|
SCREW MINI CANN 2.5 X 20 HEADLESS IH2520
|
Facility
|
OP
|
$2,927.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5685825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.34 |
| Max. Negotiated Rate |
$2,800.55 |
| Rate for Payer: Aetna Commercial |
$2,739.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.91
|
| Rate for Payer: Aetna Managed Medicare |
$852.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,978.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,522.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,461.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.36
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,800.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,703.51
|
| Rate for Payer: Health EOS Commercial |
$2,709.23
|
| Rate for Payer: HFN Commercial |
$2,800.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,283.06
|
| Rate for Payer: Multiplan Commercial |
$2,435.26
|
| Rate for Payer: NAPHCARE Commercial |
$1,826.45
|
| Rate for Payer: Preferred Network Access Commercial |
$2,800.55
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.60
|
| Rate for Payer: Quartz Commercial |
$1,978.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,826.45
|
| Rate for Payer: The Alliance Commercial |
$1,522.04
|
| Rate for Payer: WEA Trust Commercial |
$1,674.24
|
| Rate for Payer: WPS Commercial |
$2,254.67
|
|
|
SCREW MINI CANN 2.5 X 22 HEADLESS IH2522
|
Facility
|
IP
|
$2,570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,309.67 |
| Max. Negotiated Rate |
$2,458.98 |
| Rate for Payer: Aetna Commercial |
$2,405.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,298.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,416.58
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,458.98
|
| Rate for Payer: Health EOS Commercial |
$2,378.79
|
| Rate for Payer: HFN Commercial |
$2,458.98
|
| Rate for Payer: Multiplan Commercial |
$2,138.24
|
| Rate for Payer: Preferred Network Access Commercial |
$2,458.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,309.67
|
| Rate for Payer: Quartz Commercial |
$1,603.68
|
| Rate for Payer: WEA Trust Commercial |
$1,470.04
|
| Rate for Payer: WPS Commercial |
$1,979.67
|
|
|
SCREW MINI CANN 2.5 X 22 HEADLESS IH2522
|
Facility
|
OP
|
$2,570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$748.38 |
| Max. Negotiated Rate |
$2,458.98 |
| Rate for Payer: Aetna Commercial |
$2,405.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,298.61
|
| Rate for Payer: Aetna Managed Medicare |
$748.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,737.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,336.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,282.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,416.58
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,458.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,495.74
|
| Rate for Payer: Health EOS Commercial |
$2,378.79
|
| Rate for Payer: HFN Commercial |
$2,458.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,004.60
|
| Rate for Payer: Multiplan Commercial |
$2,138.24
|
| Rate for Payer: NAPHCARE Commercial |
$1,603.68
|
| Rate for Payer: Preferred Network Access Commercial |
$2,458.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,309.67
|
| Rate for Payer: Quartz Commercial |
$1,737.32
|
| Rate for Payer: Quartz Medicare Advantage |
$1,603.68
|
| Rate for Payer: The Alliance Commercial |
$1,336.40
|
| Rate for Payer: WEA Trust Commercial |
$1,470.04
|
| Rate for Payer: WPS Commercial |
$1,979.67
|
|
|
SCREW MINI CANN 2.5 X 28 HEADLESS IH2528
|
Facility
|
OP
|
$2,452.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6190986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.02 |
| Max. Negotiated Rate |
$2,346.07 |
| Rate for Payer: Aetna Commercial |
$2,295.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,193.07
|
| Rate for Payer: Aetna Managed Medicare |
$714.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,657.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,275.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,224.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,351.54
|
| Rate for Payer: Cash Price |
$735.60
|
| Rate for Payer: Cigna Commercial |
$2,346.07
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,427.06
|
| Rate for Payer: Health EOS Commercial |
$2,269.57
|
| Rate for Payer: HFN Commercial |
$2,346.07
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,912.56
|
| Rate for Payer: Multiplan Commercial |
$2,040.06
|
| Rate for Payer: NAPHCARE Commercial |
$1,530.05
|
| Rate for Payer: Preferred Network Access Commercial |
$2,346.07
|
| Rate for Payer: Quartz Beloit One Network |
$1,249.54
|
| Rate for Payer: Quartz Commercial |
$1,657.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,530.05
|
| Rate for Payer: The Alliance Commercial |
$1,275.04
|
| Rate for Payer: WEA Trust Commercial |
$1,402.54
|
| Rate for Payer: WPS Commercial |
$1,888.78
|
|
|
SCREW MINI CANN 2.5 X 28 HEADLESS IH2528
|
Facility
|
IP
|
$2,452.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6190986
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,249.54 |
| Max. Negotiated Rate |
$2,346.07 |
| Rate for Payer: Aetna Commercial |
$2,295.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,193.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,351.54
|
| Rate for Payer: Cash Price |
$735.60
|
| Rate for Payer: Cigna Commercial |
$2,346.07
|
| Rate for Payer: Health EOS Commercial |
$2,269.57
|
| Rate for Payer: HFN Commercial |
$2,346.07
|
| Rate for Payer: Multiplan Commercial |
$2,040.06
|
| Rate for Payer: Preferred Network Access Commercial |
$2,346.07
|
| Rate for Payer: Quartz Beloit One Network |
$1,249.54
|
| Rate for Payer: Quartz Commercial |
$1,530.05
|
| Rate for Payer: WEA Trust Commercial |
$1,402.54
|
| Rate for Payer: WPS Commercial |
$1,888.78
|
|
|
SCREW MINI CANN 2.5 X 30 HEADLESS IH2530
|
Facility
|
IP
|
$2,570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,309.67 |
| Max. Negotiated Rate |
$2,458.98 |
| Rate for Payer: Aetna Commercial |
$2,405.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,298.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,416.58
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,458.98
|
| Rate for Payer: Health EOS Commercial |
$2,378.79
|
| Rate for Payer: HFN Commercial |
$2,458.98
|
| Rate for Payer: Multiplan Commercial |
$2,138.24
|
| Rate for Payer: Preferred Network Access Commercial |
$2,458.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,309.67
|
| Rate for Payer: Quartz Commercial |
$1,603.68
|
| Rate for Payer: WEA Trust Commercial |
$1,470.04
|
| Rate for Payer: WPS Commercial |
$1,979.67
|
|
|
SCREW MINI CANN 2.5 X 30 HEADLESS IH2530
|
Facility
|
OP
|
$2,570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6173855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$748.38 |
| Max. Negotiated Rate |
$2,458.98 |
| Rate for Payer: Aetna Commercial |
$2,405.52
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,298.61
|
| Rate for Payer: Aetna Managed Medicare |
$748.38
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,737.32
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,336.40
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,282.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,416.58
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,458.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,495.74
|
| Rate for Payer: Health EOS Commercial |
$2,378.79
|
| Rate for Payer: HFN Commercial |
$2,458.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,004.60
|
| Rate for Payer: Multiplan Commercial |
$2,138.24
|
| Rate for Payer: NAPHCARE Commercial |
$1,603.68
|
| Rate for Payer: Preferred Network Access Commercial |
$2,458.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,309.67
|
| Rate for Payer: Quartz Commercial |
$1,737.32
|
| Rate for Payer: Quartz Medicare Advantage |
$1,603.68
|
| Rate for Payer: The Alliance Commercial |
$1,336.40
|
| Rate for Payer: WEA Trust Commercial |
$1,470.04
|
| Rate for Payer: WPS Commercial |
$1,979.67
|
|
|
SCREW MINI CANN 3.0 X 14MM HEADLESS IH3014
|
Facility
|
OP
|
$2,471.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6232161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$719.56 |
| Max. Negotiated Rate |
$2,364.25 |
| Rate for Payer: Aetna Commercial |
$2,312.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.06
|
| Rate for Payer: Aetna Managed Medicare |
$719.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,670.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,284.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,233.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.02
|
| Rate for Payer: Cash Price |
$741.30
|
| Rate for Payer: Cigna Commercial |
$2,364.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,438.12
|
| Rate for Payer: Health EOS Commercial |
$2,287.16
|
| Rate for Payer: HFN Commercial |
$2,364.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,927.38
|
| Rate for Payer: Multiplan Commercial |
$2,055.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,541.90
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.22
|
| Rate for Payer: Quartz Commercial |
$1,670.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,541.90
|
| Rate for Payer: The Alliance Commercial |
$1,284.92
|
| Rate for Payer: WEA Trust Commercial |
$1,413.41
|
| Rate for Payer: WPS Commercial |
$1,903.41
|
|
|
SCREW MINI CANN 3.0 X 14MM HEADLESS IH3014
|
Facility
|
IP
|
$2,471.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6232161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,259.22 |
| Max. Negotiated Rate |
$2,364.25 |
| Rate for Payer: Aetna Commercial |
$2,312.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.02
|
| Rate for Payer: Cash Price |
$741.30
|
| Rate for Payer: Cigna Commercial |
$2,364.25
|
| Rate for Payer: Health EOS Commercial |
$2,287.16
|
| Rate for Payer: HFN Commercial |
$2,364.25
|
| Rate for Payer: Multiplan Commercial |
$2,055.87
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.22
|
| Rate for Payer: Quartz Commercial |
$1,541.90
|
| Rate for Payer: WEA Trust Commercial |
$1,413.41
|
| Rate for Payer: WPS Commercial |
$1,903.41
|
|
|
SCREW MINI CANN 3.0 X 16MM HEADLESS IH3016
|
Facility
|
IP
|
$2,471.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6232162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,259.22 |
| Max. Negotiated Rate |
$2,364.25 |
| Rate for Payer: Aetna Commercial |
$2,312.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.02
|
| Rate for Payer: Cash Price |
$741.30
|
| Rate for Payer: Cigna Commercial |
$2,364.25
|
| Rate for Payer: Health EOS Commercial |
$2,287.16
|
| Rate for Payer: HFN Commercial |
$2,364.25
|
| Rate for Payer: Multiplan Commercial |
$2,055.87
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.22
|
| Rate for Payer: Quartz Commercial |
$1,541.90
|
| Rate for Payer: WEA Trust Commercial |
$1,413.41
|
| Rate for Payer: WPS Commercial |
$1,903.41
|
|
|
SCREW MINI CANN 3.0 X 16MM HEADLESS IH3016
|
Facility
|
OP
|
$2,471.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6232162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$719.56 |
| Max. Negotiated Rate |
$2,364.25 |
| Rate for Payer: Aetna Commercial |
$2,312.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.06
|
| Rate for Payer: Aetna Managed Medicare |
$719.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,670.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,284.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,233.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.02
|
| Rate for Payer: Cash Price |
$741.30
|
| Rate for Payer: Cigna Commercial |
$2,364.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,438.12
|
| Rate for Payer: Health EOS Commercial |
$2,287.16
|
| Rate for Payer: HFN Commercial |
$2,364.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,927.38
|
| Rate for Payer: Multiplan Commercial |
$2,055.87
|
| Rate for Payer: NAPHCARE Commercial |
$1,541.90
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.22
|
| Rate for Payer: Quartz Commercial |
$1,670.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,541.90
|
| Rate for Payer: The Alliance Commercial |
$1,284.92
|
| Rate for Payer: WEA Trust Commercial |
$1,413.41
|
| Rate for Payer: WPS Commercial |
$1,903.41
|
|
|
SCREW MINI CANN 3.0 X 20MM HEADLESS IH3020
|
Facility
|
IP
|
$2,927.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5831689
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.60 |
| Max. Negotiated Rate |
$2,800.55 |
| Rate for Payer: Aetna Commercial |
$2,739.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.36
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,800.55
|
| Rate for Payer: Health EOS Commercial |
$2,709.23
|
| Rate for Payer: HFN Commercial |
$2,800.55
|
| Rate for Payer: Multiplan Commercial |
$2,435.26
|
| Rate for Payer: Preferred Network Access Commercial |
$2,800.55
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.60
|
| Rate for Payer: Quartz Commercial |
$1,826.45
|
| Rate for Payer: WEA Trust Commercial |
$1,674.24
|
| Rate for Payer: WPS Commercial |
$2,254.67
|
|
|
SCREW MINI CANN 3.0 X 20MM HEADLESS IH3020
|
Facility
|
OP
|
$2,927.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5831689
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.34 |
| Max. Negotiated Rate |
$2,800.55 |
| Rate for Payer: Aetna Commercial |
$2,739.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.91
|
| Rate for Payer: Aetna Managed Medicare |
$852.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,978.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,522.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,461.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.36
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,800.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,703.51
|
| Rate for Payer: Health EOS Commercial |
$2,709.23
|
| Rate for Payer: HFN Commercial |
$2,800.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,283.06
|
| Rate for Payer: Multiplan Commercial |
$2,435.26
|
| Rate for Payer: NAPHCARE Commercial |
$1,826.45
|
| Rate for Payer: Preferred Network Access Commercial |
$2,800.55
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.60
|
| Rate for Payer: Quartz Commercial |
$1,978.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,826.45
|
| Rate for Payer: The Alliance Commercial |
$1,522.04
|
| Rate for Payer: WEA Trust Commercial |
$1,674.24
|
| Rate for Payer: WPS Commercial |
$2,254.67
|
|
|
SCREW MINI CANN 3.0 X 22MM HEADLESS IH3022
|
Facility
|
IP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6049657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,434.01 |
| Max. Negotiated Rate |
$2,692.44 |
| Rate for Payer: Aetna Commercial |
$2,633.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,516.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,551.08
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,692.44
|
| Rate for Payer: Health EOS Commercial |
$2,604.64
|
| Rate for Payer: HFN Commercial |
$2,692.44
|
| Rate for Payer: Multiplan Commercial |
$2,341.25
|
| Rate for Payer: Preferred Network Access Commercial |
$2,692.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,434.01
|
| Rate for Payer: Quartz Commercial |
$1,755.94
|
| Rate for Payer: WEA Trust Commercial |
$1,609.61
|
| Rate for Payer: WPS Commercial |
$2,167.62
|
|
|
SCREW MINI CANN 3.0 X 22MM HEADLESS IH3022
|
Facility
|
OP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6049657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$819.44 |
| Max. Negotiated Rate |
$2,692.44 |
| Rate for Payer: Aetna Commercial |
$2,633.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,516.84
|
| Rate for Payer: Aetna Managed Medicare |
$819.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,902.26
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,463.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,404.75
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,551.08
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,692.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,637.75
|
| Rate for Payer: Health EOS Commercial |
$2,604.64
|
| Rate for Payer: HFN Commercial |
$2,692.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,194.92
|
| Rate for Payer: Multiplan Commercial |
$2,341.25
|
| Rate for Payer: NAPHCARE Commercial |
$1,755.94
|
| Rate for Payer: Preferred Network Access Commercial |
$2,692.44
|
| Rate for Payer: Quartz Beloit One Network |
$1,434.01
|
| Rate for Payer: Quartz Commercial |
$1,902.26
|
| Rate for Payer: Quartz Medicare Advantage |
$1,755.94
|
| Rate for Payer: The Alliance Commercial |
$1,463.28
|
| Rate for Payer: WEA Trust Commercial |
$1,609.61
|
| Rate for Payer: WPS Commercial |
$2,167.62
|
|
|
SCREW MINI CANN 3.0 X 24MM HEADLESS IH3024
|
Facility
|
OP
|
$2,927.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5659623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.34 |
| Max. Negotiated Rate |
$2,800.55 |
| Rate for Payer: Aetna Commercial |
$2,739.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.91
|
| Rate for Payer: Aetna Managed Medicare |
$852.34
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,978.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,522.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,461.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.36
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,800.55
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,703.51
|
| Rate for Payer: Health EOS Commercial |
$2,709.23
|
| Rate for Payer: HFN Commercial |
$2,800.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,283.06
|
| Rate for Payer: Multiplan Commercial |
$2,435.26
|
| Rate for Payer: NAPHCARE Commercial |
$1,826.45
|
| Rate for Payer: Preferred Network Access Commercial |
$2,800.55
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.60
|
| Rate for Payer: Quartz Commercial |
$1,978.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,826.45
|
| Rate for Payer: The Alliance Commercial |
$1,522.04
|
| Rate for Payer: WEA Trust Commercial |
$1,674.24
|
| Rate for Payer: WPS Commercial |
$2,254.67
|
|
|
SCREW MINI CANN 3.0 X 24MM HEADLESS IH3024
|
Facility
|
IP
|
$2,927.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5659623
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.60 |
| Max. Negotiated Rate |
$2,800.55 |
| Rate for Payer: Aetna Commercial |
$2,739.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,617.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,613.36
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,800.55
|
| Rate for Payer: Health EOS Commercial |
$2,709.23
|
| Rate for Payer: HFN Commercial |
$2,800.55
|
| Rate for Payer: Multiplan Commercial |
$2,435.26
|
| Rate for Payer: Preferred Network Access Commercial |
$2,800.55
|
| Rate for Payer: Quartz Beloit One Network |
$1,491.60
|
| Rate for Payer: Quartz Commercial |
$1,826.45
|
| Rate for Payer: WEA Trust Commercial |
$1,674.24
|
| Rate for Payer: WPS Commercial |
$2,254.67
|
|
|
SCREW NEXFIX SNAP-OFF MODEL 2 NSO-2012
|
Facility
|
OP
|
$2,147.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6181254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$625.21 |
| Max. Negotiated Rate |
$2,054.25 |
| Rate for Payer: Aetna Commercial |
$2,009.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,920.28
|
| Rate for Payer: Aetna Managed Medicare |
$625.21
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,451.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,116.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,071.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,183.43
|
| Rate for Payer: Cash Price |
$644.10
|
| Rate for Payer: Cigna Commercial |
$2,054.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,249.55
|
| Rate for Payer: Health EOS Commercial |
$1,987.26
|
| Rate for Payer: HFN Commercial |
$2,054.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,674.66
|
| Rate for Payer: Multiplan Commercial |
$1,786.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,339.73
|
| Rate for Payer: Preferred Network Access Commercial |
$2,054.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,094.11
|
| Rate for Payer: Quartz Commercial |
$1,451.37
|
| Rate for Payer: Quartz Medicare Advantage |
$1,339.73
|
| Rate for Payer: The Alliance Commercial |
$1,116.44
|
| Rate for Payer: WEA Trust Commercial |
$1,228.08
|
| Rate for Payer: WPS Commercial |
$1,653.83
|
|
|
SCREW NEXFIX SNAP-OFF MODEL 2 NSO-2012
|
Facility
|
IP
|
$2,147.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6181254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,094.11 |
| Max. Negotiated Rate |
$2,054.25 |
| Rate for Payer: Aetna Commercial |
$2,009.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,920.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,183.43
|
| Rate for Payer: Cash Price |
$644.10
|
| Rate for Payer: Cigna Commercial |
$2,054.25
|
| Rate for Payer: Health EOS Commercial |
$1,987.26
|
| Rate for Payer: HFN Commercial |
$2,054.25
|
| Rate for Payer: Multiplan Commercial |
$1,786.30
|
| Rate for Payer: Preferred Network Access Commercial |
$2,054.25
|
| Rate for Payer: Quartz Beloit One Network |
$1,094.11
|
| Rate for Payer: Quartz Commercial |
$1,339.73
|
| Rate for Payer: WEA Trust Commercial |
$1,228.08
|
| Rate for Payer: WPS Commercial |
$1,653.83
|
|
|
SCREW NON-LOCK 1.7 X 10MM 662610
|
Facility
|
OP
|
$1,268.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6170223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$369.24 |
| Max. Negotiated Rate |
$1,213.22 |
| Rate for Payer: Aetna Commercial |
$1,186.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,134.10
|
| Rate for Payer: Aetna Managed Medicare |
$369.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$857.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$659.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$632.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$698.92
|
| Rate for Payer: Cash Price |
$380.40
|
| Rate for Payer: Cigna Commercial |
$1,213.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$737.98
|
| Rate for Payer: Health EOS Commercial |
$1,173.66
|
| Rate for Payer: HFN Commercial |
$1,213.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$989.04
|
| Rate for Payer: Multiplan Commercial |
$1,054.98
|
| Rate for Payer: NAPHCARE Commercial |
$791.23
|
| Rate for Payer: Preferred Network Access Commercial |
$1,213.22
|
| Rate for Payer: Quartz Beloit One Network |
$646.17
|
| Rate for Payer: Quartz Commercial |
$857.17
|
| Rate for Payer: Quartz Medicare Advantage |
$791.23
|
| Rate for Payer: The Alliance Commercial |
$659.36
|
| Rate for Payer: WEA Trust Commercial |
$725.30
|
| Rate for Payer: WPS Commercial |
$976.74
|
|
|
SCREW NON-LOCK 1.7 X 10MM 662610
|
Facility
|
IP
|
$1,268.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6170223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$646.17 |
| Max. Negotiated Rate |
$1,213.22 |
| Rate for Payer: Aetna Commercial |
$1,186.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,134.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$698.92
|
| Rate for Payer: Cash Price |
$380.40
|
| Rate for Payer: Cigna Commercial |
$1,213.22
|
| Rate for Payer: Health EOS Commercial |
$1,173.66
|
| Rate for Payer: HFN Commercial |
$1,213.22
|
| Rate for Payer: Multiplan Commercial |
$1,054.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,213.22
|
| Rate for Payer: Quartz Beloit One Network |
$646.17
|
| Rate for Payer: Quartz Commercial |
$791.23
|
| Rate for Payer: WEA Trust Commercial |
$725.30
|
| Rate for Payer: WPS Commercial |
$976.74
|
|
|
SCREW NON-LOCK 1.7 X 13MM 662613
|
Facility
|
OP
|
$1,268.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6170225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$369.24 |
| Max. Negotiated Rate |
$1,213.22 |
| Rate for Payer: Aetna Commercial |
$1,186.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,134.10
|
| Rate for Payer: Aetna Managed Medicare |
$369.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$857.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$659.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$632.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$698.92
|
| Rate for Payer: Cash Price |
$380.40
|
| Rate for Payer: Cigna Commercial |
$1,213.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$737.98
|
| Rate for Payer: Health EOS Commercial |
$1,173.66
|
| Rate for Payer: HFN Commercial |
$1,213.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$989.04
|
| Rate for Payer: Multiplan Commercial |
$1,054.98
|
| Rate for Payer: NAPHCARE Commercial |
$791.23
|
| Rate for Payer: Preferred Network Access Commercial |
$1,213.22
|
| Rate for Payer: Quartz Beloit One Network |
$646.17
|
| Rate for Payer: Quartz Commercial |
$857.17
|
| Rate for Payer: Quartz Medicare Advantage |
$791.23
|
| Rate for Payer: The Alliance Commercial |
$659.36
|
| Rate for Payer: WEA Trust Commercial |
$725.30
|
| Rate for Payer: WPS Commercial |
$976.74
|
|
|
SCREW NON-LOCK 1.7 X 13MM 662613
|
Facility
|
IP
|
$1,268.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6170225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$646.17 |
| Max. Negotiated Rate |
$1,213.22 |
| Rate for Payer: Aetna Commercial |
$1,186.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,134.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$698.92
|
| Rate for Payer: Cash Price |
$380.40
|
| Rate for Payer: Cigna Commercial |
$1,213.22
|
| Rate for Payer: Health EOS Commercial |
$1,173.66
|
| Rate for Payer: HFN Commercial |
$1,213.22
|
| Rate for Payer: Multiplan Commercial |
$1,054.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,213.22
|
| Rate for Payer: Quartz Beloit One Network |
$646.17
|
| Rate for Payer: Quartz Commercial |
$791.23
|
| Rate for Payer: WEA Trust Commercial |
$725.30
|
| Rate for Payer: WPS Commercial |
$976.74
|
|
|
SCREW NON-LOCK 1.7 X 9MM 662609
|
Facility
|
OP
|
$1,268.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6170224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$369.24 |
| Max. Negotiated Rate |
$1,213.22 |
| Rate for Payer: Aetna Commercial |
$1,186.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,134.10
|
| Rate for Payer: Aetna Managed Medicare |
$369.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$857.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$659.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$632.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$698.92
|
| Rate for Payer: Cash Price |
$380.40
|
| Rate for Payer: Cigna Commercial |
$1,213.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$737.98
|
| Rate for Payer: Health EOS Commercial |
$1,173.66
|
| Rate for Payer: HFN Commercial |
$1,213.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$989.04
|
| Rate for Payer: Multiplan Commercial |
$1,054.98
|
| Rate for Payer: NAPHCARE Commercial |
$791.23
|
| Rate for Payer: Preferred Network Access Commercial |
$1,213.22
|
| Rate for Payer: Quartz Beloit One Network |
$646.17
|
| Rate for Payer: Quartz Commercial |
$857.17
|
| Rate for Payer: Quartz Medicare Advantage |
$791.23
|
| Rate for Payer: The Alliance Commercial |
$659.36
|
| Rate for Payer: WEA Trust Commercial |
$725.30
|
| Rate for Payer: WPS Commercial |
$976.74
|
|
|
SCREW NON-LOCK 1.7 X 9MM 662609
|
Facility
|
IP
|
$1,268.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6170224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$646.17 |
| Max. Negotiated Rate |
$1,213.22 |
| Rate for Payer: Aetna Commercial |
$1,186.85
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,134.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$698.92
|
| Rate for Payer: Cash Price |
$380.40
|
| Rate for Payer: Cigna Commercial |
$1,213.22
|
| Rate for Payer: Health EOS Commercial |
$1,173.66
|
| Rate for Payer: HFN Commercial |
$1,213.22
|
| Rate for Payer: Multiplan Commercial |
$1,054.98
|
| Rate for Payer: Preferred Network Access Commercial |
$1,213.22
|
| Rate for Payer: Quartz Beloit One Network |
$646.17
|
| Rate for Payer: Quartz Commercial |
$791.23
|
| Rate for Payer: WEA Trust Commercial |
$725.30
|
| Rate for Payer: WPS Commercial |
$976.74
|
|
