |
$3,040.00
|
Rate for Payer: WEA Trust Commercial |
$418.00
|
Rate for Payer: WPS Commercial |
$562.93
|
|
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 |
$34.72 |
Max. Negotiated Rate |
$496.00 |
Rate for Payer: Aetna Commercial |
$111.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$106.64
|
Rate for Payer: Aetna Managed Medicare |
$34.72
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$80.60
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$59.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.72
|
Rate for Payer: Cash Price |
$37.20
|
Rate for Payer: Cigna Commercial |
$114.08
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$69.39
|
Rate for Payer: Health EOS Commercial |
$110.36
|
Rate for Payer: HFN Commercial |
$114.08
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.00
|
Rate for Payer: Multiplan Commercial |
$99.20
|
Rate for Payer: NAPHCARE Commercial |
$74.40
|
Rate for Payer: Preferred Network Access Commercial |
$114.08
|
Rate for Payer: Quartz Beloit One Network |
$60.76
|
Rate for Payer: Quartz Commercial |
$80.60
|
Rate for Payer: Quartz Medicare Advantage |
$74.40
|
Rate for Payer: The Alliance Commercial |
$496.00
|
Rate for Payer: WEA Trust Commercial |
$68.20
|
Rate for Payer: WPS Commercial |
$91.85
|
|
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 |
$60.76 |
Max. Negotiated Rate |
$114.08 |
Rate for Payer: Aetna Commercial |
$111.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$106.64
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.72
|
Rate for Payer: Cash Price |
$37.20
|
Rate for Payer: Cigna Commercial |
$114.08
|
Rate for Payer: Health EOS Commercial |
$110.36
|
Rate for Payer: HFN Commercial |
$114.08
|
Rate for Payer: Multiplan Commercial |
$99.20
|
Rate for Payer: NAPHCARE Commercial |
$74.40
|
Rate for Payer: Preferred Network Access Commercial |
$114.08
|
Rate for Payer: Quartz Beloit One Network |
$60.76
|
Rate for Payer: Quartz Commercial |
$74.40
|
Rate for Payer: WEA Trust Commercial |
$68.20
|
Rate for Payer: WPS Commercial |
$91.85
|
|
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 |
$295.47 |
Max. Negotiated Rate |
$554.76 |
Rate for Payer: Aetna Commercial |
$542.70
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.58
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.59
|
Rate for Payer: Cash Price |
$180.90
|
Rate for Payer: Cigna Commercial |
$554.76
|
Rate for Payer: Health EOS Commercial |
$536.67
|
Rate for Payer: HFN Commercial |
$554.76
|
Rate for Payer: Multiplan Commercial |
$482.40
|
Rate for Payer: NAPHCARE Commercial |
$361.80
|
Rate for Payer: Preferred Network Access Commercial |
$554.76
|
Rate for Payer: Quartz Beloit One Network |
$295.47
|
Rate for Payer: Quartz Commercial |
$361.80
|
Rate for Payer: WEA Trust Commercial |
$331.65
|
Rate for Payer: WPS Commercial |
$446.64
|
|
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 |
$168.84 |
Max. Negotiated Rate |
$2,412.00 |
Rate for Payer: Aetna Commercial |
$542.70
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.58
|
Rate for Payer: Aetna Managed Medicare |
$168.84
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$391.95
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$301.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$289.44
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.59
|
Rate for Payer: Cash Price |
$180.90
|
Rate for Payer: Cigna Commercial |
$554.76
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$337.44
|
Rate for Payer: Health EOS Commercial |
$536.67
|
Rate for Payer: HFN Commercial |
$554.76
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$452.25
|
Rate for Payer: Multiplan Commercial |
$482.40
|
Rate for Payer: NAPHCARE Commercial |
$361.80
|
Rate for Payer: Preferred Network Access Commercial |
$554.76
|
Rate for Payer: Quartz Beloit One Network |
$295.47
|
Rate for Payer: Quartz Commercial |
$391.95
|
Rate for Payer: Quartz Medicare Advantage |
$361.80
|
Rate for Payer: The Alliance Commercial |
$2,412.00
|
Rate for Payer: WEA Trust Commercial |
$331.65
|
Rate for Payer: WPS Commercial |
$446.64
|
|
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 |
$182.56 |
Max. Negotiated Rate |
$2,608.00 |
Rate for Payer: Aetna Commercial |
$586.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.72
|
Rate for Payer: Aetna Managed Medicare |
$182.56
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.80
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$326.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$312.96
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.56
|
Rate for Payer: Cash Price |
$195.60
|
Rate for Payer: Cigna Commercial |
$599.84
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$364.86
|
Rate for Payer: Health EOS Commercial |
$580.28
|
Rate for Payer: HFN Commercial |
$599.84
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$489.00
|
Rate for Payer: Multiplan Commercial |
$521.60
|
Rate for Payer: NAPHCARE Commercial |
$391.20
|
Rate for Payer: Preferred Network Access Commercial |
$599.84
|
Rate for Payer: Quartz Beloit One Network |
$319.48
|
Rate for Payer: Quartz Commercial |
$423.80
|
Rate for Payer: Quartz Medicare Advantage |
$391.20
|
Rate for Payer: The Alliance Commercial |
$2,608.00
|
Rate for Payer: WEA Trust Commercial |
$358.60
|
Rate for Payer: WPS Commercial |
$482.94
|
|
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 |
$319.48 |
Max. Negotiated Rate |
$599.84 |
Rate for Payer: Aetna Commercial |
$586.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.72
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.56
|
Rate for Payer: Cash Price |
$195.60
|
Rate for Payer: Cigna Commercial |
$599.84
|
Rate for Payer: Health EOS Commercial |
$580.28
|
Rate for Payer: HFN Commercial |
$599.84
|
Rate for Payer: Multiplan Commercial |
$521.60
|
Rate for Payer: NAPHCARE Commercial |
$391.20
|
Rate for Payer: Preferred Network Access Commercial |
$599.84
|
Rate for Payer: Quartz Beloit One Network |
$319.48
|
Rate for Payer: Quartz Commercial |
$391.20
|
Rate for Payer: WEA Trust Commercial |
$358.60
|
Rate for Payer: WPS Commercial |
$482.94
|
|
SCREW CORT 3.5 X 48MM LP AR-8835-48
|
Facility
|
OP
|
$603.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
6105629
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$168.84 |
Max. Negotiated Rate |
$2,412.00 |
Rate for Payer: Aetna Commercial |
$542.70
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.58
|
Rate for Payer: Aetna Managed Medicare |
$168.84
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$391.95
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$301.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$289.44
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.59
|
Rate for Payer: Cash Price |
$180.90
|
Rate for Payer: Cigna Commercial |
$554.76
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$337.44
|
Rate for Payer: Health EOS Commercial |
$536.67
|
Rate for Payer: HFN Commercial |
$554.76
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$452.25
|
Rate for Payer: Multiplan Commercial |
$482.40
|
Rate for Payer: NAPHCARE Commercial |
$361.80
|
Rate for Payer: Preferred Network Access Commercial |
$554.76
|
Rate for Payer: Quartz Beloit One Network |
$295.47
|
Rate for Payer: Quartz Commercial |
$391.95
|
Rate for Payer: Quartz Medicare Advantage |
$361.80
|
Rate for Payer: The Alliance Commercial |
$2,412.00
|
Rate for Payer: WEA Trust Commercial |
$331.65
|
Rate for Payer: WPS Commercial |
$446.64
|
|
SCREW CORT 3.5 X 48MM LP AR-8835-48
|
Facility
|
IP
|
$603.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
6105629
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$295.47 |
Max. Negotiated Rate |
$554.76 |
Rate for Payer: Aetna Commercial |
$542.70
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$518.58
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$319.59
|
Rate for Payer: Cash Price |
$180.90
|
Rate for Payer: Cigna Commercial |
$554.76
|
Rate for Payer: Health EOS Commercial |
$536.67
|
Rate for Payer: HFN Commercial |
$554.76
|
Rate for Payer: Multiplan Commercial |
$482.40
|
Rate for Payer: NAPHCARE Commercial |
$361.80
|
Rate for Payer: Preferred Network Access Commercial |
$554.76
|
Rate for Payer: Quartz Beloit One Network |
$295.47
|
Rate for Payer: Quartz Commercial |
$361.80
|
Rate for Payer: WEA Trust Commercial |
$331.65
|
Rate for Payer: WPS Commercial |
$446.64
|
|
SCREW CORT 3.5 X 50 204.850
|
Facility
|
OP
|
$124.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
2966902
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$34.72 |
Max. Negotiated Rate |
$496.00 |
Rate for Payer: Aetna Commercial |
$111.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$106.64
|
Rate for Payer: Aetna Managed Medicare |
$34.72
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$80.60
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$59.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.72
|
Rate for Payer: Cash Price |
$37.20
|
Rate for Payer: Cigna Commercial |
$114.08
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$69.39
|
Rate for Payer: Health EOS Commercial |
$110.36
|
Rate for Payer: HFN Commercial |
$114.08
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$93.00
|
Rate for Payer: Multiplan Commercial |
$99.20
|
Rate for Payer: NAPHCARE Commercial |
$74.40
|
Rate for Payer: Preferred Network Access Commercial |
$114.08
|
Rate for Payer: Quartz Beloit One Network |
$60.76
|
Rate for Payer: Quartz Commercial |
$80.60
|
Rate for Payer: Quartz Medicare Advantage |
$74.40
|
Rate for Payer: The Alliance Commercial |
$496.00
|
Rate for Payer: WEA Trust Commercial |
$68.20
|
Rate for Payer: WPS Commercial |
$91.85
|
|
SCREW CORT 3.5 X 50 204.850
|
Facility
|
IP
|
$124.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
2966902
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$60.76 |
Max. Negotiated Rate |
$114.08 |
Rate for Payer: Aetna Commercial |
$111.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$106.64
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$65.72
|
Rate for Payer: Cash Price |
$37.20
|
Rate for Payer: Cigna Commercial |
$114.08
|
Rate for Payer: Health EOS Commercial |
$110.36
|
Rate for Payer: HFN Commercial |
$114.08
|
Rate for Payer: Multiplan Commercial |
$99.20
|
Rate for Payer: NAPHCARE Commercial |
$74.40
|
Rate for Payer: Preferred Network Access Commercial |
$114.08
|
Rate for Payer: Quartz Beloit One Network |
$60.76
|
Rate for Payer: Quartz Commercial |
$74.40
|
Rate for Payer: WEA Trust Commercial |
$68.20
|
Rate for Payer: WPS Commercial |
$91.85
|
|
SCREW CORT 3.5 X 50MM LP AR-8835-50
|
Facility
|
OP
|
$652.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
5416039
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$182.56 |
Max. Negotiated Rate |
$2,608.00 |
Rate for Payer: Aetna Commercial |
$586.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.72
|
Rate for Payer: Aetna Managed Medicare |
$182.56
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$423.80
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$326.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$312.96
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.56
|
Rate for Payer: Cash Price |
$195.60
|
Rate for Payer: Cigna Commercial |
$599.84
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$364.86
|
Rate for Payer: Health EOS Commercial |
$580.28
|
Rate for Payer: HFN Commercial |
$599.84
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$489.00
|
Rate for Payer: Multiplan Commercial |
$521.60
|
Rate for Payer: NAPHCARE Commercial |
$391.20
|
Rate for Payer: Preferred Network Access Commercial |
$599.84
|
Rate for Payer: Quartz Beloit One Network |
$319.48
|
Rate for Payer: Quartz Commercial |
$423.80
|
Rate for Payer: Quartz Medicare Advantage |
$391.20
|
Rate for Payer: The Alliance Commercial |
$2,608.00
|
Rate for Payer: WEA Trust Commercial |
$358.60
|
Rate for Payer: WPS Commercial |
$482.94
|
|
SCREW CORT 3.5 X 50MM LP AR-8835-50
|
Facility
|
IP
|
$652.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
5416039
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$319.48 |
Max. Negotiated Rate |
$599.84 |
Rate for Payer: Aetna Commercial |
$586.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$560.72
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$345.56
|
Rate for Payer: Cash Price |
$195.60
|
Rate for Payer: Cigna Commercial |
$599.84
|
Rate for Payer: Health EOS Commercial |
$580.28
|
Rate for Payer: HFN Commercial |
$599.84
|
Rate for Payer: Multiplan Commercial |
$521.60
|
Rate for Payer: NAPHCARE Commercial |
$391.20
|
Rate for Payer: Preferred Network Access Commercial |
$599.84
|
Rate for Payer: Quartz Beloit One Network |
$319.48
|
Rate for Payer: Quartz Commercial |
$391.20
|
Rate for Payer: WEA Trust Commercial |
$358.60
|
Rate for Payer: WPS Commercial |
$482.94
|
|