|
SCREW LOCK 2.7 X 12 ST 202.212
|
Facility
|
IP
|
$1,766.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.95 |
| Max. Negotiated Rate |
$1,689.71 |
| Rate for Payer: Aetna Commercial |
$1,652.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,579.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$973.42
|
| Rate for Payer: Cash Price |
$529.80
|
| Rate for Payer: Cigna Commercial |
$1,689.71
|
| Rate for Payer: Health EOS Commercial |
$1,634.61
|
| Rate for Payer: HFN Commercial |
$1,689.71
|
| Rate for Payer: Multiplan Commercial |
$1,469.31
|
| Rate for Payer: Preferred Network Access Commercial |
$1,689.71
|
| Rate for Payer: Quartz Beloit One Network |
$899.95
|
| Rate for Payer: Quartz Commercial |
$1,101.98
|
| Rate for Payer: WEA Trust Commercial |
$1,010.15
|
| Rate for Payer: WPS Commercial |
$1,360.35
|
|
|
SCREW LOCK 2.7 X 12 ST 202.212
|
Facility
|
OP
|
$1,766.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$514.26 |
| Max. Negotiated Rate |
$1,689.71 |
| Rate for Payer: Aetna Commercial |
$1,652.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,579.51
|
| Rate for Payer: Aetna Managed Medicare |
$514.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,193.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$918.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$881.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$973.42
|
| Rate for Payer: Cash Price |
$529.80
|
| Rate for Payer: Cigna Commercial |
$1,689.71
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,027.81
|
| Rate for Payer: Health EOS Commercial |
$1,634.61
|
| Rate for Payer: HFN Commercial |
$1,689.71
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,377.48
|
| Rate for Payer: Multiplan Commercial |
$1,469.31
|
| Rate for Payer: NAPHCARE Commercial |
$1,101.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,689.71
|
| Rate for Payer: Quartz Beloit One Network |
$899.95
|
| Rate for Payer: Quartz Commercial |
$1,193.82
|
| Rate for Payer: Quartz Medicare Advantage |
$1,101.98
|
| Rate for Payer: The Alliance Commercial |
$918.32
|
| Rate for Payer: WEA Trust Commercial |
$1,010.15
|
| Rate for Payer: WPS Commercial |
$1,360.35
|
|
|
SCREW LOCK 2.7 X 13 ST 202.213
|
Facility
|
IP
|
$1,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5414733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$682.86 |
| Max. Negotiated Rate |
$1,282.11 |
| Rate for Payer: Aetna Commercial |
$1,254.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,198.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$738.61
|
| Rate for Payer: Cash Price |
$402.00
|
| Rate for Payer: Cigna Commercial |
$1,282.11
|
| Rate for Payer: Health EOS Commercial |
$1,240.30
|
| Rate for Payer: HFN Commercial |
$1,282.11
|
| Rate for Payer: Multiplan Commercial |
$1,114.88
|
| Rate for Payer: Preferred Network Access Commercial |
$1,282.11
|
| Rate for Payer: Quartz Beloit One Network |
$682.86
|
| Rate for Payer: Quartz Commercial |
$836.16
|
| Rate for Payer: WEA Trust Commercial |
$766.48
|
| Rate for Payer: WPS Commercial |
$1,032.20
|
|
|
SCREW LOCK 2.7 X 13 ST 202.213
|
Facility
|
OP
|
$1,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5414733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$390.21 |
| Max. Negotiated Rate |
$1,282.11 |
| Rate for Payer: Aetna Commercial |
$1,254.24
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,198.50
|
| Rate for Payer: Aetna Managed Medicare |
$390.21
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$905.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$696.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$668.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$738.61
|
| Rate for Payer: Cash Price |
$402.00
|
| Rate for Payer: Cigna Commercial |
$1,282.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$779.88
|
| Rate for Payer: Health EOS Commercial |
$1,240.30
|
| Rate for Payer: HFN Commercial |
$1,282.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,045.20
|
| Rate for Payer: Multiplan Commercial |
$1,114.88
|
| Rate for Payer: NAPHCARE Commercial |
$836.16
|
| Rate for Payer: Preferred Network Access Commercial |
$1,282.11
|
| Rate for Payer: Quartz Beloit One Network |
$682.86
|
| Rate for Payer: Quartz Commercial |
$905.84
|
| Rate for Payer: Quartz Medicare Advantage |
$836.16
|
| Rate for Payer: The Alliance Commercial |
$696.80
|
| Rate for Payer: WEA Trust Commercial |
$766.48
|
| Rate for Payer: WPS Commercial |
$1,032.20
|
|
|
SCREW LOCK 2.7 X 14MM 02.211.014
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$593.76 |
| Max. Negotiated Rate |
$1,950.92 |
| Rate for Payer: Aetna Commercial |
$1,908.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,823.68
|
| Rate for Payer: Aetna Managed Medicare |
$593.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,378.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,060.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,017.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,123.90
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,950.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,186.70
|
| Rate for Payer: Health EOS Commercial |
$1,887.30
|
| Rate for Payer: HFN Commercial |
$1,950.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,590.42
|
| Rate for Payer: Multiplan Commercial |
$1,696.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,272.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,950.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,039.07
|
| Rate for Payer: Quartz Commercial |
$1,378.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,272.34
|
| Rate for Payer: The Alliance Commercial |
$1,060.28
|
| Rate for Payer: WEA Trust Commercial |
$1,166.31
|
| Rate for Payer: WPS Commercial |
$1,570.64
|
|
|
SCREW LOCK 2.7 X 14MM 02.211.014
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,039.07 |
| Max. Negotiated Rate |
$1,950.92 |
| Rate for Payer: Aetna Commercial |
$1,908.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,823.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,123.90
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,950.92
|
| Rate for Payer: Health EOS Commercial |
$1,887.30
|
| Rate for Payer: HFN Commercial |
$1,950.92
|
| Rate for Payer: Multiplan Commercial |
$1,696.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,950.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,039.07
|
| Rate for Payer: Quartz Commercial |
$1,272.34
|
| Rate for Payer: WEA Trust Commercial |
$1,166.31
|
| Rate for Payer: WPS Commercial |
$1,570.64
|
|
|
SCREW LOCK 2.7 X 14MM SS LP AR-8827L-14
|
Facility
|
OP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.83 |
| Max. Negotiated Rate |
$1,464.86 |
| Rate for Payer: Aetna Commercial |
$1,433.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Aetna Managed Medicare |
$445.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,034.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$796.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$764.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$843.89
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,464.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$891.04
|
| Rate for Payer: Health EOS Commercial |
$1,417.09
|
| Rate for Payer: HFN Commercial |
$1,464.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,194.18
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: NAPHCARE Commercial |
$955.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,464.86
|
| Rate for Payer: Quartz Beloit One Network |
$780.20
|
| Rate for Payer: Quartz Commercial |
$1,034.96
|
| Rate for Payer: Quartz Medicare Advantage |
$955.34
|
| Rate for Payer: The Alliance Commercial |
$796.12
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$1,179.33
|
|
|
SCREW LOCK 2.7 X 14MM SS LP AR-8827L-14
|
Facility
|
IP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.20 |
| Max. Negotiated Rate |
$1,464.86 |
| Rate for Payer: Aetna Commercial |
$1,433.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$843.89
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,464.86
|
| Rate for Payer: Health EOS Commercial |
$1,417.09
|
| Rate for Payer: HFN Commercial |
$1,464.86
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,464.86
|
| Rate for Payer: Quartz Beloit One Network |
$780.20
|
| Rate for Payer: Quartz Commercial |
$955.34
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$1,179.33
|
|
|
SCREW LOCK 2.7 X 14 ST 202.214
|
Facility
|
IP
|
$1,746.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$889.76 |
| Max. Negotiated Rate |
$1,670.57 |
| Rate for Payer: Aetna Commercial |
$1,634.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,561.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$962.40
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$1,670.57
|
| Rate for Payer: Health EOS Commercial |
$1,616.10
|
| Rate for Payer: HFN Commercial |
$1,670.57
|
| Rate for Payer: Multiplan Commercial |
$1,452.67
|
| Rate for Payer: Preferred Network Access Commercial |
$1,670.57
|
| Rate for Payer: Quartz Beloit One Network |
$889.76
|
| Rate for Payer: Quartz Commercial |
$1,089.50
|
| Rate for Payer: WEA Trust Commercial |
$998.71
|
| Rate for Payer: WPS Commercial |
$1,344.94
|
|
|
SCREW LOCK 2.7 X 14 ST 202.214
|
Facility
|
OP
|
$1,746.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$508.44 |
| Max. Negotiated Rate |
$1,670.57 |
| Rate for Payer: Aetna Commercial |
$1,634.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,561.62
|
| Rate for Payer: Aetna Managed Medicare |
$508.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,180.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$907.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$871.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$962.40
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$1,670.57
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,016.17
|
| Rate for Payer: Health EOS Commercial |
$1,616.10
|
| Rate for Payer: HFN Commercial |
$1,670.57
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,361.88
|
| Rate for Payer: Multiplan Commercial |
$1,452.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,089.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,670.57
|
| Rate for Payer: Quartz Beloit One Network |
$889.76
|
| Rate for Payer: Quartz Commercial |
$1,180.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,089.50
|
| Rate for Payer: The Alliance Commercial |
$907.92
|
| Rate for Payer: WEA Trust Commercial |
$998.71
|
| Rate for Payer: WPS Commercial |
$1,344.94
|
|
|
SCREW LOCK 2.7 X 16MM 02.211.016
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$593.76 |
| Max. Negotiated Rate |
$1,950.92 |
| Rate for Payer: Aetna Commercial |
$1,908.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,823.68
|
| Rate for Payer: Aetna Managed Medicare |
$593.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,378.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,060.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,017.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,123.90
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,950.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,186.70
|
| Rate for Payer: Health EOS Commercial |
$1,887.30
|
| Rate for Payer: HFN Commercial |
$1,950.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,590.42
|
| Rate for Payer: Multiplan Commercial |
$1,696.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,272.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,950.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,039.07
|
| Rate for Payer: Quartz Commercial |
$1,378.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,272.34
|
| Rate for Payer: The Alliance Commercial |
$1,060.28
|
| Rate for Payer: WEA Trust Commercial |
$1,166.31
|
| Rate for Payer: WPS Commercial |
$1,570.64
|
|
|
SCREW LOCK 2.7 X 16MM 02.211.016
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,039.07 |
| Max. Negotiated Rate |
$1,950.92 |
| Rate for Payer: Aetna Commercial |
$1,908.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,823.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,123.90
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,950.92
|
| Rate for Payer: Health EOS Commercial |
$1,887.30
|
| Rate for Payer: HFN Commercial |
$1,950.92
|
| Rate for Payer: Multiplan Commercial |
$1,696.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,950.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,039.07
|
| Rate for Payer: Quartz Commercial |
$1,272.34
|
| Rate for Payer: WEA Trust Commercial |
$1,166.31
|
| Rate for Payer: WPS Commercial |
$1,570.64
|
|
|
SCREW LOCK 2.7 X 16MM SS LP AR-8827L-16
|
Facility
|
OP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.83 |
| Max. Negotiated Rate |
$1,464.86 |
| Rate for Payer: Aetna Commercial |
$1,433.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Aetna Managed Medicare |
$445.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,034.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$796.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$764.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$843.89
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,464.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$891.04
|
| Rate for Payer: Health EOS Commercial |
$1,417.09
|
| Rate for Payer: HFN Commercial |
$1,464.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,194.18
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: NAPHCARE Commercial |
$955.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,464.86
|
| Rate for Payer: Quartz Beloit One Network |
$780.20
|
| Rate for Payer: Quartz Commercial |
$1,034.96
|
| Rate for Payer: Quartz Medicare Advantage |
$955.34
|
| Rate for Payer: The Alliance Commercial |
$796.12
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$1,179.33
|
|
|
SCREW LOCK 2.7 X 16MM SS LP AR-8827L-16
|
Facility
|
IP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.20 |
| Max. Negotiated Rate |
$1,464.86 |
| Rate for Payer: Aetna Commercial |
$1,433.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$843.89
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,464.86
|
| Rate for Payer: Health EOS Commercial |
$1,417.09
|
| Rate for Payer: HFN Commercial |
$1,464.86
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,464.86
|
| Rate for Payer: Quartz Beloit One Network |
$780.20
|
| Rate for Payer: Quartz Commercial |
$955.34
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$1,179.33
|
|
|
SCREW LOCK 2.7 X 16 ST 202.216
|
Facility
|
OP
|
$2,918.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$849.72 |
| Max. Negotiated Rate |
$2,791.94 |
| Rate for Payer: Aetna Commercial |
$2,731.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,609.86
|
| Rate for Payer: Aetna Managed Medicare |
$849.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,972.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,517.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,456.67
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,608.40
|
| Rate for Payer: Cash Price |
$875.40
|
| Rate for Payer: Cigna Commercial |
$2,791.94
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,698.28
|
| Rate for Payer: Health EOS Commercial |
$2,700.90
|
| Rate for Payer: HFN Commercial |
$2,791.94
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,276.04
|
| Rate for Payer: Multiplan Commercial |
$2,427.78
|
| Rate for Payer: NAPHCARE Commercial |
$1,820.83
|
| Rate for Payer: Preferred Network Access Commercial |
$2,791.94
|
| Rate for Payer: Quartz Beloit One Network |
$1,487.01
|
| Rate for Payer: Quartz Commercial |
$1,972.57
|
| Rate for Payer: Quartz Medicare Advantage |
$1,820.83
|
| Rate for Payer: The Alliance Commercial |
$1,517.36
|
| Rate for Payer: WEA Trust Commercial |
$1,669.10
|
| Rate for Payer: WPS Commercial |
$2,247.74
|
|
|
SCREW LOCK 2.7 X 16 ST 202.216
|
Facility
|
IP
|
$2,918.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,487.01 |
| Max. Negotiated Rate |
$2,791.94 |
| Rate for Payer: Aetna Commercial |
$2,731.25
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,609.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,608.40
|
| Rate for Payer: Cash Price |
$875.40
|
| Rate for Payer: Cigna Commercial |
$2,791.94
|
| Rate for Payer: Health EOS Commercial |
$2,700.90
|
| Rate for Payer: HFN Commercial |
$2,791.94
|
| Rate for Payer: Multiplan Commercial |
$2,427.78
|
| Rate for Payer: Preferred Network Access Commercial |
$2,791.94
|
| Rate for Payer: Quartz Beloit One Network |
$1,487.01
|
| Rate for Payer: Quartz Commercial |
$1,820.83
|
| Rate for Payer: WEA Trust Commercial |
$1,669.10
|
| Rate for Payer: WPS Commercial |
$2,247.74
|
|
|
SCREW LOCK 2.7 X 18MM 02.211.018
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,039.07 |
| Max. Negotiated Rate |
$1,950.92 |
| Rate for Payer: Aetna Commercial |
$1,908.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,823.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,123.90
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,950.92
|
| Rate for Payer: Health EOS Commercial |
$1,887.30
|
| Rate for Payer: HFN Commercial |
$1,950.92
|
| Rate for Payer: Multiplan Commercial |
$1,696.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,950.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,039.07
|
| Rate for Payer: Quartz Commercial |
$1,272.34
|
| Rate for Payer: WEA Trust Commercial |
$1,166.31
|
| Rate for Payer: WPS Commercial |
$1,570.64
|
|
|
SCREW LOCK 2.7 X 18MM 02.211.018
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$593.76 |
| Max. Negotiated Rate |
$1,950.92 |
| Rate for Payer: Aetna Commercial |
$1,908.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,823.68
|
| Rate for Payer: Aetna Managed Medicare |
$593.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,378.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,060.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,017.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,123.90
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,950.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,186.70
|
| Rate for Payer: Health EOS Commercial |
$1,887.30
|
| Rate for Payer: HFN Commercial |
$1,950.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,590.42
|
| Rate for Payer: Multiplan Commercial |
$1,696.45
|
| Rate for Payer: NAPHCARE Commercial |
$1,272.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,950.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,039.07
|
| Rate for Payer: Quartz Commercial |
$1,378.36
|
| Rate for Payer: Quartz Medicare Advantage |
$1,272.34
|
| Rate for Payer: The Alliance Commercial |
$1,060.28
|
| Rate for Payer: WEA Trust Commercial |
$1,166.31
|
| Rate for Payer: WPS Commercial |
$1,570.64
|
|
|
SCREW LOCK 2.7 X 18MM SS LP AR-8827L-18
|
Facility
|
OP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.83 |
| Max. Negotiated Rate |
$1,464.86 |
| Rate for Payer: Aetna Commercial |
$1,433.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Aetna Managed Medicare |
$445.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,034.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$796.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$764.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$843.89
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,464.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$891.04
|
| Rate for Payer: Health EOS Commercial |
$1,417.09
|
| Rate for Payer: HFN Commercial |
$1,464.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,194.18
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: NAPHCARE Commercial |
$955.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,464.86
|
| Rate for Payer: Quartz Beloit One Network |
$780.20
|
| Rate for Payer: Quartz Commercial |
$1,034.96
|
| Rate for Payer: Quartz Medicare Advantage |
$955.34
|
| Rate for Payer: The Alliance Commercial |
$796.12
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$1,179.33
|
|
|
SCREW LOCK 2.7 X 18MM SS LP AR-8827L-18
|
Facility
|
IP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.20 |
| Max. Negotiated Rate |
$1,464.86 |
| Rate for Payer: Aetna Commercial |
$1,433.02
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,369.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$843.89
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,464.86
|
| Rate for Payer: Health EOS Commercial |
$1,417.09
|
| Rate for Payer: HFN Commercial |
$1,464.86
|
| Rate for Payer: Multiplan Commercial |
$1,273.79
|
| Rate for Payer: Preferred Network Access Commercial |
$1,464.86
|
| Rate for Payer: Quartz Beloit One Network |
$780.20
|
| Rate for Payer: Quartz Commercial |
$955.34
|
| Rate for Payer: WEA Trust Commercial |
$875.73
|
| Rate for Payer: WPS Commercial |
$1,179.33
|
|
|
SCREW LOCK 2.7 X 18 ST 202.218
|
Facility
|
IP
|
$1,829.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966483
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$932.06 |
| Max. Negotiated Rate |
$1,749.99 |
| Rate for Payer: Aetna Commercial |
$1,711.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,635.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,008.14
|
| Rate for Payer: Cash Price |
$548.70
|
| Rate for Payer: Cigna Commercial |
$1,749.99
|
| Rate for Payer: Health EOS Commercial |
$1,692.92
|
| Rate for Payer: HFN Commercial |
$1,749.99
|
| Rate for Payer: Multiplan Commercial |
$1,521.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,749.99
|
| Rate for Payer: Quartz Beloit One Network |
$932.06
|
| Rate for Payer: Quartz Commercial |
$1,141.30
|
| Rate for Payer: WEA Trust Commercial |
$1,046.19
|
| Rate for Payer: WPS Commercial |
$1,408.88
|
|
|
SCREW LOCK 2.7 X 18 ST 202.218
|
Facility
|
OP
|
$1,829.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966483
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.60 |
| Max. Negotiated Rate |
$1,749.99 |
| Rate for Payer: Aetna Commercial |
$1,711.94
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,635.86
|
| Rate for Payer: Aetna Managed Medicare |
$532.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,236.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$951.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$913.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,008.14
|
| Rate for Payer: Cash Price |
$548.70
|
| Rate for Payer: Cigna Commercial |
$1,749.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,064.48
|
| Rate for Payer: Health EOS Commercial |
$1,692.92
|
| Rate for Payer: HFN Commercial |
$1,749.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,426.62
|
| Rate for Payer: Multiplan Commercial |
$1,521.73
|
| Rate for Payer: NAPHCARE Commercial |
$1,141.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,749.99
|
| Rate for Payer: Quartz Beloit One Network |
$932.06
|
| Rate for Payer: Quartz Commercial |
$1,236.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,141.30
|
| Rate for Payer: The Alliance Commercial |
$951.08
|
| Rate for Payer: WEA Trust Commercial |
$1,046.19
|
| Rate for Payer: WPS Commercial |
$1,408.88
|
|
|
SCREW LOCK 2.7 X 20MM 02.211.020
|
Facility
|
OP
|
$2,188.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.15 |
| Max. Negotiated Rate |
$2,093.48 |
| Rate for Payer: Aetna Commercial |
$2,047.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,956.95
|
| Rate for Payer: Aetna Managed Medicare |
$637.15
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,479.09
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,137.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,092.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,206.03
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$2,093.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,273.42
|
| Rate for Payer: Health EOS Commercial |
$2,025.21
|
| Rate for Payer: HFN Commercial |
$2,093.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,706.64
|
| Rate for Payer: Multiplan Commercial |
$1,820.42
|
| Rate for Payer: NAPHCARE Commercial |
$1,365.31
|
| Rate for Payer: Preferred Network Access Commercial |
$2,093.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,115.00
|
| Rate for Payer: Quartz Commercial |
$1,479.09
|
| Rate for Payer: Quartz Medicare Advantage |
$1,365.31
|
| Rate for Payer: The Alliance Commercial |
$1,137.76
|
| Rate for Payer: WEA Trust Commercial |
$1,251.54
|
| Rate for Payer: WPS Commercial |
$1,685.42
|
|
|
SCREW LOCK 2.7 X 20MM 02.211.020
|
Facility
|
IP
|
$2,188.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.00 |
| Max. Negotiated Rate |
$2,093.48 |
| Rate for Payer: Aetna Commercial |
$2,047.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,956.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,206.03
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$2,093.48
|
| Rate for Payer: Health EOS Commercial |
$2,025.21
|
| Rate for Payer: HFN Commercial |
$2,093.48
|
| Rate for Payer: Multiplan Commercial |
$1,820.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,093.48
|
| Rate for Payer: Quartz Beloit One Network |
$1,115.00
|
| Rate for Payer: Quartz Commercial |
$1,365.31
|
| Rate for Payer: WEA Trust Commercial |
$1,251.54
|
| Rate for Payer: WPS Commercial |
$1,685.42
|
|
|
SCREW LOCK 2.7 X 20MM SS LP AR-8827L-20
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5659717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.13 |
| Max. Negotiated Rate |
$1,408.41 |
| Rate for Payer: Aetna Commercial |
$1,377.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.37
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cigna Commercial |
$1,408.41
|
| Rate for Payer: Health EOS Commercial |
$1,362.48
|
| Rate for Payer: HFN Commercial |
$1,408.41
|
| Rate for Payer: Multiplan Commercial |
$1,224.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.41
|
| Rate for Payer: Quartz Beloit One Network |
$750.13
|
| Rate for Payer: Quartz Commercial |
$918.53
|
| Rate for Payer: WEA Trust Commercial |
$841.98
|
| Rate for Payer: WPS Commercial |
$1,133.88
|
|
