|
BLADE 4.2 CUDA STRAIGHT C9254
|
Facility
IP
|
$991.00
|
|
| Hospital Charge Code |
2965523
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.59 |
| Max. Negotiated Rate |
$911.72 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$594.60
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.2 FULL RADIUS 9247A
|
Facility
IP
|
$1,343.00
|
|
| Hospital Charge Code |
2964871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$658.07 |
| Max. Negotiated Rate |
$1,235.56 |
| Rate for Payer: Aetna Commercial |
$1,208.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$711.79
|
| Rate for Payer: Cash Price |
$402.90
|
| Rate for Payer: Cigna Commercial |
$1,235.56
|
| Rate for Payer: Health EOS Commercial |
$1,195.27
|
| Rate for Payer: HFN Commercial |
$1,235.56
|
| Rate for Payer: Multiplan Commercial |
$1,074.40
|
| Rate for Payer: NAPHCARE Commercial |
$805.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,235.56
|
| Rate for Payer: Quartz Beloit One Network |
$658.07
|
| Rate for Payer: Quartz Commercial |
$805.80
|
| Rate for Payer: WEA Trust Commercial |
$738.65
|
| Rate for Payer: WPS Commercial |
$994.76
|
|
|
BLADE 4.2 FULL RADIUS 9247A
|
Facility
OP
|
$1,343.00
|
|
| Hospital Charge Code |
2964871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$376.04 |
| Max. Negotiated Rate |
$5,372.00 |
| Rate for Payer: Aetna Commercial |
$1,208.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,154.98
|
| Rate for Payer: Aetna Managed Medicare |
$376.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$872.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$671.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$644.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$711.79
|
| Rate for Payer: Cash Price |
$402.90
|
| Rate for Payer: Cigna Commercial |
$1,235.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$751.54
|
| Rate for Payer: Health EOS Commercial |
$1,195.27
|
| Rate for Payer: HFN Commercial |
$1,235.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,007.25
|
| Rate for Payer: Multiplan Commercial |
$1,074.40
|
| Rate for Payer: NAPHCARE Commercial |
$805.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,235.56
|
| Rate for Payer: Quartz Beloit One Network |
$658.07
|
| Rate for Payer: Quartz Commercial |
$872.95
|
| Rate for Payer: Quartz Medicare Advantage |
$805.80
|
| Rate for Payer: The Alliance Commercial |
$5,372.00
|
| Rate for Payer: WEA Trust Commercial |
$738.65
|
| Rate for Payer: WPS Commercial |
$994.76
|
|
|
BLADE 4.2 FULL RADIUS C9241
|
Facility
OP
|
$642.00
|
|
| Hospital Charge Code |
2964870
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.76 |
| Max. Negotiated Rate |
$2,568.00 |
| Rate for Payer: Aetna Commercial |
$577.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$552.12
|
| Rate for Payer: Aetna Managed Medicare |
$179.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$417.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$321.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$308.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$340.26
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$590.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$359.26
|
| Rate for Payer: Health EOS Commercial |
$571.38
|
| Rate for Payer: HFN Commercial |
$590.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$481.50
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: NAPHCARE Commercial |
$385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$590.64
|
| Rate for Payer: Quartz Beloit One Network |
$314.58
|
| Rate for Payer: Quartz Commercial |
$417.30
|
| Rate for Payer: Quartz Medicare Advantage |
$385.20
|
| Rate for Payer: The Alliance Commercial |
$2,568.00
|
| Rate for Payer: WEA Trust Commercial |
$353.10
|
| Rate for Payer: WPS Commercial |
$475.53
|
|
|
BLADE 4.2 FULL RADIUS C9241
|
Facility
IP
|
$642.00
|
|
| Hospital Charge Code |
2964870
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$590.64 |
| Rate for Payer: Aetna Commercial |
$577.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$340.26
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$590.64
|
| Rate for Payer: Health EOS Commercial |
$571.38
|
| Rate for Payer: HFN Commercial |
$590.64
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: NAPHCARE Commercial |
$385.20
|
| Rate for Payer: Preferred Network Access Commercial |
$590.64
|
| Rate for Payer: Quartz Beloit One Network |
$314.58
|
| Rate for Payer: Quartz Commercial |
$385.20
|
| Rate for Payer: WEA Trust Commercial |
$353.10
|
| Rate for Payer: WPS Commercial |
$475.53
|
|
|
BLADE 4.2 GREAT WHITE 9299A
|
Facility
OP
|
$991.00
|
|
| Hospital Charge Code |
2965521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.48 |
| Max. Negotiated Rate |
$3,964.00 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.26
|
| Rate for Payer: Aetna Managed Medicare |
$277.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.56
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.25
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$644.15
|
| Rate for Payer: Quartz Medicare Advantage |
$594.60
|
| Rate for Payer: The Alliance Commercial |
$3,964.00
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.2 GREAT WHITE 9299A
|
Facility
IP
|
$991.00
|
|
| Hospital Charge Code |
2965521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.59 |
| Max. Negotiated Rate |
$911.72 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$594.60
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.2 GREAT WHITE BENT C9299M
|
Facility
IP
|
$991.00
|
|
| Hospital Charge Code |
2965525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.59 |
| Max. Negotiated Rate |
$911.72 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$594.60
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.2 GREAT WHITE BENT C9299M
|
Facility
OP
|
$991.00
|
|
| Hospital Charge Code |
2965525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.48 |
| Max. Negotiated Rate |
$3,964.00 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.26
|
| Rate for Payer: Aetna Managed Medicare |
$277.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.56
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.25
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$644.15
|
| Rate for Payer: Quartz Medicare Advantage |
$594.60
|
| Rate for Payer: The Alliance Commercial |
$3,964.00
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.2 SLOTTED WHISKER C9274
|
Facility
IP
|
$991.00
|
|
| Hospital Charge Code |
2965532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.59 |
| Max. Negotiated Rate |
$911.72 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$594.60
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.2 SLOTTED WHISKER C9274
|
Facility
OP
|
$991.00
|
|
| Hospital Charge Code |
2965532
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.48 |
| Max. Negotiated Rate |
$3,964.00 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.26
|
| Rate for Payer: Aetna Managed Medicare |
$277.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.56
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.25
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$644.15
|
| Rate for Payer: Quartz Medicare Advantage |
$594.60
|
| Rate for Payer: The Alliance Commercial |
$3,964.00
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.8 GATOR C9262
|
Facility
OP
|
$991.00
|
|
| Hospital Charge Code |
2964872
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.48 |
| Max. Negotiated Rate |
$3,964.00 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.26
|
| Rate for Payer: Aetna Managed Medicare |
$277.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.56
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.25
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$644.15
|
| Rate for Payer: Quartz Medicare Advantage |
$594.60
|
| Rate for Payer: The Alliance Commercial |
$3,964.00
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 4.8 GATOR C9262
|
Facility
IP
|
$991.00
|
|
| Hospital Charge Code |
2964872
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.59 |
| Max. Negotiated Rate |
$911.72 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$594.60
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 48MM SPIRAL TITANIUM
|
Facility
IP
|
$6,225.00
|
|
| Hospital Charge Code |
2966151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,050.25 |
| Max. Negotiated Rate |
$5,727.00 |
| Rate for Payer: Aetna Commercial |
$5,602.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,299.25
|
| Rate for Payer: Cash Price |
$1,867.50
|
| Rate for Payer: Cigna Commercial |
$5,727.00
|
| Rate for Payer: Health EOS Commercial |
$5,540.25
|
| Rate for Payer: HFN Commercial |
$5,727.00
|
| Rate for Payer: Multiplan Commercial |
$4,980.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,735.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,727.00
|
| Rate for Payer: Quartz Beloit One Network |
$3,050.25
|
| Rate for Payer: Quartz Commercial |
$3,735.00
|
| Rate for Payer: WEA Trust Commercial |
$3,423.75
|
| Rate for Payer: WPS Commercial |
$4,610.86
|
|
|
BLADE 48MM SPIRAL TITANIUM
|
Facility
OP
|
$6,225.00
|
|
| Hospital Charge Code |
2966151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,743.00 |
| Max. Negotiated Rate |
$24,900.00 |
| Rate for Payer: Aetna Commercial |
$5,602.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,353.50
|
| Rate for Payer: Aetna Managed Medicare |
$1,743.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,046.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,112.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,988.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,299.25
|
| Rate for Payer: Cash Price |
$1,867.50
|
| Rate for Payer: Cigna Commercial |
$5,727.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,483.51
|
| Rate for Payer: Health EOS Commercial |
$5,540.25
|
| Rate for Payer: HFN Commercial |
$5,727.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,668.75
|
| Rate for Payer: Multiplan Commercial |
$4,980.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,735.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,727.00
|
| Rate for Payer: Quartz Beloit One Network |
$3,050.25
|
| Rate for Payer: Quartz Commercial |
$4,046.25
|
| Rate for Payer: Quartz Medicare Advantage |
$3,735.00
|
| Rate for Payer: The Alliance Commercial |
$24,900.00
|
| Rate for Payer: WEA Trust Commercial |
$3,423.75
|
| Rate for Payer: WPS Commercial |
$4,610.86
|
|
|
BLADE 4MM TRICUT 188404
|
Facility
OP
|
$1,179.00
|
|
| Hospital Charge Code |
2965308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$330.12 |
| Max. Negotiated Rate |
$4,716.00 |
| Rate for Payer: Aetna Commercial |
$1,061.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,013.94
|
| Rate for Payer: Aetna Managed Medicare |
$330.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$766.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$589.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$565.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$624.87
|
| Rate for Payer: Cash Price |
$353.70
|
| Rate for Payer: Cigna Commercial |
$1,084.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$659.77
|
| Rate for Payer: Health EOS Commercial |
$1,049.31
|
| Rate for Payer: HFN Commercial |
$1,084.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$884.25
|
| Rate for Payer: Multiplan Commercial |
$943.20
|
| Rate for Payer: NAPHCARE Commercial |
$707.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,084.68
|
| Rate for Payer: Quartz Beloit One Network |
$577.71
|
| Rate for Payer: Quartz Commercial |
$766.35
|
| Rate for Payer: Quartz Medicare Advantage |
$707.40
|
| Rate for Payer: The Alliance Commercial |
$4,716.00
|
| Rate for Payer: WEA Trust Commercial |
$648.45
|
| Rate for Payer: WPS Commercial |
$873.29
|
|
|
BLADE 4MM TRICUT 188404
|
Facility
IP
|
$1,179.00
|
|
| Hospital Charge Code |
2965308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$577.71 |
| Max. Negotiated Rate |
$1,084.68 |
| Rate for Payer: Aetna Commercial |
$1,061.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$624.87
|
| Rate for Payer: Cash Price |
$353.70
|
| Rate for Payer: Cigna Commercial |
$1,084.68
|
| Rate for Payer: Health EOS Commercial |
$1,049.31
|
| Rate for Payer: HFN Commercial |
$1,084.68
|
| Rate for Payer: Multiplan Commercial |
$943.20
|
| Rate for Payer: NAPHCARE Commercial |
$707.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,084.68
|
| Rate for Payer: Quartz Beloit One Network |
$577.71
|
| Rate for Payer: Quartz Commercial |
$707.40
|
| Rate for Payer: WEA Trust Commercial |
$648.45
|
| Rate for Payer: WPS Commercial |
$873.29
|
|
|
BLADE 5.2 ANGLED SLIT 8065995661
|
Facility
OP
|
$534.00
|
|
| Hospital Charge Code |
2964179
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.52 |
| Max. Negotiated Rate |
$2,136.00 |
| Rate for Payer: Aetna Commercial |
$480.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$459.24
|
| Rate for Payer: Aetna Managed Medicare |
$149.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$347.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$267.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$256.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$283.02
|
| Rate for Payer: Cash Price |
$160.20
|
| Rate for Payer: Cigna Commercial |
$491.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$298.83
|
| Rate for Payer: Health EOS Commercial |
$475.26
|
| Rate for Payer: HFN Commercial |
$491.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$400.50
|
| Rate for Payer: Multiplan Commercial |
$427.20
|
| Rate for Payer: NAPHCARE Commercial |
$320.40
|
| Rate for Payer: Preferred Network Access Commercial |
$491.28
|
| Rate for Payer: Quartz Beloit One Network |
$261.66
|
| Rate for Payer: Quartz Commercial |
$347.10
|
| Rate for Payer: Quartz Medicare Advantage |
$320.40
|
| Rate for Payer: The Alliance Commercial |
$2,136.00
|
| Rate for Payer: WEA Trust Commercial |
$293.70
|
| Rate for Payer: WPS Commercial |
$395.53
|
|
|
BLADE 5.2 ANGLED SLIT 8065995661
|
Facility
IP
|
$534.00
|
|
| Hospital Charge Code |
2964179
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.66 |
| Max. Negotiated Rate |
$491.28 |
| Rate for Payer: Aetna Commercial |
$480.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$283.02
|
| Rate for Payer: Cash Price |
$160.20
|
| Rate for Payer: Cigna Commercial |
$491.28
|
| Rate for Payer: Health EOS Commercial |
$475.26
|
| Rate for Payer: HFN Commercial |
$491.28
|
| Rate for Payer: Multiplan Commercial |
$427.20
|
| Rate for Payer: NAPHCARE Commercial |
$320.40
|
| Rate for Payer: Preferred Network Access Commercial |
$491.28
|
| Rate for Payer: Quartz Beloit One Network |
$261.66
|
| Rate for Payer: Quartz Commercial |
$320.40
|
| Rate for Payer: WEA Trust Commercial |
$293.70
|
| Rate for Payer: WPS Commercial |
$395.53
|
|
|
BLADE 5.5 CUDA C9255
|
Facility
OP
|
$991.00
|
|
| Hospital Charge Code |
2965524
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.48 |
| Max. Negotiated Rate |
$3,964.00 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$852.26
|
| Rate for Payer: Aetna Managed Medicare |
$277.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$644.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$495.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$475.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$554.56
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$743.25
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$644.15
|
| Rate for Payer: Quartz Medicare Advantage |
$594.60
|
| Rate for Payer: The Alliance Commercial |
$3,964.00
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 5.5 CUDA C9255
|
Facility
IP
|
$991.00
|
|
| Hospital Charge Code |
2965524
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.59 |
| Max. Negotiated Rate |
$911.72 |
| Rate for Payer: Aetna Commercial |
$891.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$525.23
|
| Rate for Payer: Cash Price |
$297.30
|
| Rate for Payer: Cigna Commercial |
$911.72
|
| Rate for Payer: Health EOS Commercial |
$881.99
|
| Rate for Payer: HFN Commercial |
$911.72
|
| Rate for Payer: Multiplan Commercial |
$792.80
|
| Rate for Payer: NAPHCARE Commercial |
$594.60
|
| Rate for Payer: Preferred Network Access Commercial |
$911.72
|
| Rate for Payer: Quartz Beloit One Network |
$485.59
|
| Rate for Payer: Quartz Commercial |
$594.60
|
| Rate for Payer: WEA Trust Commercial |
$545.05
|
| Rate for Payer: WPS Commercial |
$734.03
|
|
|
BLADE 69 BEAVER 376900
|
Facility
IP
|
$73.00
|
|
| Hospital Charge Code |
2965511
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.77 |
| Max. Negotiated Rate |
$67.16 |
| Rate for Payer: Aetna Commercial |
$65.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.69
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cigna Commercial |
$67.16
|
| Rate for Payer: Health EOS Commercial |
$64.97
|
| Rate for Payer: HFN Commercial |
$67.16
|
| Rate for Payer: Multiplan Commercial |
$58.40
|
| Rate for Payer: NAPHCARE Commercial |
$43.80
|
| Rate for Payer: Preferred Network Access Commercial |
$67.16
|
| Rate for Payer: Quartz Beloit One Network |
$35.77
|
| Rate for Payer: Quartz Commercial |
$43.80
|
| Rate for Payer: WEA Trust Commercial |
$40.15
|
| Rate for Payer: WPS Commercial |
$54.07
|
|
|
BLADE 69 BEAVER 376900
|
Facility
OP
|
$73.00
|
|
| Hospital Charge Code |
2965511
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$292.00 |
| Rate for Payer: Aetna Commercial |
$65.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$62.78
|
| Rate for Payer: Aetna Managed Medicare |
$20.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$47.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$36.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$35.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$38.69
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cigna Commercial |
$67.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$40.85
|
| Rate for Payer: Health EOS Commercial |
$64.97
|
| Rate for Payer: HFN Commercial |
$67.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$54.75
|
| Rate for Payer: Multiplan Commercial |
$58.40
|
| Rate for Payer: NAPHCARE Commercial |
$43.80
|
| Rate for Payer: Preferred Network Access Commercial |
$67.16
|
| Rate for Payer: Quartz Beloit One Network |
$35.77
|
| Rate for Payer: Quartz Commercial |
$47.45
|
| Rate for Payer: Quartz Medicare Advantage |
$43.80
|
| Rate for Payer: The Alliance Commercial |
$292.00
|
| Rate for Payer: WEA Trust Commercial |
$40.15
|
| Rate for Payer: WPS Commercial |
$54.07
|
|
|
BLADE 8MM FLEXIBLE OSTEOTOME 71369208
|
Facility
OP
|
$1,556.00
|
|
| Hospital Charge Code |
2965977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.68 |
| Max. Negotiated Rate |
$6,224.00 |
| Rate for Payer: Aetna Commercial |
$1,400.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,338.16
|
| Rate for Payer: Aetna Managed Medicare |
$435.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,011.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$778.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$746.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$824.68
|
| Rate for Payer: Cash Price |
$466.80
|
| Rate for Payer: Cigna Commercial |
$1,431.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$870.74
|
| Rate for Payer: Health EOS Commercial |
$1,384.84
|
| Rate for Payer: HFN Commercial |
$1,431.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,167.00
|
| Rate for Payer: Multiplan Commercial |
$1,244.80
|
| Rate for Payer: NAPHCARE Commercial |
$933.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,431.52
|
| Rate for Payer: Quartz Beloit One Network |
$762.44
|
| Rate for Payer: Quartz Commercial |
$1,011.40
|
| Rate for Payer: Quartz Medicare Advantage |
$933.60
|
| Rate for Payer: The Alliance Commercial |
$6,224.00
|
| Rate for Payer: WEA Trust Commercial |
$855.80
|
| Rate for Payer: WPS Commercial |
$1,152.53
|
|
|
BLADE 8MM FLEXIBLE OSTEOTOME 71369208
|
Facility
IP
|
$1,556.00
|
|
| Hospital Charge Code |
2965977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$762.44 |
| Max. Negotiated Rate |
$1,431.52 |
| Rate for Payer: Aetna Commercial |
$1,400.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$824.68
|
| Rate for Payer: Cash Price |
$466.80
|
| Rate for Payer: Cigna Commercial |
$1,431.52
|
| Rate for Payer: Health EOS Commercial |
$1,384.84
|
| Rate for Payer: HFN Commercial |
$1,431.52
|
| Rate for Payer: Multiplan Commercial |
$1,244.80
|
| Rate for Payer: NAPHCARE Commercial |
$933.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,431.52
|
| Rate for Payer: Quartz Beloit One Network |
$762.44
|
| Rate for Payer: Quartz Commercial |
$933.60
|
| Rate for Payer: WEA Trust Commercial |
$855.80
|
| Rate for Payer: WPS Commercial |
$1,152.53
|
|
