|
SCREW HEADLESS COMPRESSION 7.0 X 60MM SHORT THREAD TI 658360
|
Facility
|
OP
|
$4,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5641641
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,195.96 |
| Max. Negotiated Rate |
$3,929.58 |
| Rate for Payer: Aetna Commercial |
$3,844.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,673.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,195.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,776.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,135.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,050.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,263.78
|
| Rate for Payer: Cash Price |
$1,232.10
|
| Rate for Payer: Cigna Commercial |
$3,929.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,390.27
|
| Rate for Payer: Health EOS Commercial |
$3,801.44
|
| Rate for Payer: HFN Commercial |
$3,929.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,203.46
|
| Rate for Payer: Multiplan Commercial |
$3,417.02
|
| Rate for Payer: NAPHCARE Commercial |
$2,562.77
|
| Rate for Payer: Preferred Network Access Commercial |
$3,929.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,092.93
|
| Rate for Payer: Quartz Commercial |
$2,776.33
|
| Rate for Payer: Quartz Medicare Advantage |
$2,562.77
|
| Rate for Payer: The Alliance Commercial |
$2,135.64
|
| Rate for Payer: WEA Trust Commercial |
$2,349.20
|
| Rate for Payer: WPS Commercial |
$3,163.62
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 65MM LONG THREAD TI 658565
|
Facility
|
IP
|
$4,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6217042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,092.93 |
| Max. Negotiated Rate |
$3,929.58 |
| Rate for Payer: Aetna Commercial |
$3,844.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,673.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,263.78
|
| Rate for Payer: Cash Price |
$1,232.10
|
| Rate for Payer: Cigna Commercial |
$3,929.58
|
| Rate for Payer: Health EOS Commercial |
$3,801.44
|
| Rate for Payer: HFN Commercial |
$3,929.58
|
| Rate for Payer: Multiplan Commercial |
$3,417.02
|
| Rate for Payer: Preferred Network Access Commercial |
$3,929.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,092.93
|
| Rate for Payer: Quartz Commercial |
$2,562.77
|
| Rate for Payer: WEA Trust Commercial |
$2,349.20
|
| Rate for Payer: WPS Commercial |
$3,163.62
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 65MM LONG THREAD TI 658565
|
Facility
|
OP
|
$4,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6217042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,195.96 |
| Max. Negotiated Rate |
$3,929.58 |
| Rate for Payer: Aetna Commercial |
$3,844.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,673.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,195.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,776.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,135.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,050.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,263.78
|
| Rate for Payer: Cash Price |
$1,232.10
|
| Rate for Payer: Cigna Commercial |
$3,929.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,390.27
|
| Rate for Payer: Health EOS Commercial |
$3,801.44
|
| Rate for Payer: HFN Commercial |
$3,929.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,203.46
|
| Rate for Payer: Multiplan Commercial |
$3,417.02
|
| Rate for Payer: NAPHCARE Commercial |
$2,562.77
|
| Rate for Payer: Preferred Network Access Commercial |
$3,929.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,092.93
|
| Rate for Payer: Quartz Commercial |
$2,776.33
|
| Rate for Payer: Quartz Medicare Advantage |
$2,562.77
|
| Rate for Payer: The Alliance Commercial |
$2,135.64
|
| Rate for Payer: WEA Trust Commercial |
$2,349.20
|
| Rate for Payer: WPS Commercial |
$3,163.62
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 65MM SHORT THREAD TI 658365
|
Facility
|
IP
|
$5,315.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,708.52 |
| Max. Negotiated Rate |
$5,085.39 |
| Rate for Payer: Aetna Commercial |
$4,974.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,753.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,929.63
|
| Rate for Payer: Cash Price |
$1,594.50
|
| Rate for Payer: Cigna Commercial |
$5,085.39
|
| Rate for Payer: Health EOS Commercial |
$4,919.56
|
| Rate for Payer: HFN Commercial |
$5,085.39
|
| Rate for Payer: Multiplan Commercial |
$4,422.08
|
| Rate for Payer: Preferred Network Access Commercial |
$5,085.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,708.52
|
| Rate for Payer: Quartz Commercial |
$3,316.56
|
| Rate for Payer: WEA Trust Commercial |
$3,040.18
|
| Rate for Payer: WPS Commercial |
$4,094.14
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 65MM SHORT THREAD TI 658365
|
Facility
|
OP
|
$5,315.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,547.73 |
| Max. Negotiated Rate |
$5,085.39 |
| Rate for Payer: Aetna Commercial |
$4,974.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,753.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,547.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,592.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,763.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,653.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,929.63
|
| Rate for Payer: Cash Price |
$1,594.50
|
| Rate for Payer: Cigna Commercial |
$5,085.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,093.33
|
| Rate for Payer: Health EOS Commercial |
$4,919.56
|
| Rate for Payer: HFN Commercial |
$5,085.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,145.70
|
| Rate for Payer: Multiplan Commercial |
$4,422.08
|
| Rate for Payer: NAPHCARE Commercial |
$3,316.56
|
| Rate for Payer: Preferred Network Access Commercial |
$5,085.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,708.52
|
| Rate for Payer: Quartz Commercial |
$3,592.94
|
| Rate for Payer: Quartz Medicare Advantage |
$3,316.56
|
| Rate for Payer: The Alliance Commercial |
$2,763.80
|
| Rate for Payer: WEA Trust Commercial |
$3,040.18
|
| Rate for Payer: WPS Commercial |
$4,094.14
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 70MM SHORT THREAD TI 658370
|
Facility
|
IP
|
$5,315.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861723
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,708.52 |
| Max. Negotiated Rate |
$5,085.39 |
| Rate for Payer: Aetna Commercial |
$4,974.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,753.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,929.63
|
| Rate for Payer: Cash Price |
$1,594.50
|
| Rate for Payer: Cigna Commercial |
$5,085.39
|
| Rate for Payer: Health EOS Commercial |
$4,919.56
|
| Rate for Payer: HFN Commercial |
$5,085.39
|
| Rate for Payer: Multiplan Commercial |
$4,422.08
|
| Rate for Payer: Preferred Network Access Commercial |
$5,085.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,708.52
|
| Rate for Payer: Quartz Commercial |
$3,316.56
|
| Rate for Payer: WEA Trust Commercial |
$3,040.18
|
| Rate for Payer: WPS Commercial |
$4,094.14
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 70MM SHORT THREAD TI 658370
|
Facility
|
OP
|
$5,315.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861723
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,547.73 |
| Max. Negotiated Rate |
$5,085.39 |
| Rate for Payer: Aetna Commercial |
$4,974.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,753.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,547.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,592.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,763.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,653.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,929.63
|
| Rate for Payer: Cash Price |
$1,594.50
|
| Rate for Payer: Cigna Commercial |
$5,085.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,093.33
|
| Rate for Payer: Health EOS Commercial |
$4,919.56
|
| Rate for Payer: HFN Commercial |
$5,085.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,145.70
|
| Rate for Payer: Multiplan Commercial |
$4,422.08
|
| Rate for Payer: NAPHCARE Commercial |
$3,316.56
|
| Rate for Payer: Preferred Network Access Commercial |
$5,085.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,708.52
|
| Rate for Payer: Quartz Commercial |
$3,592.94
|
| Rate for Payer: Quartz Medicare Advantage |
$3,316.56
|
| Rate for Payer: The Alliance Commercial |
$2,763.80
|
| Rate for Payer: WEA Trust Commercial |
$3,040.18
|
| Rate for Payer: WPS Commercial |
$4,094.14
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 75MM SHORT THREAD TI 658375
|
Facility
|
IP
|
$4,271.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861724
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,176.50 |
| Max. Negotiated Rate |
$4,086.49 |
| Rate for Payer: Aetna Commercial |
$3,997.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,819.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,354.18
|
| Rate for Payer: Cash Price |
$1,281.30
|
| Rate for Payer: Cigna Commercial |
$4,086.49
|
| Rate for Payer: Health EOS Commercial |
$3,953.24
|
| Rate for Payer: HFN Commercial |
$4,086.49
|
| Rate for Payer: Multiplan Commercial |
$3,553.47
|
| Rate for Payer: Preferred Network Access Commercial |
$4,086.49
|
| Rate for Payer: Quartz Beloit One Network |
$2,176.50
|
| Rate for Payer: Quartz Commercial |
$2,665.10
|
| Rate for Payer: WEA Trust Commercial |
$2,443.01
|
| Rate for Payer: WPS Commercial |
$3,289.95
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 75MM SHORT THREAD TI 658375
|
Facility
|
OP
|
$4,271.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861724
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,243.72 |
| Max. Negotiated Rate |
$4,086.49 |
| Rate for Payer: Aetna Commercial |
$3,997.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,819.98
|
| Rate for Payer: Aetna Managed Medicare |
$1,243.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,887.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,220.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,132.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,354.18
|
| Rate for Payer: Cash Price |
$1,281.30
|
| Rate for Payer: Cigna Commercial |
$4,086.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,485.72
|
| Rate for Payer: Health EOS Commercial |
$3,953.24
|
| Rate for Payer: HFN Commercial |
$4,086.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,331.38
|
| Rate for Payer: Multiplan Commercial |
$3,553.47
|
| Rate for Payer: NAPHCARE Commercial |
$2,665.10
|
| Rate for Payer: Preferred Network Access Commercial |
$4,086.49
|
| Rate for Payer: Quartz Beloit One Network |
$2,176.50
|
| Rate for Payer: Quartz Commercial |
$2,887.20
|
| Rate for Payer: Quartz Medicare Advantage |
$2,665.10
|
| Rate for Payer: The Alliance Commercial |
$2,220.92
|
| Rate for Payer: WEA Trust Commercial |
$2,443.01
|
| Rate for Payer: WPS Commercial |
$3,289.95
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 80MM SHORT THREAD TI 658380
|
Facility
|
IP
|
$4,271.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6166141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,176.50 |
| Max. Negotiated Rate |
$4,086.49 |
| Rate for Payer: Aetna Commercial |
$3,997.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,819.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,354.18
|
| Rate for Payer: Cash Price |
$1,281.30
|
| Rate for Payer: Cigna Commercial |
$4,086.49
|
| Rate for Payer: Health EOS Commercial |
$3,953.24
|
| Rate for Payer: HFN Commercial |
$4,086.49
|
| Rate for Payer: Multiplan Commercial |
$3,553.47
|
| Rate for Payer: Preferred Network Access Commercial |
$4,086.49
|
| Rate for Payer: Quartz Beloit One Network |
$2,176.50
|
| Rate for Payer: Quartz Commercial |
$2,665.10
|
| Rate for Payer: WEA Trust Commercial |
$2,443.01
|
| Rate for Payer: WPS Commercial |
$3,289.95
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 80MM SHORT THREAD TI 658380
|
Facility
|
OP
|
$4,271.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6166141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,243.72 |
| Max. Negotiated Rate |
$4,086.49 |
| Rate for Payer: Aetna Commercial |
$3,997.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,819.98
|
| Rate for Payer: Aetna Managed Medicare |
$1,243.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,887.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,220.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,132.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,354.18
|
| Rate for Payer: Cash Price |
$1,281.30
|
| Rate for Payer: Cigna Commercial |
$4,086.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,485.72
|
| Rate for Payer: Health EOS Commercial |
$3,953.24
|
| Rate for Payer: HFN Commercial |
$4,086.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,331.38
|
| Rate for Payer: Multiplan Commercial |
$3,553.47
|
| Rate for Payer: NAPHCARE Commercial |
$2,665.10
|
| Rate for Payer: Preferred Network Access Commercial |
$4,086.49
|
| Rate for Payer: Quartz Beloit One Network |
$2,176.50
|
| Rate for Payer: Quartz Commercial |
$2,887.20
|
| Rate for Payer: Quartz Medicare Advantage |
$2,665.10
|
| Rate for Payer: The Alliance Commercial |
$2,220.92
|
| Rate for Payer: WEA Trust Commercial |
$2,443.01
|
| Rate for Payer: WPS Commercial |
$3,289.95
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 85MM SHORT THREAD TI 658385
|
Facility
|
OP
|
$4,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6181253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,195.96 |
| Max. Negotiated Rate |
$3,929.58 |
| Rate for Payer: Aetna Commercial |
$3,844.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,673.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,195.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,776.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,135.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,050.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,263.78
|
| Rate for Payer: Cash Price |
$1,232.10
|
| Rate for Payer: Cigna Commercial |
$3,929.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,390.27
|
| Rate for Payer: Health EOS Commercial |
$3,801.44
|
| Rate for Payer: HFN Commercial |
$3,929.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,203.46
|
| Rate for Payer: Multiplan Commercial |
$3,417.02
|
| Rate for Payer: NAPHCARE Commercial |
$2,562.77
|
| Rate for Payer: Preferred Network Access Commercial |
$3,929.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,092.93
|
| Rate for Payer: Quartz Commercial |
$2,776.33
|
| Rate for Payer: Quartz Medicare Advantage |
$2,562.77
|
| Rate for Payer: The Alliance Commercial |
$2,135.64
|
| Rate for Payer: WEA Trust Commercial |
$2,349.20
|
| Rate for Payer: WPS Commercial |
$3,163.62
|
|
|
SCREW HEADLESS COMPRESSION 7.0 X 85MM SHORT THREAD TI 658385
|
Facility
|
IP
|
$4,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6181253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,092.93 |
| Max. Negotiated Rate |
$3,929.58 |
| Rate for Payer: Aetna Commercial |
$3,844.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,673.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,263.78
|
| Rate for Payer: Cash Price |
$1,232.10
|
| Rate for Payer: Cigna Commercial |
$3,929.58
|
| Rate for Payer: Health EOS Commercial |
$3,801.44
|
| Rate for Payer: HFN Commercial |
$3,929.58
|
| Rate for Payer: Multiplan Commercial |
$3,417.02
|
| Rate for Payer: Preferred Network Access Commercial |
$3,929.58
|
| Rate for Payer: Quartz Beloit One Network |
$2,092.93
|
| Rate for Payer: Quartz Commercial |
$2,562.77
|
| Rate for Payer: WEA Trust Commercial |
$2,349.20
|
| Rate for Payer: WPS Commercial |
$3,163.62
|
|
|
SCREW HEX HEADED 3.5MM X 48MM 00-5901-035-48
|
Facility
|
IP
|
$2,174.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6192963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,107.87 |
| Max. Negotiated Rate |
$2,080.08 |
| Rate for Payer: Aetna Commercial |
$2,034.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,944.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,198.31
|
| Rate for Payer: Cash Price |
$652.20
|
| Rate for Payer: Cigna Commercial |
$2,080.08
|
| Rate for Payer: Health EOS Commercial |
$2,012.25
|
| Rate for Payer: HFN Commercial |
$2,080.08
|
| Rate for Payer: Multiplan Commercial |
$1,808.77
|
| Rate for Payer: Preferred Network Access Commercial |
$2,080.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,107.87
|
| Rate for Payer: Quartz Commercial |
$1,356.58
|
| Rate for Payer: WEA Trust Commercial |
$1,243.53
|
| Rate for Payer: WPS Commercial |
$1,674.63
|
|
|
SCREW HEX HEADED 3.5MM X 48MM 00-5901-035-48
|
Facility
|
OP
|
$2,174.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6192963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$633.07 |
| Max. Negotiated Rate |
$2,080.08 |
| Rate for Payer: Aetna Commercial |
$2,034.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,944.43
|
| Rate for Payer: Aetna Managed Medicare |
$633.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,469.62
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,130.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,085.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,198.31
|
| Rate for Payer: Cash Price |
$652.20
|
| Rate for Payer: Cigna Commercial |
$2,080.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,265.27
|
| Rate for Payer: Health EOS Commercial |
$2,012.25
|
| Rate for Payer: HFN Commercial |
$2,080.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,695.72
|
| Rate for Payer: Multiplan Commercial |
$1,808.77
|
| Rate for Payer: NAPHCARE Commercial |
$1,356.58
|
| Rate for Payer: Preferred Network Access Commercial |
$2,080.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,107.87
|
| Rate for Payer: Quartz Commercial |
$1,469.62
|
| Rate for Payer: Quartz Medicare Advantage |
$1,356.58
|
| Rate for Payer: The Alliance Commercial |
$1,130.48
|
| Rate for Payer: WEA Trust Commercial |
$1,243.53
|
| Rate for Payer: WPS Commercial |
$1,674.63
|
|
|
SCREW HOLE PLUG CONTINUUM 00-8757-000-02
|
Facility
|
OP
|
$2,230.00
|
|
| Hospital Charge Code |
2967810
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$649.38 |
| Max. Negotiated Rate |
$2,133.66 |
| Rate for Payer: Aetna Commercial |
$2,087.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,994.51
|
| Rate for Payer: Aetna Managed Medicare |
$649.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,507.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,159.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,113.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,229.18
|
| Rate for Payer: Cash Price |
$669.00
|
| Rate for Payer: Cigna Commercial |
$2,133.66
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,297.86
|
| Rate for Payer: Health EOS Commercial |
$2,064.09
|
| Rate for Payer: HFN Commercial |
$2,133.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,739.40
|
| Rate for Payer: Multiplan Commercial |
$1,855.36
|
| Rate for Payer: NAPHCARE Commercial |
$1,391.52
|
| Rate for Payer: Preferred Network Access Commercial |
$2,133.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,136.41
|
| Rate for Payer: Quartz Commercial |
$1,507.48
|
| Rate for Payer: Quartz Medicare Advantage |
$1,391.52
|
| Rate for Payer: The Alliance Commercial |
$1,159.60
|
| Rate for Payer: WEA Trust Commercial |
$1,275.56
|
| Rate for Payer: WPS Commercial |
$1,717.77
|
|
|
SCREW HOLE PLUG CONTINUUM 00-8757-000-02
|
Facility
|
IP
|
$2,230.00
|
|
| Hospital Charge Code |
2967810
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,136.41 |
| Max. Negotiated Rate |
$2,133.66 |
| Rate for Payer: Aetna Commercial |
$2,087.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,994.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,229.18
|
| Rate for Payer: Cash Price |
$669.00
|
| Rate for Payer: Cigna Commercial |
$2,133.66
|
| Rate for Payer: Health EOS Commercial |
$2,064.09
|
| Rate for Payer: HFN Commercial |
$2,133.66
|
| Rate for Payer: Multiplan Commercial |
$1,855.36
|
| Rate for Payer: Preferred Network Access Commercial |
$2,133.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,136.41
|
| Rate for Payer: Quartz Commercial |
$1,391.52
|
| Rate for Payer: WEA Trust Commercial |
$1,275.56
|
| Rate for Payer: WPS Commercial |
$1,717.77
|
|
|
SCREW INTERFERENCE 10 X 28 FULL THREAD AR-1400TC
|
Facility
|
OP
|
$6,041.00
|
|
| Hospital Charge Code |
2964695
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,759.14 |
| Max. Negotiated Rate |
$5,780.03 |
| Rate for Payer: Aetna Commercial |
$5,654.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,403.07
|
| Rate for Payer: Aetna Managed Medicare |
$1,759.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,083.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,141.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,015.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,329.80
|
| Rate for Payer: Cash Price |
$1,812.30
|
| Rate for Payer: Cigna Commercial |
$5,780.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,515.86
|
| Rate for Payer: Health EOS Commercial |
$5,591.55
|
| Rate for Payer: HFN Commercial |
$5,780.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,711.98
|
| Rate for Payer: Multiplan Commercial |
$5,026.11
|
| Rate for Payer: NAPHCARE Commercial |
$3,769.58
|
| Rate for Payer: Preferred Network Access Commercial |
$5,780.03
|
| Rate for Payer: Quartz Beloit One Network |
$3,078.49
|
| Rate for Payer: Quartz Commercial |
$4,083.72
|
| Rate for Payer: Quartz Medicare Advantage |
$3,769.58
|
| Rate for Payer: The Alliance Commercial |
$3,141.32
|
| Rate for Payer: WEA Trust Commercial |
$3,455.45
|
| Rate for Payer: WPS Commercial |
$4,653.38
|
|
|
SCREW INTERFERENCE 10 X 28 FULL THREAD AR-1400TC
|
Facility
|
IP
|
$6,041.00
|
|
| Hospital Charge Code |
2964695
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,078.49 |
| Max. Negotiated Rate |
$5,780.03 |
| Rate for Payer: Aetna Commercial |
$5,654.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,403.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,329.80
|
| Rate for Payer: Cash Price |
$1,812.30
|
| Rate for Payer: Cigna Commercial |
$5,780.03
|
| Rate for Payer: Health EOS Commercial |
$5,591.55
|
| Rate for Payer: HFN Commercial |
$5,780.03
|
| Rate for Payer: Multiplan Commercial |
$5,026.11
|
| Rate for Payer: Preferred Network Access Commercial |
$5,780.03
|
| Rate for Payer: Quartz Beloit One Network |
$3,078.49
|
| Rate for Payer: Quartz Commercial |
$3,769.58
|
| Rate for Payer: WEA Trust Commercial |
$3,455.45
|
| Rate for Payer: WPS Commercial |
$4,653.38
|
|
|
SCREW INTERFERENCE 10 X 30MM FASTTHREAD AR-4030C-10
|
Facility
|
IP
|
$3,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5496692
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,599.63 |
| Max. Negotiated Rate |
$3,003.40 |
| Rate for Payer: Aetna Commercial |
$2,938.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,807.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,730.22
|
| Rate for Payer: Cash Price |
$941.70
|
| Rate for Payer: Cigna Commercial |
$3,003.40
|
| Rate for Payer: Health EOS Commercial |
$2,905.46
|
| Rate for Payer: HFN Commercial |
$3,003.40
|
| Rate for Payer: Multiplan Commercial |
$2,611.65
|
| Rate for Payer: Preferred Network Access Commercial |
$3,003.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,599.63
|
| Rate for Payer: Quartz Commercial |
$1,958.74
|
| Rate for Payer: WEA Trust Commercial |
$1,795.51
|
| Rate for Payer: WPS Commercial |
$2,417.97
|
|
|
SCREW INTERFERENCE 10 X 30MM FASTTHREAD AR-4030C-10
|
Facility
|
OP
|
$3,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5496692
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$914.08 |
| Max. Negotiated Rate |
$3,003.40 |
| Rate for Payer: Aetna Commercial |
$2,938.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,807.52
|
| Rate for Payer: Aetna Managed Medicare |
$914.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,121.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,632.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,566.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,730.22
|
| Rate for Payer: Cash Price |
$941.70
|
| Rate for Payer: Cigna Commercial |
$3,003.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,826.90
|
| Rate for Payer: Health EOS Commercial |
$2,905.46
|
| Rate for Payer: HFN Commercial |
$3,003.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,448.42
|
| Rate for Payer: Multiplan Commercial |
$2,611.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,958.74
|
| Rate for Payer: Preferred Network Access Commercial |
$3,003.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,599.63
|
| Rate for Payer: Quartz Commercial |
$2,121.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,958.74
|
| Rate for Payer: The Alliance Commercial |
$1,632.28
|
| Rate for Payer: WEA Trust Commercial |
$1,795.51
|
| Rate for Payer: WPS Commercial |
$2,417.97
|
|
|
SCREW INTERFERENCE 7 X 20MM BC VENTED AR-4020C-07
|
Facility
|
IP
|
$3,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,599.63 |
| Max. Negotiated Rate |
$3,003.40 |
| Rate for Payer: Aetna Commercial |
$2,938.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,807.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,730.22
|
| Rate for Payer: Cash Price |
$941.70
|
| Rate for Payer: Cigna Commercial |
$3,003.40
|
| Rate for Payer: Health EOS Commercial |
$2,905.46
|
| Rate for Payer: HFN Commercial |
$3,003.40
|
| Rate for Payer: Multiplan Commercial |
$2,611.65
|
| Rate for Payer: Preferred Network Access Commercial |
$3,003.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,599.63
|
| Rate for Payer: Quartz Commercial |
$1,958.74
|
| Rate for Payer: WEA Trust Commercial |
$1,795.51
|
| Rate for Payer: WPS Commercial |
$2,417.97
|
|
|
SCREW INTERFERENCE 7 X 20MM BC VENTED AR-4020C-07
|
Facility
|
OP
|
$3,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$914.08 |
| Max. Negotiated Rate |
$3,003.40 |
| Rate for Payer: Aetna Commercial |
$2,938.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,807.52
|
| Rate for Payer: Aetna Managed Medicare |
$914.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,121.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,632.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,566.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,730.22
|
| Rate for Payer: Cash Price |
$941.70
|
| Rate for Payer: Cigna Commercial |
$3,003.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,826.90
|
| Rate for Payer: Health EOS Commercial |
$2,905.46
|
| Rate for Payer: HFN Commercial |
$3,003.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,448.42
|
| Rate for Payer: Multiplan Commercial |
$2,611.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,958.74
|
| Rate for Payer: Preferred Network Access Commercial |
$3,003.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,599.63
|
| Rate for Payer: Quartz Commercial |
$2,121.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,958.74
|
| Rate for Payer: The Alliance Commercial |
$1,632.28
|
| Rate for Payer: WEA Trust Commercial |
$1,795.51
|
| Rate for Payer: WPS Commercial |
$2,417.97
|
|
|
SCREW INTERFERENCE 7 X 30MM BC VENTED AR-4030C-07
|
Facility
|
OP
|
$3,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$914.08 |
| Max. Negotiated Rate |
$3,003.40 |
| Rate for Payer: Aetna Commercial |
$2,938.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,807.52
|
| Rate for Payer: Aetna Managed Medicare |
$914.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,121.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,632.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,566.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,730.22
|
| Rate for Payer: Cash Price |
$941.70
|
| Rate for Payer: Cigna Commercial |
$3,003.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,826.90
|
| Rate for Payer: Health EOS Commercial |
$2,905.46
|
| Rate for Payer: HFN Commercial |
$3,003.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,448.42
|
| Rate for Payer: Multiplan Commercial |
$2,611.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,958.74
|
| Rate for Payer: Preferred Network Access Commercial |
$3,003.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,599.63
|
| Rate for Payer: Quartz Commercial |
$2,121.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,958.74
|
| Rate for Payer: The Alliance Commercial |
$1,632.28
|
| Rate for Payer: WEA Trust Commercial |
$1,795.51
|
| Rate for Payer: WPS Commercial |
$2,417.97
|
|
|
SCREW INTERFERENCE 7 X 30MM BC VENTED AR-4030C-07
|
Facility
|
IP
|
$3,139.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,599.63 |
| Max. Negotiated Rate |
$3,003.40 |
| Rate for Payer: Aetna Commercial |
$2,938.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,807.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,730.22
|
| Rate for Payer: Cash Price |
$941.70
|
| Rate for Payer: Cigna Commercial |
$3,003.40
|
| Rate for Payer: Health EOS Commercial |
$2,905.46
|
| Rate for Payer: HFN Commercial |
$3,003.40
|
| Rate for Payer: Multiplan Commercial |
$2,611.65
|
| Rate for Payer: Preferred Network Access Commercial |
$3,003.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,599.63
|
| Rate for Payer: Quartz Commercial |
$1,958.74
|
| Rate for Payer: WEA Trust Commercial |
$1,795.51
|
| Rate for Payer: WPS Commercial |
$2,417.97
|
|
