SCREW LOCK 5.0 X 58MM XL25 IM NAIL TI 04.045.058S
|
Facility
|
OP
|
$2,717.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
6202971
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$760.76 |
Max. Negotiated Rate |
$10,868.00 |
Rate for Payer: Aetna Commercial |
$2,445.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.62
|
Rate for Payer: Aetna Managed Medicare |
$760.76
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,766.05
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,358.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,304.16
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,440.01
|
Rate for Payer: Cash Price |
$815.10
|
Rate for Payer: Cigna Commercial |
$2,499.64
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,520.43
|
Rate for Payer: Health EOS Commercial |
$2,418.13
|
Rate for Payer: HFN Commercial |
$2,499.64
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,037.75
|
Rate for Payer: Multiplan Commercial |
$2,173.60
|
Rate for Payer: NAPHCARE Commercial |
$1,630.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,499.64
|
Rate for Payer: Quartz Beloit One Network |
$1,331.33
|
Rate for Payer: Quartz Commercial |
$1,766.05
|
Rate for Payer: Quartz Medicare Advantage |
$1,630.20
|
Rate for Payer: The Alliance Commercial |
$10,868.00
|
Rate for Payer: WEA Trust Commercial |
$1,494.35
|
Rate for Payer: WPS Commercial |
$2,012.48
|
|
SCREW-LOCK 5.0 X 58 TFN 458.958
|
Facility
|
IP
|
$2,724.00
|
|
Hospital Charge Code |
2966992
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,334.76 |
Max. Negotiated Rate |
$2,506.08 |
Rate for Payer: Aetna Commercial |
$2,451.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,342.64
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,443.72
|
Rate for Payer: Cash Price |
$817.20
|
Rate for Payer: Cigna Commercial |
$2,506.08
|
Rate for Payer: Health EOS Commercial |
$2,424.36
|
Rate for Payer: HFN Commercial |
$2,506.08
|
Rate for Payer: Multiplan Commercial |
$2,179.20
|
Rate for Payer: NAPHCARE Commercial |
$1,634.40
|
Rate for Payer: Preferred Network Access Commercial |
$2,506.08
|
Rate for Payer: Quartz Beloit One Network |
$1,334.76
|
Rate for Payer: Quartz Commercial |
$1,634.40
|
Rate for Payer: WEA Trust Commercial |
$1,498.20
|
Rate for Payer: WPS Commercial |
$2,017.67
|
|
SCREW-LOCK 5.0 X 58 TFN 458.958
|
Facility
|
OP
|
$2,724.00
|
|
Hospital Charge Code |
2966992
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$762.72 |
Max. Negotiated Rate |
$10,896.00 |
Rate for Payer: Aetna Commercial |
$2,451.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,342.64
|
Rate for Payer: Aetna Managed Medicare |
$762.72
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,770.60
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,362.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,307.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,443.72
|
Rate for Payer: Cash Price |
$817.20
|
Rate for Payer: Cigna Commercial |
$2,506.08
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,524.35
|
Rate for Payer: Health EOS Commercial |
$2,424.36
|
Rate for Payer: HFN Commercial |
$2,506.08
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,043.00
|
Rate for Payer: Multiplan Commercial |
$2,179.20
|
Rate for Payer: NAPHCARE Commercial |
$1,634.40
|
Rate for Payer: Preferred Network Access Commercial |
$2,506.08
|
Rate for Payer: Quartz Beloit One Network |
$1,334.76
|
Rate for Payer: Quartz Commercial |
$1,770.60
|
Rate for Payer: Quartz Medicare Advantage |
$1,634.40
|
Rate for Payer: The Alliance Commercial |
$10,896.00
|
Rate for Payer: WEA Trust Commercial |
$1,498.20
|
Rate for Payer: WPS Commercial |
$2,017.67
|
|
SCREW-LOCK 5.0X60 212.221
|
Facility
|
OP
|
$1,917.00
|
|
Hospital Charge Code |
2966994
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$536.76 |
Max. Negotiated Rate |
$7,668.00 |
Rate for Payer: Aetna Commercial |
$1,725.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,648.62
|
Rate for Payer: Aetna Managed Medicare |
$536.76
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,246.05
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$958.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$920.16
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,016.01
|
Rate for Payer: Cash Price |
$575.10
|
Rate for Payer: Cigna Commercial |
$1,763.64
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,072.75
|
Rate for Payer: Health EOS Commercial |
$1,706.13
|
Rate for Payer: HFN Commercial |
$1,763.64
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,437.75
|
Rate for Payer: Multiplan Commercial |
$1,533.60
|
Rate for Payer: NAPHCARE Commercial |
$1,150.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,763.64
|
Rate for Payer: Quartz Beloit One Network |
$939.33
|
Rate for Payer: Quartz Commercial |
$1,246.05
|
Rate for Payer: Quartz Medicare Advantage |
$1,150.20
|
Rate for Payer: The Alliance Commercial |
$7,668.00
|
Rate for Payer: WEA Trust Commercial |
$1,054.35
|
Rate for Payer: WPS Commercial |
$1,419.92
|
|
SCREW-LOCK 5.0X60 212.221
|
Facility
|
IP
|
$1,917.00
|
|
Hospital Charge Code |
2966994
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$939.33 |
Max. Negotiated Rate |
$1,763.64 |
Rate for Payer: Aetna Commercial |
$1,725.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,648.62
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,016.01
|
Rate for Payer: Cash Price |
$575.10
|
Rate for Payer: Cigna Commercial |
$1,763.64
|
Rate for Payer: Health EOS Commercial |
$1,706.13
|
Rate for Payer: HFN Commercial |
$1,763.64
|
Rate for Payer: Multiplan Commercial |
$1,533.60
|
Rate for Payer: NAPHCARE Commercial |
$1,150.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,763.64
|
Rate for Payer: Quartz Beloit One Network |
$939.33
|
Rate for Payer: Quartz Commercial |
$1,150.20
|
Rate for Payer: WEA Trust Commercial |
$1,054.35
|
Rate for Payer: WPS Commercial |
$1,419.92
|
|
SCREW LOCK 5.0 X 60 FULLY THREAD 1896-5060S
|
Facility
|
IP
|
$1,882.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
4508991
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$922.18 |
Max. Negotiated Rate |
$1,731.44 |
Rate for Payer: Aetna Commercial |
$1,693.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.46
|
Rate for Payer: Cash Price |
$564.60
|
Rate for Payer: Cigna Commercial |
$1,731.44
|
Rate for Payer: Health EOS Commercial |
$1,674.98
|
Rate for Payer: HFN Commercial |
$1,731.44
|
Rate for Payer: Multiplan Commercial |
$1,505.60
|
Rate for Payer: NAPHCARE Commercial |
$1,129.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,731.44
|
Rate for Payer: Quartz Beloit One Network |
$922.18
|
Rate for Payer: Quartz Commercial |
$1,129.20
|
Rate for Payer: WEA Trust Commercial |
$1,035.10
|
Rate for Payer: WPS Commercial |
$1,394.00
|
|
SCREW LOCK 5.0 X 60 FULLY THREAD 1896-5060S
|
Facility
|
OP
|
$1,882.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
4508991
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$526.96 |
Max. Negotiated Rate |
$7,528.00 |
Rate for Payer: Aetna Commercial |
$1,693.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.52
|
Rate for Payer: Aetna Managed Medicare |
$526.96
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,223.30
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$941.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$903.36
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.46
|
Rate for Payer: Cash Price |
$564.60
|
Rate for Payer: Cigna Commercial |
$1,731.44
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,053.17
|
Rate for Payer: Health EOS Commercial |
$1,674.98
|
Rate for Payer: HFN Commercial |
$1,731.44
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,411.50
|
Rate for Payer: Multiplan Commercial |
$1,505.60
|
Rate for Payer: NAPHCARE Commercial |
$1,129.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,731.44
|
Rate for Payer: Quartz Beloit One Network |
$922.18
|
Rate for Payer: Quartz Commercial |
$1,223.30
|
Rate for Payer: Quartz Medicare Advantage |
$1,129.20
|
Rate for Payer: The Alliance Commercial |
$7,528.00
|
Rate for Payer: WEA Trust Commercial |
$1,035.10
|
Rate for Payer: WPS Commercial |
$1,394.00
|
|
SCREW-LOCK 5.0 X 60 TFN 458.960
|
Facility
|
OP
|
$2,724.00
|
|
Hospital Charge Code |
2966995
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$762.72 |
Max. Negotiated Rate |
$10,896.00 |
Rate for Payer: Aetna Commercial |
$2,451.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,342.64
|
Rate for Payer: Aetna Managed Medicare |
$762.72
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,770.60
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,362.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,307.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,443.72
|
Rate for Payer: Cash Price |
$817.20
|
Rate for Payer: Cigna Commercial |
$2,506.08
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,524.35
|
Rate for Payer: Health EOS Commercial |
$2,424.36
|
Rate for Payer: HFN Commercial |
$2,506.08
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,043.00
|
Rate for Payer: Multiplan Commercial |
$2,179.20
|
Rate for Payer: NAPHCARE Commercial |
$1,634.40
|
Rate for Payer: Preferred Network Access Commercial |
$2,506.08
|
Rate for Payer: Quartz Beloit One Network |
$1,334.76
|
Rate for Payer: Quartz Commercial |
$1,770.60
|
Rate for Payer: Quartz Medicare Advantage |
$1,634.40
|
Rate for Payer: The Alliance Commercial |
$10,896.00
|
Rate for Payer: WEA Trust Commercial |
$1,498.20
|
Rate for Payer: WPS Commercial |
$2,017.67
|
|
SCREW-LOCK 5.0 X 60 TFN 458.960
|
Facility
|
IP
|
$2,724.00
|
|
Hospital Charge Code |
2966995
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,334.76 |
Max. Negotiated Rate |
$2,506.08 |
Rate for Payer: Aetna Commercial |
$2,451.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,342.64
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,443.72
|
Rate for Payer: Cash Price |
$817.20
|
Rate for Payer: Cigna Commercial |
$2,506.08
|
Rate for Payer: Health EOS Commercial |
$2,424.36
|
Rate for Payer: HFN Commercial |
$2,506.08
|
Rate for Payer: Multiplan Commercial |
$2,179.20
|
Rate for Payer: NAPHCARE Commercial |
$1,634.40
|
Rate for Payer: Preferred Network Access Commercial |
$2,506.08
|
Rate for Payer: Quartz Beloit One Network |
$1,334.76
|
Rate for Payer: Quartz Commercial |
$1,634.40
|
Rate for Payer: WEA Trust Commercial |
$1,498.20
|
Rate for Payer: WPS Commercial |
$2,017.67
|
|
SCREW LOCK 5.0 X 60 VA 02.231.260
|
Facility
|
OP
|
$2,255.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
4494423
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$631.40 |
Max. Negotiated Rate |
$9,020.00 |
Rate for Payer: Aetna Commercial |
$2,029.50
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,939.30
|
Rate for Payer: Aetna Managed Medicare |
$631.40
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,465.75
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,127.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,082.40
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,195.15
|
Rate for Payer: Cash Price |
$676.50
|
Rate for Payer: Cigna Commercial |
$2,074.60
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,261.90
|
Rate for Payer: Health EOS Commercial |
$2,006.95
|
Rate for Payer: HFN Commercial |
$2,074.60
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,691.25
|
Rate for Payer: Multiplan Commercial |
$1,804.00
|
Rate for Payer: NAPHCARE Commercial |
$1,353.00
|
Rate for Payer: Preferred Network Access Commercial |
$2,074.60
|
Rate for Payer: Quartz Beloit One Network |
$1,104.95
|
Rate for Payer: Quartz Commercial |
$1,465.75
|
Rate for Payer: Quartz Medicare Advantage |
$1,353.00
|
Rate for Payer: The Alliance Commercial |
$9,020.00
|
Rate for Payer: WEA Trust Commercial |
$1,240.25
|
Rate for Payer: WPS Commercial |
$1,670.28
|
|
SCREW LOCK 5.0 X 60 VA 02.231.260
|
Facility
|
IP
|
$2,255.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
4494423
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,104.95 |
Max. Negotiated Rate |
$2,074.60 |
Rate for Payer: Aetna Commercial |
$2,029.50
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,939.30
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,195.15
|
Rate for Payer: Cash Price |
$676.50
|
Rate for Payer: Cigna Commercial |
$2,074.60
|
Rate for Payer: Health EOS Commercial |
$2,006.95
|
Rate for Payer: HFN Commercial |
$2,074.60
|
Rate for Payer: Multiplan Commercial |
$1,804.00
|
Rate for Payer: NAPHCARE Commercial |
$1,353.00
|
Rate for Payer: Preferred Network Access Commercial |
$2,074.60
|
Rate for Payer: Quartz Beloit One Network |
$1,104.95
|
Rate for Payer: Quartz Commercial |
$1,353.00
|
Rate for Payer: WEA Trust Commercial |
$1,240.25
|
Rate for Payer: WPS Commercial |
$1,670.28
|
|
SCREW LOCK 5.0 X 62MM TI 04.005.552S
|
Facility
|
IP
|
$2,232.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
4520291
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,093.68 |
Max. Negotiated Rate |
$2,053.44 |
Rate for Payer: Aetna Commercial |
$2,008.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,919.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,182.96
|
Rate for Payer: Cash Price |
$669.60
|
Rate for Payer: Cigna Commercial |
$2,053.44
|
Rate for Payer: Health EOS Commercial |
$1,986.48
|
Rate for Payer: HFN Commercial |
$2,053.44
|
Rate for Payer: Multiplan Commercial |
$1,785.60
|
Rate for Payer: NAPHCARE Commercial |
$1,339.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,053.44
|
Rate for Payer: Quartz Beloit One Network |
$1,093.68
|
Rate for Payer: Quartz Commercial |
$1,339.20
|
Rate for Payer: WEA Trust Commercial |
$1,227.60
|
Rate for Payer: WPS Commercial |
$1,653.24
|
|
SCREW LOCK 5.0 X 62MM TI 04.005.552S
|
Facility
|
OP
|
$2,232.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
4520291
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$624.96 |
Max. Negotiated Rate |
$8,928.00 |
Rate for Payer: Aetna Commercial |
$2,008.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,919.52
|
Rate for Payer: Aetna Managed Medicare |
$624.96
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,450.80
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,116.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,071.36
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,182.96
|
Rate for Payer: Cash Price |
$669.60
|
Rate for Payer: Cigna Commercial |
$2,053.44
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,249.03
|
Rate for Payer: Health EOS Commercial |
$1,986.48
|
Rate for Payer: HFN Commercial |
$2,053.44
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,674.00
|
Rate for Payer: Multiplan Commercial |
$1,785.60
|
Rate for Payer: NAPHCARE Commercial |
$1,339.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,053.44
|
Rate for Payer: Quartz Beloit One Network |
$1,093.68
|
Rate for Payer: Quartz Commercial |
$1,450.80
|
Rate for Payer: Quartz Medicare Advantage |
$1,339.20
|
Rate for Payer: The Alliance Commercial |
$8,928.00
|
Rate for Payer: WEA Trust Commercial |
$1,227.60
|
Rate for Payer: WPS Commercial |
$1,653.24
|
|
SCREW LOCK 5.0 X 64MM TI 04.005.554S
|
Facility
|
IP
|
$2,012.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
5415198
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$985.88 |
Max. Negotiated Rate |
$1,851.04 |
Rate for Payer: Aetna Commercial |
$1,810.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,730.32
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,066.36
|
Rate for Payer: Cash Price |
$603.60
|
Rate for Payer: Cigna Commercial |
$1,851.04
|
Rate for Payer: Health EOS Commercial |
$1,790.68
|
Rate for Payer: HFN Commercial |
$1,851.04
|
Rate for Payer: Multiplan Commercial |
$1,609.60
|
Rate for Payer: NAPHCARE Commercial |
$1,207.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,851.04
|
Rate for Payer: Quartz Beloit One Network |
$985.88
|
Rate for Payer: Quartz Commercial |
$1,207.20
|
Rate for Payer: WEA Trust Commercial |
$1,106.60
|
Rate for Payer: WPS Commercial |
$1,490.29
|
|
SCREW LOCK 5.0 X 64MM TI 04.005.554S
|
Facility
|
OP
|
$2,012.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
5415198
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$563.36 |
Max. Negotiated Rate |
$8,048.00 |
Rate for Payer: Aetna Commercial |
$1,810.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,730.32
|
Rate for Payer: Aetna Managed Medicare |
$563.36
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,307.80
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,006.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$965.76
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,066.36
|
Rate for Payer: Cash Price |
$603.60
|
Rate for Payer: Cigna Commercial |
$1,851.04
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,125.92
|
Rate for Payer: Health EOS Commercial |
$1,790.68
|
Rate for Payer: HFN Commercial |
$1,851.04
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,509.00
|
Rate for Payer: Multiplan Commercial |
$1,609.60
|
Rate for Payer: NAPHCARE Commercial |
$1,207.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,851.04
|
Rate for Payer: Quartz Beloit One Network |
$985.88
|
Rate for Payer: Quartz Commercial |
$1,307.80
|
Rate for Payer: Quartz Medicare Advantage |
$1,207.20
|
Rate for Payer: The Alliance Commercial |
$8,048.00
|
Rate for Payer: WEA Trust Commercial |
$1,106.60
|
Rate for Payer: WPS Commercial |
$1,490.29
|
|
SCREW-LOCK 5.0 X 64 TFN 458.964
|
Facility
|
IP
|
$2,724.00
|
|
Hospital Charge Code |
2966996
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,334.76 |
Max. Negotiated Rate |
$2,506.08 |
Rate for Payer: Aetna Commercial |
$2,451.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,342.64
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,443.72
|
Rate for Payer: Cash Price |
$817.20
|
Rate for Payer: Cigna Commercial |
$2,506.08
|
Rate for Payer: Health EOS Commercial |
$2,424.36
|
Rate for Payer: HFN Commercial |
$2,506.08
|
Rate for Payer: Multiplan Commercial |
$2,179.20
|
Rate for Payer: NAPHCARE Commercial |
$1,634.40
|
Rate for Payer: Preferred Network Access Commercial |
$2,506.08
|
Rate for Payer: Quartz Beloit One Network |
$1,334.76
|
Rate for Payer: Quartz Commercial |
$1,634.40
|
Rate for Payer: WEA Trust Commercial |
$1,498.20
|
Rate for Payer: WPS Commercial |
$2,017.67
|
|
SCREW-LOCK 5.0 X 64 TFN 458.964
|
Facility
|
OP
|
$2,724.00
|
|
Hospital Charge Code |
2966996
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$762.72 |
Max. Negotiated Rate |
$10,896.00 |
Rate for Payer: Aetna Commercial |
$2,451.60
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,342.64
|
Rate for Payer: Aetna Managed Medicare |
$762.72
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,770.60
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,362.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,307.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,443.72
|
Rate for Payer: Cash Price |
$817.20
|
Rate for Payer: Cigna Commercial |
$2,506.08
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,524.35
|
Rate for Payer: Health EOS Commercial |
$2,424.36
|
Rate for Payer: HFN Commercial |
$2,506.08
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,043.00
|
Rate for Payer: Multiplan Commercial |
$2,179.20
|
Rate for Payer: NAPHCARE Commercial |
$1,634.40
|
Rate for Payer: Preferred Network Access Commercial |
$2,506.08
|
Rate for Payer: Quartz Beloit One Network |
$1,334.76
|
Rate for Payer: Quartz Commercial |
$1,770.60
|
Rate for Payer: Quartz Medicare Advantage |
$1,634.40
|
Rate for Payer: The Alliance Commercial |
$10,896.00
|
Rate for Payer: WEA Trust Commercial |
$1,498.20
|
Rate for Payer: WPS Commercial |
$2,017.67
|
|
SCREW-LOCK 5.0X65 212.222
|
Facility
|
OP
|
$1,917.00
|
|
Hospital Charge Code |
2966997
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$536.76 |
Max. Negotiated Rate |
$7,668.00 |
Rate for Payer: Aetna Commercial |
$1,725.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,648.62
|
Rate for Payer: Aetna Managed Medicare |
$536.76
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,246.05
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$958.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$920.16
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,016.01
|
Rate for Payer: Cash Price |
$575.10
|
Rate for Payer: Cigna Commercial |
$1,763.64
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,072.75
|
Rate for Payer: Health EOS Commercial |
$1,706.13
|
Rate for Payer: HFN Commercial |
$1,763.64
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,437.75
|
Rate for Payer: Multiplan Commercial |
$1,533.60
|
Rate for Payer: NAPHCARE Commercial |
$1,150.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,763.64
|
Rate for Payer: Quartz Beloit One Network |
$939.33
|
Rate for Payer: Quartz Commercial |
$1,246.05
|
Rate for Payer: Quartz Medicare Advantage |
$1,150.20
|
Rate for Payer: The Alliance Commercial |
$7,668.00
|
Rate for Payer: WEA Trust Commercial |
$1,054.35
|
Rate for Payer: WPS Commercial |
$1,419.92
|
|
SCREW-LOCK 5.0X65 212.222
|
Facility
|
IP
|
$1,917.00
|
|
Hospital Charge Code |
2966997
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$939.33 |
Max. Negotiated Rate |
$1,763.64 |
Rate for Payer: Aetna Commercial |
$1,725.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,648.62
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,016.01
|
Rate for Payer: Cash Price |
$575.10
|
Rate for Payer: Cigna Commercial |
$1,763.64
|
Rate for Payer: Health EOS Commercial |
$1,706.13
|
Rate for Payer: HFN Commercial |
$1,763.64
|
Rate for Payer: Multiplan Commercial |
$1,533.60
|
Rate for Payer: NAPHCARE Commercial |
$1,150.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,763.64
|
Rate for Payer: Quartz Beloit One Network |
$939.33
|
Rate for Payer: Quartz Commercial |
$1,150.20
|
Rate for Payer: WEA Trust Commercial |
$1,054.35
|
Rate for Payer: WPS Commercial |
$1,419.92
|
|
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 |
$922.18 |
Max. Negotiated Rate |
$1,731.44 |
Rate for Payer: Aetna Commercial |
$1,693.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.52
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.46
|
Rate for Payer: Cash Price |
$564.60
|
Rate for Payer: Cigna Commercial |
$1,731.44
|
Rate for Payer: Health EOS Commercial |
$1,674.98
|
Rate for Payer: HFN Commercial |
$1,731.44
|
Rate for Payer: Multiplan Commercial |
$1,505.60
|
Rate for Payer: NAPHCARE Commercial |
$1,129.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,731.44
|
Rate for Payer: Quartz Beloit One Network |
$922.18
|
Rate for Payer: Quartz Commercial |
$1,129.20
|
Rate for Payer: WEA Trust Commercial |
$1,035.10
|
Rate for Payer: WPS Commercial |
$1,394.00
|
|
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 |
$526.96 |
Max. Negotiated Rate |
$7,528.00 |
Rate for Payer: Aetna Commercial |
$1,693.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.52
|
Rate for Payer: Aetna Managed Medicare |
$526.96
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,223.30
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$941.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$903.36
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.46
|
Rate for Payer: Cash Price |
$564.60
|
Rate for Payer: Cigna Commercial |
$1,731.44
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,053.17
|
Rate for Payer: Health EOS Commercial |
$1,674.98
|
Rate for Payer: HFN Commercial |
$1,731.44
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,411.50
|
Rate for Payer: Multiplan Commercial |
$1,505.60
|
Rate for Payer: NAPHCARE Commercial |
$1,129.20
|
Rate for Payer: Preferred Network Access Commercial |
$1,731.44
|
Rate for Payer: Quartz Beloit One Network |
$922.18
|
Rate for Payer: Quartz Commercial |
$1,223.30
|
Rate for Payer: Quartz Medicare Advantage |
$1,129.20
|
Rate for Payer: The Alliance Commercial |
$7,528.00
|
Rate for Payer: WEA Trust Commercial |
$1,035.10
|
Rate for Payer: WPS Commercial |
$1,394.00
|
|
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 |
$1,147.58 |
Max. Negotiated Rate |
$2,154.64 |
Rate for Payer: Aetna Commercial |
$2,107.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,014.12
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,241.26
|
Rate for Payer: Cash Price |
$702.60
|
Rate for Payer: Cigna Commercial |
$2,154.64
|
Rate for Payer: Health EOS Commercial |
$2,084.38
|
Rate for Payer: HFN Commercial |
$2,154.64
|
Rate for Payer: Multiplan Commercial |
$1,873.60
|
Rate for Payer: NAPHCARE Commercial |
$1,405.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,154.64
|
Rate for Payer: Quartz Beloit One Network |
$1,147.58
|
Rate for Payer: Quartz Commercial |
$1,405.20
|
Rate for Payer: WEA Trust Commercial |
$1,288.10
|
Rate for Payer: WPS Commercial |
$1,734.72
|
|
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 |
$655.76 |
Max. Negotiated Rate |
$9,368.00 |
Rate for Payer: Aetna Commercial |
$2,107.80
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,014.12
|
Rate for Payer: Aetna Managed Medicare |
$655.76
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,522.30
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,171.00
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,124.16
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,241.26
|
Rate for Payer: Cash Price |
$702.60
|
Rate for Payer: Cigna Commercial |
$2,154.64
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,310.58
|
Rate for Payer: Health EOS Commercial |
$2,084.38
|
Rate for Payer: HFN Commercial |
$2,154.64
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,756.50
|
Rate for Payer: Multiplan Commercial |
$1,873.60
|
Rate for Payer: NAPHCARE Commercial |
$1,405.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,154.64
|
Rate for Payer: Quartz Beloit One Network |
$1,147.58
|
Rate for Payer: Quartz Commercial |
$1,522.30
|
Rate for Payer: Quartz Medicare Advantage |
$1,405.20
|
Rate for Payer: The Alliance Commercial |
$9,368.00
|
Rate for Payer: WEA Trust Commercial |
$1,288.10
|
Rate for Payer: WPS Commercial |
$1,734.72
|
|
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 |
$1,331.33 |
Max. Negotiated Rate |
$2,499.64 |
Rate for Payer: Aetna Commercial |
$2,445.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.62
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,440.01
|
Rate for Payer: Cash Price |
$815.10
|
Rate for Payer: Cigna Commercial |
$2,499.64
|
Rate for Payer: Health EOS Commercial |
$2,418.13
|
Rate for Payer: HFN Commercial |
$2,499.64
|
Rate for Payer: Multiplan Commercial |
$2,173.60
|
Rate for Payer: NAPHCARE Commercial |
$1,630.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,499.64
|
Rate for Payer: Quartz Beloit One Network |
$1,331.33
|
Rate for Payer: Quartz Commercial |
$1,630.20
|
Rate for Payer: WEA Trust Commercial |
$1,494.35
|
Rate for Payer: WPS Commercial |
$2,012.48
|
|
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 |
$760.76 |
Max. Negotiated Rate |
$10,868.00 |
Rate for Payer: Aetna Commercial |
$2,445.30
|
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,336.62
|
Rate for Payer: Aetna Managed Medicare |
$760.76
|
Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,766.05
|
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,358.50
|
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,304.16
|
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,440.01
|
Rate for Payer: Cash Price |
$815.10
|
Rate for Payer: Cigna Commercial |
$2,499.64
|
Rate for Payer: Dean Health DHI/DHP/ASO |
$1,520.43
|
Rate for Payer: Health EOS Commercial |
$2,418.13
|
Rate for Payer: HFN Commercial |
$2,499.64
|
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,037.75
|
Rate for Payer: Multiplan Commercial |
$2,173.60
|
Rate for Payer: NAPHCARE Commercial |
$1,630.20
|
Rate for Payer: Preferred Network Access Commercial |
$2,499.64
|
Rate for Payer: Quartz Beloit One Network |
$1,331.33
|
Rate for Payer: Quartz Commercial |
$1,766.05
|
Rate for Payer: Quartz Medicare Advantage |
$1,630.20
|
Rate for Payer: The Alliance Commercial |
$10,868.00
|
Rate for Payer: WEA Trust Commercial |
$1,494.35
|
Rate for Payer: WPS Commercial |
$2,012.48
|
|