|
SCREW-LOCK 2.4 X 18 412.818
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$361.31 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$442.42
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-LOCK 2.4 X 18MM 04.210.118
|
Facility
|
IP
|
$2,106.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,073.22 |
| Max. Negotiated Rate |
$2,015.02 |
| Rate for Payer: Aetna Commercial |
$1,971.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,883.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,160.83
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$2,015.02
|
| Rate for Payer: Health EOS Commercial |
$1,949.31
|
| Rate for Payer: HFN Commercial |
$2,015.02
|
| Rate for Payer: Multiplan Commercial |
$1,752.19
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.22
|
| Rate for Payer: Quartz Commercial |
$1,314.14
|
| Rate for Payer: WEA Trust Commercial |
$1,204.63
|
| Rate for Payer: WPS Commercial |
$1,622.25
|
|
|
SCREW-LOCK 2.4 X 18MM 04.210.118
|
Facility
|
OP
|
$2,106.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$613.27 |
| Max. Negotiated Rate |
$2,015.02 |
| Rate for Payer: Aetna Commercial |
$1,971.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,883.61
|
| Rate for Payer: Aetna Managed Medicare |
$613.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,423.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,095.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,051.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,160.83
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$2,015.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,225.69
|
| Rate for Payer: Health EOS Commercial |
$1,949.31
|
| Rate for Payer: HFN Commercial |
$2,015.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,642.68
|
| Rate for Payer: Multiplan Commercial |
$1,752.19
|
| Rate for Payer: NAPHCARE Commercial |
$1,314.14
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.22
|
| Rate for Payer: Quartz Commercial |
$1,423.66
|
| Rate for Payer: Quartz Medicare Advantage |
$1,314.14
|
| Rate for Payer: The Alliance Commercial |
$1,095.12
|
| Rate for Payer: WEA Trust Commercial |
$1,204.63
|
| Rate for Payer: WPS Commercial |
$1,622.25
|
|
|
SCREW LOCK 2.4 X 18MM 212.818
|
Facility
|
OP
|
$1,897.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966451
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$552.41 |
| Max. Negotiated Rate |
$1,815.05 |
| Rate for Payer: Aetna Commercial |
$1,775.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,696.68
|
| Rate for Payer: Aetna Managed Medicare |
$552.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,282.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$986.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$946.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,045.63
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: Cigna Commercial |
$1,815.05
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,104.05
|
| Rate for Payer: Health EOS Commercial |
$1,755.86
|
| Rate for Payer: HFN Commercial |
$1,815.05
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,479.66
|
| Rate for Payer: Multiplan Commercial |
$1,578.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,183.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,815.05
|
| Rate for Payer: Quartz Beloit One Network |
$966.71
|
| Rate for Payer: Quartz Commercial |
$1,282.37
|
| Rate for Payer: Quartz Medicare Advantage |
$1,183.73
|
| Rate for Payer: The Alliance Commercial |
$986.44
|
| Rate for Payer: WEA Trust Commercial |
$1,085.08
|
| Rate for Payer: WPS Commercial |
$1,461.26
|
|
|
SCREW LOCK 2.4 X 18MM 212.818
|
Facility
|
IP
|
$1,897.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966451
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$966.71 |
| Max. Negotiated Rate |
$1,815.05 |
| Rate for Payer: Aetna Commercial |
$1,775.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,696.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,045.63
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: Cigna Commercial |
$1,815.05
|
| Rate for Payer: Health EOS Commercial |
$1,755.86
|
| Rate for Payer: HFN Commercial |
$1,815.05
|
| Rate for Payer: Multiplan Commercial |
$1,578.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,815.05
|
| Rate for Payer: Quartz Beloit One Network |
$966.71
|
| Rate for Payer: Quartz Commercial |
$1,183.73
|
| Rate for Payer: WEA Trust Commercial |
$1,085.08
|
| Rate for Payer: WPS Commercial |
$1,461.26
|
|
|
SCREW LOCK 2.4 X 18 STARDRIVE 02.210.118
|
Facility
|
IP
|
$2,027.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,032.96 |
| Max. Negotiated Rate |
$1,939.43 |
| Rate for Payer: Aetna Commercial |
$1,897.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,812.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,117.28
|
| Rate for Payer: Cash Price |
$608.10
|
| Rate for Payer: Cigna Commercial |
$1,939.43
|
| Rate for Payer: Health EOS Commercial |
$1,876.19
|
| Rate for Payer: HFN Commercial |
$1,939.43
|
| Rate for Payer: Multiplan Commercial |
$1,686.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,939.43
|
| Rate for Payer: Quartz Beloit One Network |
$1,032.96
|
| Rate for Payer: Quartz Commercial |
$1,264.85
|
| Rate for Payer: WEA Trust Commercial |
$1,159.44
|
| Rate for Payer: WPS Commercial |
$1,561.40
|
|
|
SCREW LOCK 2.4 X 18 STARDRIVE 02.210.118
|
Facility
|
OP
|
$2,027.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$590.26 |
| Max. Negotiated Rate |
$1,939.43 |
| Rate for Payer: Aetna Commercial |
$1,897.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,812.95
|
| Rate for Payer: Aetna Managed Medicare |
$590.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,370.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,054.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,011.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,117.28
|
| Rate for Payer: Cash Price |
$608.10
|
| Rate for Payer: Cigna Commercial |
$1,939.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,179.71
|
| Rate for Payer: Health EOS Commercial |
$1,876.19
|
| Rate for Payer: HFN Commercial |
$1,939.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,581.06
|
| Rate for Payer: Multiplan Commercial |
$1,686.46
|
| Rate for Payer: NAPHCARE Commercial |
$1,264.85
|
| Rate for Payer: Preferred Network Access Commercial |
$1,939.43
|
| Rate for Payer: Quartz Beloit One Network |
$1,032.96
|
| Rate for Payer: Quartz Commercial |
$1,370.25
|
| Rate for Payer: Quartz Medicare Advantage |
$1,264.85
|
| Rate for Payer: The Alliance Commercial |
$1,054.04
|
| Rate for Payer: WEA Trust Commercial |
$1,159.44
|
| Rate for Payer: WPS Commercial |
$1,561.40
|
|
|
SCREW-LOCK 2.4 X 20 412.820
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966811
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$361.31 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$442.42
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-LOCK 2.4 X 20 412.820
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966811
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.46 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Aetna Managed Medicare |
$206.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$479.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$368.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$353.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$412.64
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$553.02
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: NAPHCARE Commercial |
$442.42
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$479.28
|
| Rate for Payer: Quartz Medicare Advantage |
$442.42
|
| Rate for Payer: The Alliance Commercial |
$368.68
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-LOCK 2.4 X 20MM 04.210.120
|
Facility
|
IP
|
$2,106.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966812
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,073.22 |
| Max. Negotiated Rate |
$2,015.02 |
| Rate for Payer: Aetna Commercial |
$1,971.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,883.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,160.83
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$2,015.02
|
| Rate for Payer: Health EOS Commercial |
$1,949.31
|
| Rate for Payer: HFN Commercial |
$2,015.02
|
| Rate for Payer: Multiplan Commercial |
$1,752.19
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.22
|
| Rate for Payer: Quartz Commercial |
$1,314.14
|
| Rate for Payer: WEA Trust Commercial |
$1,204.63
|
| Rate for Payer: WPS Commercial |
$1,622.25
|
|
|
SCREW-LOCK 2.4 X 20MM 04.210.120
|
Facility
|
OP
|
$2,106.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966812
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$613.27 |
| Max. Negotiated Rate |
$2,015.02 |
| Rate for Payer: Aetna Commercial |
$1,971.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,883.61
|
| Rate for Payer: Aetna Managed Medicare |
$613.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,423.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,095.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,051.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,160.83
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$2,015.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,225.69
|
| Rate for Payer: Health EOS Commercial |
$1,949.31
|
| Rate for Payer: HFN Commercial |
$2,015.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,642.68
|
| Rate for Payer: Multiplan Commercial |
$1,752.19
|
| Rate for Payer: NAPHCARE Commercial |
$1,314.14
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.22
|
| Rate for Payer: Quartz Commercial |
$1,423.66
|
| Rate for Payer: Quartz Medicare Advantage |
$1,314.14
|
| Rate for Payer: The Alliance Commercial |
$1,095.12
|
| Rate for Payer: WEA Trust Commercial |
$1,204.63
|
| Rate for Payer: WPS Commercial |
$1,622.25
|
|
|
SCREW LOCK 2.4 X 20MM 212.820
|
Facility
|
IP
|
$1,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.80 |
| Max. Negotiated Rate |
$1,674.40 |
| Rate for Payer: Aetna Commercial |
$1,638.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,565.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$964.60
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna Commercial |
$1,674.40
|
| Rate for Payer: Health EOS Commercial |
$1,619.80
|
| Rate for Payer: HFN Commercial |
$1,674.40
|
| Rate for Payer: Multiplan Commercial |
$1,456.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,674.40
|
| Rate for Payer: Quartz Beloit One Network |
$891.80
|
| Rate for Payer: Quartz Commercial |
$1,092.00
|
| Rate for Payer: WEA Trust Commercial |
$1,001.00
|
| Rate for Payer: WPS Commercial |
$1,348.03
|
|
|
SCREW LOCK 2.4 X 20MM 212.820
|
Facility
|
OP
|
$1,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.60 |
| Max. Negotiated Rate |
$1,674.40 |
| Rate for Payer: Aetna Commercial |
$1,638.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,565.20
|
| Rate for Payer: Aetna Managed Medicare |
$509.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,183.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$910.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$873.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$964.60
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna Commercial |
$1,674.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,018.50
|
| Rate for Payer: Health EOS Commercial |
$1,619.80
|
| Rate for Payer: HFN Commercial |
$1,674.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,365.00
|
| Rate for Payer: Multiplan Commercial |
$1,456.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,092.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,674.40
|
| Rate for Payer: Quartz Beloit One Network |
$891.80
|
| Rate for Payer: Quartz Commercial |
$1,183.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,092.00
|
| Rate for Payer: The Alliance Commercial |
$910.00
|
| Rate for Payer: WEA Trust Commercial |
$1,001.00
|
| Rate for Payer: WPS Commercial |
$1,348.03
|
|
|
SCREW LOCK 2.4 X 20 STARDRIVE 02.210.120
|
Facility
|
IP
|
$1,961.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$999.33 |
| Max. Negotiated Rate |
$1,876.28 |
| Rate for Payer: Aetna Commercial |
$1,835.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.90
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cigna Commercial |
$1,876.28
|
| Rate for Payer: Health EOS Commercial |
$1,815.10
|
| Rate for Payer: HFN Commercial |
$1,876.28
|
| Rate for Payer: Multiplan Commercial |
$1,631.55
|
| Rate for Payer: Preferred Network Access Commercial |
$1,876.28
|
| Rate for Payer: Quartz Beloit One Network |
$999.33
|
| Rate for Payer: Quartz Commercial |
$1,223.66
|
| Rate for Payer: WEA Trust Commercial |
$1,121.69
|
| Rate for Payer: WPS Commercial |
$1,510.56
|
|
|
SCREW LOCK 2.4 X 20 STARDRIVE 02.210.120
|
Facility
|
OP
|
$1,961.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$571.04 |
| Max. Negotiated Rate |
$1,876.28 |
| Rate for Payer: Aetna Commercial |
$1,835.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.92
|
| Rate for Payer: Aetna Managed Medicare |
$571.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,325.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,019.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$978.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.90
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cigna Commercial |
$1,876.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,141.30
|
| Rate for Payer: Health EOS Commercial |
$1,815.10
|
| Rate for Payer: HFN Commercial |
$1,876.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,529.58
|
| Rate for Payer: Multiplan Commercial |
$1,631.55
|
| Rate for Payer: NAPHCARE Commercial |
$1,223.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,876.28
|
| Rate for Payer: Quartz Beloit One Network |
$999.33
|
| Rate for Payer: Quartz Commercial |
$1,325.64
|
| Rate for Payer: Quartz Medicare Advantage |
$1,223.66
|
| Rate for Payer: The Alliance Commercial |
$1,019.72
|
| Rate for Payer: WEA Trust Commercial |
$1,121.69
|
| Rate for Payer: WPS Commercial |
$1,510.56
|
|
|
SCREW-LOCK 2.4 X 22 412.822
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.46 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Aetna Managed Medicare |
$206.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$479.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$368.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$353.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$412.64
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$553.02
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: NAPHCARE Commercial |
$442.42
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$479.28
|
| Rate for Payer: Quartz Medicare Advantage |
$442.42
|
| Rate for Payer: The Alliance Commercial |
$368.68
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-LOCK 2.4 X 22 412.822
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$361.31 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$442.42
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-LOCK 2.4 X 22MM 04.210.122
|
Facility
|
OP
|
$2,106.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$613.27 |
| Max. Negotiated Rate |
$2,015.02 |
| Rate for Payer: Aetna Commercial |
$1,971.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,883.61
|
| Rate for Payer: Aetna Managed Medicare |
$613.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,423.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,095.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,051.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,160.83
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$2,015.02
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,225.69
|
| Rate for Payer: Health EOS Commercial |
$1,949.31
|
| Rate for Payer: HFN Commercial |
$2,015.02
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,642.68
|
| Rate for Payer: Multiplan Commercial |
$1,752.19
|
| Rate for Payer: NAPHCARE Commercial |
$1,314.14
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.22
|
| Rate for Payer: Quartz Commercial |
$1,423.66
|
| Rate for Payer: Quartz Medicare Advantage |
$1,314.14
|
| Rate for Payer: The Alliance Commercial |
$1,095.12
|
| Rate for Payer: WEA Trust Commercial |
$1,204.63
|
| Rate for Payer: WPS Commercial |
$1,622.25
|
|
|
SCREW-LOCK 2.4 X 22MM 04.210.122
|
Facility
|
IP
|
$2,106.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,073.22 |
| Max. Negotiated Rate |
$2,015.02 |
| Rate for Payer: Aetna Commercial |
$1,971.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,883.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,160.83
|
| Rate for Payer: Cash Price |
$631.80
|
| Rate for Payer: Cigna Commercial |
$2,015.02
|
| Rate for Payer: Health EOS Commercial |
$1,949.31
|
| Rate for Payer: HFN Commercial |
$2,015.02
|
| Rate for Payer: Multiplan Commercial |
$1,752.19
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.02
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.22
|
| Rate for Payer: Quartz Commercial |
$1,314.14
|
| Rate for Payer: WEA Trust Commercial |
$1,204.63
|
| Rate for Payer: WPS Commercial |
$1,622.25
|
|
|
SCREW LOCK 2.4 X 22MM 212.822
|
Facility
|
OP
|
$1,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.60 |
| Max. Negotiated Rate |
$1,674.40 |
| Rate for Payer: Aetna Commercial |
$1,638.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,565.20
|
| Rate for Payer: Aetna Managed Medicare |
$509.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,183.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$910.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$873.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$964.60
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna Commercial |
$1,674.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,018.50
|
| Rate for Payer: Health EOS Commercial |
$1,619.80
|
| Rate for Payer: HFN Commercial |
$1,674.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,365.00
|
| Rate for Payer: Multiplan Commercial |
$1,456.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,092.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,674.40
|
| Rate for Payer: Quartz Beloit One Network |
$891.80
|
| Rate for Payer: Quartz Commercial |
$1,183.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,092.00
|
| Rate for Payer: The Alliance Commercial |
$910.00
|
| Rate for Payer: WEA Trust Commercial |
$1,001.00
|
| Rate for Payer: WPS Commercial |
$1,348.03
|
|
|
SCREW LOCK 2.4 X 22MM 212.822
|
Facility
|
IP
|
$1,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$891.80 |
| Max. Negotiated Rate |
$1,674.40 |
| Rate for Payer: Aetna Commercial |
$1,638.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,565.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$964.60
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna Commercial |
$1,674.40
|
| Rate for Payer: Health EOS Commercial |
$1,619.80
|
| Rate for Payer: HFN Commercial |
$1,674.40
|
| Rate for Payer: Multiplan Commercial |
$1,456.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,674.40
|
| Rate for Payer: Quartz Beloit One Network |
$891.80
|
| Rate for Payer: Quartz Commercial |
$1,092.00
|
| Rate for Payer: WEA Trust Commercial |
$1,001.00
|
| Rate for Payer: WPS Commercial |
$1,348.03
|
|
|
SCREW LOCK 2.4 X 22 STARDRIVE 02.210.122
|
Facility
|
IP
|
$1,961.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$999.33 |
| Max. Negotiated Rate |
$1,876.28 |
| Rate for Payer: Aetna Commercial |
$1,835.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.90
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cigna Commercial |
$1,876.28
|
| Rate for Payer: Health EOS Commercial |
$1,815.10
|
| Rate for Payer: HFN Commercial |
$1,876.28
|
| Rate for Payer: Multiplan Commercial |
$1,631.55
|
| Rate for Payer: Preferred Network Access Commercial |
$1,876.28
|
| Rate for Payer: Quartz Beloit One Network |
$999.33
|
| Rate for Payer: Quartz Commercial |
$1,223.66
|
| Rate for Payer: WEA Trust Commercial |
$1,121.69
|
| Rate for Payer: WPS Commercial |
$1,510.56
|
|
|
SCREW LOCK 2.4 X 22 STARDRIVE 02.210.122
|
Facility
|
OP
|
$1,961.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$571.04 |
| Max. Negotiated Rate |
$1,876.28 |
| Rate for Payer: Aetna Commercial |
$1,835.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.92
|
| Rate for Payer: Aetna Managed Medicare |
$571.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,325.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,019.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$978.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.90
|
| Rate for Payer: Cash Price |
$588.30
|
| Rate for Payer: Cigna Commercial |
$1,876.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,141.30
|
| Rate for Payer: Health EOS Commercial |
$1,815.10
|
| Rate for Payer: HFN Commercial |
$1,876.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,529.58
|
| Rate for Payer: Multiplan Commercial |
$1,631.55
|
| Rate for Payer: NAPHCARE Commercial |
$1,223.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,876.28
|
| Rate for Payer: Quartz Beloit One Network |
$999.33
|
| Rate for Payer: Quartz Commercial |
$1,325.64
|
| Rate for Payer: Quartz Medicare Advantage |
$1,223.66
|
| Rate for Payer: The Alliance Commercial |
$1,019.72
|
| Rate for Payer: WEA Trust Commercial |
$1,121.69
|
| Rate for Payer: WPS Commercial |
$1,510.56
|
|
|
SCREW-LOCK 2.4 X 24 412.824
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.46 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Aetna Managed Medicare |
$206.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$479.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$368.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$353.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$412.64
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$553.02
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: NAPHCARE Commercial |
$442.42
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$479.28
|
| Rate for Payer: Quartz Medicare Advantage |
$442.42
|
| Rate for Payer: The Alliance Commercial |
$368.68
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
|
SCREW-LOCK 2.4 X 24 412.824
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966817
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$361.31 |
| Max. Negotiated Rate |
$678.37 |
| Rate for Payer: Aetna Commercial |
$663.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$634.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$390.80
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cigna Commercial |
$678.37
|
| Rate for Payer: Health EOS Commercial |
$656.25
|
| Rate for Payer: HFN Commercial |
$678.37
|
| Rate for Payer: Multiplan Commercial |
$589.89
|
| Rate for Payer: Preferred Network Access Commercial |
$678.37
|
| Rate for Payer: Quartz Beloit One Network |
$361.31
|
| Rate for Payer: Quartz Commercial |
$442.42
|
| Rate for Payer: WEA Trust Commercial |
$405.55
|
| Rate for Payer: WPS Commercial |
$546.14
|
|
