|
SCREW LOCK 2.7 X 14MM SS LP AR-8827L-14
|
Facility
|
IP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.19 |
| Max. Negotiated Rate |
$1,408.52 |
| Rate for Payer: Aetna Commercial |
$1,377.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.43
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,408.52
|
| Rate for Payer: Health EOS Commercial |
$1,362.59
|
| Rate for Payer: HFN Commercial |
$1,408.52
|
| Rate for Payer: Multiplan Commercial |
$1,224.80
|
| Rate for Payer: NAPHCARE Commercial |
$918.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.52
|
| Rate for Payer: Quartz Beloit One Network |
$750.19
|
| Rate for Payer: Quartz Commercial |
$918.60
|
| Rate for Payer: WEA Trust Commercial |
$842.05
|
| Rate for Payer: WPS Commercial |
$1,134.01
|
|
|
SCREW LOCK 2.7 X 14MM SS LP AR-8827L-14
|
Facility
|
OP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508980
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$428.68 |
| Max. Negotiated Rate |
$6,124.00 |
| Rate for Payer: Aetna Commercial |
$1,377.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.66
|
| Rate for Payer: Aetna Managed Medicare |
$428.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$995.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$765.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$734.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.43
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,408.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$856.75
|
| Rate for Payer: Health EOS Commercial |
$1,362.59
|
| Rate for Payer: HFN Commercial |
$1,408.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,148.25
|
| Rate for Payer: Multiplan Commercial |
$1,224.80
|
| Rate for Payer: NAPHCARE Commercial |
$918.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.52
|
| Rate for Payer: Quartz Beloit One Network |
$750.19
|
| Rate for Payer: Quartz Commercial |
$995.15
|
| Rate for Payer: Quartz Medicare Advantage |
$918.60
|
| Rate for Payer: The Alliance Commercial |
$6,124.00
|
| Rate for Payer: WEA Trust Commercial |
$842.05
|
| Rate for Payer: WPS Commercial |
$1,134.01
|
|
|
SCREW LOCK 2.7 X 14 ST 202.214
|
Facility
|
OP
|
$1,746.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$488.88 |
| Max. Negotiated Rate |
$6,984.00 |
| Rate for Payer: Aetna Commercial |
$1,571.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,501.56
|
| Rate for Payer: Aetna Managed Medicare |
$488.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,134.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$873.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$838.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$925.38
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$1,606.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$977.06
|
| Rate for Payer: Health EOS Commercial |
$1,553.94
|
| Rate for Payer: HFN Commercial |
$1,606.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,309.50
|
| Rate for Payer: Multiplan Commercial |
$1,396.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,606.32
|
| Rate for Payer: Quartz Beloit One Network |
$855.54
|
| Rate for Payer: Quartz Commercial |
$1,134.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,047.60
|
| Rate for Payer: The Alliance Commercial |
$6,984.00
|
| Rate for Payer: WEA Trust Commercial |
$960.30
|
| Rate for Payer: WPS Commercial |
$1,293.26
|
|
|
SCREW LOCK 2.7 X 14 ST 202.214
|
Facility
|
IP
|
$1,746.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.54 |
| Max. Negotiated Rate |
$1,606.32 |
| Rate for Payer: Aetna Commercial |
$1,571.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,501.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$925.38
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$1,606.32
|
| Rate for Payer: Health EOS Commercial |
$1,553.94
|
| Rate for Payer: HFN Commercial |
$1,606.32
|
| Rate for Payer: Multiplan Commercial |
$1,396.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,047.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,606.32
|
| Rate for Payer: Quartz Beloit One Network |
$855.54
|
| Rate for Payer: Quartz Commercial |
$1,047.60
|
| Rate for Payer: WEA Trust Commercial |
$960.30
|
| Rate for Payer: WPS Commercial |
$1,293.26
|
|
|
SCREW LOCK 2.7 X 16MM 02.211.016
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$999.11 |
| Max. Negotiated Rate |
$1,875.88 |
| Rate for Payer: Aetna Commercial |
$1,835.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.67
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,875.88
|
| Rate for Payer: Health EOS Commercial |
$1,814.71
|
| Rate for Payer: HFN Commercial |
$1,875.88
|
| Rate for Payer: Multiplan Commercial |
$1,631.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,223.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,875.88
|
| Rate for Payer: Quartz Beloit One Network |
$999.11
|
| Rate for Payer: Quartz Commercial |
$1,223.40
|
| Rate for Payer: WEA Trust Commercial |
$1,121.45
|
| Rate for Payer: WPS Commercial |
$1,510.29
|
|
|
SCREW LOCK 2.7 X 16MM 02.211.016
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$570.92 |
| Max. Negotiated Rate |
$8,156.00 |
| Rate for Payer: Aetna Commercial |
$1,835.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.54
|
| Rate for Payer: Aetna Managed Medicare |
$570.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,325.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,019.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$978.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.67
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,875.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,141.02
|
| Rate for Payer: Health EOS Commercial |
$1,814.71
|
| Rate for Payer: HFN Commercial |
$1,875.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,529.25
|
| Rate for Payer: Multiplan Commercial |
$1,631.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,223.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,875.88
|
| Rate for Payer: Quartz Beloit One Network |
$999.11
|
| Rate for Payer: Quartz Commercial |
$1,325.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,223.40
|
| Rate for Payer: The Alliance Commercial |
$8,156.00
|
| Rate for Payer: WEA Trust Commercial |
$1,121.45
|
| Rate for Payer: WPS Commercial |
$1,510.29
|
|
|
SCREW LOCK 2.7 X 16MM SS LP AR-8827L-16
|
Facility
|
IP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.19 |
| Max. Negotiated Rate |
$1,408.52 |
| Rate for Payer: Aetna Commercial |
$1,377.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.43
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,408.52
|
| Rate for Payer: Health EOS Commercial |
$1,362.59
|
| Rate for Payer: HFN Commercial |
$1,408.52
|
| Rate for Payer: Multiplan Commercial |
$1,224.80
|
| Rate for Payer: NAPHCARE Commercial |
$918.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.52
|
| Rate for Payer: Quartz Beloit One Network |
$750.19
|
| Rate for Payer: Quartz Commercial |
$918.60
|
| Rate for Payer: WEA Trust Commercial |
$842.05
|
| Rate for Payer: WPS Commercial |
$1,134.01
|
|
|
SCREW LOCK 2.7 X 16MM SS LP AR-8827L-16
|
Facility
|
OP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$428.68 |
| Max. Negotiated Rate |
$6,124.00 |
| Rate for Payer: Aetna Commercial |
$1,377.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.66
|
| Rate for Payer: Aetna Managed Medicare |
$428.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$995.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$765.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$734.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.43
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,408.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$856.75
|
| Rate for Payer: Health EOS Commercial |
$1,362.59
|
| Rate for Payer: HFN Commercial |
$1,408.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,148.25
|
| Rate for Payer: Multiplan Commercial |
$1,224.80
|
| Rate for Payer: NAPHCARE Commercial |
$918.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.52
|
| Rate for Payer: Quartz Beloit One Network |
$750.19
|
| Rate for Payer: Quartz Commercial |
$995.15
|
| Rate for Payer: Quartz Medicare Advantage |
$918.60
|
| Rate for Payer: The Alliance Commercial |
$6,124.00
|
| Rate for Payer: WEA Trust Commercial |
$842.05
|
| Rate for Payer: WPS Commercial |
$1,134.01
|
|
|
SCREW LOCK 2.7 X 16 ST 202.216
|
Facility
|
IP
|
$2,918.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,429.82 |
| Max. Negotiated Rate |
$2,684.56 |
| Rate for Payer: Aetna Commercial |
$2,626.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,509.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,546.54
|
| Rate for Payer: Cash Price |
$875.40
|
| Rate for Payer: Cigna Commercial |
$2,684.56
|
| Rate for Payer: Health EOS Commercial |
$2,597.02
|
| Rate for Payer: HFN Commercial |
$2,684.56
|
| Rate for Payer: Multiplan Commercial |
$2,334.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,750.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,684.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,429.82
|
| Rate for Payer: Quartz Commercial |
$1,750.80
|
| Rate for Payer: WEA Trust Commercial |
$1,604.90
|
| Rate for Payer: WPS Commercial |
$2,161.36
|
|
|
SCREW LOCK 2.7 X 16 ST 202.216
|
Facility
|
OP
|
$2,918.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$817.04 |
| Max. Negotiated Rate |
$11,672.00 |
| Rate for Payer: Aetna Commercial |
$2,626.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,509.48
|
| Rate for Payer: Aetna Managed Medicare |
$817.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,896.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,459.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,400.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,546.54
|
| Rate for Payer: Cash Price |
$875.40
|
| Rate for Payer: Cigna Commercial |
$2,684.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,632.91
|
| Rate for Payer: Health EOS Commercial |
$2,597.02
|
| Rate for Payer: HFN Commercial |
$2,684.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,188.50
|
| Rate for Payer: Multiplan Commercial |
$2,334.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,750.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,684.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,429.82
|
| Rate for Payer: Quartz Commercial |
$1,896.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,750.80
|
| Rate for Payer: The Alliance Commercial |
$11,672.00
|
| Rate for Payer: WEA Trust Commercial |
$1,604.90
|
| Rate for Payer: WPS Commercial |
$2,161.36
|
|
|
SCREW LOCK 2.7 X 18MM 02.211.018
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$999.11 |
| Max. Negotiated Rate |
$1,875.88 |
| Rate for Payer: Aetna Commercial |
$1,835.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.67
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,875.88
|
| Rate for Payer: Health EOS Commercial |
$1,814.71
|
| Rate for Payer: HFN Commercial |
$1,875.88
|
| Rate for Payer: Multiplan Commercial |
$1,631.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,223.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,875.88
|
| Rate for Payer: Quartz Beloit One Network |
$999.11
|
| Rate for Payer: Quartz Commercial |
$1,223.40
|
| Rate for Payer: WEA Trust Commercial |
$1,121.45
|
| Rate for Payer: WPS Commercial |
$1,510.29
|
|
|
SCREW LOCK 2.7 X 18MM 02.211.018
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$570.92 |
| Max. Negotiated Rate |
$8,156.00 |
| Rate for Payer: Aetna Commercial |
$1,835.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,753.54
|
| Rate for Payer: Aetna Managed Medicare |
$570.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,325.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,019.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$978.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,080.67
|
| Rate for Payer: Cash Price |
$611.70
|
| Rate for Payer: Cigna Commercial |
$1,875.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,141.02
|
| Rate for Payer: Health EOS Commercial |
$1,814.71
|
| Rate for Payer: HFN Commercial |
$1,875.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,529.25
|
| Rate for Payer: Multiplan Commercial |
$1,631.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,223.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,875.88
|
| Rate for Payer: Quartz Beloit One Network |
$999.11
|
| Rate for Payer: Quartz Commercial |
$1,325.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,223.40
|
| Rate for Payer: The Alliance Commercial |
$8,156.00
|
| Rate for Payer: WEA Trust Commercial |
$1,121.45
|
| Rate for Payer: WPS Commercial |
$1,510.29
|
|
|
SCREW LOCK 2.7 X 18MM SS LP AR-8827L-18
|
Facility
|
IP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.19 |
| Max. Negotiated Rate |
$1,408.52 |
| Rate for Payer: Aetna Commercial |
$1,377.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.43
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,408.52
|
| Rate for Payer: Health EOS Commercial |
$1,362.59
|
| Rate for Payer: HFN Commercial |
$1,408.52
|
| Rate for Payer: Multiplan Commercial |
$1,224.80
|
| Rate for Payer: NAPHCARE Commercial |
$918.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.52
|
| Rate for Payer: Quartz Beloit One Network |
$750.19
|
| Rate for Payer: Quartz Commercial |
$918.60
|
| Rate for Payer: WEA Trust Commercial |
$842.05
|
| Rate for Payer: WPS Commercial |
$1,134.01
|
|
|
SCREW LOCK 2.7 X 18MM SS LP AR-8827L-18
|
Facility
|
OP
|
$1,531.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$428.68 |
| Max. Negotiated Rate |
$6,124.00 |
| Rate for Payer: Aetna Commercial |
$1,377.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,316.66
|
| Rate for Payer: Aetna Managed Medicare |
$428.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$995.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$765.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$734.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$811.43
|
| Rate for Payer: Cash Price |
$459.30
|
| Rate for Payer: Cigna Commercial |
$1,408.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$856.75
|
| Rate for Payer: Health EOS Commercial |
$1,362.59
|
| Rate for Payer: HFN Commercial |
$1,408.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,148.25
|
| Rate for Payer: Multiplan Commercial |
$1,224.80
|
| Rate for Payer: NAPHCARE Commercial |
$918.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,408.52
|
| Rate for Payer: Quartz Beloit One Network |
$750.19
|
| Rate for Payer: Quartz Commercial |
$995.15
|
| Rate for Payer: Quartz Medicare Advantage |
$918.60
|
| Rate for Payer: The Alliance Commercial |
$6,124.00
|
| Rate for Payer: WEA Trust Commercial |
$842.05
|
| Rate for Payer: WPS Commercial |
$1,134.01
|
|
|
SCREW LOCK 2.7 X 18 ST 202.218
|
Facility
|
OP
|
$1,829.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966483
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$512.12 |
| Max. Negotiated Rate |
$7,316.00 |
| Rate for Payer: Aetna Commercial |
$1,646.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,572.94
|
| Rate for Payer: Aetna Managed Medicare |
$512.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,188.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$914.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$877.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$969.37
|
| Rate for Payer: Cash Price |
$548.70
|
| Rate for Payer: Cigna Commercial |
$1,682.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,023.51
|
| Rate for Payer: Health EOS Commercial |
$1,627.81
|
| Rate for Payer: HFN Commercial |
$1,682.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,371.75
|
| Rate for Payer: Multiplan Commercial |
$1,463.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,097.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,682.68
|
| Rate for Payer: Quartz Beloit One Network |
$896.21
|
| Rate for Payer: Quartz Commercial |
$1,188.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,097.40
|
| Rate for Payer: The Alliance Commercial |
$7,316.00
|
| Rate for Payer: WEA Trust Commercial |
$1,005.95
|
| Rate for Payer: WPS Commercial |
$1,354.74
|
|
|
SCREW LOCK 2.7 X 18 ST 202.218
|
Facility
|
IP
|
$1,829.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966483
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$896.21 |
| Max. Negotiated Rate |
$1,682.68 |
| Rate for Payer: Aetna Commercial |
$1,646.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,572.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$969.37
|
| Rate for Payer: Cash Price |
$548.70
|
| Rate for Payer: Cigna Commercial |
$1,682.68
|
| Rate for Payer: Health EOS Commercial |
$1,627.81
|
| Rate for Payer: HFN Commercial |
$1,682.68
|
| Rate for Payer: Multiplan Commercial |
$1,463.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,097.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,682.68
|
| Rate for Payer: Quartz Beloit One Network |
$896.21
|
| Rate for Payer: Quartz Commercial |
$1,097.40
|
| Rate for Payer: WEA Trust Commercial |
$1,005.95
|
| Rate for Payer: WPS Commercial |
$1,354.74
|
|
|
SCREW LOCK 2.7 X 20MM 02.211.020
|
Facility
|
OP
|
$2,188.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.64 |
| Max. Negotiated Rate |
$8,752.00 |
| Rate for Payer: Aetna Commercial |
$1,969.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,881.68
|
| Rate for Payer: Aetna Managed Medicare |
$612.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,422.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,094.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,050.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,159.64
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$2,012.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,224.40
|
| Rate for Payer: Health EOS Commercial |
$1,947.32
|
| Rate for Payer: HFN Commercial |
$2,012.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,641.00
|
| Rate for Payer: Multiplan Commercial |
$1,750.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,312.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,012.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,072.12
|
| Rate for Payer: Quartz Commercial |
$1,422.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,312.80
|
| Rate for Payer: The Alliance Commercial |
$8,752.00
|
| Rate for Payer: WEA Trust Commercial |
$1,203.40
|
| Rate for Payer: WPS Commercial |
$1,620.65
|
|
|
SCREW LOCK 2.7 X 20MM 02.211.020
|
Facility
|
IP
|
$2,188.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,072.12 |
| Max. Negotiated Rate |
$2,012.96 |
| Rate for Payer: Aetna Commercial |
$1,969.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,881.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,159.64
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$2,012.96
|
| Rate for Payer: Health EOS Commercial |
$1,947.32
|
| Rate for Payer: HFN Commercial |
$2,012.96
|
| Rate for Payer: Multiplan Commercial |
$1,750.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,312.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,012.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,072.12
|
| Rate for Payer: Quartz Commercial |
$1,312.80
|
| Rate for Payer: WEA Trust Commercial |
$1,203.40
|
| Rate for Payer: WPS Commercial |
$1,620.65
|
|
|
SCREW LOCK 2.7 X 20MM SS LP AR-8827L-20
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5659717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$721.28 |
| Max. Negotiated Rate |
$1,354.24 |
| Rate for Payer: Aetna Commercial |
$1,324.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,265.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$780.16
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cigna Commercial |
$1,354.24
|
| Rate for Payer: Health EOS Commercial |
$1,310.08
|
| Rate for Payer: HFN Commercial |
$1,354.24
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: NAPHCARE Commercial |
$883.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,354.24
|
| Rate for Payer: Quartz Beloit One Network |
$721.28
|
| Rate for Payer: Quartz Commercial |
$883.20
|
| Rate for Payer: WEA Trust Commercial |
$809.60
|
| Rate for Payer: WPS Commercial |
$1,090.31
|
|
|
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 |
$412.16 |
| Max. Negotiated Rate |
$5,888.00 |
| Rate for Payer: Aetna Commercial |
$1,324.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,265.92
|
| Rate for Payer: Aetna Managed Medicare |
$412.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$956.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$736.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$706.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$780.16
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cigna Commercial |
$1,354.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$823.73
|
| Rate for Payer: Health EOS Commercial |
$1,310.08
|
| Rate for Payer: HFN Commercial |
$1,354.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,104.00
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: NAPHCARE Commercial |
$883.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,354.24
|
| Rate for Payer: Quartz Beloit One Network |
$721.28
|
| Rate for Payer: Quartz Commercial |
$956.80
|
| Rate for Payer: Quartz Medicare Advantage |
$883.20
|
| Rate for Payer: The Alliance Commercial |
$5,888.00
|
| Rate for Payer: WEA Trust Commercial |
$809.60
|
| Rate for Payer: WPS Commercial |
$1,090.31
|
|
|
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 |
$493.36 |
| Max. Negotiated Rate |
$7,048.00 |
| Rate for Payer: Aetna Commercial |
$1,585.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,515.32
|
| Rate for Payer: Aetna Managed Medicare |
$493.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,145.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$881.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$845.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$933.86
|
| Rate for Payer: Cash Price |
$528.60
|
| Rate for Payer: Cigna Commercial |
$1,621.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$986.02
|
| Rate for Payer: Health EOS Commercial |
$1,568.18
|
| Rate for Payer: HFN Commercial |
$1,621.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,321.50
|
| Rate for Payer: Multiplan Commercial |
$1,409.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,057.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,621.04
|
| Rate for Payer: Quartz Beloit One Network |
$863.38
|
| Rate for Payer: Quartz Commercial |
$1,145.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,057.20
|
| Rate for Payer: The Alliance Commercial |
$7,048.00
|
| Rate for Payer: WEA Trust Commercial |
$969.10
|
| Rate for Payer: WPS Commercial |
$1,305.11
|
|
|
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 |
$863.38 |
| Max. Negotiated Rate |
$1,621.04 |
| Rate for Payer: Aetna Commercial |
$1,585.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,515.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$933.86
|
| Rate for Payer: Cash Price |
$528.60
|
| Rate for Payer: Cigna Commercial |
$1,621.04
|
| Rate for Payer: Health EOS Commercial |
$1,568.18
|
| Rate for Payer: HFN Commercial |
$1,621.04
|
| Rate for Payer: Multiplan Commercial |
$1,409.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,057.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,621.04
|
| Rate for Payer: Quartz Beloit One Network |
$863.38
|
| Rate for Payer: Quartz Commercial |
$1,057.20
|
| Rate for Payer: WEA Trust Commercial |
$969.10
|
| Rate for Payer: WPS Commercial |
$1,305.11
|
|
|
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 |
$612.64 |
| Max. Negotiated Rate |
$8,752.00 |
| Rate for Payer: Aetna Commercial |
$1,969.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,881.68
|
| Rate for Payer: Aetna Managed Medicare |
$612.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,422.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,094.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,050.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,159.64
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$2,012.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,224.40
|
| Rate for Payer: Health EOS Commercial |
$1,947.32
|
| Rate for Payer: HFN Commercial |
$2,012.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,641.00
|
| Rate for Payer: Multiplan Commercial |
$1,750.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,312.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,012.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,072.12
|
| Rate for Payer: Quartz Commercial |
$1,422.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,312.80
|
| Rate for Payer: The Alliance Commercial |
$8,752.00
|
| Rate for Payer: WEA Trust Commercial |
$1,203.40
|
| Rate for Payer: WPS Commercial |
$1,620.65
|
|
|
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 |
$1,072.12 |
| Max. Negotiated Rate |
$2,012.96 |
| Rate for Payer: Aetna Commercial |
$1,969.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,881.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,159.64
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$2,012.96
|
| Rate for Payer: Health EOS Commercial |
$1,947.32
|
| Rate for Payer: HFN Commercial |
$2,012.96
|
| Rate for Payer: Multiplan Commercial |
$1,750.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,312.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,012.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,072.12
|
| Rate for Payer: Quartz Commercial |
$1,312.80
|
| Rate for Payer: WEA Trust Commercial |
$1,203.40
|
| Rate for Payer: WPS Commercial |
$1,620.65
|
|
|
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 |
$886.41 |
| Max. Negotiated Rate |
$1,664.28 |
| Rate for Payer: Aetna Commercial |
$1,628.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,555.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$958.77
|
| Rate for Payer: Cash Price |
$542.70
|
| Rate for Payer: Cigna Commercial |
$1,664.28
|
| Rate for Payer: Health EOS Commercial |
$1,610.01
|
| Rate for Payer: HFN Commercial |
$1,664.28
|
| Rate for Payer: Multiplan Commercial |
$1,447.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,085.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,664.28
|
| Rate for Payer: Quartz Beloit One Network |
$886.41
|
| Rate for Payer: Quartz Commercial |
$1,085.40
|
| Rate for Payer: WEA Trust Commercial |
$994.95
|
| Rate for Payer: WPS Commercial |
$1,339.93
|
|
