|
SCREW GRIDLOCK LOCK 2.4 X 18MM 302-24-018
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5456744
|
|
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 18MM 302-24-018
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5456744
|
|
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 20MM 302-24-020
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5416000
|
|
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 20MM 302-24-020
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5416000
|
|
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 22MM 302-24-022
|
Facility
|
OP
|
$2,585.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5416001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$752.75 |
| Max. Negotiated Rate |
$2,473.33 |
| Rate for Payer: Aetna Commercial |
$2,419.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,312.02
|
| Rate for Payer: Aetna Managed Medicare |
$752.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,747.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,344.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,290.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,424.85
|
| Rate for Payer: Cash Price |
$775.50
|
| Rate for Payer: Cigna Commercial |
$2,473.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,504.47
|
| Rate for Payer: Health EOS Commercial |
$2,392.68
|
| Rate for Payer: HFN Commercial |
$2,473.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,016.30
|
| Rate for Payer: Multiplan Commercial |
$2,150.72
|
| Rate for Payer: NAPHCARE Commercial |
$1,613.04
|
| Rate for Payer: Preferred Network Access Commercial |
$2,473.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,317.32
|
| Rate for Payer: Quartz Commercial |
$1,747.46
|
| Rate for Payer: Quartz Medicare Advantage |
$1,613.04
|
| Rate for Payer: The Alliance Commercial |
$1,344.20
|
| Rate for Payer: WEA Trust Commercial |
$1,478.62
|
| Rate for Payer: WPS Commercial |
$1,991.23
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 22MM 302-24-022
|
Facility
|
IP
|
$2,585.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5416001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,317.32 |
| Max. Negotiated Rate |
$2,473.33 |
| Rate for Payer: Aetna Commercial |
$2,419.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,312.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,424.85
|
| Rate for Payer: Cash Price |
$775.50
|
| Rate for Payer: Cigna Commercial |
$2,473.33
|
| Rate for Payer: Health EOS Commercial |
$2,392.68
|
| Rate for Payer: HFN Commercial |
$2,473.33
|
| Rate for Payer: Multiplan Commercial |
$2,150.72
|
| Rate for Payer: Preferred Network Access Commercial |
$2,473.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,317.32
|
| Rate for Payer: Quartz Commercial |
$1,613.04
|
| Rate for Payer: WEA Trust Commercial |
$1,478.62
|
| Rate for Payer: WPS Commercial |
$1,991.23
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 24MM 302-24-024
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5496816
|
|
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 24MM 302-24-024
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5496816
|
|
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 HEADED 2.0 X 12 DART-FIRE COMPRESSION D1N20012S
|
Facility
|
IP
|
$3,868.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,971.13 |
| Max. Negotiated Rate |
$3,700.90 |
| Rate for Payer: Aetna Commercial |
$3,620.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,459.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,132.04
|
| Rate for Payer: Cash Price |
$1,160.40
|
| Rate for Payer: Cigna Commercial |
$3,700.90
|
| Rate for Payer: Health EOS Commercial |
$3,580.22
|
| Rate for Payer: HFN Commercial |
$3,700.90
|
| Rate for Payer: Multiplan Commercial |
$3,218.18
|
| Rate for Payer: Preferred Network Access Commercial |
$3,700.90
|
| Rate for Payer: Quartz Beloit One Network |
$1,971.13
|
| Rate for Payer: Quartz Commercial |
$2,413.63
|
| Rate for Payer: WEA Trust Commercial |
$2,212.50
|
| Rate for Payer: WPS Commercial |
$2,979.52
|
|
|
SCREW HEADED 2.0 X 12 DART-FIRE COMPRESSION D1N20012S
|
Facility
|
OP
|
$3,868.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,126.36 |
| Max. Negotiated Rate |
$3,700.90 |
| Rate for Payer: Aetna Commercial |
$3,620.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,459.54
|
| Rate for Payer: Aetna Managed Medicare |
$1,126.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,614.77
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,011.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,930.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,132.04
|
| Rate for Payer: Cash Price |
$1,160.40
|
| Rate for Payer: Cigna Commercial |
$3,700.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,251.18
|
| Rate for Payer: Health EOS Commercial |
$3,580.22
|
| Rate for Payer: HFN Commercial |
$3,700.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,017.04
|
| Rate for Payer: Multiplan Commercial |
$3,218.18
|
| Rate for Payer: NAPHCARE Commercial |
$2,413.63
|
| Rate for Payer: Preferred Network Access Commercial |
$3,700.90
|
| Rate for Payer: Quartz Beloit One Network |
$1,971.13
|
| Rate for Payer: Quartz Commercial |
$2,614.77
|
| Rate for Payer: Quartz Medicare Advantage |
$2,413.63
|
| Rate for Payer: The Alliance Commercial |
$2,011.36
|
| Rate for Payer: WEA Trust Commercial |
$2,212.50
|
| Rate for Payer: WPS Commercial |
$2,979.52
|
|
|
SCREW HEADED 2.5 X 10MM IC2510
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.10 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Aetna Managed Medicare |
$612.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,420.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,093.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,049.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,223.36
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,639.56
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,311.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,420.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,311.65
|
| Rate for Payer: The Alliance Commercial |
$1,093.04
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 10MM IC2510
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,071.18 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,311.65
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 12MM IC2512
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,071.18 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,311.65
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 12MM IC2512
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.10 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Aetna Managed Medicare |
$612.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,420.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,093.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,049.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,223.36
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,639.56
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,311.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,420.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,311.65
|
| Rate for Payer: The Alliance Commercial |
$1,093.04
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 14MM IC2514
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,071.18 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,311.65
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 14MM IC2514
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.10 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Aetna Managed Medicare |
$612.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,420.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,093.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,049.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,223.36
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,639.56
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,311.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,420.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,311.65
|
| Rate for Payer: The Alliance Commercial |
$1,093.04
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 16MM IC2516
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729904
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.10 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Aetna Managed Medicare |
$612.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,420.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,093.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,049.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,223.36
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,639.56
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,311.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,420.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,311.65
|
| Rate for Payer: The Alliance Commercial |
$1,093.04
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 16MM IC2516
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729904
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,071.18 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,311.65
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 18MM IC2518
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.10 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Aetna Managed Medicare |
$612.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,420.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,093.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,049.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,223.36
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,639.56
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,311.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,420.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,311.65
|
| Rate for Payer: The Alliance Commercial |
$1,093.04
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 18MM IC2518
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,071.18 |
| Max. Negotiated Rate |
$2,011.19 |
| Rate for Payer: Aetna Commercial |
$1,967.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,880.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,158.62
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$2,011.19
|
| Rate for Payer: Health EOS Commercial |
$1,945.61
|
| Rate for Payer: HFN Commercial |
$2,011.19
|
| Rate for Payer: Multiplan Commercial |
$1,748.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,011.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,071.18
|
| Rate for Payer: Quartz Commercial |
$1,311.65
|
| Rate for Payer: WEA Trust Commercial |
$1,202.34
|
| Rate for Payer: WPS Commercial |
$1,619.17
|
|
|
SCREW HEADED 2.5 X 32MM IC2532
|
Facility
|
IP
|
$2,021.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5957657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.90 |
| Max. Negotiated Rate |
$1,933.69 |
| Rate for Payer: Aetna Commercial |
$1,891.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,113.98
|
| Rate for Payer: Cash Price |
$606.30
|
| Rate for Payer: Cigna Commercial |
$1,933.69
|
| Rate for Payer: Health EOS Commercial |
$1,870.64
|
| Rate for Payer: HFN Commercial |
$1,933.69
|
| Rate for Payer: Multiplan Commercial |
$1,681.47
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.69
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.90
|
| Rate for Payer: Quartz Commercial |
$1,261.10
|
| Rate for Payer: WEA Trust Commercial |
$1,156.01
|
| Rate for Payer: WPS Commercial |
$1,556.78
|
|
|
SCREW HEADED 2.5 X 32MM IC2532
|
Facility
|
OP
|
$2,021.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5957657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.52 |
| Max. Negotiated Rate |
$1,933.69 |
| Rate for Payer: Aetna Commercial |
$1,891.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.58
|
| Rate for Payer: Aetna Managed Medicare |
$588.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,050.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,113.98
|
| Rate for Payer: Cash Price |
$606.30
|
| Rate for Payer: Cigna Commercial |
$1,933.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.22
|
| Rate for Payer: Health EOS Commercial |
$1,870.64
|
| Rate for Payer: HFN Commercial |
$1,933.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.38
|
| Rate for Payer: Multiplan Commercial |
$1,681.47
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.69
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.90
|
| Rate for Payer: Quartz Commercial |
$1,366.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.10
|
| Rate for Payer: The Alliance Commercial |
$1,050.92
|
| Rate for Payer: WEA Trust Commercial |
$1,156.01
|
| Rate for Payer: WPS Commercial |
$1,556.78
|
|
|
SCREW HEADED 3.0MM X 22MM D1N30022S
|
Facility
|
IP
|
$2,486.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,266.87 |
| Max. Negotiated Rate |
$2,378.60 |
| Rate for Payer: Aetna Commercial |
$2,326.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,223.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,370.28
|
| Rate for Payer: Cash Price |
$745.80
|
| Rate for Payer: Cigna Commercial |
$2,378.60
|
| Rate for Payer: Health EOS Commercial |
$2,301.04
|
| Rate for Payer: HFN Commercial |
$2,378.60
|
| Rate for Payer: Multiplan Commercial |
$2,068.35
|
| Rate for Payer: Preferred Network Access Commercial |
$2,378.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,266.87
|
| Rate for Payer: Quartz Commercial |
$1,551.26
|
| Rate for Payer: WEA Trust Commercial |
$1,421.99
|
| Rate for Payer: WPS Commercial |
$1,914.97
|
|
|
SCREW HEADED 3.0MM X 22MM D1N30022S
|
Facility
|
OP
|
$2,486.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$723.92 |
| Max. Negotiated Rate |
$2,378.60 |
| Rate for Payer: Aetna Commercial |
$2,326.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,223.48
|
| Rate for Payer: Aetna Managed Medicare |
$723.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,680.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,292.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,241.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,370.28
|
| Rate for Payer: Cash Price |
$745.80
|
| Rate for Payer: Cigna Commercial |
$2,378.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,446.85
|
| Rate for Payer: Health EOS Commercial |
$2,301.04
|
| Rate for Payer: HFN Commercial |
$2,378.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,939.08
|
| Rate for Payer: Multiplan Commercial |
$2,068.35
|
| Rate for Payer: NAPHCARE Commercial |
$1,551.26
|
| Rate for Payer: Preferred Network Access Commercial |
$2,378.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,266.87
|
| Rate for Payer: Quartz Commercial |
$1,680.54
|
| Rate for Payer: Quartz Medicare Advantage |
$1,551.26
|
| Rate for Payer: The Alliance Commercial |
$1,292.72
|
| Rate for Payer: WEA Trust Commercial |
$1,421.99
|
| Rate for Payer: WPS Commercial |
$1,914.97
|
|
|
SCREW HEADED 4.0MM X 36MM D1N40036S
|
Facility
|
OP
|
$2,241.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6200970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$652.58 |
| Max. Negotiated Rate |
$2,144.19 |
| Rate for Payer: Aetna Commercial |
$2,097.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,004.35
|
| Rate for Payer: Aetna Managed Medicare |
$652.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,514.92
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,165.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,118.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,235.24
|
| Rate for Payer: Cash Price |
$672.30
|
| Rate for Payer: Cigna Commercial |
$2,144.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,304.26
|
| Rate for Payer: Health EOS Commercial |
$2,074.27
|
| Rate for Payer: HFN Commercial |
$2,144.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,747.98
|
| Rate for Payer: Multiplan Commercial |
$1,864.51
|
| Rate for Payer: NAPHCARE Commercial |
$1,398.38
|
| Rate for Payer: Preferred Network Access Commercial |
$2,144.19
|
| Rate for Payer: Quartz Beloit One Network |
$1,142.01
|
| Rate for Payer: Quartz Commercial |
$1,514.92
|
| Rate for Payer: Quartz Medicare Advantage |
$1,398.38
|
| Rate for Payer: The Alliance Commercial |
$1,165.32
|
| Rate for Payer: WEA Trust Commercial |
$1,281.85
|
| Rate for Payer: WPS Commercial |
$1,726.24
|
|
