|
SCREW LOCK 5.0 X 65 FULLY THREAD 1896-5065S
|
Facility
|
OP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508992
|
|
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 65 FULLY THREAD 1896-5065S
|
Facility
|
IP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508992
|
|
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 65 VA 02.231.265
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,193.48 |
| Max. Negotiated Rate |
$2,240.83 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,461.41
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
SCREW LOCK 5.0 X 65 VA 02.231.265
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4494424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$681.99 |
| Max. Negotiated Rate |
$2,240.83 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Aetna Managed Medicare |
$681.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,583.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,217.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,169.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,363.04
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,826.76
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: NAPHCARE Commercial |
$1,461.41
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,583.19
|
| Rate for Payer: Quartz Medicare Advantage |
$1,461.41
|
| Rate for Payer: The Alliance Commercial |
$1,217.84
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
SCREW LOCK 5.0 X 68MM XL25 IM NAIL TI 04.045.068S
|
Facility
|
OP
|
$2,717.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6202970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$791.19 |
| Max. Negotiated Rate |
$2,599.63 |
| Rate for Payer: Aetna Commercial |
$2,543.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,430.08
|
| Rate for Payer: Aetna Managed Medicare |
$791.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,836.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,412.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,356.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,497.61
|
| Rate for Payer: Cash Price |
$815.10
|
| Rate for Payer: Cigna Commercial |
$2,599.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,581.29
|
| Rate for Payer: Health EOS Commercial |
$2,514.86
|
| Rate for Payer: HFN Commercial |
$2,599.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,119.26
|
| Rate for Payer: Multiplan Commercial |
$2,260.54
|
| Rate for Payer: NAPHCARE Commercial |
$1,695.41
|
| Rate for Payer: Preferred Network Access Commercial |
$2,599.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,384.58
|
| Rate for Payer: Quartz Commercial |
$1,836.69
|
| Rate for Payer: Quartz Medicare Advantage |
$1,695.41
|
| Rate for Payer: The Alliance Commercial |
$1,412.84
|
| Rate for Payer: WEA Trust Commercial |
$1,554.12
|
| Rate for Payer: WPS Commercial |
$2,092.91
|
|
|
SCREW LOCK 5.0 X 68MM XL25 IM NAIL TI 04.045.068S
|
Facility
|
IP
|
$2,717.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6202970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.58 |
| Max. Negotiated Rate |
$2,599.63 |
| Rate for Payer: Aetna Commercial |
$2,543.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,430.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,497.61
|
| Rate for Payer: Cash Price |
$815.10
|
| Rate for Payer: Cigna Commercial |
$2,599.63
|
| Rate for Payer: Health EOS Commercial |
$2,514.86
|
| Rate for Payer: HFN Commercial |
$2,599.63
|
| Rate for Payer: Multiplan Commercial |
$2,260.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,599.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,384.58
|
| Rate for Payer: Quartz Commercial |
$1,695.41
|
| Rate for Payer: WEA Trust Commercial |
$1,554.12
|
| Rate for Payer: WPS Commercial |
$2,092.91
|
|
|
SCREW-LOCK 5.0 X 68 TFN 458.968
|
Facility
|
OP
|
$2,724.00
|
|
| Hospital Charge Code |
2966998
|
|
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 68 TFN 458.968
|
Facility
|
IP
|
$2,724.00
|
|
| Hospital Charge Code |
2966998
|
|
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 5.0X70 212.223
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2967000
|
|
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 5.0X70 212.223
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2967000
|
|
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 70 FULLY THREAD 1896-5070S
|
Facility
|
IP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508993
|
|
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 70 FULLY THREAD 1896-5070S
|
Facility
|
OP
|
$1,882.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508993
|
|
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 70MM TI 04.005.560S
|
Facility
|
IP
|
$2,232.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3961329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,137.43 |
| Max. Negotiated Rate |
$2,135.58 |
| Rate for Payer: Aetna Commercial |
$2,089.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,996.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,230.28
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cigna Commercial |
$2,135.58
|
| Rate for Payer: Health EOS Commercial |
$2,065.94
|
| Rate for Payer: HFN Commercial |
$2,135.58
|
| Rate for Payer: Multiplan Commercial |
$1,857.02
|
| Rate for Payer: Preferred Network Access Commercial |
$2,135.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,137.43
|
| Rate for Payer: Quartz Commercial |
$1,392.77
|
| Rate for Payer: WEA Trust Commercial |
$1,276.70
|
| Rate for Payer: WPS Commercial |
$1,719.31
|
|
|
SCREW LOCK 5.0 X 70MM TI 04.005.560S
|
Facility
|
OP
|
$2,232.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3961329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$649.96 |
| Max. Negotiated Rate |
$2,135.58 |
| Rate for Payer: Aetna Commercial |
$2,089.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,996.30
|
| Rate for Payer: Aetna Managed Medicare |
$649.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,508.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,160.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,114.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,230.28
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cigna Commercial |
$2,135.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,299.02
|
| Rate for Payer: Health EOS Commercial |
$2,065.94
|
| Rate for Payer: HFN Commercial |
$2,135.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,740.96
|
| Rate for Payer: Multiplan Commercial |
$1,857.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,392.77
|
| Rate for Payer: Preferred Network Access Commercial |
$2,135.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,137.43
|
| Rate for Payer: Quartz Commercial |
$1,508.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,392.77
|
| Rate for Payer: The Alliance Commercial |
$1,160.64
|
| Rate for Payer: WEA Trust Commercial |
$1,276.70
|
| Rate for Payer: WPS Commercial |
$1,719.31
|
|
|
SCREW LOCK 5.0 X 70 VA 02.231.270
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4778611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,193.48 |
| Max. Negotiated Rate |
$2,240.83 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,461.41
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
SCREW LOCK 5.0 X 70 VA 02.231.270
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4778611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$681.99 |
| Max. Negotiated Rate |
$2,240.83 |
| Rate for Payer: Aetna Commercial |
$2,192.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,094.68
|
| Rate for Payer: Aetna Managed Medicare |
$681.99
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,583.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,217.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,169.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,290.91
|
| Rate for Payer: Cash Price |
$702.60
|
| Rate for Payer: Cigna Commercial |
$2,240.83
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,363.04
|
| Rate for Payer: Health EOS Commercial |
$2,167.76
|
| Rate for Payer: HFN Commercial |
$2,240.83
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,826.76
|
| Rate for Payer: Multiplan Commercial |
$1,948.54
|
| Rate for Payer: NAPHCARE Commercial |
$1,461.41
|
| Rate for Payer: Preferred Network Access Commercial |
$2,240.83
|
| Rate for Payer: Quartz Beloit One Network |
$1,193.48
|
| Rate for Payer: Quartz Commercial |
$1,583.19
|
| Rate for Payer: Quartz Medicare Advantage |
$1,461.41
|
| Rate for Payer: The Alliance Commercial |
$1,217.84
|
| Rate for Payer: WEA Trust Commercial |
$1,339.62
|
| Rate for Payer: WPS Commercial |
$1,804.04
|
|
|
SCREW LOCK 5.0 X 72MM XL25 IM NAIL TI 04.045.072S
|
Facility
|
IP
|
$2,717.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6202969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.58 |
| Max. Negotiated Rate |
$2,599.63 |
| Rate for Payer: Aetna Commercial |
$2,543.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,430.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,497.61
|
| Rate for Payer: Cash Price |
$815.10
|
| Rate for Payer: Cigna Commercial |
$2,599.63
|
| Rate for Payer: Health EOS Commercial |
$2,514.86
|
| Rate for Payer: HFN Commercial |
$2,599.63
|
| Rate for Payer: Multiplan Commercial |
$2,260.54
|
| Rate for Payer: Preferred Network Access Commercial |
$2,599.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,384.58
|
| Rate for Payer: Quartz Commercial |
$1,695.41
|
| Rate for Payer: WEA Trust Commercial |
$1,554.12
|
| Rate for Payer: WPS Commercial |
$2,092.91
|
|
|
SCREW LOCK 5.0 X 72MM XL25 IM NAIL TI 04.045.072S
|
Facility
|
OP
|
$2,717.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6202969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$791.19 |
| Max. Negotiated Rate |
$2,599.63 |
| Rate for Payer: Aetna Commercial |
$2,543.11
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,430.08
|
| Rate for Payer: Aetna Managed Medicare |
$791.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,836.69
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,412.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,356.33
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,497.61
|
| Rate for Payer: Cash Price |
$815.10
|
| Rate for Payer: Cigna Commercial |
$2,599.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,581.29
|
| Rate for Payer: Health EOS Commercial |
$2,514.86
|
| Rate for Payer: HFN Commercial |
$2,599.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,119.26
|
| Rate for Payer: Multiplan Commercial |
$2,260.54
|
| Rate for Payer: NAPHCARE Commercial |
$1,695.41
|
| Rate for Payer: Preferred Network Access Commercial |
$2,599.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,384.58
|
| Rate for Payer: Quartz Commercial |
$1,836.69
|
| Rate for Payer: Quartz Medicare Advantage |
$1,695.41
|
| Rate for Payer: The Alliance Commercial |
$1,412.84
|
| Rate for Payer: WEA Trust Commercial |
$1,554.12
|
| Rate for Payer: WPS Commercial |
$2,092.91
|
|
|
SCREW-LOCK 5.0 X 72 TFN 458.972
|
Facility
|
OP
|
$2,724.00
|
|
| Hospital Charge Code |
2967001
|
|
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 72 TFN 458.972
|
Facility
|
IP
|
$2,724.00
|
|
| Hospital Charge Code |
2967001
|
|
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 74MM TI 04.005.564S
|
Facility
|
IP
|
$2,232.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,137.43 |
| Max. Negotiated Rate |
$2,135.58 |
| Rate for Payer: Aetna Commercial |
$2,089.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,996.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,230.28
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cigna Commercial |
$2,135.58
|
| Rate for Payer: Health EOS Commercial |
$2,065.94
|
| Rate for Payer: HFN Commercial |
$2,135.58
|
| Rate for Payer: Multiplan Commercial |
$1,857.02
|
| Rate for Payer: Preferred Network Access Commercial |
$2,135.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,137.43
|
| Rate for Payer: Quartz Commercial |
$1,392.77
|
| Rate for Payer: WEA Trust Commercial |
$1,276.70
|
| Rate for Payer: WPS Commercial |
$1,719.31
|
|
|
SCREW LOCK 5.0 X 74MM TI 04.005.564S
|
Facility
|
OP
|
$2,232.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$649.96 |
| Max. Negotiated Rate |
$2,135.58 |
| Rate for Payer: Aetna Commercial |
$2,089.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,996.30
|
| Rate for Payer: Aetna Managed Medicare |
$649.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,508.83
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,160.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,114.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,230.28
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cigna Commercial |
$2,135.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,299.02
|
| Rate for Payer: Health EOS Commercial |
$2,065.94
|
| Rate for Payer: HFN Commercial |
$2,135.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,740.96
|
| Rate for Payer: Multiplan Commercial |
$1,857.02
|
| Rate for Payer: NAPHCARE Commercial |
$1,392.77
|
| Rate for Payer: Preferred Network Access Commercial |
$2,135.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,137.43
|
| Rate for Payer: Quartz Commercial |
$1,508.83
|
| Rate for Payer: Quartz Medicare Advantage |
$1,392.77
|
| Rate for Payer: The Alliance Commercial |
$1,160.64
|
| Rate for Payer: WEA Trust Commercial |
$1,276.70
|
| Rate for Payer: WPS Commercial |
$1,719.31
|
|
|
SCREW-LOCK 5.0X75 212.224
|
Facility
|
IP
|
$1,917.00
|
|
| Hospital Charge Code |
2967002
|
|
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 5.0X75 212.224
|
Facility
|
OP
|
$1,917.00
|
|
| Hospital Charge Code |
2967002
|
|
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 75 FULL THREAD 1896-5075S
|
Facility
|
OP
|
$2,661.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3072612
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$774.88 |
| Max. Negotiated Rate |
$2,546.04 |
| Rate for Payer: Aetna Commercial |
$2,490.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,380.00
|
| Rate for Payer: Aetna Managed Medicare |
$774.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,798.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,383.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,328.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.74
|
| Rate for Payer: Cash Price |
$798.30
|
| Rate for Payer: Cigna Commercial |
$2,546.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,548.70
|
| Rate for Payer: Health EOS Commercial |
$2,463.02
|
| Rate for Payer: HFN Commercial |
$2,546.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,075.58
|
| Rate for Payer: Multiplan Commercial |
$2,213.95
|
| Rate for Payer: NAPHCARE Commercial |
$1,660.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,546.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,356.05
|
| Rate for Payer: Quartz Commercial |
$1,798.84
|
| Rate for Payer: Quartz Medicare Advantage |
$1,660.46
|
| Rate for Payer: The Alliance Commercial |
$1,383.72
|
| Rate for Payer: WEA Trust Commercial |
$1,522.09
|
| Rate for Payer: WPS Commercial |
$2,049.77
|
|
