|
SCREW METAPHYSEAL 2.7 X 70MM 02.118.570
|
Facility
|
OP
|
$817.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265485
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$228.76 |
| Max. Negotiated Rate |
$3,268.00 |
| Rate for Payer: Aetna Commercial |
$735.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$702.62
|
| Rate for Payer: Aetna Managed Medicare |
$228.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$531.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$408.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$392.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$433.01
|
| Rate for Payer: Cash Price |
$245.10
|
| Rate for Payer: Cigna Commercial |
$751.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$457.19
|
| Rate for Payer: Health EOS Commercial |
$727.13
|
| Rate for Payer: HFN Commercial |
$751.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$612.75
|
| Rate for Payer: Multiplan Commercial |
$653.60
|
| Rate for Payer: NAPHCARE Commercial |
$490.20
|
| Rate for Payer: Preferred Network Access Commercial |
$751.64
|
| Rate for Payer: Quartz Beloit One Network |
$400.33
|
| Rate for Payer: Quartz Commercial |
$531.05
|
| Rate for Payer: Quartz Medicare Advantage |
$490.20
|
| Rate for Payer: The Alliance Commercial |
$3,268.00
|
| Rate for Payer: WEA Trust Commercial |
$449.35
|
| Rate for Payer: WPS Commercial |
$605.15
|
|
|
SCREW METAPHYSEAL 2.7 X 70MM 02.118.570
|
Facility
|
IP
|
$817.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3265485
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$400.33 |
| Max. Negotiated Rate |
$751.64 |
| Rate for Payer: Aetna Commercial |
$735.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$702.62
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$433.01
|
| Rate for Payer: Cash Price |
$245.10
|
| Rate for Payer: Cigna Commercial |
$751.64
|
| Rate for Payer: Health EOS Commercial |
$727.13
|
| Rate for Payer: HFN Commercial |
$751.64
|
| Rate for Payer: Multiplan Commercial |
$653.60
|
| Rate for Payer: NAPHCARE Commercial |
$490.20
|
| Rate for Payer: Preferred Network Access Commercial |
$751.64
|
| Rate for Payer: Quartz Beloit One Network |
$400.33
|
| Rate for Payer: Quartz Commercial |
$490.20
|
| Rate for Payer: WEA Trust Commercial |
$449.35
|
| Rate for Payer: WPS Commercial |
$605.15
|
|
|
SCREW MICRO CANN 2.0 X 15 6MM THREAD LENGTH ASNIS TI 40-20115
|
Facility
|
IP
|
$1,845.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6171703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$904.05 |
| Max. Negotiated Rate |
$1,697.40 |
| Rate for Payer: Aetna Commercial |
$1,660.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,586.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$977.85
|
| Rate for Payer: Cash Price |
$553.50
|
| Rate for Payer: Cigna Commercial |
$1,697.40
|
| Rate for Payer: Health EOS Commercial |
$1,642.05
|
| Rate for Payer: HFN Commercial |
$1,697.40
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,697.40
|
| Rate for Payer: Quartz Beloit One Network |
$904.05
|
| Rate for Payer: Quartz Commercial |
$1,107.00
|
| Rate for Payer: WEA Trust Commercial |
$1,014.75
|
| Rate for Payer: WPS Commercial |
$1,366.59
|
|
|
SCREW MICRO CANN 2.0 X 15 6MM THREAD LENGTH ASNIS TI 40-20115
|
Facility
|
OP
|
$1,845.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6171703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$516.60 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$1,660.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,586.70
|
| Rate for Payer: Aetna Managed Medicare |
$516.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,199.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$922.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$885.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$977.85
|
| Rate for Payer: Cash Price |
$553.50
|
| Rate for Payer: Cigna Commercial |
$1,697.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,032.46
|
| Rate for Payer: Health EOS Commercial |
$1,642.05
|
| Rate for Payer: HFN Commercial |
$1,697.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,383.75
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,697.40
|
| Rate for Payer: Quartz Beloit One Network |
$904.05
|
| Rate for Payer: Quartz Commercial |
$1,199.25
|
| Rate for Payer: Quartz Medicare Advantage |
$1,107.00
|
| Rate for Payer: The Alliance Commercial |
$7,380.00
|
| Rate for Payer: WEA Trust Commercial |
$1,014.75
|
| Rate for Payer: WPS Commercial |
$1,366.59
|
|
|
SCREW MICRO CANN 2.0 X 16 7MM THREAD LENGTH ASNIS TI 40-20116
|
Facility
|
OP
|
$1,845.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6171704
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$516.60 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$1,660.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,586.70
|
| Rate for Payer: Aetna Managed Medicare |
$516.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,199.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$922.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$885.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$977.85
|
| Rate for Payer: Cash Price |
$553.50
|
| Rate for Payer: Cigna Commercial |
$1,697.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,032.46
|
| Rate for Payer: Health EOS Commercial |
$1,642.05
|
| Rate for Payer: HFN Commercial |
$1,697.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,383.75
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,697.40
|
| Rate for Payer: Quartz Beloit One Network |
$904.05
|
| Rate for Payer: Quartz Commercial |
$1,199.25
|
| Rate for Payer: Quartz Medicare Advantage |
$1,107.00
|
| Rate for Payer: The Alliance Commercial |
$7,380.00
|
| Rate for Payer: WEA Trust Commercial |
$1,014.75
|
| Rate for Payer: WPS Commercial |
$1,366.59
|
|
|
SCREW MICRO CANN 2.0 X 16 7MM THREAD LENGTH ASNIS TI 40-20116
|
Facility
|
IP
|
$1,845.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6171704
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$904.05 |
| Max. Negotiated Rate |
$1,697.40 |
| Rate for Payer: Aetna Commercial |
$1,660.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,586.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$977.85
|
| Rate for Payer: Cash Price |
$553.50
|
| Rate for Payer: Cigna Commercial |
$1,697.40
|
| Rate for Payer: Health EOS Commercial |
$1,642.05
|
| Rate for Payer: HFN Commercial |
$1,697.40
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,107.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,697.40
|
| Rate for Payer: Quartz Beloit One Network |
$904.05
|
| Rate for Payer: Quartz Commercial |
$1,107.00
|
| Rate for Payer: WEA Trust Commercial |
$1,014.75
|
| Rate for Payer: WPS Commercial |
$1,366.59
|
|
|
SCREW MICRO CANN 2.0 X 24MM X 6MM THREAD ASNIS 40-20124
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW MICRO CANN 2.0 X 24MM X 6MM THREAD ASNIS 40-20124
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW MICRO CANN 2.0 X 28MM X 6MMTHREAD ASNIS 40-20128
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,029.98 |
| Max. Negotiated Rate |
$1,933.84 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,261.20
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW MICRO CANN 2.0 X 28MM X 6MMTHREAD ASNIS 40-20128
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5767636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$588.56 |
| Max. Negotiated Rate |
$8,408.00 |
| Rate for Payer: Aetna Commercial |
$1,891.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,807.72
|
| Rate for Payer: Aetna Managed Medicare |
$588.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,366.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,051.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,008.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,114.06
|
| Rate for Payer: Cash Price |
$630.60
|
| Rate for Payer: Cigna Commercial |
$1,933.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,176.28
|
| Rate for Payer: Health EOS Commercial |
$1,870.78
|
| Rate for Payer: HFN Commercial |
$1,933.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,576.50
|
| Rate for Payer: Multiplan Commercial |
$1,681.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,261.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,933.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,029.98
|
| Rate for Payer: Quartz Commercial |
$1,366.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,261.20
|
| Rate for Payer: The Alliance Commercial |
$8,408.00
|
| Rate for Payer: WEA Trust Commercial |
$1,156.10
|
| Rate for Payer: WPS Commercial |
$1,556.95
|
|
|
SCREW MINI CANN 2.5 X 12 HEADLESS IH2512
|
Facility
|
IP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5947649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,378.86 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,688.40
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 12 HEADLESS IH2512
|
Facility
|
OP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5947649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.92 |
| Max. Negotiated Rate |
$11,256.00 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Aetna Managed Medicare |
$787.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,829.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,407.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,350.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,574.71
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,110.50
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,829.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,688.40
|
| Rate for Payer: The Alliance Commercial |
$11,256.00
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 14 HEADLESS IH2514
|
Facility
|
IP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5947650
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,378.86 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,688.40
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 14 HEADLESS IH2514
|
Facility
|
OP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5947650
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.92 |
| Max. Negotiated Rate |
$11,256.00 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Aetna Managed Medicare |
$787.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,829.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,407.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,350.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,574.71
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,110.50
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,829.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,688.40
|
| Rate for Payer: The Alliance Commercial |
$11,256.00
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 16 HEADLESS IH2516
|
Facility
|
IP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6153683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,378.86 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,688.40
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 16 HEADLESS IH2516
|
Facility
|
OP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6153683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.92 |
| Max. Negotiated Rate |
$11,256.00 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Aetna Managed Medicare |
$787.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,829.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,407.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,350.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,574.71
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,110.50
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,829.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,688.40
|
| Rate for Payer: The Alliance Commercial |
$11,256.00
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 18 HEADLESS IH2518
|
Facility
|
OP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6166134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.92 |
| Max. Negotiated Rate |
$11,256.00 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Aetna Managed Medicare |
$787.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,829.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,407.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,350.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,574.71
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,110.50
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,829.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,688.40
|
| Rate for Payer: The Alliance Commercial |
$11,256.00
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
SCREW MINI CANN 2.5 X 18 HEADLESS IH2518
|
Facility
|
IP
|
$2,814.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6166134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,378.86 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Aetna Commercial |
$2,532.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,420.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,491.42
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$2,588.88
|
| Rate for Payer: Health EOS Commercial |
$2,504.46
|
| Rate for Payer: HFN Commercial |
$2,588.88
|
| Rate for Payer: Multiplan Commercial |
$2,251.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,688.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,588.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,378.86
|
| Rate for Payer: Quartz Commercial |
$1,688.40
|
| Rate for Payer: WEA Trust Commercial |
$1,547.70
|
| Rate for Payer: WPS Commercial |
$2,084.33
|
|
|
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 |
$819.56 |
| Max. Negotiated Rate |
$11,708.00 |
| Rate for Payer: Aetna Commercial |
$2,634.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,517.22
|
| Rate for Payer: Aetna Managed Medicare |
$819.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,902.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,463.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,404.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,551.31
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,692.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,637.95
|
| Rate for Payer: Health EOS Commercial |
$2,605.03
|
| Rate for Payer: HFN Commercial |
$2,692.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,195.25
|
| Rate for Payer: Multiplan Commercial |
$2,341.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,756.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,692.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,434.23
|
| Rate for Payer: Quartz Commercial |
$1,902.55
|
| Rate for Payer: Quartz Medicare Advantage |
$1,756.20
|
| Rate for Payer: The Alliance Commercial |
$11,708.00
|
| Rate for Payer: WEA Trust Commercial |
$1,609.85
|
| Rate for Payer: WPS Commercial |
$2,168.03
|
|
|
SCREW MINI CANN 2.5 X 20 HEADLESS IH2520
|
Facility
|
IP
|
$2,927.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5685825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,434.23 |
| Max. Negotiated Rate |
$2,692.84 |
| Rate for Payer: Aetna Commercial |
$2,634.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,517.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,551.31
|
| Rate for Payer: Cash Price |
$878.10
|
| Rate for Payer: Cigna Commercial |
$2,692.84
|
| Rate for Payer: Health EOS Commercial |
$2,605.03
|
| Rate for Payer: HFN Commercial |
$2,692.84
|
| Rate for Payer: Multiplan Commercial |
$2,341.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,756.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,692.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,434.23
|
| Rate for Payer: Quartz Commercial |
$1,756.20
|
| Rate for Payer: WEA Trust Commercial |
$1,609.85
|
| Rate for Payer: WPS Commercial |
$2,168.03
|
|
|
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 |
$719.60 |
| Max. Negotiated Rate |
$10,280.00 |
| Rate for Payer: Aetna Commercial |
$2,313.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.20
|
| Rate for Payer: Aetna Managed Medicare |
$719.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,670.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,285.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,233.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.10
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,364.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,438.17
|
| Rate for Payer: Health EOS Commercial |
$2,287.30
|
| Rate for Payer: HFN Commercial |
$2,364.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,927.50
|
| Rate for Payer: Multiplan Commercial |
$2,056.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,542.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.30
|
| Rate for Payer: Quartz Commercial |
$1,670.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,542.00
|
| Rate for Payer: The Alliance Commercial |
$10,280.00
|
| Rate for Payer: WEA Trust Commercial |
$1,413.50
|
| Rate for Payer: WPS Commercial |
$1,903.60
|
|
|
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 |
$1,259.30 |
| Max. Negotiated Rate |
$2,364.40 |
| Rate for Payer: Aetna Commercial |
$2,313.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.10
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,364.40
|
| Rate for Payer: Health EOS Commercial |
$2,287.30
|
| Rate for Payer: HFN Commercial |
$2,364.40
|
| Rate for Payer: Multiplan Commercial |
$2,056.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,542.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.30
|
| Rate for Payer: Quartz Commercial |
$1,542.00
|
| Rate for Payer: WEA Trust Commercial |
$1,413.50
|
| Rate for Payer: WPS Commercial |
$1,903.60
|
|
|
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 |
$686.56 |
| Max. Negotiated Rate |
$9,808.00 |
| Rate for Payer: Aetna Commercial |
$2,206.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,108.72
|
| Rate for Payer: Aetna Managed Medicare |
$686.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,593.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,226.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,176.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,299.56
|
| Rate for Payer: Cash Price |
$735.60
|
| Rate for Payer: Cigna Commercial |
$2,255.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,372.14
|
| Rate for Payer: Health EOS Commercial |
$2,182.28
|
| Rate for Payer: HFN Commercial |
$2,255.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,839.00
|
| Rate for Payer: Multiplan Commercial |
$1,961.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,471.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,255.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,201.48
|
| Rate for Payer: Quartz Commercial |
$1,593.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,471.20
|
| Rate for Payer: The Alliance Commercial |
$9,808.00
|
| Rate for Payer: WEA Trust Commercial |
$1,348.60
|
| Rate for Payer: WPS Commercial |
$1,816.20
|
|
|
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 |
$1,201.48 |
| Max. Negotiated Rate |
$2,255.84 |
| Rate for Payer: Aetna Commercial |
$2,206.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,108.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,299.56
|
| Rate for Payer: Cash Price |
$735.60
|
| Rate for Payer: Cigna Commercial |
$2,255.84
|
| Rate for Payer: Health EOS Commercial |
$2,182.28
|
| Rate for Payer: HFN Commercial |
$2,255.84
|
| Rate for Payer: Multiplan Commercial |
$1,961.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,471.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,255.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,201.48
|
| Rate for Payer: Quartz Commercial |
$1,471.20
|
| Rate for Payer: WEA Trust Commercial |
$1,348.60
|
| Rate for Payer: WPS Commercial |
$1,816.20
|
|
|
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 |
$719.60 |
| Max. Negotiated Rate |
$10,280.00 |
| Rate for Payer: Aetna Commercial |
$2,313.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,210.20
|
| Rate for Payer: Aetna Managed Medicare |
$719.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,670.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,285.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,233.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,362.10
|
| Rate for Payer: Cash Price |
$771.00
|
| Rate for Payer: Cigna Commercial |
$2,364.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,438.17
|
| Rate for Payer: Health EOS Commercial |
$2,287.30
|
| Rate for Payer: HFN Commercial |
$2,364.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,927.50
|
| Rate for Payer: Multiplan Commercial |
$2,056.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,542.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,364.40
|
| Rate for Payer: Quartz Beloit One Network |
$1,259.30
|
| Rate for Payer: Quartz Commercial |
$1,670.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,542.00
|
| Rate for Payer: The Alliance Commercial |
$10,280.00
|
| Rate for Payer: WEA Trust Commercial |
$1,413.50
|
| Rate for Payer: WPS Commercial |
$1,903.60
|
|
