|
SCREW NON-LOCK 2.7MM X 16MM 657116
|
Facility
|
IP
|
$1,374.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415590
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.19 |
| Max. Negotiated Rate |
$1,314.64 |
| Rate for Payer: Aetna Commercial |
$1,286.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$757.35
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cigna Commercial |
$1,314.64
|
| Rate for Payer: Health EOS Commercial |
$1,271.77
|
| Rate for Payer: HFN Commercial |
$1,314.64
|
| Rate for Payer: Multiplan Commercial |
$1,143.17
|
| Rate for Payer: Preferred Network Access Commercial |
$1,314.64
|
| Rate for Payer: Quartz Beloit One Network |
$700.19
|
| Rate for Payer: Quartz Commercial |
$857.38
|
| Rate for Payer: WEA Trust Commercial |
$785.93
|
| Rate for Payer: WPS Commercial |
$1,058.39
|
|
|
SCREW NON-LOCK 2.7MM X 18MM 657118
|
Facility
|
IP
|
$1,322.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415591
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$673.69 |
| Max. Negotiated Rate |
$1,264.89 |
| Rate for Payer: Aetna Commercial |
$1,237.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,182.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$728.69
|
| Rate for Payer: Cash Price |
$396.60
|
| Rate for Payer: Cigna Commercial |
$1,264.89
|
| Rate for Payer: Health EOS Commercial |
$1,223.64
|
| Rate for Payer: HFN Commercial |
$1,264.89
|
| Rate for Payer: Multiplan Commercial |
$1,099.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,264.89
|
| Rate for Payer: Quartz Beloit One Network |
$673.69
|
| Rate for Payer: Quartz Commercial |
$824.93
|
| Rate for Payer: WEA Trust Commercial |
$756.18
|
| Rate for Payer: WPS Commercial |
$1,018.34
|
|
|
SCREW NON-LOCK 2.7MM X 18MM 657118
|
Facility
|
OP
|
$1,322.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5415591
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$384.97 |
| Max. Negotiated Rate |
$1,264.89 |
| Rate for Payer: Aetna Commercial |
$1,237.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,182.40
|
| Rate for Payer: Aetna Managed Medicare |
$384.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$893.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$687.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$659.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$728.69
|
| Rate for Payer: Cash Price |
$396.60
|
| Rate for Payer: Cigna Commercial |
$1,264.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$769.40
|
| Rate for Payer: Health EOS Commercial |
$1,223.64
|
| Rate for Payer: HFN Commercial |
$1,264.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,031.16
|
| Rate for Payer: Multiplan Commercial |
$1,099.90
|
| Rate for Payer: NAPHCARE Commercial |
$824.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,264.89
|
| Rate for Payer: Quartz Beloit One Network |
$673.69
|
| Rate for Payer: Quartz Commercial |
$893.67
|
| Rate for Payer: Quartz Medicare Advantage |
$824.93
|
| Rate for Payer: The Alliance Commercial |
$687.44
|
| Rate for Payer: WEA Trust Commercial |
$756.18
|
| Rate for Payer: WPS Commercial |
$1,018.34
|
|
|
SCREW NON-LOCK 2.7MM X 22MM 657122
|
Facility
|
OP
|
$1,322.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6151691
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$384.97 |
| Max. Negotiated Rate |
$1,264.89 |
| Rate for Payer: Aetna Commercial |
$1,237.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,182.40
|
| Rate for Payer: Aetna Managed Medicare |
$384.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$893.67
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$687.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$659.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$728.69
|
| Rate for Payer: Cash Price |
$396.60
|
| Rate for Payer: Cigna Commercial |
$1,264.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$769.40
|
| Rate for Payer: Health EOS Commercial |
$1,223.64
|
| Rate for Payer: HFN Commercial |
$1,264.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,031.16
|
| Rate for Payer: Multiplan Commercial |
$1,099.90
|
| Rate for Payer: NAPHCARE Commercial |
$824.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,264.89
|
| Rate for Payer: Quartz Beloit One Network |
$673.69
|
| Rate for Payer: Quartz Commercial |
$893.67
|
| Rate for Payer: Quartz Medicare Advantage |
$824.93
|
| Rate for Payer: The Alliance Commercial |
$687.44
|
| Rate for Payer: WEA Trust Commercial |
$756.18
|
| Rate for Payer: WPS Commercial |
$1,018.34
|
|
|
SCREW NON-LOCK 2.7MM X 22MM 657122
|
Facility
|
IP
|
$1,322.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6151691
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$673.69 |
| Max. Negotiated Rate |
$1,264.89 |
| Rate for Payer: Aetna Commercial |
$1,237.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,182.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$728.69
|
| Rate for Payer: Cash Price |
$396.60
|
| Rate for Payer: Cigna Commercial |
$1,264.89
|
| Rate for Payer: Health EOS Commercial |
$1,223.64
|
| Rate for Payer: HFN Commercial |
$1,264.89
|
| Rate for Payer: Multiplan Commercial |
$1,099.90
|
| Rate for Payer: Preferred Network Access Commercial |
$1,264.89
|
| Rate for Payer: Quartz Beloit One Network |
$673.69
|
| Rate for Payer: Quartz Commercial |
$824.93
|
| Rate for Payer: WEA Trust Commercial |
$756.18
|
| Rate for Payer: WPS Commercial |
$1,018.34
|
|
|
SCREW NON-LOCK 3.5MM X 12MM 657412
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 12MM 657412
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 14MM 657414
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599681
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 14MM 657414
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599681
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 16MM 657416
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 16MM 657416
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 18MM 657418
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599684
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 18MM 657418
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599684
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 20MM 657420
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599685
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 20MM 657420
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599685
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 22MM 657422
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 22MM 657422
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5547413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 24MM 657424
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599686
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 24MM 657424
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599686
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 26MM 657426
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599687
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 26MM 657426
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599687
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 28MM 657428
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599688
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 28MM 657428
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5599688
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 30MM 657430
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603670
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.73 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$892.32
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
|
SCREW NON-LOCK 3.5MM X 30MM 657430
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603670
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$1,368.22 |
| Rate for Payer: Aetna Commercial |
$1,338.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.99
|
| Rate for Payer: Aetna Managed Medicare |
$416.42
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.68
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$788.22
|
| Rate for Payer: Cash Price |
$429.00
|
| Rate for Payer: Cigna Commercial |
$1,368.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$832.26
|
| Rate for Payer: Health EOS Commercial |
$1,323.61
|
| Rate for Payer: HFN Commercial |
$1,368.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,115.40
|
| Rate for Payer: Multiplan Commercial |
$1,189.76
|
| Rate for Payer: NAPHCARE Commercial |
$892.32
|
| Rate for Payer: Preferred Network Access Commercial |
$1,368.22
|
| Rate for Payer: Quartz Beloit One Network |
$728.73
|
| Rate for Payer: Quartz Commercial |
$966.68
|
| Rate for Payer: Quartz Medicare Advantage |
$892.32
|
| Rate for Payer: The Alliance Commercial |
$743.60
|
| Rate for Payer: WEA Trust Commercial |
$817.96
|
| Rate for Payer: WPS Commercial |
$1,101.53
|
|
