|
SCREW LOCK 2.7 X 54MM 02.211.054
|
Facility
|
IP
|
$1,484.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$756.55 |
| 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: 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: Health EOS Commercial |
$1,374.15
|
| Rate for Payer: HFN Commercial |
$1,420.47
|
| Rate for Payer: Multiplan Commercial |
$1,235.19
|
| Rate for Payer: Preferred Network Access Commercial |
$1,420.47
|
| Rate for Payer: Quartz Beloit One Network |
$756.55
|
| Rate for Payer: Quartz Commercial |
$926.39
|
| Rate for Payer: WEA Trust Commercial |
$849.19
|
| Rate for Payer: WPS Commercial |
$1,143.59
|
|
|
SCREW LOCK 2.7 X 60MM 02.211.060
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127492
|
|
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 60MM 02.211.060
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127492
|
|
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 8 ST 202.208
|
Facility
|
OP
|
$1,700.00
|
|
| Hospital Charge Code |
2966490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$495.04 |
| Max. Negotiated Rate |
$1,626.56 |
| Rate for Payer: Aetna Commercial |
$1,591.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,520.48
|
| Rate for Payer: Aetna Managed Medicare |
$495.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,149.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$884.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$848.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$937.04
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cigna Commercial |
$1,626.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$989.40
|
| Rate for Payer: Health EOS Commercial |
$1,573.52
|
| Rate for Payer: HFN Commercial |
$1,626.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,326.00
|
| Rate for Payer: Multiplan Commercial |
$1,414.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,060.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,626.56
|
| Rate for Payer: Quartz Beloit One Network |
$866.32
|
| Rate for Payer: Quartz Commercial |
$1,149.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,060.80
|
| Rate for Payer: The Alliance Commercial |
$884.00
|
| Rate for Payer: WEA Trust Commercial |
$972.40
|
| Rate for Payer: WPS Commercial |
$1,309.51
|
|
|
SCREW LOCK 2.7 X 8 ST 202.208
|
Facility
|
IP
|
$1,700.00
|
|
| Hospital Charge Code |
2966490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$866.32 |
| Max. Negotiated Rate |
$1,626.56 |
| Rate for Payer: Aetna Commercial |
$1,591.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,520.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$937.04
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cigna Commercial |
$1,626.56
|
| Rate for Payer: Health EOS Commercial |
$1,573.52
|
| Rate for Payer: HFN Commercial |
$1,626.56
|
| Rate for Payer: Multiplan Commercial |
$1,414.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,626.56
|
| Rate for Payer: Quartz Beloit One Network |
$866.32
|
| Rate for Payer: Quartz Commercial |
$1,060.80
|
| Rate for Payer: WEA Trust Commercial |
$972.40
|
| Rate for Payer: WPS Commercial |
$1,309.51
|
|
|
SCREW LOCK 3.5MM X 10MM T10 657310
|
Facility
|
IP
|
$2,024.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6185028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.43 |
| Max. Negotiated Rate |
$1,936.56 |
| Rate for Payer: Aetna Commercial |
$1,894.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,810.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,115.63
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$1,936.56
|
| Rate for Payer: Health EOS Commercial |
$1,873.41
|
| Rate for Payer: HFN Commercial |
$1,936.56
|
| Rate for Payer: Multiplan Commercial |
$1,683.97
|
| Rate for Payer: Preferred Network Access Commercial |
$1,936.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,031.43
|
| Rate for Payer: Quartz Commercial |
$1,262.98
|
| Rate for Payer: WEA Trust Commercial |
$1,157.73
|
| Rate for Payer: WPS Commercial |
$1,559.09
|
|
|
SCREW LOCK 3.5MM X 10MM T10 657310
|
Facility
|
OP
|
$2,024.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6185028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$589.39 |
| Max. Negotiated Rate |
$1,936.56 |
| Rate for Payer: Aetna Commercial |
$1,894.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,810.27
|
| Rate for Payer: Aetna Managed Medicare |
$589.39
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,368.22
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,052.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,010.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,115.63
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$1,936.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,177.97
|
| Rate for Payer: Health EOS Commercial |
$1,873.41
|
| Rate for Payer: HFN Commercial |
$1,936.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,578.72
|
| Rate for Payer: Multiplan Commercial |
$1,683.97
|
| Rate for Payer: NAPHCARE Commercial |
$1,262.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,936.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,031.43
|
| Rate for Payer: Quartz Commercial |
$1,368.22
|
| Rate for Payer: Quartz Medicare Advantage |
$1,262.98
|
| Rate for Payer: The Alliance Commercial |
$1,052.48
|
| Rate for Payer: WEA Trust Commercial |
$1,157.73
|
| Rate for Payer: WPS Commercial |
$1,559.09
|
|
|
SCREW LOCK 3.5MM X 12MM T10 657312
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 12MM T10 657312
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 14MM T10 657314
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 14MM T10 657314
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 16MM T10 657316
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 16MM T10 657316
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 18MM T10 657318
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 18MM T10 657318
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 20MM T10 657320
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 20MM T10 657320
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 22MM T10 657322
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 22MM T10 657322
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 24MM T10 657324
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 24MM T10 657324
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 26MM T10 657326
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599679
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 26MM T10 657326
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599679
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 28MM T10 657328
|
Facility
|
OP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$637.73 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Aetna Managed Medicare |
$637.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,480.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,138.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,093.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,274.58
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,708.20
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: NAPHCARE Commercial |
$1,366.56
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,480.44
|
| Rate for Payer: Quartz Medicare Advantage |
$1,366.56
|
| Rate for Payer: The Alliance Commercial |
$1,138.80
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
|
SCREW LOCK 3.5MM X 28MM T10 657328
|
Facility
|
IP
|
$2,190.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5583325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.02 |
| Max. Negotiated Rate |
$2,095.39 |
| Rate for Payer: Aetna Commercial |
$2,049.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,958.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,207.13
|
| Rate for Payer: Cash Price |
$657.00
|
| Rate for Payer: Cigna Commercial |
$2,095.39
|
| Rate for Payer: Health EOS Commercial |
$2,027.06
|
| Rate for Payer: HFN Commercial |
$2,095.39
|
| Rate for Payer: Multiplan Commercial |
$1,822.08
|
| Rate for Payer: Preferred Network Access Commercial |
$2,095.39
|
| Rate for Payer: Quartz Beloit One Network |
$1,116.02
|
| Rate for Payer: Quartz Commercial |
$1,366.56
|
| Rate for Payer: WEA Trust Commercial |
$1,252.68
|
| Rate for Payer: WPS Commercial |
$1,686.96
|
|
