|
SCREW LOCKING 2.4 X 8 MS-2408L
|
Facility
|
OP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
6170098
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$362.04 |
| Max. Negotiated Rate |
$5,172.00 |
| Rate for Payer: Aetna Commercial |
$1,163.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,111.98
|
| Rate for Payer: Aetna Managed Medicare |
$362.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$840.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$646.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$620.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$685.29
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,189.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$723.56
|
| Rate for Payer: Health EOS Commercial |
$1,150.77
|
| Rate for Payer: HFN Commercial |
$1,189.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$969.75
|
| Rate for Payer: Multiplan Commercial |
$1,034.40
|
| Rate for Payer: NAPHCARE Commercial |
$775.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,189.56
|
| Rate for Payer: Quartz Beloit One Network |
$633.57
|
| Rate for Payer: Quartz Commercial |
$840.45
|
| Rate for Payer: Quartz Medicare Advantage |
$775.80
|
| Rate for Payer: The Alliance Commercial |
$5,172.00
|
| Rate for Payer: WEA Trust Commercial |
$711.15
|
| Rate for Payer: WPS Commercial |
$957.73
|
|
|
SCREW LOCKING 2.4 X 8 MS-2408L
|
Facility
|
IP
|
$1,293.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
6170098
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$633.57 |
| Max. Negotiated Rate |
$1,189.56 |
| Rate for Payer: Aetna Commercial |
$1,163.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,111.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$685.29
|
| Rate for Payer: Cash Price |
$387.90
|
| Rate for Payer: Cigna Commercial |
$1,189.56
|
| Rate for Payer: Health EOS Commercial |
$1,150.77
|
| Rate for Payer: HFN Commercial |
$1,189.56
|
| Rate for Payer: Multiplan Commercial |
$1,034.40
|
| Rate for Payer: NAPHCARE Commercial |
$775.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,189.56
|
| Rate for Payer: Quartz Beloit One Network |
$633.57
|
| Rate for Payer: Quartz Commercial |
$775.80
|
| Rate for Payer: WEA Trust Commercial |
$711.15
|
| Rate for Payer: WPS Commercial |
$957.73
|
|
|
SCREW LOCKING 2.7 X 10MM 656310
|
Facility
|
IP
|
$1,883.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$922.67 |
| Max. Negotiated Rate |
$1,732.36 |
| Rate for Payer: Aetna Commercial |
$1,694.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,619.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.99
|
| Rate for Payer: Cash Price |
$564.90
|
| Rate for Payer: Cigna Commercial |
$1,732.36
|
| Rate for Payer: Health EOS Commercial |
$1,675.87
|
| Rate for Payer: HFN Commercial |
$1,732.36
|
| Rate for Payer: Multiplan Commercial |
$1,506.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,129.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,732.36
|
| Rate for Payer: Quartz Beloit One Network |
$922.67
|
| Rate for Payer: Quartz Commercial |
$1,129.80
|
| Rate for Payer: WEA Trust Commercial |
$1,035.65
|
| Rate for Payer: WPS Commercial |
$1,394.74
|
|
|
SCREW LOCKING 2.7 X 10MM 656310
|
Facility
|
OP
|
$1,883.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.24 |
| Max. Negotiated Rate |
$7,532.00 |
| Rate for Payer: Aetna Commercial |
$1,694.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,619.38
|
| Rate for Payer: Aetna Managed Medicare |
$527.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,223.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$941.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$903.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.99
|
| Rate for Payer: Cash Price |
$564.90
|
| Rate for Payer: Cigna Commercial |
$1,732.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,053.73
|
| Rate for Payer: Health EOS Commercial |
$1,675.87
|
| Rate for Payer: HFN Commercial |
$1,732.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,412.25
|
| Rate for Payer: Multiplan Commercial |
$1,506.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,129.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,732.36
|
| Rate for Payer: Quartz Beloit One Network |
$922.67
|
| Rate for Payer: Quartz Commercial |
$1,223.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,129.80
|
| Rate for Payer: The Alliance Commercial |
$7,532.00
|
| Rate for Payer: WEA Trust Commercial |
$1,035.65
|
| Rate for Payer: WPS Commercial |
$1,394.74
|
|
|
SCREW LOCKING 2.7 X 12MM 656312
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 12MM 656312
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 14MM 656314
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 14MM 656314
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 16MM 656316
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 16MM 656316
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 18MM 656318
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563676
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 18MM 656318
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563676
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 20MM 656320
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 20MM 656320
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 22MM 656322
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 22MM 656322
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 24MM 656324
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.61 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,133.40
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 2.7 X 24MM 656324
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$7,556.00 |
| Rate for Payer: Aetna Commercial |
$1,700.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,624.54
|
| Rate for Payer: Aetna Managed Medicare |
$528.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,227.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$944.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$906.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,001.17
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,737.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,057.08
|
| Rate for Payer: Health EOS Commercial |
$1,681.21
|
| Rate for Payer: HFN Commercial |
$1,737.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,416.75
|
| Rate for Payer: Multiplan Commercial |
$1,511.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,133.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,737.88
|
| Rate for Payer: Quartz Beloit One Network |
$925.61
|
| Rate for Payer: Quartz Commercial |
$1,227.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,133.40
|
| Rate for Payer: The Alliance Commercial |
$7,556.00
|
| Rate for Payer: WEA Trust Commercial |
$1,038.95
|
| Rate for Payer: WPS Commercial |
$1,399.18
|
|
|
SCREW LOCKING 3.5 X 26 213.026
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.56 |
| Max. Negotiated Rate |
$8,008.00 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Aetna Managed Medicare |
$560.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,301.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,001.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$960.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,120.32
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,501.50
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,301.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,201.20
|
| Rate for Payer: The Alliance Commercial |
$8,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW LOCKING 3.5 X 26 213.026
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.98 |
| Max. Negotiated Rate |
$1,841.84 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,201.20
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW LOCKING 3.5 X 28 213.028
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.56 |
| Max. Negotiated Rate |
$8,008.00 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Aetna Managed Medicare |
$560.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,301.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,001.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$960.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,120.32
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,501.50
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,301.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,201.20
|
| Rate for Payer: The Alliance Commercial |
$8,008.00
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW LOCKING 3.5 X 28 213.028
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.98 |
| Max. Negotiated Rate |
$1,841.84 |
| Rate for Payer: Aetna Commercial |
$1,801.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,721.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,061.06
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,841.84
|
| Rate for Payer: Health EOS Commercial |
$1,781.78
|
| Rate for Payer: HFN Commercial |
$1,841.84
|
| Rate for Payer: Multiplan Commercial |
$1,601.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,201.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,841.84
|
| Rate for Payer: Quartz Beloit One Network |
$980.98
|
| Rate for Payer: Quartz Commercial |
$1,201.20
|
| Rate for Payer: WEA Trust Commercial |
$1,101.10
|
| Rate for Payer: WPS Commercial |
$1,482.88
|
|
|
SCREW LOCKING 5.0 VA 02.231.220
|
Facility
|
OP
|
$2,118.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6178023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$8,472.00 |
| Rate for Payer: Aetna Commercial |
$1,906.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,821.48
|
| Rate for Payer: Aetna Managed Medicare |
$593.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,376.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,059.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,016.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,122.54
|
| Rate for Payer: Cash Price |
$635.40
|
| Rate for Payer: Cigna Commercial |
$1,948.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,185.23
|
| Rate for Payer: Health EOS Commercial |
$1,885.02
|
| Rate for Payer: HFN Commercial |
$1,948.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,588.50
|
| Rate for Payer: Multiplan Commercial |
$1,694.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,270.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,948.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,037.82
|
| Rate for Payer: Quartz Commercial |
$1,376.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,270.80
|
| Rate for Payer: The Alliance Commercial |
$8,472.00
|
| Rate for Payer: WEA Trust Commercial |
$1,164.90
|
| Rate for Payer: WPS Commercial |
$1,568.80
|
|
|
SCREW LOCKING 5.0 VA 02.231.220
|
Facility
|
IP
|
$2,118.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6178023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,037.82 |
| Max. Negotiated Rate |
$1,948.56 |
| Rate for Payer: Aetna Commercial |
$1,906.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,821.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,122.54
|
| Rate for Payer: Cash Price |
$635.40
|
| Rate for Payer: Cigna Commercial |
$1,948.56
|
| Rate for Payer: Health EOS Commercial |
$1,885.02
|
| Rate for Payer: HFN Commercial |
$1,948.56
|
| Rate for Payer: Multiplan Commercial |
$1,694.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,270.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,948.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,037.82
|
| Rate for Payer: Quartz Commercial |
$1,270.80
|
| Rate for Payer: WEA Trust Commercial |
$1,164.90
|
| Rate for Payer: WPS Commercial |
$1,568.80
|
|
|
SCREW LOCKING 5.5 X 38MM ORTHOLOC 59215538
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$781.20 |
| Max. Negotiated Rate |
$11,160.00 |
| Rate for Payer: Aetna Commercial |
$2,511.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,399.40
|
| Rate for Payer: Aetna Managed Medicare |
$781.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,813.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,395.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,339.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,478.70
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,566.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,561.28
|
| Rate for Payer: Health EOS Commercial |
$2,483.10
|
| Rate for Payer: HFN Commercial |
$2,566.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,092.50
|
| Rate for Payer: Multiplan Commercial |
$2,232.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,674.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,566.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,367.10
|
| Rate for Payer: Quartz Commercial |
$1,813.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,674.00
|
| Rate for Payer: The Alliance Commercial |
$11,160.00
|
| Rate for Payer: WEA Trust Commercial |
$1,534.50
|
| Rate for Payer: WPS Commercial |
$2,066.55
|
|
