|
SCREW LOCK 2.7 X 40MM 02.211.040
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.92 |
| Max. Negotiated Rate |
$1,479.36 |
| Rate for Payer: Aetna Commercial |
$1,447.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.24
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,479.36
|
| Rate for Payer: Health EOS Commercial |
$1,431.12
|
| Rate for Payer: HFN Commercial |
$1,479.36
|
| Rate for Payer: Multiplan Commercial |
$1,286.40
|
| Rate for Payer: NAPHCARE Commercial |
$964.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.36
|
| Rate for Payer: Quartz Beloit One Network |
$787.92
|
| Rate for Payer: Quartz Commercial |
$964.80
|
| Rate for Payer: WEA Trust Commercial |
$884.40
|
| Rate for Payer: WPS Commercial |
$1,191.05
|
|
|
SCREW LOCK 2.7 X 40MM 02.211.040
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3127491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$450.24 |
| Max. Negotiated Rate |
$6,432.00 |
| Rate for Payer: Aetna Commercial |
$1,447.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.88
|
| Rate for Payer: Aetna Managed Medicare |
$450.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,045.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$804.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$771.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.24
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,479.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$899.84
|
| Rate for Payer: Health EOS Commercial |
$1,431.12
|
| Rate for Payer: HFN Commercial |
$1,479.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,206.00
|
| Rate for Payer: Multiplan Commercial |
$1,286.40
|
| Rate for Payer: NAPHCARE Commercial |
$964.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.36
|
| Rate for Payer: Quartz Beloit One Network |
$787.92
|
| Rate for Payer: Quartz Commercial |
$1,045.20
|
| Rate for Payer: Quartz Medicare Advantage |
$964.80
|
| Rate for Payer: The Alliance Commercial |
$6,432.00
|
| Rate for Payer: WEA Trust Commercial |
$884.40
|
| Rate for Payer: WPS Commercial |
$1,191.05
|
|
|
SCREW LOCK 2.7 X 40 ST 202.240
|
Facility
|
OP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$516.88 |
| Max. Negotiated Rate |
$7,384.00 |
| Rate for Payer: Aetna Commercial |
$1,661.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,587.56
|
| Rate for Payer: Aetna Managed Medicare |
$516.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,199.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$923.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$886.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$978.38
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,698.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,033.02
|
| Rate for Payer: Health EOS Commercial |
$1,642.94
|
| Rate for Payer: HFN Commercial |
$1,698.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,384.50
|
| Rate for Payer: Multiplan Commercial |
$1,476.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,698.32
|
| Rate for Payer: Quartz Beloit One Network |
$904.54
|
| Rate for Payer: Quartz Commercial |
$1,199.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,107.60
|
| Rate for Payer: The Alliance Commercial |
$7,384.00
|
| Rate for Payer: WEA Trust Commercial |
$1,015.30
|
| Rate for Payer: WPS Commercial |
$1,367.33
|
|
|
SCREW LOCK 2.7 X 40 ST 202.240
|
Facility
|
IP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$904.54 |
| Max. Negotiated Rate |
$1,698.32 |
| Rate for Payer: Aetna Commercial |
$1,661.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,587.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$978.38
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,698.32
|
| Rate for Payer: Health EOS Commercial |
$1,642.94
|
| Rate for Payer: HFN Commercial |
$1,698.32
|
| Rate for Payer: Multiplan Commercial |
$1,476.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,698.32
|
| Rate for Payer: Quartz Beloit One Network |
$904.54
|
| Rate for Payer: Quartz Commercial |
$1,107.60
|
| Rate for Payer: WEA Trust Commercial |
$1,015.30
|
| Rate for Payer: WPS Commercial |
$1,367.33
|
|
|
SCREW LOCK 2.7 X 42MM 02.211.042
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.88 |
| Max. Negotiated Rate |
$6,184.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Aetna Managed Medicare |
$432.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,004.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$773.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$742.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$865.14
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,159.50
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$1,004.90
|
| Rate for Payer: Quartz Medicare Advantage |
$927.60
|
| Rate for Payer: The Alliance Commercial |
$6,184.00
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 42MM 02.211.042
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$757.54 |
| Max. Negotiated Rate |
$1,422.32 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$927.60
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 44MM 02.211.044
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$450.24 |
| Max. Negotiated Rate |
$6,432.00 |
| Rate for Payer: Aetna Commercial |
$1,447.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.88
|
| Rate for Payer: Aetna Managed Medicare |
$450.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,045.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$804.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$771.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.24
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,479.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$899.84
|
| Rate for Payer: Health EOS Commercial |
$1,431.12
|
| Rate for Payer: HFN Commercial |
$1,479.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,206.00
|
| Rate for Payer: Multiplan Commercial |
$1,286.40
|
| Rate for Payer: NAPHCARE Commercial |
$964.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.36
|
| Rate for Payer: Quartz Beloit One Network |
$787.92
|
| Rate for Payer: Quartz Commercial |
$1,045.20
|
| Rate for Payer: Quartz Medicare Advantage |
$964.80
|
| Rate for Payer: The Alliance Commercial |
$6,432.00
|
| Rate for Payer: WEA Trust Commercial |
$884.40
|
| Rate for Payer: WPS Commercial |
$1,191.05
|
|
|
SCREW LOCK 2.7 X 44MM 02.211.044
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.92 |
| Max. Negotiated Rate |
$1,479.36 |
| Rate for Payer: Aetna Commercial |
$1,447.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,382.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$852.24
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna Commercial |
$1,479.36
|
| Rate for Payer: Health EOS Commercial |
$1,431.12
|
| Rate for Payer: HFN Commercial |
$1,479.36
|
| Rate for Payer: Multiplan Commercial |
$1,286.40
|
| Rate for Payer: NAPHCARE Commercial |
$964.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,479.36
|
| Rate for Payer: Quartz Beloit One Network |
$787.92
|
| Rate for Payer: Quartz Commercial |
$964.80
|
| Rate for Payer: WEA Trust Commercial |
$884.40
|
| Rate for Payer: WPS Commercial |
$1,191.05
|
|
|
SCREW LOCK 2.7 X 46MM 02.211.046
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.88 |
| Max. Negotiated Rate |
$6,184.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Aetna Managed Medicare |
$432.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,004.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$773.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$742.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$865.14
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,159.50
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$1,004.90
|
| Rate for Payer: Quartz Medicare Advantage |
$927.60
|
| Rate for Payer: The Alliance Commercial |
$6,184.00
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 46MM 02.211.046
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$757.54 |
| Max. Negotiated Rate |
$1,422.32 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$927.60
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 48MM 02.211.048
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$757.54 |
| Max. Negotiated Rate |
$1,422.32 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$927.60
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 48MM 02.211.048
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.88 |
| Max. Negotiated Rate |
$6,184.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Aetna Managed Medicare |
$432.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,004.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$773.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$742.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$865.14
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,159.50
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$1,004.90
|
| Rate for Payer: Quartz Medicare Advantage |
$927.60
|
| Rate for Payer: The Alliance Commercial |
$6,184.00
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 50MM 02.211.050
|
Facility
|
OP
|
$2,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$589.96 |
| Max. Negotiated Rate |
$8,428.00 |
| Rate for Payer: Aetna Commercial |
$1,896.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,812.02
|
| Rate for Payer: Aetna Managed Medicare |
$589.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,369.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,053.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,011.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,116.71
|
| Rate for Payer: Cash Price |
$632.10
|
| Rate for Payer: Cigna Commercial |
$1,938.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,179.08
|
| Rate for Payer: Health EOS Commercial |
$1,875.23
|
| Rate for Payer: HFN Commercial |
$1,938.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,580.25
|
| Rate for Payer: Multiplan Commercial |
$1,685.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,264.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,938.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,032.43
|
| Rate for Payer: Quartz Commercial |
$1,369.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,264.20
|
| Rate for Payer: The Alliance Commercial |
$8,428.00
|
| Rate for Payer: WEA Trust Commercial |
$1,158.85
|
| Rate for Payer: WPS Commercial |
$1,560.65
|
|
|
SCREW LOCK 2.7 X 50MM 02.211.050
|
Facility
|
IP
|
$2,107.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,032.43 |
| Max. Negotiated Rate |
$1,938.44 |
| Rate for Payer: Aetna Commercial |
$1,896.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,812.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,116.71
|
| Rate for Payer: Cash Price |
$632.10
|
| Rate for Payer: Cigna Commercial |
$1,938.44
|
| Rate for Payer: Health EOS Commercial |
$1,875.23
|
| Rate for Payer: HFN Commercial |
$1,938.44
|
| Rate for Payer: Multiplan Commercial |
$1,685.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,264.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,938.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,032.43
|
| Rate for Payer: Quartz Commercial |
$1,264.20
|
| Rate for Payer: WEA Trust Commercial |
$1,158.85
|
| Rate for Payer: WPS Commercial |
$1,560.65
|
|
|
SCREW LOCK 2.7 X 50 ST 202.250
|
Facility
|
IP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$904.54 |
| Max. Negotiated Rate |
$1,698.32 |
| Rate for Payer: Aetna Commercial |
$1,661.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,587.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$978.38
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,698.32
|
| Rate for Payer: Health EOS Commercial |
$1,642.94
|
| Rate for Payer: HFN Commercial |
$1,698.32
|
| Rate for Payer: Multiplan Commercial |
$1,476.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,698.32
|
| Rate for Payer: Quartz Beloit One Network |
$904.54
|
| Rate for Payer: Quartz Commercial |
$1,107.60
|
| Rate for Payer: WEA Trust Commercial |
$1,015.30
|
| Rate for Payer: WPS Commercial |
$1,367.33
|
|
|
SCREW LOCK 2.7 X 50 ST 202.250
|
Facility
|
OP
|
$1,846.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$516.88 |
| Max. Negotiated Rate |
$7,384.00 |
| Rate for Payer: Aetna Commercial |
$1,661.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,587.56
|
| Rate for Payer: Aetna Managed Medicare |
$516.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,199.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$923.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$886.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$978.38
|
| Rate for Payer: Cash Price |
$553.80
|
| Rate for Payer: Cigna Commercial |
$1,698.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,033.02
|
| Rate for Payer: Health EOS Commercial |
$1,642.94
|
| Rate for Payer: HFN Commercial |
$1,698.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,384.50
|
| Rate for Payer: Multiplan Commercial |
$1,476.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,698.32
|
| Rate for Payer: Quartz Beloit One Network |
$904.54
|
| Rate for Payer: Quartz Commercial |
$1,199.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,107.60
|
| Rate for Payer: The Alliance Commercial |
$7,384.00
|
| Rate for Payer: WEA Trust Commercial |
$1,015.30
|
| Rate for Payer: WPS Commercial |
$1,367.33
|
|
|
SCREW LOCK 2.7 X 52MM 02.211.052
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$432.88 |
| Max. Negotiated Rate |
$6,184.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Aetna Managed Medicare |
$432.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,004.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$773.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$742.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$865.14
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,159.50
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$1,004.90
|
| Rate for Payer: Quartz Medicare Advantage |
$927.60
|
| Rate for Payer: The Alliance Commercial |
$6,184.00
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 52MM 02.211.052
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4028667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$757.54 |
| Max. Negotiated Rate |
$1,422.32 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$927.60
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
SCREW LOCK 2.7 X 54MM 02.211.054
|
Facility
|
OP
|
$1,484.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$415.69 |
| Max. Negotiated Rate |
$5,938.40 |
| Rate for Payer: Aetna Commercial |
$1,336.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,276.76
|
| Rate for Payer: Aetna Managed Medicare |
$415.69
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$964.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$742.30
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$712.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$786.84
|
| Rate for Payer: Cash Price |
$445.38
|
| Rate for Payer: Cigna Commercial |
$1,365.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$830.78
|
| Rate for Payer: Health EOS Commercial |
$1,321.29
|
| Rate for Payer: HFN Commercial |
$1,365.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,113.45
|
| Rate for Payer: Multiplan Commercial |
$1,187.68
|
| Rate for Payer: NAPHCARE Commercial |
$890.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,365.83
|
| Rate for Payer: Quartz Beloit One Network |
$727.45
|
| Rate for Payer: Quartz Commercial |
$964.99
|
| Rate for Payer: Quartz Medicare Advantage |
$890.76
|
| Rate for Payer: The Alliance Commercial |
$5,938.40
|
| Rate for Payer: WEA Trust Commercial |
$816.53
|
| Rate for Payer: WPS Commercial |
$1,099.64
|
|
|
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 |
$727.45 |
| Max. Negotiated Rate |
$1,365.83 |
| Rate for Payer: Aetna Commercial |
$1,336.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,276.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$786.84
|
| Rate for Payer: Cash Price |
$445.38
|
| Rate for Payer: Cigna Commercial |
$1,365.83
|
| Rate for Payer: Health EOS Commercial |
$1,321.29
|
| Rate for Payer: HFN Commercial |
$1,365.83
|
| Rate for Payer: Multiplan Commercial |
$1,187.68
|
| Rate for Payer: NAPHCARE Commercial |
$890.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,365.83
|
| Rate for Payer: Quartz Beloit One Network |
$727.45
|
| Rate for Payer: Quartz Commercial |
$890.76
|
| Rate for Payer: WEA Trust Commercial |
$816.53
|
| Rate for Payer: WPS Commercial |
$1,099.64
|
|
|
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 |
$432.88 |
| Max. Negotiated Rate |
$6,184.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Aetna Managed Medicare |
$432.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,004.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$773.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$742.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$865.14
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,159.50
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$1,004.90
|
| Rate for Payer: Quartz Medicare Advantage |
$927.60
|
| Rate for Payer: The Alliance Commercial |
$6,184.00
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
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 |
$757.54 |
| Max. Negotiated Rate |
$1,422.32 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,329.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$819.38
|
| Rate for Payer: Cash Price |
$463.80
|
| Rate for Payer: Cigna Commercial |
$1,422.32
|
| Rate for Payer: Health EOS Commercial |
$1,375.94
|
| Rate for Payer: HFN Commercial |
$1,422.32
|
| Rate for Payer: Multiplan Commercial |
$1,236.80
|
| Rate for Payer: NAPHCARE Commercial |
$927.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,422.32
|
| Rate for Payer: Quartz Beloit One Network |
$757.54
|
| Rate for Payer: Quartz Commercial |
$927.60
|
| Rate for Payer: WEA Trust Commercial |
$850.30
|
| Rate for Payer: WPS Commercial |
$1,145.12
|
|
|
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 |
$476.00 |
| Max. Negotiated Rate |
$6,800.00 |
| Rate for Payer: Aetna Commercial |
$1,530.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,462.00
|
| Rate for Payer: Aetna Managed Medicare |
$476.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,105.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$850.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$816.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$901.00
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cigna Commercial |
$1,564.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$951.32
|
| Rate for Payer: Health EOS Commercial |
$1,513.00
|
| Rate for Payer: HFN Commercial |
$1,564.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,275.00
|
| Rate for Payer: Multiplan Commercial |
$1,360.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,020.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,564.00
|
| Rate for Payer: Quartz Beloit One Network |
$833.00
|
| Rate for Payer: Quartz Commercial |
$1,105.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,020.00
|
| Rate for Payer: The Alliance Commercial |
$6,800.00
|
| Rate for Payer: WEA Trust Commercial |
$935.00
|
| Rate for Payer: WPS Commercial |
$1,259.19
|
|
|
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 |
$833.00 |
| Max. Negotiated Rate |
$1,564.00 |
| Rate for Payer: Aetna Commercial |
$1,530.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,462.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$901.00
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cigna Commercial |
$1,564.00
|
| Rate for Payer: Health EOS Commercial |
$1,513.00
|
| Rate for Payer: HFN Commercial |
$1,564.00
|
| Rate for Payer: Multiplan Commercial |
$1,360.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,020.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,564.00
|
| Rate for Payer: Quartz Beloit One Network |
$833.00
|
| Rate for Payer: Quartz Commercial |
$1,020.00
|
| Rate for Payer: WEA Trust Commercial |
$935.00
|
| Rate for Payer: WPS Commercial |
$1,259.19
|
|
|
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 |
$566.72 |
| Max. Negotiated Rate |
$8,096.00 |
| Rate for Payer: Aetna Commercial |
$1,821.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,740.64
|
| Rate for Payer: Aetna Managed Medicare |
$566.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,315.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,012.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$971.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,072.72
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$1,862.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,132.63
|
| Rate for Payer: Health EOS Commercial |
$1,801.36
|
| Rate for Payer: HFN Commercial |
$1,862.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,518.00
|
| Rate for Payer: Multiplan Commercial |
$1,619.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,214.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,862.08
|
| Rate for Payer: Quartz Beloit One Network |
$991.76
|
| Rate for Payer: Quartz Commercial |
$1,315.60
|
| Rate for Payer: Quartz Medicare Advantage |
$1,214.40
|
| Rate for Payer: The Alliance Commercial |
$8,096.00
|
| Rate for Payer: WEA Trust Commercial |
$1,113.20
|
| Rate for Payer: WPS Commercial |
$1,499.18
|
|
