|
SCREW GRIDLOCK LOCK 2.4 X 24MM 302-24-024
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5496816
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.32 |
| Max. Negotiated Rate |
$9,576.00 |
| Rate for Payer: Aetna Commercial |
$2,154.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,058.84
|
| Rate for Payer: Aetna Managed Medicare |
$670.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,556.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,197.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,149.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,268.82
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,202.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,339.68
|
| Rate for Payer: Health EOS Commercial |
$2,130.66
|
| Rate for Payer: HFN Commercial |
$2,202.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,795.50
|
| Rate for Payer: Multiplan Commercial |
$1,915.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,436.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,202.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.06
|
| Rate for Payer: Quartz Commercial |
$1,556.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,436.40
|
| Rate for Payer: The Alliance Commercial |
$9,576.00
|
| Rate for Payer: WEA Trust Commercial |
$1,316.70
|
| Rate for Payer: WPS Commercial |
$1,773.24
|
|
|
SCREW GRIDLOCK LOCK 2.4 X 24MM 302-24-024
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5496816
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,173.06 |
| Max. Negotiated Rate |
$2,202.48 |
| Rate for Payer: Aetna Commercial |
$2,154.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,058.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,268.82
|
| Rate for Payer: Cash Price |
$718.20
|
| Rate for Payer: Cigna Commercial |
$2,202.48
|
| Rate for Payer: Health EOS Commercial |
$2,130.66
|
| Rate for Payer: HFN Commercial |
$2,202.48
|
| Rate for Payer: Multiplan Commercial |
$1,915.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,436.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,202.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,173.06
|
| Rate for Payer: Quartz Commercial |
$1,436.40
|
| Rate for Payer: WEA Trust Commercial |
$1,316.70
|
| Rate for Payer: WPS Commercial |
$1,773.24
|
|
|
SCREW HEADED 2.0 X 12 DART-FIRE COMPRESSION D1N20012S
|
Facility
|
OP
|
$3,868.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,083.04 |
| Max. Negotiated Rate |
$15,472.00 |
| Rate for Payer: Aetna Commercial |
$3,481.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,326.48
|
| Rate for Payer: Aetna Managed Medicare |
$1,083.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,514.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,934.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,856.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,050.04
|
| Rate for Payer: Cash Price |
$1,160.40
|
| Rate for Payer: Cigna Commercial |
$3,558.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,164.53
|
| Rate for Payer: Health EOS Commercial |
$3,442.52
|
| Rate for Payer: HFN Commercial |
$3,558.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,901.00
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,320.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,558.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,895.32
|
| Rate for Payer: Quartz Commercial |
$2,514.20
|
| Rate for Payer: Quartz Medicare Advantage |
$2,320.80
|
| Rate for Payer: The Alliance Commercial |
$15,472.00
|
| Rate for Payer: WEA Trust Commercial |
$2,127.40
|
| Rate for Payer: WPS Commercial |
$2,865.03
|
|
|
SCREW HEADED 2.0 X 12 DART-FIRE COMPRESSION D1N20012S
|
Facility
|
IP
|
$3,868.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,895.32 |
| Max. Negotiated Rate |
$3,558.56 |
| Rate for Payer: Aetna Commercial |
$3,481.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,326.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,050.04
|
| Rate for Payer: Cash Price |
$1,160.40
|
| Rate for Payer: Cigna Commercial |
$3,558.56
|
| Rate for Payer: Health EOS Commercial |
$3,442.52
|
| Rate for Payer: HFN Commercial |
$3,558.56
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,320.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,558.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,895.32
|
| Rate for Payer: Quartz Commercial |
$2,320.80
|
| Rate for Payer: WEA Trust Commercial |
$2,127.40
|
| Rate for Payer: WPS Commercial |
$2,865.03
|
|
|
SCREW HEADED 2.5 X 10MM IC2510
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 10MM IC2510
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 12MM IC2512
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 12MM IC2512
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 14MM IC2514
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 14MM IC2514
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767631
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 16MM IC2516
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729904
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 16MM IC2516
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729904
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 18MM IC2518
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 18MM IC2518
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729905
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW HEADED 2.5 X 32MM IC2532
|
Facility
|
IP
|
$2,021.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5957657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$990.29 |
| Max. Negotiated Rate |
$1,859.32 |
| Rate for Payer: Aetna Commercial |
$1,818.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.13
|
| Rate for Payer: Cash Price |
$606.30
|
| Rate for Payer: Cigna Commercial |
$1,859.32
|
| Rate for Payer: Health EOS Commercial |
$1,798.69
|
| Rate for Payer: HFN Commercial |
$1,859.32
|
| Rate for Payer: Multiplan Commercial |
$1,616.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,212.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,859.32
|
| Rate for Payer: Quartz Beloit One Network |
$990.29
|
| Rate for Payer: Quartz Commercial |
$1,212.60
|
| Rate for Payer: WEA Trust Commercial |
$1,111.55
|
| Rate for Payer: WPS Commercial |
$1,496.95
|
|
|
SCREW HEADED 2.5 X 32MM IC2532
|
Facility
|
OP
|
$2,021.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5957657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$565.88 |
| Max. Negotiated Rate |
$8,084.00 |
| Rate for Payer: Aetna Commercial |
$1,818.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,738.06
|
| Rate for Payer: Aetna Managed Medicare |
$565.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,313.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,010.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$970.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,071.13
|
| Rate for Payer: Cash Price |
$606.30
|
| Rate for Payer: Cigna Commercial |
$1,859.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,130.95
|
| Rate for Payer: Health EOS Commercial |
$1,798.69
|
| Rate for Payer: HFN Commercial |
$1,859.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,515.75
|
| Rate for Payer: Multiplan Commercial |
$1,616.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,212.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,859.32
|
| Rate for Payer: Quartz Beloit One Network |
$990.29
|
| Rate for Payer: Quartz Commercial |
$1,313.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,212.60
|
| Rate for Payer: The Alliance Commercial |
$8,084.00
|
| Rate for Payer: WEA Trust Commercial |
$1,111.55
|
| Rate for Payer: WPS Commercial |
$1,496.95
|
|
|
SCREW HEADED 3.0MM X 22MM D1N30022S
|
Facility
|
IP
|
$2,486.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.14 |
| Max. Negotiated Rate |
$2,287.12 |
| Rate for Payer: Aetna Commercial |
$2,237.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,137.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,317.58
|
| Rate for Payer: Cash Price |
$745.80
|
| Rate for Payer: Cigna Commercial |
$2,287.12
|
| Rate for Payer: Health EOS Commercial |
$2,212.54
|
| Rate for Payer: HFN Commercial |
$2,287.12
|
| Rate for Payer: Multiplan Commercial |
$1,988.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,491.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,287.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,218.14
|
| Rate for Payer: Quartz Commercial |
$1,491.60
|
| Rate for Payer: WEA Trust Commercial |
$1,367.30
|
| Rate for Payer: WPS Commercial |
$1,841.38
|
|
|
SCREW HEADED 3.0MM X 22MM D1N30022S
|
Facility
|
OP
|
$2,486.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6165648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$696.08 |
| Max. Negotiated Rate |
$9,944.00 |
| Rate for Payer: Aetna Commercial |
$2,237.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,137.96
|
| Rate for Payer: Aetna Managed Medicare |
$696.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,615.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,243.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,193.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,317.58
|
| Rate for Payer: Cash Price |
$745.80
|
| Rate for Payer: Cigna Commercial |
$2,287.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,391.17
|
| Rate for Payer: Health EOS Commercial |
$2,212.54
|
| Rate for Payer: HFN Commercial |
$2,287.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,864.50
|
| Rate for Payer: Multiplan Commercial |
$1,988.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,491.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,287.12
|
| Rate for Payer: Quartz Beloit One Network |
$1,218.14
|
| Rate for Payer: Quartz Commercial |
$1,615.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,491.60
|
| Rate for Payer: The Alliance Commercial |
$9,944.00
|
| Rate for Payer: WEA Trust Commercial |
$1,367.30
|
| Rate for Payer: WPS Commercial |
$1,841.38
|
|
|
SCREW HEADED 4.0MM X 36MM D1N40036S
|
Facility
|
OP
|
$2,241.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6200970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.48 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Aetna Commercial |
$2,016.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,927.26
|
| Rate for Payer: Aetna Managed Medicare |
$627.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,456.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,120.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,075.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,187.73
|
| Rate for Payer: Cash Price |
$672.30
|
| Rate for Payer: Cigna Commercial |
$2,061.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,254.06
|
| Rate for Payer: Health EOS Commercial |
$1,994.49
|
| Rate for Payer: HFN Commercial |
$2,061.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,680.75
|
| Rate for Payer: Multiplan Commercial |
$1,792.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,344.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,061.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,098.09
|
| Rate for Payer: Quartz Commercial |
$1,456.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,344.60
|
| Rate for Payer: The Alliance Commercial |
$8,964.00
|
| Rate for Payer: WEA Trust Commercial |
$1,232.55
|
| Rate for Payer: WPS Commercial |
$1,659.91
|
|
|
SCREW HEADED 4.0MM X 36MM D1N40036S
|
Facility
|
IP
|
$2,241.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6200970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,098.09 |
| Max. Negotiated Rate |
$2,061.72 |
| Rate for Payer: Aetna Commercial |
$2,016.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,927.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,187.73
|
| Rate for Payer: Cash Price |
$672.30
|
| Rate for Payer: Cigna Commercial |
$2,061.72
|
| Rate for Payer: Health EOS Commercial |
$1,994.49
|
| Rate for Payer: HFN Commercial |
$2,061.72
|
| Rate for Payer: Multiplan Commercial |
$1,792.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,344.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,061.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,098.09
|
| Rate for Payer: Quartz Commercial |
$1,344.60
|
| Rate for Payer: WEA Trust Commercial |
$1,232.55
|
| Rate for Payer: WPS Commercial |
$1,659.91
|
|
|
SCREW HEADED 4.0MM X 52MM D1N40052S
|
Facility
|
IP
|
$2,241.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6178986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,098.09 |
| Max. Negotiated Rate |
$2,061.72 |
| Rate for Payer: Aetna Commercial |
$2,016.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,927.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,187.73
|
| Rate for Payer: Cash Price |
$672.30
|
| Rate for Payer: Cigna Commercial |
$2,061.72
|
| Rate for Payer: Health EOS Commercial |
$1,994.49
|
| Rate for Payer: HFN Commercial |
$2,061.72
|
| Rate for Payer: Multiplan Commercial |
$1,792.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,344.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,061.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,098.09
|
| Rate for Payer: Quartz Commercial |
$1,344.60
|
| Rate for Payer: WEA Trust Commercial |
$1,232.55
|
| Rate for Payer: WPS Commercial |
$1,659.91
|
|
|
SCREW HEADED 4.0MM X 52MM D1N40052S
|
Facility
|
OP
|
$2,241.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6178986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.48 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Aetna Commercial |
$2,016.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,927.26
|
| Rate for Payer: Aetna Managed Medicare |
$627.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,456.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,120.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,075.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,187.73
|
| Rate for Payer: Cash Price |
$672.30
|
| Rate for Payer: Cigna Commercial |
$2,061.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,254.06
|
| Rate for Payer: Health EOS Commercial |
$1,994.49
|
| Rate for Payer: HFN Commercial |
$2,061.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,680.75
|
| Rate for Payer: Multiplan Commercial |
$1,792.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,344.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,061.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,098.09
|
| Rate for Payer: Quartz Commercial |
$1,456.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,344.60
|
| Rate for Payer: The Alliance Commercial |
$8,964.00
|
| Rate for Payer: WEA Trust Commercial |
$1,232.55
|
| Rate for Payer: WPS Commercial |
$1,659.91
|
|
|
SCREW HEADED 4.0MM X 60MM D1N40060S
|
Facility
|
OP
|
$2,331.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173853
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$652.68 |
| Max. Negotiated Rate |
$9,324.00 |
| Rate for Payer: Aetna Commercial |
$2,097.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,004.66
|
| Rate for Payer: Aetna Managed Medicare |
$652.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,515.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,165.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,118.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,235.43
|
| Rate for Payer: Cash Price |
$699.30
|
| Rate for Payer: Cigna Commercial |
$2,144.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,304.43
|
| Rate for Payer: Health EOS Commercial |
$2,074.59
|
| Rate for Payer: HFN Commercial |
$2,144.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,748.25
|
| Rate for Payer: Multiplan Commercial |
$1,864.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,398.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,144.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,142.19
|
| Rate for Payer: Quartz Commercial |
$1,515.15
|
| Rate for Payer: Quartz Medicare Advantage |
$1,398.60
|
| Rate for Payer: The Alliance Commercial |
$9,324.00
|
| Rate for Payer: WEA Trust Commercial |
$1,282.05
|
| Rate for Payer: WPS Commercial |
$1,726.57
|
|
|
SCREW HEADED 4.0MM X 60MM D1N40060S
|
Facility
|
IP
|
$2,331.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173853
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,142.19 |
| Max. Negotiated Rate |
$2,144.52 |
| Rate for Payer: Aetna Commercial |
$2,097.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,004.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,235.43
|
| Rate for Payer: Cash Price |
$699.30
|
| Rate for Payer: Cigna Commercial |
$2,144.52
|
| Rate for Payer: Health EOS Commercial |
$2,074.59
|
| Rate for Payer: HFN Commercial |
$2,144.52
|
| Rate for Payer: Multiplan Commercial |
$1,864.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,398.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,144.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,142.19
|
| Rate for Payer: Quartz Commercial |
$1,398.60
|
| Rate for Payer: WEA Trust Commercial |
$1,282.05
|
| Rate for Payer: WPS Commercial |
$1,726.57
|
|
|
SCREW HEADED 4.0 X 38MM IC4038
|
Facility
|
OP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6211042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$501.20 |
| Max. Negotiated Rate |
$7,160.00 |
| Rate for Payer: Aetna Commercial |
$1,611.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,539.40
|
| Rate for Payer: Aetna Managed Medicare |
$501.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,163.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$895.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$859.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$948.70
|
| Rate for Payer: Cash Price |
$537.00
|
| Rate for Payer: Cigna Commercial |
$1,646.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,001.68
|
| Rate for Payer: Health EOS Commercial |
$1,593.10
|
| Rate for Payer: HFN Commercial |
$1,646.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,342.50
|
| Rate for Payer: Multiplan Commercial |
$1,432.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,074.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,646.80
|
| Rate for Payer: Quartz Beloit One Network |
$877.10
|
| Rate for Payer: Quartz Commercial |
$1,163.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,074.00
|
| Rate for Payer: The Alliance Commercial |
$7,160.00
|
| Rate for Payer: WEA Trust Commercial |
$984.50
|
| Rate for Payer: WPS Commercial |
$1,325.85
|
|
