|
SCREW LOCK 4.5 X 30MM LP TI AR-8545L-30
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 30MM LP TI AR-8545L-30
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 32MM LP TI AR-8545L-32
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803662
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 32MM LP TI AR-8545L-32
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803662
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 34MM LP TI AR-8545L-34
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 34MM LP TI AR-8545L-34
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 36MM LP TI AR-8545L-36
|
Facility
|
OP
|
$2,596.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$755.96 |
| Max. Negotiated Rate |
$2,483.85 |
| Rate for Payer: Aetna Commercial |
$2,429.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,321.86
|
| Rate for Payer: Aetna Managed Medicare |
$755.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,754.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,349.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,295.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,430.92
|
| Rate for Payer: Cash Price |
$778.80
|
| Rate for Payer: Cigna Commercial |
$2,483.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,510.87
|
| Rate for Payer: Health EOS Commercial |
$2,402.86
|
| Rate for Payer: HFN Commercial |
$2,483.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,024.88
|
| Rate for Payer: Multiplan Commercial |
$2,159.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,619.90
|
| Rate for Payer: Preferred Network Access Commercial |
$2,483.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,322.92
|
| Rate for Payer: Quartz Commercial |
$1,754.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,619.90
|
| Rate for Payer: The Alliance Commercial |
$1,349.92
|
| Rate for Payer: WEA Trust Commercial |
$1,484.91
|
| Rate for Payer: WPS Commercial |
$1,999.70
|
|
|
SCREW LOCK 4.5 X 36MM LP TI AR-8545L-36
|
Facility
|
IP
|
$2,596.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,322.92 |
| Max. Negotiated Rate |
$2,483.85 |
| Rate for Payer: Aetna Commercial |
$2,429.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,321.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,430.92
|
| Rate for Payer: Cash Price |
$778.80
|
| Rate for Payer: Cigna Commercial |
$2,483.85
|
| Rate for Payer: Health EOS Commercial |
$2,402.86
|
| Rate for Payer: HFN Commercial |
$2,483.85
|
| Rate for Payer: Multiplan Commercial |
$2,159.87
|
| Rate for Payer: Preferred Network Access Commercial |
$2,483.85
|
| Rate for Payer: Quartz Beloit One Network |
$1,322.92
|
| Rate for Payer: Quartz Commercial |
$1,619.90
|
| Rate for Payer: WEA Trust Commercial |
$1,484.91
|
| Rate for Payer: WPS Commercial |
$1,999.70
|
|
|
SCREW LOCK 4.5 X 38MM LP TI AR-8545L-38
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 38MM LP TI AR-8545L-38
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 40MM LP TI AR-8545L-40
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 40MM LP TI AR-8545L-40
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 42MM LP TI AR-8545L-42
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803666
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 42MM LP TI AR-8545L-42
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803666
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 44MM LP TI AR-8545L-44
|
Facility
|
IP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,271.96 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,557.50
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 4.5 X 44MM LP TI AR-8545L-44
|
Facility
|
OP
|
$2,496.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.84 |
| Max. Negotiated Rate |
$2,388.17 |
| Rate for Payer: Aetna Commercial |
$2,336.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,232.42
|
| Rate for Payer: Aetna Managed Medicare |
$726.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,687.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,297.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,246.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,375.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna Commercial |
$2,388.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,452.67
|
| Rate for Payer: Health EOS Commercial |
$2,310.30
|
| Rate for Payer: HFN Commercial |
$2,388.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,946.88
|
| Rate for Payer: Multiplan Commercial |
$2,076.67
|
| Rate for Payer: NAPHCARE Commercial |
$1,557.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,388.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,271.96
|
| Rate for Payer: Quartz Commercial |
$1,687.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,557.50
|
| Rate for Payer: The Alliance Commercial |
$1,297.92
|
| Rate for Payer: WEA Trust Commercial |
$1,427.71
|
| Rate for Payer: WPS Commercial |
$1,922.67
|
|
|
SCREW LOCK 5.0 X 100 FULL THREAD 1896-5100S
|
Facility
|
OP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$548.04 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Aetna Managed Medicare |
$548.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,272.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$978.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$939.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,095.32
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,467.96
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: NAPHCARE Commercial |
$1,174.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,272.23
|
| Rate for Payer: Quartz Medicare Advantage |
$1,174.37
|
| Rate for Payer: The Alliance Commercial |
$978.64
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
|
SCREW LOCK 5.0 X 100 FULL THREAD 1896-5100S
|
Facility
|
IP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$959.07 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,174.37
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
|
SCREW-LOCK 5.0 X 100 TFN 458.999
|
Facility
|
OP
|
$2,724.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966950
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$793.23 |
| Max. Negotiated Rate |
$2,606.32 |
| Rate for Payer: Aetna Commercial |
$2,549.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,436.35
|
| Rate for Payer: Aetna Managed Medicare |
$793.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,841.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,416.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,359.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,501.47
|
| Rate for Payer: Cash Price |
$817.20
|
| Rate for Payer: Cigna Commercial |
$2,606.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,585.37
|
| Rate for Payer: Health EOS Commercial |
$2,521.33
|
| Rate for Payer: HFN Commercial |
$2,606.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,124.72
|
| Rate for Payer: Multiplan Commercial |
$2,266.37
|
| Rate for Payer: NAPHCARE Commercial |
$1,699.78
|
| Rate for Payer: Preferred Network Access Commercial |
$2,606.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,388.15
|
| Rate for Payer: Quartz Commercial |
$1,841.42
|
| Rate for Payer: Quartz Medicare Advantage |
$1,699.78
|
| Rate for Payer: The Alliance Commercial |
$1,416.48
|
| Rate for Payer: WEA Trust Commercial |
$1,558.13
|
| Rate for Payer: WPS Commercial |
$2,098.30
|
|
|
SCREW-LOCK 5.0 X 100 TFN 458.999
|
Facility
|
IP
|
$2,724.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966950
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,388.15 |
| Max. Negotiated Rate |
$2,606.32 |
| Rate for Payer: Aetna Commercial |
$2,549.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,436.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,501.47
|
| Rate for Payer: Cash Price |
$817.20
|
| Rate for Payer: Cigna Commercial |
$2,606.32
|
| Rate for Payer: Health EOS Commercial |
$2,521.33
|
| Rate for Payer: HFN Commercial |
$2,606.32
|
| Rate for Payer: Multiplan Commercial |
$2,266.37
|
| Rate for Payer: Preferred Network Access Commercial |
$2,606.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,388.15
|
| Rate for Payer: Quartz Commercial |
$1,699.78
|
| Rate for Payer: WEA Trust Commercial |
$1,558.13
|
| Rate for Payer: WPS Commercial |
$2,098.30
|
|
|
SCREW LOCK 5.0 X 105 FULL THREAD 1896-5105S
|
Facility
|
OP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508998
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$548.04 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Aetna Managed Medicare |
$548.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,272.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$978.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$939.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,095.32
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,467.96
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: NAPHCARE Commercial |
$1,174.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,272.23
|
| Rate for Payer: Quartz Medicare Advantage |
$1,174.37
|
| Rate for Payer: The Alliance Commercial |
$978.64
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
|
SCREW LOCK 5.0 X 105 FULL THREAD 1896-5105S
|
Facility
|
IP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508998
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$959.07 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,174.37
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
|
SCREW LOCK 5.0 X 10MM PERI 02.231.010
|
Facility
|
OP
|
$2,333.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5799778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$679.37 |
| Max. Negotiated Rate |
$2,232.21 |
| Rate for Payer: Aetna Commercial |
$2,183.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,086.64
|
| Rate for Payer: Aetna Managed Medicare |
$679.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,577.11
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,213.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,164.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,285.95
|
| Rate for Payer: Cash Price |
$699.90
|
| Rate for Payer: Cigna Commercial |
$2,232.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,357.81
|
| Rate for Payer: Health EOS Commercial |
$2,159.42
|
| Rate for Payer: HFN Commercial |
$2,232.21
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,819.74
|
| Rate for Payer: Multiplan Commercial |
$1,941.06
|
| Rate for Payer: NAPHCARE Commercial |
$1,455.79
|
| Rate for Payer: Preferred Network Access Commercial |
$2,232.21
|
| Rate for Payer: Quartz Beloit One Network |
$1,188.90
|
| Rate for Payer: Quartz Commercial |
$1,577.11
|
| Rate for Payer: Quartz Medicare Advantage |
$1,455.79
|
| Rate for Payer: The Alliance Commercial |
$1,213.16
|
| Rate for Payer: WEA Trust Commercial |
$1,334.48
|
| Rate for Payer: WPS Commercial |
$1,797.11
|
|
|
SCREW LOCK 5.0 X 10MM PERI 02.231.010
|
Facility
|
IP
|
$2,333.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5799778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,188.90 |
| Max. Negotiated Rate |
$2,232.21 |
| Rate for Payer: Aetna Commercial |
$2,183.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,086.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,285.95
|
| Rate for Payer: Cash Price |
$699.90
|
| Rate for Payer: Cigna Commercial |
$2,232.21
|
| Rate for Payer: Health EOS Commercial |
$2,159.42
|
| Rate for Payer: HFN Commercial |
$2,232.21
|
| Rate for Payer: Multiplan Commercial |
$1,941.06
|
| Rate for Payer: Preferred Network Access Commercial |
$2,232.21
|
| Rate for Payer: Quartz Beloit One Network |
$1,188.90
|
| Rate for Payer: Quartz Commercial |
$1,455.79
|
| Rate for Payer: WEA Trust Commercial |
$1,334.48
|
| Rate for Payer: WPS Commercial |
$1,797.11
|
|
|
SCREW LOCK 5.0 X 110 FULL THREAD 1896-5110S
|
Facility
|
IP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$959.07 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,174.37
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
