|
SCREW CORT LOW PROFILE 3.5 X 50 02.206.250
|
Facility
|
OP
|
$519.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3259479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.32 |
| Max. Negotiated Rate |
$2,076.00 |
| Rate for Payer: Aetna Commercial |
$467.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$446.34
|
| Rate for Payer: Aetna Managed Medicare |
$145.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$337.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$259.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$249.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$275.07
|
| Rate for Payer: Cash Price |
$155.70
|
| Rate for Payer: Cigna Commercial |
$477.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$290.43
|
| Rate for Payer: Health EOS Commercial |
$461.91
|
| Rate for Payer: HFN Commercial |
$477.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$389.25
|
| Rate for Payer: Multiplan Commercial |
$415.20
|
| Rate for Payer: NAPHCARE Commercial |
$311.40
|
| Rate for Payer: Preferred Network Access Commercial |
$477.48
|
| Rate for Payer: Quartz Beloit One Network |
$254.31
|
| Rate for Payer: Quartz Commercial |
$337.35
|
| Rate for Payer: Quartz Medicare Advantage |
$311.40
|
| Rate for Payer: The Alliance Commercial |
$2,076.00
|
| Rate for Payer: WEA Trust Commercial |
$285.45
|
| Rate for Payer: WPS Commercial |
$384.42
|
|
|
SCREW CORT LOW PROFILE 3.5 X 50 02.206.250
|
Facility
|
IP
|
$519.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3259479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$254.31 |
| Max. Negotiated Rate |
$477.48 |
| Rate for Payer: Aetna Commercial |
$467.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$446.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$275.07
|
| Rate for Payer: Cash Price |
$155.70
|
| Rate for Payer: Cigna Commercial |
$477.48
|
| Rate for Payer: Health EOS Commercial |
$461.91
|
| Rate for Payer: HFN Commercial |
$477.48
|
| Rate for Payer: Multiplan Commercial |
$415.20
|
| Rate for Payer: NAPHCARE Commercial |
$311.40
|
| Rate for Payer: Preferred Network Access Commercial |
$477.48
|
| Rate for Payer: Quartz Beloit One Network |
$254.31
|
| Rate for Payer: Quartz Commercial |
$311.40
|
| Rate for Payer: WEA Trust Commercial |
$285.45
|
| Rate for Payer: WPS Commercial |
$384.42
|
|
|
SCREW CORT PELVIC 3.5 X 65 204.665
|
Facility
|
OP
|
$452.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.56 |
| Max. Negotiated Rate |
$1,808.00 |
| Rate for Payer: Aetna Commercial |
$406.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$388.72
|
| Rate for Payer: Aetna Managed Medicare |
$126.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$293.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$226.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$216.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$239.56
|
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Cigna Commercial |
$415.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$252.94
|
| Rate for Payer: Health EOS Commercial |
$402.28
|
| Rate for Payer: HFN Commercial |
$415.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$339.00
|
| Rate for Payer: Multiplan Commercial |
$361.60
|
| Rate for Payer: NAPHCARE Commercial |
$271.20
|
| Rate for Payer: Preferred Network Access Commercial |
$415.84
|
| Rate for Payer: Quartz Beloit One Network |
$221.48
|
| Rate for Payer: Quartz Commercial |
$293.80
|
| Rate for Payer: Quartz Medicare Advantage |
$271.20
|
| Rate for Payer: The Alliance Commercial |
$1,808.00
|
| Rate for Payer: WEA Trust Commercial |
$248.60
|
| Rate for Payer: WPS Commercial |
$334.80
|
|
|
SCREW CORT PELVIC 3.5 X 65 204.665
|
Facility
|
IP
|
$452.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.48 |
| Max. Negotiated Rate |
$415.84 |
| Rate for Payer: Aetna Commercial |
$406.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$388.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$239.56
|
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Cigna Commercial |
$415.84
|
| Rate for Payer: Health EOS Commercial |
$402.28
|
| Rate for Payer: HFN Commercial |
$415.84
|
| Rate for Payer: Multiplan Commercial |
$361.60
|
| Rate for Payer: NAPHCARE Commercial |
$271.20
|
| Rate for Payer: Preferred Network Access Commercial |
$415.84
|
| Rate for Payer: Quartz Beloit One Network |
$221.48
|
| Rate for Payer: Quartz Commercial |
$271.20
|
| Rate for Payer: WEA Trust Commercial |
$248.60
|
| Rate for Payer: WPS Commercial |
$334.80
|
|
|
SCREW CP 4.1MM X 30MM T10 626830
|
Facility
|
IP
|
$3,372.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,652.28 |
| Max. Negotiated Rate |
$3,102.24 |
| Rate for Payer: Aetna Commercial |
$3,034.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,899.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,787.16
|
| Rate for Payer: Cash Price |
$1,011.60
|
| Rate for Payer: Cigna Commercial |
$3,102.24
|
| Rate for Payer: Health EOS Commercial |
$3,001.08
|
| Rate for Payer: HFN Commercial |
$3,102.24
|
| Rate for Payer: Multiplan Commercial |
$2,697.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,023.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,102.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,652.28
|
| Rate for Payer: Quartz Commercial |
$2,023.20
|
| Rate for Payer: WEA Trust Commercial |
$1,854.60
|
| Rate for Payer: WPS Commercial |
$2,497.64
|
|
|
SCREW CP 4.1MM X 30MM T10 626830
|
Facility
|
OP
|
$3,372.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$944.16 |
| Max. Negotiated Rate |
$13,488.00 |
| Rate for Payer: Aetna Commercial |
$3,034.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,899.92
|
| Rate for Payer: Aetna Managed Medicare |
$944.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,191.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,686.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,618.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,787.16
|
| Rate for Payer: Cash Price |
$1,011.60
|
| Rate for Payer: Cigna Commercial |
$3,102.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,886.97
|
| Rate for Payer: Health EOS Commercial |
$3,001.08
|
| Rate for Payer: HFN Commercial |
$3,102.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,529.00
|
| Rate for Payer: Multiplan Commercial |
$2,697.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,023.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,102.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,652.28
|
| Rate for Payer: Quartz Commercial |
$2,191.80
|
| Rate for Payer: Quartz Medicare Advantage |
$2,023.20
|
| Rate for Payer: The Alliance Commercial |
$13,488.00
|
| Rate for Payer: WEA Trust Commercial |
$1,854.60
|
| Rate for Payer: WPS Commercial |
$2,497.64
|
|
|
SCREW CP 4.1MM X 32MM T10 626832
|
Facility
|
OP
|
$3,372.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$944.16 |
| Max. Negotiated Rate |
$13,488.00 |
| Rate for Payer: Aetna Commercial |
$3,034.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,899.92
|
| Rate for Payer: Aetna Managed Medicare |
$944.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,191.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,686.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,618.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,787.16
|
| Rate for Payer: Cash Price |
$1,011.60
|
| Rate for Payer: Cigna Commercial |
$3,102.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,886.97
|
| Rate for Payer: Health EOS Commercial |
$3,001.08
|
| Rate for Payer: HFN Commercial |
$3,102.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,529.00
|
| Rate for Payer: Multiplan Commercial |
$2,697.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,023.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,102.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,652.28
|
| Rate for Payer: Quartz Commercial |
$2,191.80
|
| Rate for Payer: Quartz Medicare Advantage |
$2,023.20
|
| Rate for Payer: The Alliance Commercial |
$13,488.00
|
| Rate for Payer: WEA Trust Commercial |
$1,854.60
|
| Rate for Payer: WPS Commercial |
$2,497.64
|
|
|
SCREW CP 4.1MM X 32MM T10 626832
|
Facility
|
IP
|
$3,372.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,652.28 |
| Max. Negotiated Rate |
$3,102.24 |
| Rate for Payer: Aetna Commercial |
$3,034.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,899.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,787.16
|
| Rate for Payer: Cash Price |
$1,011.60
|
| Rate for Payer: Cigna Commercial |
$3,102.24
|
| Rate for Payer: Health EOS Commercial |
$3,001.08
|
| Rate for Payer: HFN Commercial |
$3,102.24
|
| Rate for Payer: Multiplan Commercial |
$2,697.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,023.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,102.24
|
| Rate for Payer: Quartz Beloit One Network |
$1,652.28
|
| Rate for Payer: Quartz Commercial |
$2,023.20
|
| Rate for Payer: WEA Trust Commercial |
$1,854.60
|
| Rate for Payer: WPS Commercial |
$2,497.64
|
|
|
SCREWDRIVER CANN 2.0MM AO 45-20001S
|
Facility
|
OP
|
$1,555.00
|
|
| Hospital Charge Code |
6171706
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.40 |
| Max. Negotiated Rate |
$6,220.00 |
| Rate for Payer: Aetna Commercial |
$1,399.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,337.30
|
| Rate for Payer: Aetna Managed Medicare |
$435.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,010.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$777.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$746.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$824.15
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Cigna Commercial |
$1,430.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$870.18
|
| Rate for Payer: Health EOS Commercial |
$1,383.95
|
| Rate for Payer: HFN Commercial |
$1,430.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,166.25
|
| Rate for Payer: Multiplan Commercial |
$1,244.00
|
| Rate for Payer: NAPHCARE Commercial |
$933.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,430.60
|
| Rate for Payer: Quartz Beloit One Network |
$761.95
|
| Rate for Payer: Quartz Commercial |
$1,010.75
|
| Rate for Payer: Quartz Medicare Advantage |
$933.00
|
| Rate for Payer: The Alliance Commercial |
$6,220.00
|
| Rate for Payer: WEA Trust Commercial |
$855.25
|
| Rate for Payer: WPS Commercial |
$1,151.79
|
|
|
SCREWDRIVER CANN 2.0MM AO 45-20001S
|
Facility
|
IP
|
$1,555.00
|
|
| Hospital Charge Code |
6171706
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$761.95 |
| Max. Negotiated Rate |
$1,430.60 |
| Rate for Payer: Aetna Commercial |
$1,399.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,337.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$824.15
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Cigna Commercial |
$1,430.60
|
| Rate for Payer: Health EOS Commercial |
$1,383.95
|
| Rate for Payer: HFN Commercial |
$1,430.60
|
| Rate for Payer: Multiplan Commercial |
$1,244.00
|
| Rate for Payer: NAPHCARE Commercial |
$933.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,430.60
|
| Rate for Payer: Quartz Beloit One Network |
$761.95
|
| Rate for Payer: Quartz Commercial |
$933.00
|
| Rate for Payer: WEA Trust Commercial |
$855.25
|
| Rate for Payer: WPS Commercial |
$1,151.79
|
|
|
SCREWDRIVER SHAFT TRILLIANT 3.0/4.0 210-40-003
|
Facility
|
OP
|
$3,048.00
|
|
| Hospital Charge Code |
3241471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$853.44 |
| Max. Negotiated Rate |
$12,192.00 |
| Rate for Payer: Aetna Commercial |
$2,743.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,621.28
|
| Rate for Payer: Aetna Managed Medicare |
$853.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,981.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,524.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,463.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,615.44
|
| Rate for Payer: Cash Price |
$914.40
|
| Rate for Payer: Cigna Commercial |
$2,804.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,705.66
|
| Rate for Payer: Health EOS Commercial |
$2,712.72
|
| Rate for Payer: HFN Commercial |
$2,804.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,286.00
|
| Rate for Payer: Multiplan Commercial |
$2,438.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,828.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,804.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,493.52
|
| Rate for Payer: Quartz Commercial |
$1,981.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,828.80
|
| Rate for Payer: The Alliance Commercial |
$12,192.00
|
| Rate for Payer: WEA Trust Commercial |
$1,676.40
|
| Rate for Payer: WPS Commercial |
$2,257.65
|
|
|
SCREWDRIVER SHAFT TRILLIANT 3.0/4.0 210-40-003
|
Facility
|
IP
|
$3,048.00
|
|
| Hospital Charge Code |
3241471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,493.52 |
| Max. Negotiated Rate |
$2,804.16 |
| Rate for Payer: Aetna Commercial |
$2,743.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,621.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,615.44
|
| Rate for Payer: Cash Price |
$914.40
|
| Rate for Payer: Cigna Commercial |
$2,804.16
|
| Rate for Payer: Health EOS Commercial |
$2,712.72
|
| Rate for Payer: HFN Commercial |
$2,804.16
|
| Rate for Payer: Multiplan Commercial |
$2,438.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,828.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,804.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,493.52
|
| Rate for Payer: Quartz Commercial |
$1,828.80
|
| Rate for Payer: WEA Trust Commercial |
$1,676.40
|
| Rate for Payer: WPS Commercial |
$2,257.65
|
|
|
SCREWDRIVER SHAFT TRILLIANT 3.0/4.0 CANNULATED 210-40-003
|
Facility
|
IP
|
$2,660.00
|
|
| Hospital Charge Code |
3241470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,303.40 |
| Max. Negotiated Rate |
$2,447.20 |
| Rate for Payer: Aetna Commercial |
$2,394.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,287.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.80
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,447.20
|
| Rate for Payer: Health EOS Commercial |
$2,367.40
|
| Rate for Payer: HFN Commercial |
$2,447.20
|
| Rate for Payer: Multiplan Commercial |
$2,128.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,596.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,447.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.40
|
| Rate for Payer: Quartz Commercial |
$1,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,463.00
|
| Rate for Payer: WPS Commercial |
$1,970.26
|
|
|
SCREWDRIVER SHAFT TRILLIANT 3.0/4.0 CANNULATED 210-40-003
|
Facility
|
OP
|
$2,660.00
|
|
| Hospital Charge Code |
3241470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$744.80 |
| Max. Negotiated Rate |
$10,640.00 |
| Rate for Payer: Aetna Commercial |
$2,394.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,287.60
|
| Rate for Payer: Aetna Managed Medicare |
$744.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,729.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,330.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,276.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.80
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,447.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,488.54
|
| Rate for Payer: Health EOS Commercial |
$2,367.40
|
| Rate for Payer: HFN Commercial |
$2,447.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,995.00
|
| Rate for Payer: Multiplan Commercial |
$2,128.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,596.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,447.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.40
|
| Rate for Payer: Quartz Commercial |
$1,729.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,596.00
|
| Rate for Payer: The Alliance Commercial |
$10,640.00
|
| Rate for Payer: WEA Trust Commercial |
$1,463.00
|
| Rate for Payer: WPS Commercial |
$1,970.26
|
|
|
SCREWDRIVER SHAFT TRILLLIANT 2.0/2.4 210-24-003
|
Facility
|
OP
|
$3,166.00
|
|
| Hospital Charge Code |
3241469
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.48 |
| Max. Negotiated Rate |
$12,664.00 |
| Rate for Payer: Aetna Commercial |
$2,849.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,722.76
|
| Rate for Payer: Aetna Managed Medicare |
$886.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,057.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,583.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,519.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,677.98
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$2,912.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,771.69
|
| Rate for Payer: Health EOS Commercial |
$2,817.74
|
| Rate for Payer: HFN Commercial |
$2,912.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,374.50
|
| Rate for Payer: Multiplan Commercial |
$2,532.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,899.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,912.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,551.34
|
| Rate for Payer: Quartz Commercial |
$2,057.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,899.60
|
| Rate for Payer: The Alliance Commercial |
$12,664.00
|
| Rate for Payer: WEA Trust Commercial |
$1,741.30
|
| Rate for Payer: WPS Commercial |
$2,345.06
|
|
|
SCREWDRIVER SHAFT TRILLLIANT 2.0/2.4 210-24-003
|
Facility
|
IP
|
$3,166.00
|
|
| Hospital Charge Code |
3241469
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,551.34 |
| Max. Negotiated Rate |
$2,912.72 |
| Rate for Payer: Aetna Commercial |
$2,849.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,722.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,677.98
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cigna Commercial |
$2,912.72
|
| Rate for Payer: Health EOS Commercial |
$2,817.74
|
| Rate for Payer: HFN Commercial |
$2,912.72
|
| Rate for Payer: Multiplan Commercial |
$2,532.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,899.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,912.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,551.34
|
| Rate for Payer: Quartz Commercial |
$1,899.60
|
| Rate for Payer: WEA Trust Commercial |
$1,741.30
|
| Rate for Payer: WPS Commercial |
$2,345.06
|
|
|
SCREW FASTPITCH 2.7MM HIGH PITCH LOCKING SD21
|
Facility
|
IP
|
$5,960.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,920.40 |
| Max. Negotiated Rate |
$5,483.20 |
| Rate for Payer: Aetna Commercial |
$5,364.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,125.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,158.80
|
| Rate for Payer: Cash Price |
$1,788.00
|
| Rate for Payer: Cigna Commercial |
$5,483.20
|
| Rate for Payer: Health EOS Commercial |
$5,304.40
|
| Rate for Payer: HFN Commercial |
$5,483.20
|
| Rate for Payer: Multiplan Commercial |
$4,768.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,576.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,483.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,920.40
|
| Rate for Payer: Quartz Commercial |
$3,576.00
|
| Rate for Payer: WEA Trust Commercial |
$3,278.00
|
| Rate for Payer: WPS Commercial |
$4,414.57
|
|
|
SCREW FASTPITCH 2.7MM HIGH PITCH LOCKING SD21
|
Facility
|
OP
|
$5,960.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,668.80 |
| Max. Negotiated Rate |
$23,840.00 |
| Rate for Payer: Aetna Commercial |
$5,364.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,125.60
|
| Rate for Payer: Aetna Managed Medicare |
$1,668.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,874.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,980.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,860.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,158.80
|
| Rate for Payer: Cash Price |
$1,788.00
|
| Rate for Payer: Cigna Commercial |
$5,483.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,335.22
|
| Rate for Payer: Health EOS Commercial |
$5,304.40
|
| Rate for Payer: HFN Commercial |
$5,483.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,470.00
|
| Rate for Payer: Multiplan Commercial |
$4,768.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,576.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,483.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,920.40
|
| Rate for Payer: Quartz Commercial |
$3,874.00
|
| Rate for Payer: Quartz Medicare Advantage |
$3,576.00
|
| Rate for Payer: The Alliance Commercial |
$23,840.00
|
| Rate for Payer: WEA Trust Commercial |
$3,278.00
|
| Rate for Payer: WPS Commercial |
$4,414.57
|
|
|
SCREW FASTPITCH 2.7MM X 22MM HIGH PITCH LOCKING SD22
|
Facility
|
IP
|
$5,511.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6180092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.39 |
| Max. Negotiated Rate |
$5,070.12 |
| Rate for Payer: Aetna Commercial |
$4,959.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,739.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,920.83
|
| Rate for Payer: Cash Price |
$1,653.30
|
| Rate for Payer: Cigna Commercial |
$5,070.12
|
| Rate for Payer: Health EOS Commercial |
$4,904.79
|
| Rate for Payer: HFN Commercial |
$5,070.12
|
| Rate for Payer: Multiplan Commercial |
$4,408.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,306.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,070.12
|
| Rate for Payer: Quartz Beloit One Network |
$2,700.39
|
| Rate for Payer: Quartz Commercial |
$3,306.60
|
| Rate for Payer: WEA Trust Commercial |
$3,031.05
|
| Rate for Payer: WPS Commercial |
$4,082.00
|
|
|
SCREW FASTPITCH 2.7MM X 22MM HIGH PITCH LOCKING SD22
|
Facility
|
OP
|
$5,511.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6180092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,543.08 |
| Max. Negotiated Rate |
$22,044.00 |
| Rate for Payer: Aetna Commercial |
$4,959.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,739.46
|
| Rate for Payer: Aetna Managed Medicare |
$1,543.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,582.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,755.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,645.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,920.83
|
| Rate for Payer: Cash Price |
$1,653.30
|
| Rate for Payer: Cigna Commercial |
$5,070.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,083.96
|
| Rate for Payer: Health EOS Commercial |
$4,904.79
|
| Rate for Payer: HFN Commercial |
$5,070.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,133.25
|
| Rate for Payer: Multiplan Commercial |
$4,408.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,306.60
|
| Rate for Payer: Preferred Network Access Commercial |
$5,070.12
|
| Rate for Payer: Quartz Beloit One Network |
$2,700.39
|
| Rate for Payer: Quartz Commercial |
$3,582.15
|
| Rate for Payer: Quartz Medicare Advantage |
$3,306.60
|
| Rate for Payer: The Alliance Commercial |
$22,044.00
|
| Rate for Payer: WEA Trust Commercial |
$3,031.05
|
| Rate for Payer: WPS Commercial |
$4,082.00
|
|
|
SCREW FEMALE PERSONA 2.5MM X 25MM 42-5099-025-25
|
Facility
|
OP
|
$2,378.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3529506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.84 |
| Max. Negotiated Rate |
$9,512.00 |
| Rate for Payer: Aetna Commercial |
$2,140.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,045.08
|
| Rate for Payer: Aetna Managed Medicare |
$665.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,545.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,189.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,141.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,260.34
|
| Rate for Payer: Cash Price |
$713.40
|
| Rate for Payer: Cigna Commercial |
$2,187.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,330.73
|
| Rate for Payer: Health EOS Commercial |
$2,116.42
|
| Rate for Payer: HFN Commercial |
$2,187.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,783.50
|
| Rate for Payer: Multiplan Commercial |
$1,902.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,426.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,187.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,165.22
|
| Rate for Payer: Quartz Commercial |
$1,545.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,426.80
|
| Rate for Payer: The Alliance Commercial |
$9,512.00
|
| Rate for Payer: WEA Trust Commercial |
$1,307.90
|
| Rate for Payer: WPS Commercial |
$1,761.38
|
|
|
SCREW FEMALE PERSONA 2.5MM X 25MM 42-5099-025-25
|
Facility
|
IP
|
$2,378.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3529506
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,165.22 |
| Max. Negotiated Rate |
$2,187.76 |
| Rate for Payer: Aetna Commercial |
$2,140.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,045.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,260.34
|
| Rate for Payer: Cash Price |
$713.40
|
| Rate for Payer: Cigna Commercial |
$2,187.76
|
| Rate for Payer: Health EOS Commercial |
$2,116.42
|
| Rate for Payer: HFN Commercial |
$2,187.76
|
| Rate for Payer: Multiplan Commercial |
$1,902.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,426.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,187.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,165.22
|
| Rate for Payer: Quartz Commercial |
$1,426.80
|
| Rate for Payer: WEA Trust Commercial |
$1,307.90
|
| Rate for Payer: WPS Commercial |
$1,761.38
|
|
|
SCREW FEMALE PERSONA 2.5MM X 48MM 42-5099-025-48
|
Facility
|
IP
|
$2,289.00
|
|
| Hospital Charge Code |
3529507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,121.61 |
| Max. Negotiated Rate |
$2,105.88 |
| Rate for Payer: Aetna Commercial |
$2,060.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,968.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,213.17
|
| Rate for Payer: Cash Price |
$686.70
|
| Rate for Payer: Cigna Commercial |
$2,105.88
|
| Rate for Payer: Health EOS Commercial |
$2,037.21
|
| Rate for Payer: HFN Commercial |
$2,105.88
|
| Rate for Payer: Multiplan Commercial |
$1,831.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,373.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,105.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,121.61
|
| Rate for Payer: Quartz Commercial |
$1,373.40
|
| Rate for Payer: WEA Trust Commercial |
$1,258.95
|
| Rate for Payer: WPS Commercial |
$1,695.46
|
|
|
SCREW FEMALE PERSONA 2.5MM X 48MM 42-5099-025-48
|
Facility
|
OP
|
$2,289.00
|
|
| Hospital Charge Code |
3529507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$640.92 |
| Max. Negotiated Rate |
$9,156.00 |
| Rate for Payer: Aetna Commercial |
$2,060.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,968.54
|
| Rate for Payer: Aetna Managed Medicare |
$640.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,487.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,144.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,098.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,213.17
|
| Rate for Payer: Cash Price |
$686.70
|
| Rate for Payer: Cigna Commercial |
$2,105.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,280.92
|
| Rate for Payer: Health EOS Commercial |
$2,037.21
|
| Rate for Payer: HFN Commercial |
$2,105.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,716.75
|
| Rate for Payer: Multiplan Commercial |
$1,831.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,373.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,105.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,121.61
|
| Rate for Payer: Quartz Commercial |
$1,487.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,373.40
|
| Rate for Payer: The Alliance Commercial |
$9,156.00
|
| Rate for Payer: WEA Trust Commercial |
$1,258.95
|
| Rate for Payer: WPS Commercial |
$1,695.46
|
|
|
SCREW FIXED LOCKING COMPREHENSIVE REVERSE SHOULDER 4.75MM X 15MM X 3.5MM HEX 180550
|
Facility
|
OP
|
$1,113.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.64 |
| Max. Negotiated Rate |
$4,452.00 |
| Rate for Payer: Aetna Commercial |
$1,001.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$957.18
|
| Rate for Payer: Aetna Managed Medicare |
$311.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$723.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$556.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$534.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$589.89
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cigna Commercial |
$1,023.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$622.83
|
| Rate for Payer: Health EOS Commercial |
$990.57
|
| Rate for Payer: HFN Commercial |
$1,023.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$834.75
|
| Rate for Payer: Multiplan Commercial |
$890.40
|
| Rate for Payer: NAPHCARE Commercial |
$667.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,023.96
|
| Rate for Payer: Quartz Beloit One Network |
$545.37
|
| Rate for Payer: Quartz Commercial |
$723.45
|
| Rate for Payer: Quartz Medicare Advantage |
$667.80
|
| Rate for Payer: The Alliance Commercial |
$4,452.00
|
| Rate for Payer: WEA Trust Commercial |
$612.15
|
| Rate for Payer: WPS Commercial |
$824.40
|
|
