|
SCREW HEADED 4.0 X 38MM IC4038
|
Facility
|
IP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6211042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.10 |
| Max. Negotiated Rate |
$1,646.80 |
| Rate for Payer: Aetna Commercial |
$1,611.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,539.40
|
| 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: Health EOS Commercial |
$1,593.10
|
| Rate for Payer: HFN Commercial |
$1,646.80
|
| 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 |
$1,074.00
|
| Rate for Payer: WEA Trust Commercial |
$984.50
|
| Rate for Payer: WPS Commercial |
$1,325.85
|
|
|
SCREW HEADED 4.0 X 40MM IC4040
|
Facility
|
IP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6211043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.10 |
| Max. Negotiated Rate |
$1,646.80 |
| Rate for Payer: Aetna Commercial |
$1,611.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,539.40
|
| 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: Health EOS Commercial |
$1,593.10
|
| Rate for Payer: HFN Commercial |
$1,646.80
|
| 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 |
$1,074.00
|
| Rate for Payer: WEA Trust Commercial |
$984.50
|
| Rate for Payer: WPS Commercial |
$1,325.85
|
|
|
SCREW HEADED 4.0 X 40MM IC4040
|
Facility
|
OP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6211043
|
|
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
|
|
|
SCREW HEADED 4.0 X 46MM IC4046
|
Facility
|
IP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6220181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.10 |
| Max. Negotiated Rate |
$1,646.80 |
| Rate for Payer: Aetna Commercial |
$1,611.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,539.40
|
| 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: Health EOS Commercial |
$1,593.10
|
| Rate for Payer: HFN Commercial |
$1,646.80
|
| 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 |
$1,074.00
|
| Rate for Payer: WEA Trust Commercial |
$984.50
|
| Rate for Payer: WPS Commercial |
$1,325.85
|
|
|
SCREW HEADED 4.0 X 46MM IC4046
|
Facility
|
OP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6220181
|
|
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
|
|
|
SCREW HEADED 4.0 X 48MM IC4048
|
Facility
|
IP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6220182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.10 |
| Max. Negotiated Rate |
$1,646.80 |
| Rate for Payer: Aetna Commercial |
$1,611.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,539.40
|
| 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: Health EOS Commercial |
$1,593.10
|
| Rate for Payer: HFN Commercial |
$1,646.80
|
| 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 |
$1,074.00
|
| Rate for Payer: WEA Trust Commercial |
$984.50
|
| Rate for Payer: WPS Commercial |
$1,325.85
|
|
|
SCREW HEADED 4.0 X 48MM IC4048
|
Facility
|
OP
|
$1,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6220182
|
|
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
|
|
|
SCREW HEADED M/G UNI 48MM 5791-41
|
Facility
|
IP
|
$2,839.00
|
|
| Hospital Charge Code |
2990959
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,391.11 |
| Max. Negotiated Rate |
$2,611.88 |
| Rate for Payer: Aetna Commercial |
$2,555.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,441.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,504.67
|
| Rate for Payer: Cash Price |
$851.70
|
| Rate for Payer: Cigna Commercial |
$2,611.88
|
| Rate for Payer: Health EOS Commercial |
$2,526.71
|
| Rate for Payer: HFN Commercial |
$2,611.88
|
| Rate for Payer: Multiplan Commercial |
$2,271.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,703.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,611.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,391.11
|
| Rate for Payer: Quartz Commercial |
$1,703.40
|
| Rate for Payer: WEA Trust Commercial |
$1,561.45
|
| Rate for Payer: WPS Commercial |
$2,102.85
|
|
|
SCREW HEADED M/G UNI 48MM 5791-41
|
Facility
|
OP
|
$2,839.00
|
|
| Hospital Charge Code |
2990959
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$794.92 |
| Max. Negotiated Rate |
$11,356.00 |
| Rate for Payer: Aetna Commercial |
$2,555.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,441.54
|
| Rate for Payer: Aetna Managed Medicare |
$794.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,845.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,419.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,362.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,504.67
|
| Rate for Payer: Cash Price |
$851.70
|
| Rate for Payer: Cigna Commercial |
$2,611.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,588.70
|
| Rate for Payer: Health EOS Commercial |
$2,526.71
|
| Rate for Payer: HFN Commercial |
$2,611.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,129.25
|
| Rate for Payer: Multiplan Commercial |
$2,271.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,703.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,611.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,391.11
|
| Rate for Payer: Quartz Commercial |
$1,845.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,703.40
|
| Rate for Payer: The Alliance Commercial |
$11,356.00
|
| Rate for Payer: WEA Trust Commercial |
$1,561.45
|
| Rate for Payer: WPS Commercial |
$2,102.85
|
|
|
SCREW HEADED ZUK 33MM 00-5791-044-00
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
2965840
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.20 |
| Max. Negotiated Rate |
$257.60 |
| Rate for Payer: Aetna Commercial |
$252.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$240.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$148.40
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cigna Commercial |
$257.60
|
| Rate for Payer: Health EOS Commercial |
$249.20
|
| Rate for Payer: HFN Commercial |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$224.00
|
| Rate for Payer: NAPHCARE Commercial |
$168.00
|
| Rate for Payer: Preferred Network Access Commercial |
$257.60
|
| Rate for Payer: Quartz Beloit One Network |
$137.20
|
| Rate for Payer: Quartz Commercial |
$168.00
|
| Rate for Payer: WEA Trust Commercial |
$154.00
|
| Rate for Payer: WPS Commercial |
$207.40
|
|
|
SCREW HEADED ZUK 33MM 00-5791-044-00
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
2965840
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.40 |
| Max. Negotiated Rate |
$1,120.00 |
| Rate for Payer: Aetna Commercial |
$252.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$240.80
|
| Rate for Payer: Aetna Managed Medicare |
$78.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$182.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$140.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$134.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$148.40
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cigna Commercial |
$257.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$156.69
|
| Rate for Payer: Health EOS Commercial |
$249.20
|
| Rate for Payer: HFN Commercial |
$257.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$224.00
|
| Rate for Payer: NAPHCARE Commercial |
$168.00
|
| Rate for Payer: Preferred Network Access Commercial |
$257.60
|
| Rate for Payer: Quartz Beloit One Network |
$137.20
|
| Rate for Payer: Quartz Commercial |
$182.00
|
| Rate for Payer: Quartz Medicare Advantage |
$168.00
|
| Rate for Payer: The Alliance Commercial |
$1,120.00
|
| Rate for Payer: WEA Trust Commercial |
$154.00
|
| Rate for Payer: WPS Commercial |
$207.40
|
|
|
SCREW HEADLESS 2.0 X 12 317-2012
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 12 317-2012
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 14 317-2014
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 14 317-2014
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 16 317-2016
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 16 317-2016
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 18 317-2018
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 18 317-2018
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965462
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 20 317-2020
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 20 317-2020
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965464
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 22 317-2022
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 22 317-2022
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 24 317-2024
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,610.63 |
| Max. Negotiated Rate |
$3,024.04 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$1,972.20
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
|
SCREW HEADLESS 2.0 X 24 317-2024
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.36 |
| Max. Negotiated Rate |
$13,148.00 |
| Rate for Payer: Aetna Commercial |
$2,958.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,826.82
|
| Rate for Payer: Aetna Managed Medicare |
$920.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,136.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,643.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,577.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,742.11
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,024.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,839.41
|
| Rate for Payer: Health EOS Commercial |
$2,925.43
|
| Rate for Payer: HFN Commercial |
$3,024.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,465.25
|
| Rate for Payer: Multiplan Commercial |
$2,629.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,972.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,024.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,610.63
|
| Rate for Payer: Quartz Commercial |
$2,136.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,972.20
|
| Rate for Payer: The Alliance Commercial |
$13,148.00
|
| Rate for Payer: WEA Trust Commercial |
$1,807.85
|
| Rate for Payer: WPS Commercial |
$2,434.68
|
|
