|
SCREW LOCKING 2.7 X 20MM 656320
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$962.63 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,178.74
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
SCREW LOCKING 2.7 X 20MM 656320
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.08 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Aetna Managed Medicare |
$550.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,276.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$982.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$942.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,099.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,473.42
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,178.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,276.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,178.74
|
| Rate for Payer: The Alliance Commercial |
$982.28
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
SCREW LOCKING 2.7 X 22MM 656322
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.08 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Aetna Managed Medicare |
$550.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,276.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$982.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$942.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,099.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,473.42
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,178.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,276.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,178.74
|
| Rate for Payer: The Alliance Commercial |
$982.28
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
SCREW LOCKING 2.7 X 22MM 656322
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$962.63 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,178.74
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
SCREW LOCKING 2.7 X 24MM 656324
|
Facility
|
OP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.08 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Aetna Managed Medicare |
$550.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,276.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$982.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$942.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,099.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,473.42
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: NAPHCARE Commercial |
$1,178.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,276.96
|
| Rate for Payer: Quartz Medicare Advantage |
$1,178.74
|
| Rate for Payer: The Alliance Commercial |
$982.28
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
SCREW LOCKING 2.7 X 24MM 656324
|
Facility
|
IP
|
$1,889.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5787777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$962.63 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$1,768.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,689.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,041.22
|
| Rate for Payer: Cash Price |
$566.70
|
| Rate for Payer: Cigna Commercial |
$1,807.40
|
| Rate for Payer: Health EOS Commercial |
$1,748.46
|
| Rate for Payer: HFN Commercial |
$1,807.40
|
| Rate for Payer: Multiplan Commercial |
$1,571.65
|
| Rate for Payer: Preferred Network Access Commercial |
$1,807.40
|
| Rate for Payer: Quartz Beloit One Network |
$962.63
|
| Rate for Payer: Quartz Commercial |
$1,178.74
|
| Rate for Payer: WEA Trust Commercial |
$1,080.51
|
| Rate for Payer: WPS Commercial |
$1,455.10
|
|
|
SCREW LOCKING 3.5 X 26 213.026
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Aetna Managed Medicare |
$582.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,353.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,041.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$999.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,165.16
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,561.56
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,249.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,353.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,249.25
|
| Rate for Payer: The Alliance Commercial |
$1,041.04
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW LOCKING 3.5 X 26 213.026
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,249.25
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW LOCKING 3.5 X 28 213.028
|
Facility
|
IP
|
$2,002.00
|
|
| Hospital Charge Code |
2966558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,249.25
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW LOCKING 3.5 X 28 213.028
|
Facility
|
OP
|
$2,002.00
|
|
| Hospital Charge Code |
2966558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$1,915.51 |
| Rate for Payer: Aetna Commercial |
$1,873.87
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,790.59
|
| Rate for Payer: Aetna Managed Medicare |
$582.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,353.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,041.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$999.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,103.50
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$1,915.51
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,165.16
|
| Rate for Payer: Health EOS Commercial |
$1,853.05
|
| Rate for Payer: HFN Commercial |
$1,915.51
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,561.56
|
| Rate for Payer: Multiplan Commercial |
$1,665.66
|
| Rate for Payer: NAPHCARE Commercial |
$1,249.25
|
| Rate for Payer: Preferred Network Access Commercial |
$1,915.51
|
| Rate for Payer: Quartz Beloit One Network |
$1,020.22
|
| Rate for Payer: Quartz Commercial |
$1,353.35
|
| Rate for Payer: Quartz Medicare Advantage |
$1,249.25
|
| Rate for Payer: The Alliance Commercial |
$1,041.04
|
| Rate for Payer: WEA Trust Commercial |
$1,145.14
|
| Rate for Payer: WPS Commercial |
$1,542.14
|
|
|
SCREW LOCKING 5.0 VA 02.231.220
|
Facility
|
IP
|
$2,118.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6178023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,079.33 |
| Max. Negotiated Rate |
$2,026.50 |
| Rate for Payer: Aetna Commercial |
$1,982.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,894.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,167.44
|
| Rate for Payer: Cash Price |
$635.40
|
| Rate for Payer: Cigna Commercial |
$2,026.50
|
| Rate for Payer: Health EOS Commercial |
$1,960.42
|
| Rate for Payer: HFN Commercial |
$2,026.50
|
| Rate for Payer: Multiplan Commercial |
$1,762.18
|
| Rate for Payer: Preferred Network Access Commercial |
$2,026.50
|
| Rate for Payer: Quartz Beloit One Network |
$1,079.33
|
| Rate for Payer: Quartz Commercial |
$1,321.63
|
| Rate for Payer: WEA Trust Commercial |
$1,211.50
|
| Rate for Payer: WPS Commercial |
$1,631.50
|
|
|
SCREW LOCKING 5.0 VA 02.231.220
|
Facility
|
OP
|
$2,118.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6178023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$616.76 |
| Max. Negotiated Rate |
$2,026.50 |
| Rate for Payer: Aetna Commercial |
$1,982.45
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,894.34
|
| Rate for Payer: Aetna Managed Medicare |
$616.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,431.77
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,101.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,057.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,167.44
|
| Rate for Payer: Cash Price |
$635.40
|
| Rate for Payer: Cigna Commercial |
$2,026.50
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,232.68
|
| Rate for Payer: Health EOS Commercial |
$1,960.42
|
| Rate for Payer: HFN Commercial |
$2,026.50
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,652.04
|
| Rate for Payer: Multiplan Commercial |
$1,762.18
|
| Rate for Payer: NAPHCARE Commercial |
$1,321.63
|
| Rate for Payer: Preferred Network Access Commercial |
$2,026.50
|
| Rate for Payer: Quartz Beloit One Network |
$1,079.33
|
| Rate for Payer: Quartz Commercial |
$1,431.77
|
| Rate for Payer: Quartz Medicare Advantage |
$1,321.63
|
| Rate for Payer: The Alliance Commercial |
$1,101.36
|
| Rate for Payer: WEA Trust Commercial |
$1,211.50
|
| Rate for Payer: WPS Commercial |
$1,631.50
|
|
|
SCREW LOCKING 5.5 X 38MM ORTHOLOC 59215538
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$812.45 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Aetna Managed Medicare |
$812.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,886.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,450.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,392.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,623.78
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,176.20
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: NAPHCARE Commercial |
$1,740.96
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,886.04
|
| Rate for Payer: Quartz Medicare Advantage |
$1,740.96
|
| Rate for Payer: The Alliance Commercial |
$1,450.80
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 38MM ORTHOLOC 59215538
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,421.78 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,740.96
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 40MM ORTHOLOC 59215540
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,421.78 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,740.96
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 40MM ORTHOLOC 59215540
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$812.45 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Aetna Managed Medicare |
$812.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,886.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,450.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,392.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,623.78
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,176.20
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: NAPHCARE Commercial |
$1,740.96
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,886.04
|
| Rate for Payer: Quartz Medicare Advantage |
$1,740.96
|
| Rate for Payer: The Alliance Commercial |
$1,450.80
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 45MM ORTHOLOC 59215545
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,421.78 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,740.96
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 45MM ORTHOLOC 59215545
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$812.45 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Aetna Managed Medicare |
$812.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,886.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,450.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,392.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,623.78
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,176.20
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: NAPHCARE Commercial |
$1,740.96
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,886.04
|
| Rate for Payer: Quartz Medicare Advantage |
$1,740.96
|
| Rate for Payer: The Alliance Commercial |
$1,450.80
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 50MM ORTHOLOC 59215550
|
Facility
|
OP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$812.45 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Aetna Managed Medicare |
$812.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,886.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,450.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,392.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,623.78
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,176.20
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: NAPHCARE Commercial |
$1,740.96
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,886.04
|
| Rate for Payer: Quartz Medicare Advantage |
$1,740.96
|
| Rate for Payer: The Alliance Commercial |
$1,450.80
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING 5.5 X 50MM ORTHOLOC 59215550
|
Facility
|
IP
|
$2,790.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,421.78 |
| Max. Negotiated Rate |
$2,669.47 |
| Rate for Payer: Aetna Commercial |
$2,611.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,495.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,537.85
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$2,669.47
|
| Rate for Payer: Health EOS Commercial |
$2,582.42
|
| Rate for Payer: HFN Commercial |
$2,669.47
|
| Rate for Payer: Multiplan Commercial |
$2,321.28
|
| Rate for Payer: Preferred Network Access Commercial |
$2,669.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,421.78
|
| Rate for Payer: Quartz Commercial |
$1,740.96
|
| Rate for Payer: WEA Trust Commercial |
$1,595.88
|
| Rate for Payer: WPS Commercial |
$2,149.14
|
|
|
SCREW LOCKING VA 3.5MM X 12MM 02.127.112
|
Facility
|
IP
|
$2,115.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,077.80 |
| Max. Negotiated Rate |
$2,023.63 |
| Rate for Payer: Aetna Commercial |
$1,979.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,891.66
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,165.79
|
| Rate for Payer: Cash Price |
$634.50
|
| Rate for Payer: Cigna Commercial |
$2,023.63
|
| Rate for Payer: Health EOS Commercial |
$1,957.64
|
| Rate for Payer: HFN Commercial |
$2,023.63
|
| Rate for Payer: Multiplan Commercial |
$1,759.68
|
| Rate for Payer: Preferred Network Access Commercial |
$2,023.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,077.80
|
| Rate for Payer: Quartz Commercial |
$1,319.76
|
| Rate for Payer: WEA Trust Commercial |
$1,209.78
|
| Rate for Payer: WPS Commercial |
$1,629.18
|
|
|
SCREW LOCKING VA 3.5MM X 12MM 02.127.112
|
Facility
|
OP
|
$2,115.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$615.89 |
| Max. Negotiated Rate |
$2,023.63 |
| Rate for Payer: Aetna Commercial |
$1,979.64
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,891.66
|
| Rate for Payer: Aetna Managed Medicare |
$615.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,429.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,099.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,055.81
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,165.79
|
| Rate for Payer: Cash Price |
$634.50
|
| Rate for Payer: Cigna Commercial |
$2,023.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,230.93
|
| Rate for Payer: Health EOS Commercial |
$1,957.64
|
| Rate for Payer: HFN Commercial |
$2,023.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,649.70
|
| Rate for Payer: Multiplan Commercial |
$1,759.68
|
| Rate for Payer: NAPHCARE Commercial |
$1,319.76
|
| Rate for Payer: Preferred Network Access Commercial |
$2,023.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,077.80
|
| Rate for Payer: Quartz Commercial |
$1,429.74
|
| Rate for Payer: Quartz Medicare Advantage |
$1,319.76
|
| Rate for Payer: The Alliance Commercial |
$1,099.80
|
| Rate for Payer: WEA Trust Commercial |
$1,209.78
|
| Rate for Payer: WPS Commercial |
$1,629.18
|
|
|
SCREW LOCKING VA 3.5MM X 16MM 02.127.116
|
Facility
|
OP
|
$1,805.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.82 |
| Max. Negotiated Rate |
$1,727.70 |
| Rate for Payer: Aetna Commercial |
$1,690.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,615.03
|
| Rate for Payer: Aetna Managed Medicare |
$525.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,220.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$938.97
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$901.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$995.31
|
| Rate for Payer: Cash Price |
$541.71
|
| Rate for Payer: Cigna Commercial |
$1,727.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,050.92
|
| Rate for Payer: Health EOS Commercial |
$1,671.37
|
| Rate for Payer: HFN Commercial |
$1,727.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,408.45
|
| Rate for Payer: Multiplan Commercial |
$1,502.35
|
| Rate for Payer: NAPHCARE Commercial |
$1,126.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,727.70
|
| Rate for Payer: Quartz Beloit One Network |
$920.19
|
| Rate for Payer: Quartz Commercial |
$1,220.66
|
| Rate for Payer: Quartz Medicare Advantage |
$1,126.76
|
| Rate for Payer: The Alliance Commercial |
$938.97
|
| Rate for Payer: WEA Trust Commercial |
$1,032.87
|
| Rate for Payer: WPS Commercial |
$1,390.94
|
|
|
SCREW LOCKING VA 3.5MM X 16MM 02.127.116
|
Facility
|
IP
|
$1,805.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$920.19 |
| Max. Negotiated Rate |
$1,727.70 |
| Rate for Payer: Aetna Commercial |
$1,690.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,615.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$995.31
|
| Rate for Payer: Cash Price |
$541.71
|
| Rate for Payer: Cigna Commercial |
$1,727.70
|
| Rate for Payer: Health EOS Commercial |
$1,671.37
|
| Rate for Payer: HFN Commercial |
$1,727.70
|
| Rate for Payer: Multiplan Commercial |
$1,502.35
|
| Rate for Payer: Preferred Network Access Commercial |
$1,727.70
|
| Rate for Payer: Quartz Beloit One Network |
$920.19
|
| Rate for Payer: Quartz Commercial |
$1,126.76
|
| Rate for Payer: WEA Trust Commercial |
$1,032.87
|
| Rate for Payer: WPS Commercial |
$1,390.94
|
|
|
SCREW LOCKING VA 3.5MM X 20MM 02.127.120
|
Facility
|
IP
|
$1,878.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6234158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.03 |
| Max. Negotiated Rate |
$1,796.87 |
| Rate for Payer: Aetna Commercial |
$1,757.81
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,679.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,035.15
|
| Rate for Payer: Cash Price |
$563.40
|
| Rate for Payer: Cigna Commercial |
$1,796.87
|
| Rate for Payer: Health EOS Commercial |
$1,738.28
|
| Rate for Payer: HFN Commercial |
$1,796.87
|
| Rate for Payer: Multiplan Commercial |
$1,562.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,796.87
|
| Rate for Payer: Quartz Beloit One Network |
$957.03
|
| Rate for Payer: Quartz Commercial |
$1,171.87
|
| Rate for Payer: WEA Trust Commercial |
$1,074.22
|
| Rate for Payer: WPS Commercial |
$1,446.62
|
|
