|
SCREW LOCK 2.7 X 20MM SS LP AR-8827L-20
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5659717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$428.65 |
| 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: Aetna Managed Medicare |
$428.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$995.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$765.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$734.82
|
| 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: Dean Health DHI/DHP/ASO |
$856.70
|
| Rate for Payer: Health EOS Commercial |
$1,362.48
|
| Rate for Payer: HFN Commercial |
$1,408.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,148.16
|
| Rate for Payer: Multiplan Commercial |
$1,224.70
|
| Rate for Payer: NAPHCARE Commercial |
$918.53
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.41
|
| Rate for Payer: Quartz Beloit One Network |
$750.13
|
| Rate for Payer: Quartz Commercial |
$995.07
|
| Rate for Payer: Quartz Medicare Advantage |
$918.53
|
| Rate for Payer: The Alliance Commercial |
$765.44
|
| Rate for Payer: WEA Trust Commercial |
$841.98
|
| Rate for Payer: WPS Commercial |
$1,133.88
|
|
|
SCREW LOCK 2.7 X 20 ST 202.220
|
Facility
|
OP
|
$1,762.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2969336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.09 |
| Max. Negotiated Rate |
$1,685.88 |
| Rate for Payer: Aetna Commercial |
$1,649.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,575.93
|
| Rate for Payer: Aetna Managed Medicare |
$513.09
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,191.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$916.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$879.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$971.21
|
| Rate for Payer: Cash Price |
$528.60
|
| Rate for Payer: Cigna Commercial |
$1,685.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,025.48
|
| Rate for Payer: Health EOS Commercial |
$1,630.91
|
| Rate for Payer: HFN Commercial |
$1,685.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,374.36
|
| Rate for Payer: Multiplan Commercial |
$1,465.98
|
| Rate for Payer: NAPHCARE Commercial |
$1,099.49
|
| Rate for Payer: Preferred Network Access Commercial |
$1,685.88
|
| Rate for Payer: Quartz Beloit One Network |
$897.92
|
| Rate for Payer: Quartz Commercial |
$1,191.11
|
| Rate for Payer: Quartz Medicare Advantage |
$1,099.49
|
| Rate for Payer: The Alliance Commercial |
$916.24
|
| Rate for Payer: WEA Trust Commercial |
$1,007.86
|
| Rate for Payer: WPS Commercial |
$1,357.27
|
|
|
SCREW LOCK 2.7 X 20 ST 202.220
|
Facility
|
IP
|
$1,762.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2969336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$897.92 |
| Max. Negotiated Rate |
$1,685.88 |
| Rate for Payer: Aetna Commercial |
$1,649.23
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,575.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$971.21
|
| Rate for Payer: Cash Price |
$528.60
|
| Rate for Payer: Cigna Commercial |
$1,685.88
|
| Rate for Payer: Health EOS Commercial |
$1,630.91
|
| Rate for Payer: HFN Commercial |
$1,685.88
|
| Rate for Payer: Multiplan Commercial |
$1,465.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,685.88
|
| Rate for Payer: Quartz Beloit One Network |
$897.92
|
| Rate for Payer: Quartz Commercial |
$1,099.49
|
| Rate for Payer: WEA Trust Commercial |
$1,007.86
|
| Rate for Payer: WPS Commercial |
$1,357.27
|
|
|
SCREW LOCK 2.7 X 22MM 02.211.022
|
Facility
|
OP
|
$2,188.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265486
|
|
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 22MM 02.211.022
|
Facility
|
IP
|
$2,188.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265486
|
|
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 22 ST 202.222
|
Facility
|
IP
|
$1,809.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$921.87 |
| Max. Negotiated Rate |
$1,730.85 |
| Rate for Payer: Aetna Commercial |
$1,693.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,617.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.12
|
| Rate for Payer: Cash Price |
$542.70
|
| Rate for Payer: Cigna Commercial |
$1,730.85
|
| Rate for Payer: Health EOS Commercial |
$1,674.41
|
| Rate for Payer: HFN Commercial |
$1,730.85
|
| Rate for Payer: Multiplan Commercial |
$1,505.09
|
| Rate for Payer: Preferred Network Access Commercial |
$1,730.85
|
| Rate for Payer: Quartz Beloit One Network |
$921.87
|
| Rate for Payer: Quartz Commercial |
$1,128.82
|
| Rate for Payer: WEA Trust Commercial |
$1,034.75
|
| Rate for Payer: WPS Commercial |
$1,393.47
|
|
|
SCREW LOCK 2.7 X 22 ST 202.222
|
Facility
|
OP
|
$1,809.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.78 |
| Max. Negotiated Rate |
$1,730.85 |
| Rate for Payer: Aetna Commercial |
$1,693.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,617.97
|
| Rate for Payer: Aetna Managed Medicare |
$526.78
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,222.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$940.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$903.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.12
|
| Rate for Payer: Cash Price |
$542.70
|
| Rate for Payer: Cigna Commercial |
$1,730.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,052.84
|
| Rate for Payer: Health EOS Commercial |
$1,674.41
|
| Rate for Payer: HFN Commercial |
$1,730.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,411.02
|
| Rate for Payer: Multiplan Commercial |
$1,505.09
|
| Rate for Payer: NAPHCARE Commercial |
$1,128.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,730.85
|
| Rate for Payer: Quartz Beloit One Network |
$921.87
|
| Rate for Payer: Quartz Commercial |
$1,222.88
|
| Rate for Payer: Quartz Medicare Advantage |
$1,128.82
|
| Rate for Payer: The Alliance Commercial |
$940.68
|
| Rate for Payer: WEA Trust Commercial |
$1,034.75
|
| Rate for Payer: WPS Commercial |
$1,393.47
|
|
|
SCREW LOCK 2.7 X 24MM 02.211.024
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$1,538.53 |
| Rate for Payer: Aetna Commercial |
$1,505.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,438.20
|
| Rate for Payer: Aetna Managed Medicare |
$468.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,087.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$836.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$802.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$886.33
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,538.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$935.86
|
| Rate for Payer: Health EOS Commercial |
$1,488.36
|
| Rate for Payer: HFN Commercial |
$1,538.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,254.24
|
| Rate for Payer: Multiplan Commercial |
$1,337.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,003.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.53
|
| Rate for Payer: Quartz Beloit One Network |
$819.44
|
| Rate for Payer: Quartz Commercial |
$1,087.01
|
| Rate for Payer: Quartz Medicare Advantage |
$1,003.39
|
| Rate for Payer: The Alliance Commercial |
$836.16
|
| Rate for Payer: WEA Trust Commercial |
$919.78
|
| Rate for Payer: WPS Commercial |
$1,238.64
|
|
|
SCREW LOCK 2.7 X 24MM 02.211.024
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$819.44 |
| Max. Negotiated Rate |
$1,538.53 |
| Rate for Payer: Aetna Commercial |
$1,505.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,438.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$886.33
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,538.53
|
| Rate for Payer: Health EOS Commercial |
$1,488.36
|
| Rate for Payer: HFN Commercial |
$1,538.53
|
| Rate for Payer: Multiplan Commercial |
$1,337.86
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.53
|
| Rate for Payer: Quartz Beloit One Network |
$819.44
|
| Rate for Payer: Quartz Commercial |
$1,003.39
|
| Rate for Payer: WEA Trust Commercial |
$919.78
|
| Rate for Payer: WPS Commercial |
$1,238.64
|
|
|
SCREW LOCK 2.7 X 24 ST 202.224
|
Facility
|
OP
|
$572.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.57 |
| Max. Negotiated Rate |
$547.29 |
| Rate for Payer: Aetna Commercial |
$535.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$511.60
|
| Rate for Payer: Aetna Managed Medicare |
$166.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$386.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$297.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$285.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$315.29
|
| Rate for Payer: Cash Price |
$171.60
|
| Rate for Payer: Cigna Commercial |
$547.29
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$332.90
|
| Rate for Payer: Health EOS Commercial |
$529.44
|
| Rate for Payer: HFN Commercial |
$547.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$446.16
|
| Rate for Payer: Multiplan Commercial |
$475.90
|
| Rate for Payer: NAPHCARE Commercial |
$356.93
|
| Rate for Payer: Preferred Network Access Commercial |
$547.29
|
| Rate for Payer: Quartz Beloit One Network |
$291.49
|
| Rate for Payer: Quartz Commercial |
$386.67
|
| Rate for Payer: Quartz Medicare Advantage |
$356.93
|
| Rate for Payer: The Alliance Commercial |
$297.44
|
| Rate for Payer: WEA Trust Commercial |
$327.18
|
| Rate for Payer: WPS Commercial |
$440.61
|
|
|
SCREW LOCK 2.7 X 24 ST 202.224
|
Facility
|
IP
|
$572.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966472
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.49 |
| Max. Negotiated Rate |
$547.29 |
| Rate for Payer: Aetna Commercial |
$535.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$511.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$315.29
|
| Rate for Payer: Cash Price |
$171.60
|
| Rate for Payer: Cigna Commercial |
$547.29
|
| Rate for Payer: Health EOS Commercial |
$529.44
|
| Rate for Payer: HFN Commercial |
$547.29
|
| Rate for Payer: Multiplan Commercial |
$475.90
|
| Rate for Payer: Preferred Network Access Commercial |
$547.29
|
| Rate for Payer: Quartz Beloit One Network |
$291.49
|
| Rate for Payer: Quartz Commercial |
$356.93
|
| Rate for Payer: WEA Trust Commercial |
$327.18
|
| Rate for Payer: WPS Commercial |
$440.61
|
|
|
SCREW LOCK 2.7 X 26MM 02.211.026
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.84 |
| Max. Negotiated Rate |
$1,479.21 |
| Rate for Payer: Aetna Commercial |
$1,447.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.16
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,479.21
|
| Rate for Payer: Health EOS Commercial |
$1,430.98
|
| Rate for Payer: HFN Commercial |
$1,479.21
|
| Rate for Payer: Multiplan Commercial |
$1,286.27
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.21
|
| Rate for Payer: Quartz Beloit One Network |
$787.84
|
| Rate for Payer: Quartz Commercial |
$964.70
|
| Rate for Payer: WEA Trust Commercial |
$884.31
|
| Rate for Payer: WPS Commercial |
$1,190.88
|
|
|
SCREW LOCK 2.7 X 26MM 02.211.026
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$450.20 |
| Max. Negotiated Rate |
$1,479.21 |
| Rate for Payer: Aetna Commercial |
$1,447.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.74
|
| Rate for Payer: Aetna Managed Medicare |
$450.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,045.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$803.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$771.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.16
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,479.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$899.77
|
| Rate for Payer: Health EOS Commercial |
$1,430.98
|
| Rate for Payer: HFN Commercial |
$1,479.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,205.88
|
| Rate for Payer: Multiplan Commercial |
$1,286.27
|
| Rate for Payer: NAPHCARE Commercial |
$964.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.21
|
| Rate for Payer: Quartz Beloit One Network |
$787.84
|
| Rate for Payer: Quartz Commercial |
$1,045.10
|
| Rate for Payer: Quartz Medicare Advantage |
$964.70
|
| Rate for Payer: The Alliance Commercial |
$803.92
|
| Rate for Payer: WEA Trust Commercial |
$884.31
|
| Rate for Payer: WPS Commercial |
$1,190.88
|
|
|
SCREW LOCK 2.7 X 26 ST 202.226
|
Facility
|
OP
|
$572.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520523
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.57 |
| Max. Negotiated Rate |
$547.29 |
| Rate for Payer: Aetna Commercial |
$535.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$511.60
|
| Rate for Payer: Aetna Managed Medicare |
$166.57
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$386.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$297.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$285.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$315.29
|
| Rate for Payer: Cash Price |
$171.60
|
| Rate for Payer: Cigna Commercial |
$547.29
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$332.90
|
| Rate for Payer: Health EOS Commercial |
$529.44
|
| Rate for Payer: HFN Commercial |
$547.29
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$446.16
|
| Rate for Payer: Multiplan Commercial |
$475.90
|
| Rate for Payer: NAPHCARE Commercial |
$356.93
|
| Rate for Payer: Preferred Network Access Commercial |
$547.29
|
| Rate for Payer: Quartz Beloit One Network |
$291.49
|
| Rate for Payer: Quartz Commercial |
$386.67
|
| Rate for Payer: Quartz Medicare Advantage |
$356.93
|
| Rate for Payer: The Alliance Commercial |
$297.44
|
| Rate for Payer: WEA Trust Commercial |
$327.18
|
| Rate for Payer: WPS Commercial |
$440.61
|
|
|
SCREW LOCK 2.7 X 26 ST 202.226
|
Facility
|
IP
|
$572.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520523
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.49 |
| Max. Negotiated Rate |
$547.29 |
| Rate for Payer: Aetna Commercial |
$535.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$511.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$315.29
|
| Rate for Payer: Cash Price |
$171.60
|
| Rate for Payer: Cigna Commercial |
$547.29
|
| Rate for Payer: Health EOS Commercial |
$529.44
|
| Rate for Payer: HFN Commercial |
$547.29
|
| Rate for Payer: Multiplan Commercial |
$475.90
|
| Rate for Payer: Preferred Network Access Commercial |
$547.29
|
| Rate for Payer: Quartz Beloit One Network |
$291.49
|
| Rate for Payer: Quartz Commercial |
$356.93
|
| Rate for Payer: WEA Trust Commercial |
$327.18
|
| Rate for Payer: WPS Commercial |
$440.61
|
|
|
SCREW LOCK 2.7 X 28MM 02.211.028
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$819.44 |
| Max. Negotiated Rate |
$1,538.53 |
| Rate for Payer: Aetna Commercial |
$1,505.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,438.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$886.33
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,538.53
|
| Rate for Payer: Health EOS Commercial |
$1,488.36
|
| Rate for Payer: HFN Commercial |
$1,538.53
|
| Rate for Payer: Multiplan Commercial |
$1,337.86
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.53
|
| Rate for Payer: Quartz Beloit One Network |
$819.44
|
| Rate for Payer: Quartz Commercial |
$1,003.39
|
| Rate for Payer: WEA Trust Commercial |
$919.78
|
| Rate for Payer: WPS Commercial |
$1,238.64
|
|
|
SCREW LOCK 2.7 X 28MM 02.211.028
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$1,538.53 |
| Rate for Payer: Aetna Commercial |
$1,505.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,438.20
|
| Rate for Payer: Aetna Managed Medicare |
$468.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,087.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$836.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$802.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$886.33
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,538.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$935.86
|
| Rate for Payer: Health EOS Commercial |
$1,488.36
|
| Rate for Payer: HFN Commercial |
$1,538.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,254.24
|
| Rate for Payer: Multiplan Commercial |
$1,337.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,003.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.53
|
| Rate for Payer: Quartz Beloit One Network |
$819.44
|
| Rate for Payer: Quartz Commercial |
$1,087.01
|
| Rate for Payer: Quartz Medicare Advantage |
$1,003.39
|
| Rate for Payer: The Alliance Commercial |
$836.16
|
| Rate for Payer: WEA Trust Commercial |
$919.78
|
| Rate for Payer: WPS Commercial |
$1,238.64
|
|
|
SCREW LOCK 2.7 X 28 ST 202.228
|
Facility
|
OP
|
$1,976.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966473
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.41 |
| Max. Negotiated Rate |
$1,890.64 |
| Rate for Payer: Aetna Commercial |
$1,849.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,767.33
|
| Rate for Payer: Aetna Managed Medicare |
$575.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,335.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,027.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$986.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,089.17
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cigna Commercial |
$1,890.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,150.03
|
| Rate for Payer: Health EOS Commercial |
$1,828.99
|
| Rate for Payer: HFN Commercial |
$1,890.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,541.28
|
| Rate for Payer: Multiplan Commercial |
$1,644.03
|
| Rate for Payer: NAPHCARE Commercial |
$1,233.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,890.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,006.97
|
| Rate for Payer: Quartz Commercial |
$1,335.78
|
| Rate for Payer: Quartz Medicare Advantage |
$1,233.02
|
| Rate for Payer: The Alliance Commercial |
$1,027.52
|
| Rate for Payer: WEA Trust Commercial |
$1,130.27
|
| Rate for Payer: WPS Commercial |
$1,522.11
|
|
|
SCREW LOCK 2.7 X 28 ST 202.228
|
Facility
|
IP
|
$1,976.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966473
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,006.97 |
| Max. Negotiated Rate |
$1,890.64 |
| Rate for Payer: Aetna Commercial |
$1,849.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,767.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,089.17
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cigna Commercial |
$1,890.64
|
| Rate for Payer: Health EOS Commercial |
$1,828.99
|
| Rate for Payer: HFN Commercial |
$1,890.64
|
| Rate for Payer: Multiplan Commercial |
$1,644.03
|
| Rate for Payer: Preferred Network Access Commercial |
$1,890.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,006.97
|
| Rate for Payer: Quartz Commercial |
$1,233.02
|
| Rate for Payer: WEA Trust Commercial |
$1,130.27
|
| Rate for Payer: WPS Commercial |
$1,522.11
|
|
|
SCREW LOCK 2.7 X 30MM 02.211.030
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.84 |
| Max. Negotiated Rate |
$1,479.21 |
| Rate for Payer: Aetna Commercial |
$1,447.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.16
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,479.21
|
| Rate for Payer: Health EOS Commercial |
$1,430.98
|
| Rate for Payer: HFN Commercial |
$1,479.21
|
| Rate for Payer: Multiplan Commercial |
$1,286.27
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.21
|
| Rate for Payer: Quartz Beloit One Network |
$787.84
|
| Rate for Payer: Quartz Commercial |
$964.70
|
| Rate for Payer: WEA Trust Commercial |
$884.31
|
| Rate for Payer: WPS Commercial |
$1,190.88
|
|
|
SCREW LOCK 2.7 X 30MM 02.211.030
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$450.20 |
| Max. Negotiated Rate |
$1,479.21 |
| Rate for Payer: Aetna Commercial |
$1,447.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.74
|
| Rate for Payer: Aetna Managed Medicare |
$450.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,045.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$803.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$771.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.16
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,479.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$899.77
|
| Rate for Payer: Health EOS Commercial |
$1,430.98
|
| Rate for Payer: HFN Commercial |
$1,479.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,205.88
|
| Rate for Payer: Multiplan Commercial |
$1,286.27
|
| Rate for Payer: NAPHCARE Commercial |
$964.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.21
|
| Rate for Payer: Quartz Beloit One Network |
$787.84
|
| Rate for Payer: Quartz Commercial |
$1,045.10
|
| Rate for Payer: Quartz Medicare Advantage |
$964.70
|
| Rate for Payer: The Alliance Commercial |
$803.92
|
| Rate for Payer: WEA Trust Commercial |
$884.31
|
| Rate for Payer: WPS Commercial |
$1,190.88
|
|
|
SCREW LOCK 2.7 X 30 ST 202.230
|
Facility
|
IP
|
$1,976.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2969337
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,006.97 |
| Max. Negotiated Rate |
$1,890.64 |
| Rate for Payer: Aetna Commercial |
$1,849.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,767.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,089.17
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cigna Commercial |
$1,890.64
|
| Rate for Payer: Health EOS Commercial |
$1,828.99
|
| Rate for Payer: HFN Commercial |
$1,890.64
|
| Rate for Payer: Multiplan Commercial |
$1,644.03
|
| Rate for Payer: Preferred Network Access Commercial |
$1,890.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,006.97
|
| Rate for Payer: Quartz Commercial |
$1,233.02
|
| Rate for Payer: WEA Trust Commercial |
$1,130.27
|
| Rate for Payer: WPS Commercial |
$1,522.11
|
|
|
SCREW LOCK 2.7 X 30 ST 202.230
|
Facility
|
OP
|
$1,976.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2969337
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.41 |
| Max. Negotiated Rate |
$1,890.64 |
| Rate for Payer: Aetna Commercial |
$1,849.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,767.33
|
| Rate for Payer: Aetna Managed Medicare |
$575.41
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,335.78
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,027.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$986.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,089.17
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cigna Commercial |
$1,890.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,150.03
|
| Rate for Payer: Health EOS Commercial |
$1,828.99
|
| Rate for Payer: HFN Commercial |
$1,890.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,541.28
|
| Rate for Payer: Multiplan Commercial |
$1,644.03
|
| Rate for Payer: NAPHCARE Commercial |
$1,233.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,890.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,006.97
|
| Rate for Payer: Quartz Commercial |
$1,335.78
|
| Rate for Payer: Quartz Medicare Advantage |
$1,233.02
|
| Rate for Payer: The Alliance Commercial |
$1,027.52
|
| Rate for Payer: WEA Trust Commercial |
$1,130.27
|
| Rate for Payer: WPS Commercial |
$1,522.11
|
|
|
SCREW LOCK 2.7 X 32MM 02.211.032
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$819.44 |
| Max. Negotiated Rate |
$1,538.53 |
| Rate for Payer: Aetna Commercial |
$1,505.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,438.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$886.33
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,538.53
|
| Rate for Payer: Health EOS Commercial |
$1,488.36
|
| Rate for Payer: HFN Commercial |
$1,538.53
|
| Rate for Payer: Multiplan Commercial |
$1,337.86
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.53
|
| Rate for Payer: Quartz Beloit One Network |
$819.44
|
| Rate for Payer: Quartz Commercial |
$1,003.39
|
| Rate for Payer: WEA Trust Commercial |
$919.78
|
| Rate for Payer: WPS Commercial |
$1,238.64
|
|
|
SCREW LOCK 2.7 X 32MM 02.211.032
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$1,538.53 |
| Rate for Payer: Aetna Commercial |
$1,505.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,438.20
|
| Rate for Payer: Aetna Managed Medicare |
$468.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,087.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$836.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$802.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$886.33
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,538.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$935.86
|
| Rate for Payer: Health EOS Commercial |
$1,488.36
|
| Rate for Payer: HFN Commercial |
$1,538.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,254.24
|
| Rate for Payer: Multiplan Commercial |
$1,337.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,003.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,538.53
|
| Rate for Payer: Quartz Beloit One Network |
$819.44
|
| Rate for Payer: Quartz Commercial |
$1,087.01
|
| Rate for Payer: Quartz Medicare Advantage |
$1,003.39
|
| Rate for Payer: The Alliance Commercial |
$836.16
|
| Rate for Payer: WEA Trust Commercial |
$919.78
|
| Rate for Payer: WPS Commercial |
$1,238.64
|
|
