|
SCREW HEADLESS 2.0 X 20 317-2020
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 20 317-2020
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 22 317-2022
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 22 317-2022
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 24 317-2024
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 24 317-2024
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 26 317-2026
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 26 317-2026
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 28 317-2028
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 28 317-2028
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 30 317-2030
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965470
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 30 317-2030
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965470
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.0 X 40 317-2040
|
Facility
|
OP
|
$3,888.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5810081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,132.19 |
| Max. Negotiated Rate |
$3,720.04 |
| Rate for Payer: Aetna Commercial |
$3,639.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,477.43
|
| Rate for Payer: Aetna Managed Medicare |
$1,132.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,628.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,021.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,940.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,143.07
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cigna Commercial |
$3,720.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,262.82
|
| Rate for Payer: Health EOS Commercial |
$3,598.73
|
| Rate for Payer: HFN Commercial |
$3,720.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,032.64
|
| Rate for Payer: Multiplan Commercial |
$3,234.82
|
| Rate for Payer: NAPHCARE Commercial |
$2,426.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,720.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,981.32
|
| Rate for Payer: Quartz Commercial |
$2,628.29
|
| Rate for Payer: Quartz Medicare Advantage |
$2,426.11
|
| Rate for Payer: The Alliance Commercial |
$2,021.76
|
| Rate for Payer: WEA Trust Commercial |
$2,223.94
|
| Rate for Payer: WPS Commercial |
$2,994.93
|
|
|
SCREW HEADLESS 2.0 X 40 317-2040
|
Facility
|
IP
|
$3,888.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5810081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,981.32 |
| Max. Negotiated Rate |
$3,720.04 |
| Rate for Payer: Aetna Commercial |
$3,639.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,477.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,143.07
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cigna Commercial |
$3,720.04
|
| Rate for Payer: Health EOS Commercial |
$3,598.73
|
| Rate for Payer: HFN Commercial |
$3,720.04
|
| Rate for Payer: Multiplan Commercial |
$3,234.82
|
| Rate for Payer: Preferred Network Access Commercial |
$3,720.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,981.32
|
| Rate for Payer: Quartz Commercial |
$2,426.11
|
| Rate for Payer: WEA Trust Commercial |
$2,223.94
|
| Rate for Payer: WPS Commercial |
$2,994.93
|
|
|
SCREW HEADLESS 2.0 X 42 317-2042
|
Facility
|
IP
|
$3,888.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5810082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,981.32 |
| Max. Negotiated Rate |
$3,720.04 |
| Rate for Payer: Aetna Commercial |
$3,639.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,477.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,143.07
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cigna Commercial |
$3,720.04
|
| Rate for Payer: Health EOS Commercial |
$3,598.73
|
| Rate for Payer: HFN Commercial |
$3,720.04
|
| Rate for Payer: Multiplan Commercial |
$3,234.82
|
| Rate for Payer: Preferred Network Access Commercial |
$3,720.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,981.32
|
| Rate for Payer: Quartz Commercial |
$2,426.11
|
| Rate for Payer: WEA Trust Commercial |
$2,223.94
|
| Rate for Payer: WPS Commercial |
$2,994.93
|
|
|
SCREW HEADLESS 2.0 X 42 317-2042
|
Facility
|
OP
|
$3,888.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5810082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,132.19 |
| Max. Negotiated Rate |
$3,720.04 |
| Rate for Payer: Aetna Commercial |
$3,639.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,477.43
|
| Rate for Payer: Aetna Managed Medicare |
$1,132.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,628.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,021.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,940.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,143.07
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cigna Commercial |
$3,720.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,262.82
|
| Rate for Payer: Health EOS Commercial |
$3,598.73
|
| Rate for Payer: HFN Commercial |
$3,720.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,032.64
|
| Rate for Payer: Multiplan Commercial |
$3,234.82
|
| Rate for Payer: NAPHCARE Commercial |
$2,426.11
|
| Rate for Payer: Preferred Network Access Commercial |
$3,720.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,981.32
|
| Rate for Payer: Quartz Commercial |
$2,628.29
|
| Rate for Payer: Quartz Medicare Advantage |
$2,426.11
|
| Rate for Payer: The Alliance Commercial |
$2,021.76
|
| Rate for Payer: WEA Trust Commercial |
$2,223.94
|
| Rate for Payer: WPS Commercial |
$2,994.93
|
|
|
SCREW HEADLESS 2.4 X 12 317-2412
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 12 317-2412
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 14 317-2414
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965476
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 14 317-2414
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965476
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 16 317-2416
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965478
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 16 317-2416
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965478
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 18 317-2418
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 18 317-2418
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 20 317-2420
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
