|
SCREW LAG GAMMA4 10.5 X 85MM 8160-0085S
|
Facility
|
IP
|
$3,862.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6181747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,968.08 |
| Max. Negotiated Rate |
$3,695.16 |
| Rate for Payer: Aetna Commercial |
$3,614.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,454.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,128.73
|
| Rate for Payer: Cash Price |
$1,158.60
|
| Rate for Payer: Cigna Commercial |
$3,695.16
|
| Rate for Payer: Health EOS Commercial |
$3,574.67
|
| Rate for Payer: HFN Commercial |
$3,695.16
|
| Rate for Payer: Multiplan Commercial |
$3,213.18
|
| Rate for Payer: Preferred Network Access Commercial |
$3,695.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,968.08
|
| Rate for Payer: Quartz Commercial |
$2,409.89
|
| Rate for Payer: WEA Trust Commercial |
$2,209.06
|
| Rate for Payer: WPS Commercial |
$2,974.90
|
|
|
SCREW LAG GAMMA4 10.5 X 85MM 8160-0085S
|
Facility
|
OP
|
$3,862.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6181747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,124.61 |
| Max. Negotiated Rate |
$3,695.16 |
| Rate for Payer: Aetna Commercial |
$3,614.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,454.17
|
| Rate for Payer: Aetna Managed Medicare |
$1,124.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,610.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,008.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,927.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,128.73
|
| Rate for Payer: Cash Price |
$1,158.60
|
| Rate for Payer: Cigna Commercial |
$3,695.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,247.68
|
| Rate for Payer: Health EOS Commercial |
$3,574.67
|
| Rate for Payer: HFN Commercial |
$3,695.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,012.36
|
| Rate for Payer: Multiplan Commercial |
$3,213.18
|
| Rate for Payer: NAPHCARE Commercial |
$2,409.89
|
| Rate for Payer: Preferred Network Access Commercial |
$3,695.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,968.08
|
| Rate for Payer: Quartz Commercial |
$2,610.71
|
| Rate for Payer: Quartz Medicare Advantage |
$2,409.89
|
| Rate for Payer: The Alliance Commercial |
$2,008.24
|
| Rate for Payer: WEA Trust Commercial |
$2,209.06
|
| Rate for Payer: WPS Commercial |
$2,974.90
|
|
|
SCREW LAG TELESCOPING 10.5MM X 100MM 1099-100
|
Facility
|
IP
|
$6,666.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6232140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,396.99 |
| Max. Negotiated Rate |
$6,378.03 |
| Rate for Payer: Aetna Commercial |
$6,239.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,962.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,674.30
|
| Rate for Payer: Cash Price |
$1,999.80
|
| Rate for Payer: Cigna Commercial |
$6,378.03
|
| Rate for Payer: Health EOS Commercial |
$6,170.05
|
| Rate for Payer: HFN Commercial |
$6,378.03
|
| Rate for Payer: Multiplan Commercial |
$5,546.11
|
| Rate for Payer: Preferred Network Access Commercial |
$6,378.03
|
| Rate for Payer: Quartz Beloit One Network |
$3,396.99
|
| Rate for Payer: Quartz Commercial |
$4,159.58
|
| Rate for Payer: WEA Trust Commercial |
$3,812.95
|
| Rate for Payer: WPS Commercial |
$5,134.82
|
|
|
SCREW LAG TELESCOPING 10.5MM X 100MM 1099-100
|
Facility
|
OP
|
$6,666.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6232140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,941.14 |
| Max. Negotiated Rate |
$6,378.03 |
| Rate for Payer: Aetna Commercial |
$6,239.38
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,962.07
|
| Rate for Payer: Aetna Managed Medicare |
$1,941.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,506.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,466.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,327.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,674.30
|
| Rate for Payer: Cash Price |
$1,999.80
|
| Rate for Payer: Cigna Commercial |
$6,378.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,879.61
|
| Rate for Payer: Health EOS Commercial |
$6,170.05
|
| Rate for Payer: HFN Commercial |
$6,378.03
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,199.48
|
| Rate for Payer: Multiplan Commercial |
$5,546.11
|
| Rate for Payer: NAPHCARE Commercial |
$4,159.58
|
| Rate for Payer: Preferred Network Access Commercial |
$6,378.03
|
| Rate for Payer: Quartz Beloit One Network |
$3,396.99
|
| Rate for Payer: Quartz Commercial |
$4,506.22
|
| Rate for Payer: Quartz Medicare Advantage |
$4,159.58
|
| Rate for Payer: The Alliance Commercial |
$3,466.32
|
| Rate for Payer: WEA Trust Commercial |
$3,812.95
|
| Rate for Payer: WPS Commercial |
$5,134.82
|
|
|
SCREW LAG TELESCOPING 10.5MM X 95MM 1099-095
|
Facility
|
OP
|
$6,665.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6234133
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,940.85 |
| Max. Negotiated Rate |
$6,377.07 |
| Rate for Payer: Aetna Commercial |
$6,238.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,961.18
|
| Rate for Payer: Aetna Managed Medicare |
$1,940.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,505.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,465.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,327.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,673.75
|
| Rate for Payer: Cash Price |
$1,999.50
|
| Rate for Payer: Cigna Commercial |
$6,377.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,879.03
|
| Rate for Payer: Health EOS Commercial |
$6,169.12
|
| Rate for Payer: HFN Commercial |
$6,377.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,198.70
|
| Rate for Payer: Multiplan Commercial |
$5,545.28
|
| Rate for Payer: NAPHCARE Commercial |
$4,158.96
|
| Rate for Payer: Preferred Network Access Commercial |
$6,377.07
|
| Rate for Payer: Quartz Beloit One Network |
$3,396.48
|
| Rate for Payer: Quartz Commercial |
$4,505.54
|
| Rate for Payer: Quartz Medicare Advantage |
$4,158.96
|
| Rate for Payer: The Alliance Commercial |
$3,465.80
|
| Rate for Payer: WEA Trust Commercial |
$3,812.38
|
| Rate for Payer: WPS Commercial |
$5,134.05
|
|
|
SCREW LAG TELESCOPING 10.5MM X 95MM 1099-095
|
Facility
|
IP
|
$6,665.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
6234133
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,396.48 |
| Max. Negotiated Rate |
$6,377.07 |
| Rate for Payer: Aetna Commercial |
$6,238.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,961.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,673.75
|
| Rate for Payer: Cash Price |
$1,999.50
|
| Rate for Payer: Cigna Commercial |
$6,377.07
|
| Rate for Payer: Health EOS Commercial |
$6,169.12
|
| Rate for Payer: HFN Commercial |
$6,377.07
|
| Rate for Payer: Multiplan Commercial |
$5,545.28
|
| Rate for Payer: Preferred Network Access Commercial |
$6,377.07
|
| Rate for Payer: Quartz Beloit One Network |
$3,396.48
|
| Rate for Payer: Quartz Commercial |
$4,158.96
|
| Rate for Payer: WEA Trust Commercial |
$3,812.38
|
| Rate for Payer: WPS Commercial |
$5,134.05
|
|
|
SCREW LOCK 1.5 X 10MM 02.214.010
|
Facility
|
IP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.11 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,047.07
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 10MM 02.214.010
|
Facility
|
OP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$488.63 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Aetna Managed Medicare |
$488.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,134.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$872.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$837.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$976.60
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,308.84
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,134.33
|
| Rate for Payer: Quartz Medicare Advantage |
$1,047.07
|
| Rate for Payer: The Alliance Commercial |
$872.56
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 11MM 02.214.008
|
Facility
|
IP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.11 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,047.07
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 11MM 02.214.008
|
Facility
|
OP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$488.63 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Aetna Managed Medicare |
$488.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,134.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$872.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$837.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$976.60
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,308.84
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,134.33
|
| Rate for Payer: Quartz Medicare Advantage |
$1,047.07
|
| Rate for Payer: The Alliance Commercial |
$872.56
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 12MM 02.214.012
|
Facility
|
IP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966409
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.11 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,047.07
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 12MM 02.214.012
|
Facility
|
OP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966409
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$488.63 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Aetna Managed Medicare |
$488.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,134.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$872.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$837.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$976.60
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,308.84
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,134.33
|
| Rate for Payer: Quartz Medicare Advantage |
$1,047.07
|
| Rate for Payer: The Alliance Commercial |
$872.56
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 13MM 02.214.013
|
Facility
|
OP
|
$1,812.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.65 |
| Max. Negotiated Rate |
$1,733.72 |
| Rate for Payer: Aetna Commercial |
$1,696.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,620.65
|
| Rate for Payer: Aetna Managed Medicare |
$527.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,224.91
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$942.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$904.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$998.77
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cigna Commercial |
$1,733.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,054.58
|
| Rate for Payer: Health EOS Commercial |
$1,677.19
|
| Rate for Payer: HFN Commercial |
$1,733.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,413.36
|
| Rate for Payer: Multiplan Commercial |
$1,507.58
|
| Rate for Payer: NAPHCARE Commercial |
$1,130.69
|
| Rate for Payer: Preferred Network Access Commercial |
$1,733.72
|
| Rate for Payer: Quartz Beloit One Network |
$923.40
|
| Rate for Payer: Quartz Commercial |
$1,224.91
|
| Rate for Payer: Quartz Medicare Advantage |
$1,130.69
|
| Rate for Payer: The Alliance Commercial |
$942.24
|
| Rate for Payer: WEA Trust Commercial |
$1,036.46
|
| Rate for Payer: WPS Commercial |
$1,395.78
|
|
|
SCREW LOCK 1.5 X 13MM 02.214.013
|
Facility
|
IP
|
$1,812.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$923.40 |
| Max. Negotiated Rate |
$1,733.72 |
| Rate for Payer: Aetna Commercial |
$1,696.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,620.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$998.77
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cigna Commercial |
$1,733.72
|
| Rate for Payer: Health EOS Commercial |
$1,677.19
|
| Rate for Payer: HFN Commercial |
$1,733.72
|
| Rate for Payer: Multiplan Commercial |
$1,507.58
|
| Rate for Payer: Preferred Network Access Commercial |
$1,733.72
|
| Rate for Payer: Quartz Beloit One Network |
$923.40
|
| Rate for Payer: Quartz Commercial |
$1,130.69
|
| Rate for Payer: WEA Trust Commercial |
$1,036.46
|
| Rate for Payer: WPS Commercial |
$1,395.78
|
|
|
SCREW LOCK 1.5 X 14MM 02.214.014
|
Facility
|
IP
|
$1,812.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$923.40 |
| Max. Negotiated Rate |
$1,733.72 |
| Rate for Payer: Aetna Commercial |
$1,696.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,620.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$998.77
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cigna Commercial |
$1,733.72
|
| Rate for Payer: Health EOS Commercial |
$1,677.19
|
| Rate for Payer: HFN Commercial |
$1,733.72
|
| Rate for Payer: Multiplan Commercial |
$1,507.58
|
| Rate for Payer: Preferred Network Access Commercial |
$1,733.72
|
| Rate for Payer: Quartz Beloit One Network |
$923.40
|
| Rate for Payer: Quartz Commercial |
$1,130.69
|
| Rate for Payer: WEA Trust Commercial |
$1,036.46
|
| Rate for Payer: WPS Commercial |
$1,395.78
|
|
|
SCREW LOCK 1.5 X 14MM 02.214.014
|
Facility
|
OP
|
$1,812.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.65 |
| Max. Negotiated Rate |
$1,733.72 |
| Rate for Payer: Aetna Commercial |
$1,696.03
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,620.65
|
| Rate for Payer: Aetna Managed Medicare |
$527.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,224.91
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$942.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$904.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$998.77
|
| Rate for Payer: Cash Price |
$543.60
|
| Rate for Payer: Cigna Commercial |
$1,733.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,054.58
|
| Rate for Payer: Health EOS Commercial |
$1,677.19
|
| Rate for Payer: HFN Commercial |
$1,733.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,413.36
|
| Rate for Payer: Multiplan Commercial |
$1,507.58
|
| Rate for Payer: NAPHCARE Commercial |
$1,130.69
|
| Rate for Payer: Preferred Network Access Commercial |
$1,733.72
|
| Rate for Payer: Quartz Beloit One Network |
$923.40
|
| Rate for Payer: Quartz Commercial |
$1,224.91
|
| Rate for Payer: Quartz Medicare Advantage |
$1,130.69
|
| Rate for Payer: The Alliance Commercial |
$942.24
|
| Rate for Payer: WEA Trust Commercial |
$1,036.46
|
| Rate for Payer: WPS Commercial |
$1,395.78
|
|
|
SCREW LOCK 1.5 X 16MM 02.214.016
|
Facility
|
IP
|
$1,826.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966417
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$930.53 |
| Max. Negotiated Rate |
$1,747.12 |
| Rate for Payer: Aetna Commercial |
$1,709.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,633.17
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,006.49
|
| Rate for Payer: Cash Price |
$547.80
|
| Rate for Payer: Cigna Commercial |
$1,747.12
|
| Rate for Payer: Health EOS Commercial |
$1,690.15
|
| Rate for Payer: HFN Commercial |
$1,747.12
|
| Rate for Payer: Multiplan Commercial |
$1,519.23
|
| Rate for Payer: Preferred Network Access Commercial |
$1,747.12
|
| Rate for Payer: Quartz Beloit One Network |
$930.53
|
| Rate for Payer: Quartz Commercial |
$1,139.42
|
| Rate for Payer: WEA Trust Commercial |
$1,044.47
|
| Rate for Payer: WPS Commercial |
$1,406.57
|
|
|
SCREW LOCK 1.5 X 16MM 02.214.016
|
Facility
|
OP
|
$1,826.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966417
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$531.73 |
| Max. Negotiated Rate |
$1,747.12 |
| Rate for Payer: Aetna Commercial |
$1,709.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,633.17
|
| Rate for Payer: Aetna Managed Medicare |
$531.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,234.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$949.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$911.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,006.49
|
| Rate for Payer: Cash Price |
$547.80
|
| Rate for Payer: Cigna Commercial |
$1,747.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,062.73
|
| Rate for Payer: Health EOS Commercial |
$1,690.15
|
| Rate for Payer: HFN Commercial |
$1,747.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,424.28
|
| Rate for Payer: Multiplan Commercial |
$1,519.23
|
| Rate for Payer: NAPHCARE Commercial |
$1,139.42
|
| Rate for Payer: Preferred Network Access Commercial |
$1,747.12
|
| Rate for Payer: Quartz Beloit One Network |
$930.53
|
| Rate for Payer: Quartz Commercial |
$1,234.38
|
| Rate for Payer: Quartz Medicare Advantage |
$1,139.42
|
| Rate for Payer: The Alliance Commercial |
$949.52
|
| Rate for Payer: WEA Trust Commercial |
$1,044.47
|
| Rate for Payer: WPS Commercial |
$1,406.57
|
|
|
SCREW LOCK 1.5 X 8MM 02.214.008
|
Facility
|
OP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$488.63 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Aetna Managed Medicare |
$488.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,134.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$872.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$837.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$976.60
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,308.84
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,134.33
|
| Rate for Payer: Quartz Medicare Advantage |
$1,047.07
|
| Rate for Payer: The Alliance Commercial |
$872.56
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 8MM 02.214.008
|
Facility
|
IP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.11 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,047.07
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 9MM 02.214.009
|
Facility
|
IP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.11 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,047.07
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 1.5 X 9MM 02.214.009
|
Facility
|
OP
|
$1,678.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$488.63 |
| Max. Negotiated Rate |
$1,605.51 |
| Rate for Payer: Aetna Commercial |
$1,570.61
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,500.80
|
| Rate for Payer: Aetna Managed Medicare |
$488.63
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,134.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$872.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$837.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$924.91
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$1,605.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$976.60
|
| Rate for Payer: Health EOS Commercial |
$1,553.16
|
| Rate for Payer: HFN Commercial |
$1,605.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,308.84
|
| Rate for Payer: Multiplan Commercial |
$1,396.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.07
|
| Rate for Payer: Preferred Network Access Commercial |
$1,605.51
|
| Rate for Payer: Quartz Beloit One Network |
$855.11
|
| Rate for Payer: Quartz Commercial |
$1,134.33
|
| Rate for Payer: Quartz Medicare Advantage |
$1,047.07
|
| Rate for Payer: The Alliance Commercial |
$872.56
|
| Rate for Payer: WEA Trust Commercial |
$959.82
|
| Rate for Payer: WPS Commercial |
$1,292.56
|
|
|
SCREW LOCK 2.0MM X 10MM STARDRIVE 201.880
|
Facility
|
IP
|
$1,759.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$896.39 |
| Max. Negotiated Rate |
$1,683.01 |
| Rate for Payer: Aetna Commercial |
$1,646.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,573.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$969.56
|
| Rate for Payer: Cash Price |
$527.70
|
| Rate for Payer: Cigna Commercial |
$1,683.01
|
| Rate for Payer: Health EOS Commercial |
$1,628.13
|
| Rate for Payer: HFN Commercial |
$1,683.01
|
| Rate for Payer: Multiplan Commercial |
$1,463.49
|
| Rate for Payer: Preferred Network Access Commercial |
$1,683.01
|
| Rate for Payer: Quartz Beloit One Network |
$896.39
|
| Rate for Payer: Quartz Commercial |
$1,097.62
|
| Rate for Payer: WEA Trust Commercial |
$1,006.15
|
| Rate for Payer: WPS Commercial |
$1,354.96
|
|
|
SCREW LOCK 2.0MM X 10MM STARDRIVE 201.880
|
Facility
|
OP
|
$1,759.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966426
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$512.22 |
| Max. Negotiated Rate |
$1,683.01 |
| Rate for Payer: Aetna Commercial |
$1,646.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,573.25
|
| Rate for Payer: Aetna Managed Medicare |
$512.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,189.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$914.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$878.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$969.56
|
| Rate for Payer: Cash Price |
$527.70
|
| Rate for Payer: Cigna Commercial |
$1,683.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,023.74
|
| Rate for Payer: Health EOS Commercial |
$1,628.13
|
| Rate for Payer: HFN Commercial |
$1,683.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,372.02
|
| Rate for Payer: Multiplan Commercial |
$1,463.49
|
| Rate for Payer: NAPHCARE Commercial |
$1,097.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,683.01
|
| Rate for Payer: Quartz Beloit One Network |
$896.39
|
| Rate for Payer: Quartz Commercial |
$1,189.08
|
| Rate for Payer: Quartz Medicare Advantage |
$1,097.62
|
| Rate for Payer: The Alliance Commercial |
$914.68
|
| Rate for Payer: WEA Trust Commercial |
$1,006.15
|
| Rate for Payer: WPS Commercial |
$1,354.96
|
|
|
SCREW LOCK 2.0MM X 12MM STARDRIVE 201.882
|
Facility
|
OP
|
$1,759.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966431
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$512.22 |
| Max. Negotiated Rate |
$1,683.01 |
| Rate for Payer: Aetna Commercial |
$1,646.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,573.25
|
| Rate for Payer: Aetna Managed Medicare |
$512.22
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,189.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$914.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$878.09
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$969.56
|
| Rate for Payer: Cash Price |
$527.70
|
| Rate for Payer: Cigna Commercial |
$1,683.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,023.74
|
| Rate for Payer: Health EOS Commercial |
$1,628.13
|
| Rate for Payer: HFN Commercial |
$1,683.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,372.02
|
| Rate for Payer: Multiplan Commercial |
$1,463.49
|
| Rate for Payer: NAPHCARE Commercial |
$1,097.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,683.01
|
| Rate for Payer: Quartz Beloit One Network |
$896.39
|
| Rate for Payer: Quartz Commercial |
$1,189.08
|
| Rate for Payer: Quartz Medicare Advantage |
$1,097.62
|
| Rate for Payer: The Alliance Commercial |
$914.68
|
| Rate for Payer: WEA Trust Commercial |
$1,006.15
|
| Rate for Payer: WPS Commercial |
$1,354.96
|
|
