|
SCREW LOCK 2.7 X 34MM 02.211.034
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265489
|
|
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 34MM 02.211.034
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265489
|
|
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 36MM 02.211.036
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265469
|
|
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 36MM 02.211.036
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265469
|
|
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 38MM 02.211.038
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265470
|
|
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 38MM 02.211.038
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265470
|
|
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 40MM 02.211.040
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127491
|
|
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 40MM 02.211.040
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127491
|
|
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 40 ST 202.240
|
Facility
|
OP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$537.56 |
| Max. Negotiated Rate |
$1,766.25 |
| Rate for Payer: Aetna Commercial |
$1,727.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,651.06
|
| Rate for Payer: Aetna Managed Medicare |
$537.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,247.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$959.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$921.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,017.52
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,766.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,074.37
|
| Rate for Payer: Health EOS Commercial |
$1,708.66
|
| Rate for Payer: HFN Commercial |
$1,766.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,439.88
|
| Rate for Payer: Multiplan Commercial |
$1,535.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,151.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,766.25
|
| Rate for Payer: Quartz Beloit One Network |
$940.72
|
| Rate for Payer: Quartz Commercial |
$1,247.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,151.90
|
| Rate for Payer: The Alliance Commercial |
$959.92
|
| Rate for Payer: WEA Trust Commercial |
$1,055.91
|
| Rate for Payer: WPS Commercial |
$1,421.97
|
|
|
SCREW LOCK 2.7 X 40 ST 202.240
|
Facility
|
IP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$940.72 |
| Max. Negotiated Rate |
$1,766.25 |
| Rate for Payer: Aetna Commercial |
$1,727.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,651.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,017.52
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,766.25
|
| Rate for Payer: Health EOS Commercial |
$1,708.66
|
| Rate for Payer: HFN Commercial |
$1,766.25
|
| Rate for Payer: Multiplan Commercial |
$1,535.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,766.25
|
| Rate for Payer: Quartz Beloit One Network |
$940.72
|
| Rate for Payer: Quartz Commercial |
$1,151.90
|
| Rate for Payer: WEA Trust Commercial |
$1,055.91
|
| Rate for Payer: WPS Commercial |
$1,421.97
|
|
|
SCREW LOCK 2.7 X 42MM 02.211.042
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265471
|
|
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 42MM 02.211.042
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265471
|
|
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 44MM 02.211.044
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028663
|
|
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 44MM 02.211.044
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028663
|
|
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 46MM 02.211.046
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028664
|
|
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 46MM 02.211.046
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028664
|
|
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 48MM 02.211.048
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028665
|
|
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 48MM 02.211.048
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028665
|
|
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 50MM 02.211.050
|
Facility
|
IP
|
$2,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,073.73 |
| Max. Negotiated Rate |
$2,015.98 |
| Rate for Payer: Aetna Commercial |
$1,972.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,884.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,161.38
|
| Rate for Payer: Cash Price |
$632.10
|
| Rate for Payer: Cigna Commercial |
$2,015.98
|
| Rate for Payer: Health EOS Commercial |
$1,950.24
|
| Rate for Payer: HFN Commercial |
$2,015.98
|
| Rate for Payer: Multiplan Commercial |
$1,753.02
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.73
|
| Rate for Payer: Quartz Commercial |
$1,314.77
|
| Rate for Payer: WEA Trust Commercial |
$1,205.20
|
| Rate for Payer: WPS Commercial |
$1,623.02
|
|
|
SCREW LOCK 2.7 X 50MM 02.211.050
|
Facility
|
OP
|
$2,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$613.56 |
| Max. Negotiated Rate |
$2,015.98 |
| Rate for Payer: Aetna Commercial |
$1,972.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,884.50
|
| Rate for Payer: Aetna Managed Medicare |
$613.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,424.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,095.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,051.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,161.38
|
| Rate for Payer: Cash Price |
$632.10
|
| Rate for Payer: Cigna Commercial |
$2,015.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,226.27
|
| Rate for Payer: Health EOS Commercial |
$1,950.24
|
| Rate for Payer: HFN Commercial |
$2,015.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,643.46
|
| Rate for Payer: Multiplan Commercial |
$1,753.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,314.77
|
| Rate for Payer: Preferred Network Access Commercial |
$2,015.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,073.73
|
| Rate for Payer: Quartz Commercial |
$1,424.33
|
| Rate for Payer: Quartz Medicare Advantage |
$1,314.77
|
| Rate for Payer: The Alliance Commercial |
$1,095.64
|
| Rate for Payer: WEA Trust Commercial |
$1,205.20
|
| Rate for Payer: WPS Commercial |
$1,623.02
|
|
|
SCREW LOCK 2.7 X 50 ST 202.250
|
Facility
|
OP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$537.56 |
| Max. Negotiated Rate |
$1,766.25 |
| Rate for Payer: Aetna Commercial |
$1,727.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,651.06
|
| Rate for Payer: Aetna Managed Medicare |
$537.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,247.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$959.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$921.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,017.52
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,766.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,074.37
|
| Rate for Payer: Health EOS Commercial |
$1,708.66
|
| Rate for Payer: HFN Commercial |
$1,766.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,439.88
|
| Rate for Payer: Multiplan Commercial |
$1,535.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,151.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,766.25
|
| Rate for Payer: Quartz Beloit One Network |
$940.72
|
| Rate for Payer: Quartz Commercial |
$1,247.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,151.90
|
| Rate for Payer: The Alliance Commercial |
$959.92
|
| Rate for Payer: WEA Trust Commercial |
$1,055.91
|
| Rate for Payer: WPS Commercial |
$1,421.97
|
|
|
SCREW LOCK 2.7 X 50 ST 202.250
|
Facility
|
IP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$940.72 |
| Max. Negotiated Rate |
$1,766.25 |
| Rate for Payer: Aetna Commercial |
$1,727.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,651.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,017.52
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,766.25
|
| Rate for Payer: Health EOS Commercial |
$1,708.66
|
| Rate for Payer: HFN Commercial |
$1,766.25
|
| Rate for Payer: Multiplan Commercial |
$1,535.87
|
| Rate for Payer: Preferred Network Access Commercial |
$1,766.25
|
| Rate for Payer: Quartz Beloit One Network |
$940.72
|
| Rate for Payer: Quartz Commercial |
$1,151.90
|
| Rate for Payer: WEA Trust Commercial |
$1,055.91
|
| Rate for Payer: WPS Commercial |
$1,421.97
|
|
|
SCREW LOCK 2.7 X 52MM 02.211.052
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028667
|
|
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 52MM 02.211.052
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028667
|
|
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 54MM 02.211.054
|
Facility
|
OP
|
$1,484.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.32 |
| Max. Negotiated Rate |
$1,420.47 |
| Rate for Payer: Aetna Commercial |
$1,389.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,327.83
|
| Rate for Payer: Aetna Managed Medicare |
$432.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,003.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$771.99
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$741.11
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$818.31
|
| Rate for Payer: Cash Price |
$445.38
|
| Rate for Payer: Cigna Commercial |
$1,420.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$864.04
|
| Rate for Payer: Health EOS Commercial |
$1,374.15
|
| Rate for Payer: HFN Commercial |
$1,420.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,157.99
|
| Rate for Payer: Multiplan Commercial |
$1,235.19
|
| Rate for Payer: NAPHCARE Commercial |
$926.39
|
| Rate for Payer: Preferred Network Access Commercial |
$1,420.47
|
| Rate for Payer: Quartz Beloit One Network |
$756.55
|
| Rate for Payer: Quartz Commercial |
$1,003.59
|
| Rate for Payer: Quartz Medicare Advantage |
$926.39
|
| Rate for Payer: The Alliance Commercial |
$771.99
|
| Rate for Payer: WEA Trust Commercial |
$849.19
|
| Rate for Payer: WPS Commercial |
$1,143.59
|
|
