|
SCREW NONLOCK 4.5 X 24MM LP TI AR-8545-24
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803653
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.46 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$335.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$778.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$599.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$575.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$670.46
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.56
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$718.85
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$778.75
|
| Rate for Payer: Quartz Medicare Advantage |
$718.85
|
| Rate for Payer: The Alliance Commercial |
$599.04
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 26MM LP TI AR-8545-26
|
Facility
|
IP
|
$1,198.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$610.50 |
| Max. Negotiated Rate |
$1,146.25 |
| Rate for Payer: Aetna Commercial |
$1,121.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,071.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$660.34
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cigna Commercial |
$1,146.25
|
| Rate for Payer: Health EOS Commercial |
$1,108.87
|
| Rate for Payer: HFN Commercial |
$1,146.25
|
| Rate for Payer: Multiplan Commercial |
$996.74
|
| Rate for Payer: Preferred Network Access Commercial |
$1,146.25
|
| Rate for Payer: Quartz Beloit One Network |
$610.50
|
| Rate for Payer: Quartz Commercial |
$747.55
|
| Rate for Payer: WEA Trust Commercial |
$685.26
|
| Rate for Payer: WPS Commercial |
$922.82
|
|
|
SCREW NONLOCK 4.5 X 26MM LP TI AR-8545-26
|
Facility
|
OP
|
$1,198.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5603786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.86 |
| Max. Negotiated Rate |
$1,146.25 |
| Rate for Payer: Aetna Commercial |
$1,121.33
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,071.49
|
| Rate for Payer: Aetna Managed Medicare |
$348.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$809.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$622.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$598.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$660.34
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cigna Commercial |
$1,146.25
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$697.24
|
| Rate for Payer: Health EOS Commercial |
$1,108.87
|
| Rate for Payer: HFN Commercial |
$1,146.25
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$934.44
|
| Rate for Payer: Multiplan Commercial |
$996.74
|
| Rate for Payer: NAPHCARE Commercial |
$747.55
|
| Rate for Payer: Preferred Network Access Commercial |
$1,146.25
|
| Rate for Payer: Quartz Beloit One Network |
$610.50
|
| Rate for Payer: Quartz Commercial |
$809.85
|
| Rate for Payer: Quartz Medicare Advantage |
$747.55
|
| Rate for Payer: The Alliance Commercial |
$622.96
|
| Rate for Payer: WEA Trust Commercial |
$685.26
|
| Rate for Payer: WPS Commercial |
$922.82
|
|
|
SCREW NONLOCK 4.5 X 28MM LP TI AR-8545-28
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803654
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.46 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$335.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$778.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$599.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$575.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$670.46
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.56
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$718.85
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$778.75
|
| Rate for Payer: Quartz Medicare Advantage |
$718.85
|
| Rate for Payer: The Alliance Commercial |
$599.04
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 28MM LP TI AR-8545-28
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803654
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.06 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$718.85
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 30MM LP TI AR-8545-30
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803655
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.06 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$718.85
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 30MM LP TI AR-8545-30
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803655
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.46 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$335.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$778.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$599.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$575.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$670.46
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.56
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$718.85
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$778.75
|
| Rate for Payer: Quartz Medicare Advantage |
$718.85
|
| Rate for Payer: The Alliance Commercial |
$599.04
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 32MM LP TI AR-8545-32
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803656
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.46 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$335.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$778.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$599.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$575.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$670.46
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.56
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$718.85
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$778.75
|
| Rate for Payer: Quartz Medicare Advantage |
$718.85
|
| Rate for Payer: The Alliance Commercial |
$599.04
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 32MM LP TI AR-8545-32
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803656
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.06 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$718.85
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 85MM LP TI AR-8545-85
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.06 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$718.85
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NONLOCK 4.5 X 85MM LP TI AR-8545-85
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5803657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.46 |
| Max. Negotiated Rate |
$1,102.23 |
| Rate for Payer: Aetna Commercial |
$1,078.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,030.35
|
| Rate for Payer: Aetna Managed Medicare |
$335.46
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$778.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$599.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$575.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$634.98
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cigna Commercial |
$1,102.23
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$670.46
|
| Rate for Payer: Health EOS Commercial |
$1,066.29
|
| Rate for Payer: HFN Commercial |
$1,102.23
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$898.56
|
| Rate for Payer: Multiplan Commercial |
$958.46
|
| Rate for Payer: NAPHCARE Commercial |
$718.85
|
| Rate for Payer: Preferred Network Access Commercial |
$1,102.23
|
| Rate for Payer: Quartz Beloit One Network |
$587.06
|
| Rate for Payer: Quartz Commercial |
$778.75
|
| Rate for Payer: Quartz Medicare Advantage |
$718.85
|
| Rate for Payer: The Alliance Commercial |
$599.04
|
| Rate for Payer: WEA Trust Commercial |
$658.94
|
| Rate for Payer: WPS Commercial |
$887.39
|
|
|
SCREW NUT 5.0 222.578
|
Facility
|
IP
|
$676.00
|
|
| Hospital Charge Code |
2967023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$344.49 |
| Max. Negotiated Rate |
$646.80 |
| Rate for Payer: Aetna Commercial |
$632.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$604.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$372.61
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$646.80
|
| Rate for Payer: Health EOS Commercial |
$625.71
|
| Rate for Payer: HFN Commercial |
$646.80
|
| Rate for Payer: Multiplan Commercial |
$562.43
|
| Rate for Payer: Preferred Network Access Commercial |
$646.80
|
| Rate for Payer: Quartz Beloit One Network |
$344.49
|
| Rate for Payer: Quartz Commercial |
$421.82
|
| Rate for Payer: WEA Trust Commercial |
$386.67
|
| Rate for Payer: WPS Commercial |
$520.72
|
|
|
SCREW NUT 5.0 222.578
|
Facility
|
OP
|
$676.00
|
|
| Hospital Charge Code |
2967023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.85 |
| Max. Negotiated Rate |
$646.80 |
| Rate for Payer: Aetna Commercial |
$632.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$604.61
|
| Rate for Payer: Aetna Managed Medicare |
$196.85
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$456.98
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$351.52
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$337.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$372.61
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$646.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$393.43
|
| Rate for Payer: Health EOS Commercial |
$625.71
|
| Rate for Payer: HFN Commercial |
$646.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$527.28
|
| Rate for Payer: Multiplan Commercial |
$562.43
|
| Rate for Payer: NAPHCARE Commercial |
$421.82
|
| Rate for Payer: Preferred Network Access Commercial |
$646.80
|
| Rate for Payer: Quartz Beloit One Network |
$344.49
|
| Rate for Payer: Quartz Commercial |
$456.98
|
| Rate for Payer: Quartz Medicare Advantage |
$421.82
|
| Rate for Payer: The Alliance Commercial |
$351.52
|
| Rate for Payer: WEA Trust Commercial |
$386.67
|
| Rate for Payer: WPS Commercial |
$520.72
|
|
|
SCREW ONE-STEP LAG 105MM 12.7MM THREAD 280.305S
|
Facility
|
IP
|
$4,306.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
2966562
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,194.34 |
| Max. Negotiated Rate |
$4,119.98 |
| Rate for Payer: Aetna Commercial |
$4,030.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,851.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,373.47
|
| Rate for Payer: Cash Price |
$1,291.80
|
| Rate for Payer: Cigna Commercial |
$4,119.98
|
| Rate for Payer: Health EOS Commercial |
$3,985.63
|
| Rate for Payer: HFN Commercial |
$4,119.98
|
| Rate for Payer: Multiplan Commercial |
$3,582.59
|
| Rate for Payer: Preferred Network Access Commercial |
$4,119.98
|
| Rate for Payer: Quartz Beloit One Network |
$2,194.34
|
| Rate for Payer: Quartz Commercial |
$2,686.94
|
| Rate for Payer: WEA Trust Commercial |
$2,463.03
|
| Rate for Payer: WPS Commercial |
$3,316.91
|
|
|
SCREW ONE-STEP LAG 105MM 12.7MM THREAD 280.305S
|
Facility
|
OP
|
$4,306.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
2966562
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,253.91 |
| Max. Negotiated Rate |
$4,119.98 |
| Rate for Payer: Aetna Commercial |
$4,030.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,851.29
|
| Rate for Payer: Aetna Managed Medicare |
$1,253.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,910.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,239.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,149.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,373.47
|
| Rate for Payer: Cash Price |
$1,291.80
|
| Rate for Payer: Cigna Commercial |
$4,119.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,506.09
|
| Rate for Payer: Health EOS Commercial |
$3,985.63
|
| Rate for Payer: HFN Commercial |
$4,119.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,358.68
|
| Rate for Payer: Multiplan Commercial |
$3,582.59
|
| Rate for Payer: NAPHCARE Commercial |
$2,686.94
|
| Rate for Payer: Preferred Network Access Commercial |
$4,119.98
|
| Rate for Payer: Quartz Beloit One Network |
$2,194.34
|
| Rate for Payer: Quartz Commercial |
$2,910.86
|
| Rate for Payer: Quartz Medicare Advantage |
$2,686.94
|
| Rate for Payer: The Alliance Commercial |
$2,239.12
|
| Rate for Payer: WEA Trust Commercial |
$2,463.03
|
| Rate for Payer: WPS Commercial |
$3,316.91
|
|
|
SCREW PEG 2.3 X 14 CO-S2314
|
Facility
|
OP
|
$1,429.00
|
|
| Hospital Charge Code |
2964149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.12 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Aetna Managed Medicare |
$416.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$831.68
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,114.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: NAPHCARE Commercial |
$891.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$966.00
|
| Rate for Payer: Quartz Medicare Advantage |
$891.70
|
| Rate for Payer: The Alliance Commercial |
$743.08
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW PEG 2.3 X 14 CO-S2314
|
Facility
|
IP
|
$1,429.00
|
|
| Hospital Charge Code |
2964149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.22 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$891.70
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW PEG 2.3 X 20 SMOOTH CO-S2320
|
Facility
|
IP
|
$1,429.00
|
|
| Hospital Charge Code |
2964152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$728.22 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$891.70
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW PEG 2.3 X 20 SMOOTH CO-S2320
|
Facility
|
OP
|
$1,429.00
|
|
| Hospital Charge Code |
2964152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.12 |
| Max. Negotiated Rate |
$1,367.27 |
| Rate for Payer: Aetna Commercial |
$1,337.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,278.10
|
| Rate for Payer: Aetna Managed Medicare |
$416.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$966.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$743.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$713.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$787.66
|
| Rate for Payer: Cash Price |
$428.70
|
| Rate for Payer: Cigna Commercial |
$1,367.27
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$831.68
|
| Rate for Payer: Health EOS Commercial |
$1,322.68
|
| Rate for Payer: HFN Commercial |
$1,367.27
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,114.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.93
|
| Rate for Payer: NAPHCARE Commercial |
$891.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,367.27
|
| Rate for Payer: Quartz Beloit One Network |
$728.22
|
| Rate for Payer: Quartz Commercial |
$966.00
|
| Rate for Payer: Quartz Medicare Advantage |
$891.70
|
| Rate for Payer: The Alliance Commercial |
$743.08
|
| Rate for Payer: WEA Trust Commercial |
$817.39
|
| Rate for Payer: WPS Commercial |
$1,100.76
|
|
|
SCREW PERIPHERAL LOCKING UNIVERS GLENOID 24MM AR-9145-24
|
Facility
|
OP
|
$1,597.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4220566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.05 |
| Max. Negotiated Rate |
$1,528.01 |
| Rate for Payer: Aetna Commercial |
$1,494.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,428.36
|
| Rate for Payer: Aetna Managed Medicare |
$465.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,079.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$830.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$797.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$880.27
|
| Rate for Payer: Cash Price |
$479.10
|
| Rate for Payer: Cigna Commercial |
$1,528.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$929.45
|
| Rate for Payer: Health EOS Commercial |
$1,478.18
|
| Rate for Payer: HFN Commercial |
$1,528.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,245.66
|
| Rate for Payer: Multiplan Commercial |
$1,328.70
|
| Rate for Payer: NAPHCARE Commercial |
$996.53
|
| Rate for Payer: Preferred Network Access Commercial |
$1,528.01
|
| Rate for Payer: Quartz Beloit One Network |
$813.83
|
| Rate for Payer: Quartz Commercial |
$1,079.57
|
| Rate for Payer: Quartz Medicare Advantage |
$996.53
|
| Rate for Payer: The Alliance Commercial |
$830.44
|
| Rate for Payer: WEA Trust Commercial |
$913.48
|
| Rate for Payer: WPS Commercial |
$1,230.17
|
|
|
SCREW PERIPHERAL LOCKING UNIVERS GLENOID 24MM AR-9145-24
|
Facility
|
IP
|
$1,597.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4220566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$813.83 |
| Max. Negotiated Rate |
$1,528.01 |
| Rate for Payer: Aetna Commercial |
$1,494.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,428.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$880.27
|
| Rate for Payer: Cash Price |
$479.10
|
| Rate for Payer: Cigna Commercial |
$1,528.01
|
| Rate for Payer: Health EOS Commercial |
$1,478.18
|
| Rate for Payer: HFN Commercial |
$1,528.01
|
| Rate for Payer: Multiplan Commercial |
$1,328.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,528.01
|
| Rate for Payer: Quartz Beloit One Network |
$813.83
|
| Rate for Payer: Quartz Commercial |
$996.53
|
| Rate for Payer: WEA Trust Commercial |
$913.48
|
| Rate for Payer: WPS Commercial |
$1,230.17
|
|
|
SCREW PERIPHERAL LOCKING UNIVERS GLENOID 30MM AR-9145-30
|
Facility
|
IP
|
$1,597.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4220568
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$813.83 |
| Max. Negotiated Rate |
$1,528.01 |
| Rate for Payer: Aetna Commercial |
$1,494.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,428.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$880.27
|
| Rate for Payer: Cash Price |
$479.10
|
| Rate for Payer: Cigna Commercial |
$1,528.01
|
| Rate for Payer: Health EOS Commercial |
$1,478.18
|
| Rate for Payer: HFN Commercial |
$1,528.01
|
| Rate for Payer: Multiplan Commercial |
$1,328.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,528.01
|
| Rate for Payer: Quartz Beloit One Network |
$813.83
|
| Rate for Payer: Quartz Commercial |
$996.53
|
| Rate for Payer: WEA Trust Commercial |
$913.48
|
| Rate for Payer: WPS Commercial |
$1,230.17
|
|
|
SCREW PERIPHERAL LOCKING UNIVERS GLENOID 30MM AR-9145-30
|
Facility
|
OP
|
$1,597.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4220568
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.05 |
| Max. Negotiated Rate |
$1,528.01 |
| Rate for Payer: Aetna Commercial |
$1,494.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,428.36
|
| Rate for Payer: Aetna Managed Medicare |
$465.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,079.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$830.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$797.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$880.27
|
| Rate for Payer: Cash Price |
$479.10
|
| Rate for Payer: Cigna Commercial |
$1,528.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$929.45
|
| Rate for Payer: Health EOS Commercial |
$1,478.18
|
| Rate for Payer: HFN Commercial |
$1,528.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,245.66
|
| Rate for Payer: Multiplan Commercial |
$1,328.70
|
| Rate for Payer: NAPHCARE Commercial |
$996.53
|
| Rate for Payer: Preferred Network Access Commercial |
$1,528.01
|
| Rate for Payer: Quartz Beloit One Network |
$813.83
|
| Rate for Payer: Quartz Commercial |
$1,079.57
|
| Rate for Payer: Quartz Medicare Advantage |
$996.53
|
| Rate for Payer: The Alliance Commercial |
$830.44
|
| Rate for Payer: WEA Trust Commercial |
$913.48
|
| Rate for Payer: WPS Commercial |
$1,230.17
|
|
|
SCREW PERIPHERAL LOCKING UNIVERS GLENOID 36MM AR-9145-36
|
Facility
|
OP
|
$1,597.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508888
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.05 |
| Max. Negotiated Rate |
$1,528.01 |
| Rate for Payer: Aetna Commercial |
$1,494.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,428.36
|
| Rate for Payer: Aetna Managed Medicare |
$465.05
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,079.57
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$830.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$797.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$880.27
|
| Rate for Payer: Cash Price |
$479.10
|
| Rate for Payer: Cigna Commercial |
$1,528.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$929.45
|
| Rate for Payer: Health EOS Commercial |
$1,478.18
|
| Rate for Payer: HFN Commercial |
$1,528.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,245.66
|
| Rate for Payer: Multiplan Commercial |
$1,328.70
|
| Rate for Payer: NAPHCARE Commercial |
$996.53
|
| Rate for Payer: Preferred Network Access Commercial |
$1,528.01
|
| Rate for Payer: Quartz Beloit One Network |
$813.83
|
| Rate for Payer: Quartz Commercial |
$1,079.57
|
| Rate for Payer: Quartz Medicare Advantage |
$996.53
|
| Rate for Payer: The Alliance Commercial |
$830.44
|
| Rate for Payer: WEA Trust Commercial |
$913.48
|
| Rate for Payer: WPS Commercial |
$1,230.17
|
|
|
SCREW PERIPHERAL LOCKING UNIVERS GLENOID 36MM AR-9145-36
|
Facility
|
IP
|
$1,597.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4508888
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$813.83 |
| Max. Negotiated Rate |
$1,528.01 |
| Rate for Payer: Aetna Commercial |
$1,494.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,428.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$880.27
|
| Rate for Payer: Cash Price |
$479.10
|
| Rate for Payer: Cigna Commercial |
$1,528.01
|
| Rate for Payer: Health EOS Commercial |
$1,478.18
|
| Rate for Payer: HFN Commercial |
$1,528.01
|
| Rate for Payer: Multiplan Commercial |
$1,328.70
|
| Rate for Payer: Preferred Network Access Commercial |
$1,528.01
|
| Rate for Payer: Quartz Beloit One Network |
$813.83
|
| Rate for Payer: Quartz Commercial |
$996.53
|
| Rate for Payer: WEA Trust Commercial |
$913.48
|
| Rate for Payer: WPS Commercial |
$1,230.17
|
|
