|
SCREW-LOCK 5.0X22 212.205
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2966955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,196.21
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW-LOCK 5.0X22 212.205
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2966955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$996.84
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW-LOCK 5.0X24 212.206
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2966956
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$996.84
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW-LOCK 5.0X24 212.206
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2966956
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,196.21
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW LOCK 5.0 X 25 FULLY THREAD 1896-5025S
|
Facility
|
OP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508987
|
|
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 25 FULLY THREAD 1896-5025S
|
Facility
|
IP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508987
|
|
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 5.0X26 212.207
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2966958
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$996.84
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW-LOCK 5.0X26 212.207
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2966958
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,196.21
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW LOCK 5.0 X 26MM SELF-TAP 661126
|
Facility
|
OP
|
$2,005.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182766
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.86 |
| Max. Negotiated Rate |
$1,918.38 |
| Rate for Payer: Aetna Commercial |
$1,876.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,793.27
|
| Rate for Payer: Aetna Managed Medicare |
$583.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,355.38
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,042.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,000.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,105.16
|
| Rate for Payer: Cash Price |
$601.50
|
| Rate for Payer: Cigna Commercial |
$1,918.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,166.91
|
| Rate for Payer: Health EOS Commercial |
$1,855.83
|
| Rate for Payer: HFN Commercial |
$1,918.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,563.90
|
| Rate for Payer: Multiplan Commercial |
$1,668.16
|
| Rate for Payer: NAPHCARE Commercial |
$1,251.12
|
| Rate for Payer: Preferred Network Access Commercial |
$1,918.38
|
| Rate for Payer: Quartz Beloit One Network |
$1,021.75
|
| Rate for Payer: Quartz Commercial |
$1,355.38
|
| Rate for Payer: Quartz Medicare Advantage |
$1,251.12
|
| Rate for Payer: The Alliance Commercial |
$1,042.60
|
| Rate for Payer: WEA Trust Commercial |
$1,146.86
|
| Rate for Payer: WPS Commercial |
$1,544.45
|
|
|
SCREW LOCK 5.0 X 26MM SELF-TAP 661126
|
Facility
|
IP
|
$2,005.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6182766
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,021.75 |
| Max. Negotiated Rate |
$1,918.38 |
| Rate for Payer: Aetna Commercial |
$1,876.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,793.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,105.16
|
| Rate for Payer: Cash Price |
$601.50
|
| Rate for Payer: Cigna Commercial |
$1,918.38
|
| Rate for Payer: Health EOS Commercial |
$1,855.83
|
| Rate for Payer: HFN Commercial |
$1,918.38
|
| Rate for Payer: Multiplan Commercial |
$1,668.16
|
| Rate for Payer: Preferred Network Access Commercial |
$1,918.38
|
| Rate for Payer: Quartz Beloit One Network |
$1,021.75
|
| Rate for Payer: Quartz Commercial |
$1,251.12
|
| Rate for Payer: WEA Trust Commercial |
$1,146.86
|
| Rate for Payer: WPS Commercial |
$1,544.45
|
|
|
SCREW-LOCK 5.0 X 26 TFN 458.926
|
Facility
|
OP
|
$2,724.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966959
|
|
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 26 TFN 458.926
|
Facility
|
IP
|
$2,724.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966959
|
|
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 26 VA 02.231.226
|
Facility
|
OP
|
$2,648.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3072541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$771.10 |
| Max. Negotiated Rate |
$2,533.61 |
| Rate for Payer: Aetna Commercial |
$2,478.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,368.37
|
| Rate for Payer: Aetna Managed Medicare |
$771.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,790.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,376.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,321.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,459.58
|
| Rate for Payer: Cash Price |
$794.40
|
| Rate for Payer: Cigna Commercial |
$2,533.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,541.14
|
| Rate for Payer: Health EOS Commercial |
$2,450.99
|
| Rate for Payer: HFN Commercial |
$2,533.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,065.44
|
| Rate for Payer: Multiplan Commercial |
$2,203.14
|
| Rate for Payer: NAPHCARE Commercial |
$1,652.35
|
| Rate for Payer: Preferred Network Access Commercial |
$2,533.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,349.42
|
| Rate for Payer: Quartz Commercial |
$1,790.05
|
| Rate for Payer: Quartz Medicare Advantage |
$1,652.35
|
| Rate for Payer: The Alliance Commercial |
$1,376.96
|
| Rate for Payer: WEA Trust Commercial |
$1,514.66
|
| Rate for Payer: WPS Commercial |
$2,039.75
|
|
|
SCREW LOCK 5.0 X 26 VA 02.231.226
|
Facility
|
IP
|
$2,648.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3072541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,349.42 |
| Max. Negotiated Rate |
$2,533.61 |
| Rate for Payer: Aetna Commercial |
$2,478.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,368.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,459.58
|
| Rate for Payer: Cash Price |
$794.40
|
| Rate for Payer: Cigna Commercial |
$2,533.61
|
| Rate for Payer: Health EOS Commercial |
$2,450.99
|
| Rate for Payer: HFN Commercial |
$2,533.61
|
| Rate for Payer: Multiplan Commercial |
$2,203.14
|
| Rate for Payer: Preferred Network Access Commercial |
$2,533.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,349.42
|
| Rate for Payer: Quartz Commercial |
$1,652.35
|
| Rate for Payer: WEA Trust Commercial |
$1,514.66
|
| Rate for Payer: WPS Commercial |
$2,039.75
|
|
|
SCREW LOCK 5.0 X 27.5 FULLY THREAD 1896-5027S
|
Facility
|
OP
|
$1,810.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6001648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.07 |
| Max. Negotiated Rate |
$1,731.81 |
| Rate for Payer: Aetna Commercial |
$1,694.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.86
|
| Rate for Payer: Aetna Managed Medicare |
$527.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,223.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$941.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$903.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.67
|
| Rate for Payer: Cash Price |
$543.00
|
| Rate for Payer: Cigna Commercial |
$1,731.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,053.42
|
| Rate for Payer: Health EOS Commercial |
$1,675.34
|
| Rate for Payer: HFN Commercial |
$1,731.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,411.80
|
| Rate for Payer: Multiplan Commercial |
$1,505.92
|
| Rate for Payer: NAPHCARE Commercial |
$1,129.44
|
| Rate for Payer: Preferred Network Access Commercial |
$1,731.81
|
| Rate for Payer: Quartz Beloit One Network |
$922.38
|
| Rate for Payer: Quartz Commercial |
$1,223.56
|
| Rate for Payer: Quartz Medicare Advantage |
$1,129.44
|
| Rate for Payer: The Alliance Commercial |
$941.20
|
| Rate for Payer: WEA Trust Commercial |
$1,035.32
|
| Rate for Payer: WPS Commercial |
$1,394.24
|
|
|
SCREW LOCK 5.0 X 27.5 FULLY THREAD 1896-5027S
|
Facility
|
IP
|
$1,810.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6001648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$922.38 |
| Max. Negotiated Rate |
$1,731.81 |
| Rate for Payer: Aetna Commercial |
$1,694.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.67
|
| Rate for Payer: Cash Price |
$543.00
|
| Rate for Payer: Cigna Commercial |
$1,731.81
|
| Rate for Payer: Health EOS Commercial |
$1,675.34
|
| Rate for Payer: HFN Commercial |
$1,731.81
|
| Rate for Payer: Multiplan Commercial |
$1,505.92
|
| Rate for Payer: Preferred Network Access Commercial |
$1,731.81
|
| Rate for Payer: Quartz Beloit One Network |
$922.38
|
| Rate for Payer: Quartz Commercial |
$1,129.44
|
| Rate for Payer: WEA Trust Commercial |
$1,035.32
|
| Rate for Payer: WPS Commercial |
$1,394.24
|
|
|
SCREW-LOCK 5.0X28 212.208
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2966960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,196.21
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW-LOCK 5.0X28 212.208
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2966960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$996.84
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW LOCK 5.0 X 28MM TI 04.005.518S
|
Facility
|
IP
|
$2,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,500.77 |
| Max. Negotiated Rate |
$2,817.78 |
| Rate for Payer: Aetna Commercial |
$2,756.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,634.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,623.28
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cigna Commercial |
$2,817.78
|
| Rate for Payer: Health EOS Commercial |
$2,725.89
|
| Rate for Payer: HFN Commercial |
$2,817.78
|
| Rate for Payer: Multiplan Commercial |
$2,450.24
|
| Rate for Payer: Preferred Network Access Commercial |
$2,817.78
|
| Rate for Payer: Quartz Beloit One Network |
$1,500.77
|
| Rate for Payer: Quartz Commercial |
$1,837.68
|
| Rate for Payer: WEA Trust Commercial |
$1,684.54
|
| Rate for Payer: WPS Commercial |
$2,268.53
|
|
|
SCREW LOCK 5.0 X 28MM TI 04.005.518S
|
Facility
|
OP
|
$2,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$857.58 |
| Max. Negotiated Rate |
$2,817.78 |
| Rate for Payer: Aetna Commercial |
$2,756.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,634.01
|
| Rate for Payer: Aetna Managed Medicare |
$857.58
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,990.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,531.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,470.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,623.28
|
| Rate for Payer: Cash Price |
$883.50
|
| Rate for Payer: Cigna Commercial |
$2,817.78
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,713.99
|
| Rate for Payer: Health EOS Commercial |
$2,725.89
|
| Rate for Payer: HFN Commercial |
$2,817.78
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,297.10
|
| Rate for Payer: Multiplan Commercial |
$2,450.24
|
| Rate for Payer: NAPHCARE Commercial |
$1,837.68
|
| Rate for Payer: Preferred Network Access Commercial |
$2,817.78
|
| Rate for Payer: Quartz Beloit One Network |
$1,500.77
|
| Rate for Payer: Quartz Commercial |
$1,990.82
|
| Rate for Payer: Quartz Medicare Advantage |
$1,837.68
|
| Rate for Payer: The Alliance Commercial |
$1,531.40
|
| Rate for Payer: WEA Trust Commercial |
$1,684.54
|
| Rate for Payer: WPS Commercial |
$2,268.53
|
|
|
SCREW-LOCK 5.0 X 28 TFN 458.928
|
Facility
|
OP
|
$2,724.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966949
|
|
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 28 TFN 458.928
|
Facility
|
IP
|
$2,724.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2966949
|
|
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 5.0X30 212.209
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2966962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,196.21
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW-LOCK 5.0X30 212.209
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2966962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$558.23 |
| Max. Negotiated Rate |
$1,834.19 |
| Rate for Payer: Aetna Commercial |
$1,794.31
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,714.56
|
| Rate for Payer: Aetna Managed Medicare |
$558.23
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,295.89
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$996.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$956.97
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,056.65
|
| Rate for Payer: Cash Price |
$575.10
|
| Rate for Payer: Cigna Commercial |
$1,834.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,115.69
|
| Rate for Payer: Health EOS Commercial |
$1,774.38
|
| Rate for Payer: HFN Commercial |
$1,834.19
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,495.26
|
| Rate for Payer: Multiplan Commercial |
$1,594.94
|
| Rate for Payer: NAPHCARE Commercial |
$1,196.21
|
| Rate for Payer: Preferred Network Access Commercial |
$1,834.19
|
| Rate for Payer: Quartz Beloit One Network |
$976.90
|
| Rate for Payer: Quartz Commercial |
$1,295.89
|
| Rate for Payer: Quartz Medicare Advantage |
$1,196.21
|
| Rate for Payer: The Alliance Commercial |
$996.84
|
| Rate for Payer: WEA Trust Commercial |
$1,096.52
|
| Rate for Payer: WPS Commercial |
$1,476.67
|
|
|
SCREW LOCK 5.0 X 30 FULLY THREAD 1896-5030S
|
Facility
|
OP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508988
|
|
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
|
|
