|
SCREW FASTPITCH 2.7MM X 22MM HIGH PITCH LOCKING SD22
|
Facility
|
OP
|
$5,511.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6180092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,604.80 |
| Max. Negotiated Rate |
$5,272.92 |
| Rate for Payer: Aetna Commercial |
$5,158.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,929.04
|
| Rate for Payer: Aetna Managed Medicare |
$1,604.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,725.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,865.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,751.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,037.66
|
| Rate for Payer: Cash Price |
$1,653.30
|
| Rate for Payer: Cigna Commercial |
$5,272.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,207.40
|
| Rate for Payer: Health EOS Commercial |
$5,100.98
|
| Rate for Payer: HFN Commercial |
$5,272.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,298.58
|
| Rate for Payer: Multiplan Commercial |
$4,585.15
|
| Rate for Payer: NAPHCARE Commercial |
$3,438.86
|
| Rate for Payer: Preferred Network Access Commercial |
$5,272.92
|
| Rate for Payer: Quartz Beloit One Network |
$2,808.41
|
| Rate for Payer: Quartz Commercial |
$3,725.44
|
| Rate for Payer: Quartz Medicare Advantage |
$3,438.86
|
| Rate for Payer: The Alliance Commercial |
$2,865.72
|
| Rate for Payer: WEA Trust Commercial |
$3,152.29
|
| Rate for Payer: WPS Commercial |
$4,245.12
|
|
|
SCREW FEMALE PERSONA 2.5MM X 25MM 42-5099-025-25
|
Facility
|
IP
|
$2,378.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3529506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,211.83 |
| Max. Negotiated Rate |
$2,275.27 |
| Rate for Payer: Aetna Commercial |
$2,225.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,126.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,310.75
|
| Rate for Payer: Cash Price |
$713.40
|
| Rate for Payer: Cigna Commercial |
$2,275.27
|
| Rate for Payer: Health EOS Commercial |
$2,201.08
|
| Rate for Payer: HFN Commercial |
$2,275.27
|
| Rate for Payer: Multiplan Commercial |
$1,978.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,275.27
|
| Rate for Payer: Quartz Beloit One Network |
$1,211.83
|
| Rate for Payer: Quartz Commercial |
$1,483.87
|
| Rate for Payer: WEA Trust Commercial |
$1,360.22
|
| Rate for Payer: WPS Commercial |
$1,831.77
|
|
|
SCREW FEMALE PERSONA 2.5MM X 25MM 42-5099-025-25
|
Facility
|
OP
|
$2,378.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3529506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$692.47 |
| Max. Negotiated Rate |
$2,275.27 |
| Rate for Payer: Aetna Commercial |
$2,225.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,126.88
|
| Rate for Payer: Aetna Managed Medicare |
$692.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,607.53
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,236.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,187.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,310.75
|
| Rate for Payer: Cash Price |
$713.40
|
| Rate for Payer: Cigna Commercial |
$2,275.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,384.00
|
| Rate for Payer: Health EOS Commercial |
$2,201.08
|
| Rate for Payer: HFN Commercial |
$2,275.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,854.84
|
| Rate for Payer: Multiplan Commercial |
$1,978.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,483.87
|
| Rate for Payer: Preferred Network Access Commercial |
$2,275.27
|
| Rate for Payer: Quartz Beloit One Network |
$1,211.83
|
| Rate for Payer: Quartz Commercial |
$1,607.53
|
| Rate for Payer: Quartz Medicare Advantage |
$1,483.87
|
| Rate for Payer: The Alliance Commercial |
$1,236.56
|
| Rate for Payer: WEA Trust Commercial |
$1,360.22
|
| Rate for Payer: WPS Commercial |
$1,831.77
|
|
|
SCREW FEMALE PERSONA 2.5MM X 48MM 42-5099-025-48
|
Facility
|
IP
|
$2,289.00
|
|
| Hospital Charge Code |
3529507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,166.47 |
| Max. Negotiated Rate |
$2,190.12 |
| Rate for Payer: Aetna Commercial |
$2,142.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,047.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,261.70
|
| Rate for Payer: Cash Price |
$686.70
|
| Rate for Payer: Cigna Commercial |
$2,190.12
|
| Rate for Payer: Health EOS Commercial |
$2,118.70
|
| Rate for Payer: HFN Commercial |
$2,190.12
|
| Rate for Payer: Multiplan Commercial |
$1,904.45
|
| Rate for Payer: Preferred Network Access Commercial |
$2,190.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,166.47
|
| Rate for Payer: Quartz Commercial |
$1,428.34
|
| Rate for Payer: WEA Trust Commercial |
$1,309.31
|
| Rate for Payer: WPS Commercial |
$1,763.22
|
|
|
SCREW FEMALE PERSONA 2.5MM X 48MM 42-5099-025-48
|
Facility
|
OP
|
$2,289.00
|
|
| Hospital Charge Code |
3529507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$666.56 |
| Max. Negotiated Rate |
$2,190.12 |
| Rate for Payer: Aetna Commercial |
$2,142.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,047.28
|
| Rate for Payer: Aetna Managed Medicare |
$666.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,547.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,190.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,142.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,261.70
|
| Rate for Payer: Cash Price |
$686.70
|
| Rate for Payer: Cigna Commercial |
$2,190.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,332.20
|
| Rate for Payer: Health EOS Commercial |
$2,118.70
|
| Rate for Payer: HFN Commercial |
$2,190.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,785.42
|
| Rate for Payer: Multiplan Commercial |
$1,904.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,428.34
|
| Rate for Payer: Preferred Network Access Commercial |
$2,190.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,166.47
|
| Rate for Payer: Quartz Commercial |
$1,547.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,428.34
|
| Rate for Payer: The Alliance Commercial |
$1,190.28
|
| Rate for Payer: WEA Trust Commercial |
$1,309.31
|
| Rate for Payer: WPS Commercial |
$1,763.22
|
|
|
SCREW FIXED LOCKING COMPREHENSIVE REVERSE SHOULDER 4.75MM X 15MM X 3.5MM HEX 180550
|
Facility
|
IP
|
$1,113.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$567.18 |
| Max. Negotiated Rate |
$1,064.92 |
| Rate for Payer: Aetna Commercial |
$1,041.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$995.47
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$613.49
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cigna Commercial |
$1,064.92
|
| Rate for Payer: Health EOS Commercial |
$1,030.19
|
| Rate for Payer: HFN Commercial |
$1,064.92
|
| Rate for Payer: Multiplan Commercial |
$926.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,064.92
|
| Rate for Payer: Quartz Beloit One Network |
$567.18
|
| Rate for Payer: Quartz Commercial |
$694.51
|
| Rate for Payer: WEA Trust Commercial |
$636.64
|
| Rate for Payer: WPS Commercial |
$857.34
|
|
|
SCREW FIXED LOCKING COMPREHENSIVE REVERSE SHOULDER 4.75MM X 15MM X 3.5MM HEX 180550
|
Facility
|
OP
|
$1,113.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.11 |
| Max. Negotiated Rate |
$1,064.92 |
| Rate for Payer: Aetna Commercial |
$1,041.77
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$995.47
|
| Rate for Payer: Aetna Managed Medicare |
$324.11
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$752.39
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$578.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$555.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$613.49
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cigna Commercial |
$1,064.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$647.77
|
| Rate for Payer: Health EOS Commercial |
$1,030.19
|
| Rate for Payer: HFN Commercial |
$1,064.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$868.14
|
| Rate for Payer: Multiplan Commercial |
$926.02
|
| Rate for Payer: NAPHCARE Commercial |
$694.51
|
| Rate for Payer: Preferred Network Access Commercial |
$1,064.92
|
| Rate for Payer: Quartz Beloit One Network |
$567.18
|
| Rate for Payer: Quartz Commercial |
$752.39
|
| Rate for Payer: Quartz Medicare Advantage |
$694.51
|
| Rate for Payer: The Alliance Commercial |
$578.76
|
| Rate for Payer: WEA Trust Commercial |
$636.64
|
| Rate for Payer: WPS Commercial |
$857.34
|
|
|
SCREW GRIDLOCK 2.4 X 12MM 301-24-012
|
Facility
|
IP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5240669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$677.77 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$829.92
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 12MM 301-24-012
|
Facility
|
OP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5240669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Aetna Managed Medicare |
$387.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$899.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$691.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$663.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$774.06
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,037.40
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: NAPHCARE Commercial |
$829.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$899.08
|
| Rate for Payer: Quartz Medicare Advantage |
$829.92
|
| Rate for Payer: The Alliance Commercial |
$691.60
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 18MM 301-24-018
|
Facility
|
OP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547333
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Aetna Managed Medicare |
$387.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$899.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$691.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$663.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$774.06
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,037.40
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: NAPHCARE Commercial |
$829.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$899.08
|
| Rate for Payer: Quartz Medicare Advantage |
$829.92
|
| Rate for Payer: The Alliance Commercial |
$691.60
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 18MM 301-24-018
|
Facility
|
IP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547333
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$677.77 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$829.92
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 20 301-24-020
|
Facility
|
IP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5520795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$677.77 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$829.92
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 20 301-24-020
|
Facility
|
OP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5520795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Aetna Managed Medicare |
$387.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$899.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$691.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$663.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$774.06
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,037.40
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: NAPHCARE Commercial |
$829.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$899.08
|
| Rate for Payer: Quartz Medicare Advantage |
$829.92
|
| Rate for Payer: The Alliance Commercial |
$691.60
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 22 301-24-022
|
Facility
|
IP
|
$1,383.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5456743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$704.78 |
| Max. Negotiated Rate |
$1,323.25 |
| Rate for Payer: Aetna Commercial |
$1,294.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,236.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$762.31
|
| Rate for Payer: Cash Price |
$414.90
|
| Rate for Payer: Cigna Commercial |
$1,323.25
|
| Rate for Payer: Health EOS Commercial |
$1,280.10
|
| Rate for Payer: HFN Commercial |
$1,323.25
|
| Rate for Payer: Multiplan Commercial |
$1,150.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,323.25
|
| Rate for Payer: Quartz Beloit One Network |
$704.78
|
| Rate for Payer: Quartz Commercial |
$862.99
|
| Rate for Payer: WEA Trust Commercial |
$791.08
|
| Rate for Payer: WPS Commercial |
$1,065.32
|
|
|
SCREW GRIDLOCK 2.4 X 22 301-24-022
|
Facility
|
OP
|
$1,383.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5456743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$402.73 |
| Max. Negotiated Rate |
$1,323.25 |
| Rate for Payer: Aetna Commercial |
$1,294.49
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,236.96
|
| Rate for Payer: Aetna Managed Medicare |
$402.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$934.91
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$719.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$690.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$762.31
|
| Rate for Payer: Cash Price |
$414.90
|
| Rate for Payer: Cigna Commercial |
$1,323.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$804.91
|
| Rate for Payer: Health EOS Commercial |
$1,280.10
|
| Rate for Payer: HFN Commercial |
$1,323.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,078.74
|
| Rate for Payer: Multiplan Commercial |
$1,150.66
|
| Rate for Payer: NAPHCARE Commercial |
$862.99
|
| Rate for Payer: Preferred Network Access Commercial |
$1,323.25
|
| Rate for Payer: Quartz Beloit One Network |
$704.78
|
| Rate for Payer: Quartz Commercial |
$934.91
|
| Rate for Payer: Quartz Medicare Advantage |
$862.99
|
| Rate for Payer: The Alliance Commercial |
$719.16
|
| Rate for Payer: WEA Trust Commercial |
$791.08
|
| Rate for Payer: WPS Commercial |
$1,065.32
|
|
|
SCREW GRIDLOCK 2.4 X 24 301-24-024
|
Facility
|
IP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$677.77 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$829.92
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK 2.4 X 24 301-24-024
|
Facility
|
OP
|
$1,330.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$1,272.54 |
| Rate for Payer: Aetna Commercial |
$1,244.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,189.55
|
| Rate for Payer: Aetna Managed Medicare |
$387.30
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$899.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$691.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$663.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$733.10
|
| Rate for Payer: Cash Price |
$399.00
|
| Rate for Payer: Cigna Commercial |
$1,272.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$774.06
|
| Rate for Payer: Health EOS Commercial |
$1,231.05
|
| Rate for Payer: HFN Commercial |
$1,272.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,037.40
|
| Rate for Payer: Multiplan Commercial |
$1,106.56
|
| Rate for Payer: NAPHCARE Commercial |
$829.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,272.54
|
| Rate for Payer: Quartz Beloit One Network |
$677.77
|
| Rate for Payer: Quartz Commercial |
$899.08
|
| Rate for Payer: Quartz Medicare Advantage |
$829.92
|
| Rate for Payer: The Alliance Commercial |
$691.60
|
| Rate for Payer: WEA Trust Commercial |
$760.76
|
| Rate for Payer: WPS Commercial |
$1,024.50
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 10MM 302-24-010
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5240667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,219.98 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,493.86
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 10MM 302-24-010
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5240667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.13 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Aetna Managed Medicare |
$697.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,618.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,244.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,195.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,393.31
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,867.32
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: NAPHCARE Commercial |
$1,493.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,618.34
|
| Rate for Payer: Quartz Medicare Advantage |
$1,493.86
|
| Rate for Payer: The Alliance Commercial |
$1,244.88
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 12MM 302-24-012
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5248607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,219.98 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,493.86
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 12MM 302-24-012
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5248607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.13 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Aetna Managed Medicare |
$697.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,618.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,244.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,195.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,393.31
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,867.32
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: NAPHCARE Commercial |
$1,493.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,618.34
|
| Rate for Payer: Quartz Medicare Advantage |
$1,493.86
|
| Rate for Payer: The Alliance Commercial |
$1,244.88
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 14MM 302-24-014
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,219.98 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,493.86
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 14MM 302-24-014
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.13 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Aetna Managed Medicare |
$697.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,618.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,244.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,195.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,393.31
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,867.32
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: NAPHCARE Commercial |
$1,493.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,618.34
|
| Rate for Payer: Quartz Medicare Advantage |
$1,493.86
|
| Rate for Payer: The Alliance Commercial |
$1,244.88
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 16MM 302-24-016
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611545
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,219.98 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,493.86
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 16MM 302-24-016
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611545
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.13 |
| Max. Negotiated Rate |
$2,290.58 |
| Rate for Payer: Aetna Commercial |
$2,240.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,141.19
|
| Rate for Payer: Aetna Managed Medicare |
$697.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,618.34
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,244.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,195.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,319.57
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,290.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,393.31
|
| Rate for Payer: Health EOS Commercial |
$2,215.89
|
| Rate for Payer: HFN Commercial |
$2,290.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,867.32
|
| Rate for Payer: Multiplan Commercial |
$1,991.81
|
| Rate for Payer: NAPHCARE Commercial |
$1,493.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,290.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,219.98
|
| Rate for Payer: Quartz Commercial |
$1,618.34
|
| Rate for Payer: Quartz Medicare Advantage |
$1,493.86
|
| Rate for Payer: The Alliance Commercial |
$1,244.88
|
| Rate for Payer: WEA Trust Commercial |
$1,369.37
|
| Rate for Payer: WPS Commercial |
$1,844.10
|
|
