|
DRILL BIT 2.5MM GRADUATED & LASER MARKED AR-8943-42
|
Facility
IP
|
$1,357.00
|
|
| Hospital Charge Code |
5349252
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$664.93 |
| Max. Negotiated Rate |
$1,248.44 |
| Rate for Payer: Aetna Commercial |
$1,221.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$719.21
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,248.44
|
| Rate for Payer: Health EOS Commercial |
$1,207.73
|
| Rate for Payer: HFN Commercial |
$1,248.44
|
| Rate for Payer: Multiplan Commercial |
$1,085.60
|
| Rate for Payer: NAPHCARE Commercial |
$814.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,248.44
|
| Rate for Payer: Quartz Beloit One Network |
$664.93
|
| Rate for Payer: Quartz Commercial |
$814.20
|
| Rate for Payer: WEA Trust Commercial |
$746.35
|
| Rate for Payer: WPS Commercial |
$1,005.13
|
|
|
DRILL BIT 2.5MM X12.7CM 3/32 00-2318-025-06
|
Facility
IP
|
$908.00
|
|
| Hospital Charge Code |
2967403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$444.92 |
| Max. Negotiated Rate |
$835.36 |
| Rate for Payer: Aetna Commercial |
$817.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$481.24
|
| Rate for Payer: Cash Price |
$272.40
|
| Rate for Payer: Cigna Commercial |
$835.36
|
| Rate for Payer: Health EOS Commercial |
$808.12
|
| Rate for Payer: HFN Commercial |
$835.36
|
| Rate for Payer: Multiplan Commercial |
$726.40
|
| Rate for Payer: NAPHCARE Commercial |
$544.80
|
| Rate for Payer: Preferred Network Access Commercial |
$835.36
|
| Rate for Payer: Quartz Beloit One Network |
$444.92
|
| Rate for Payer: Quartz Commercial |
$544.80
|
| Rate for Payer: WEA Trust Commercial |
$499.40
|
| Rate for Payer: WPS Commercial |
$672.56
|
|
|
DRILL BIT 2.5MM X12.7CM 3/32 00-2318-025-06
|
Facility
OP
|
$908.00
|
|
| Hospital Charge Code |
2967403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.24 |
| Max. Negotiated Rate |
$3,632.00 |
| Rate for Payer: Aetna Commercial |
$817.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$780.88
|
| Rate for Payer: Aetna Managed Medicare |
$254.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$590.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$454.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$435.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$481.24
|
| Rate for Payer: Cash Price |
$272.40
|
| Rate for Payer: Cigna Commercial |
$835.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$508.12
|
| Rate for Payer: Health EOS Commercial |
$808.12
|
| Rate for Payer: HFN Commercial |
$835.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$681.00
|
| Rate for Payer: Multiplan Commercial |
$726.40
|
| Rate for Payer: NAPHCARE Commercial |
$544.80
|
| Rate for Payer: Preferred Network Access Commercial |
$835.36
|
| Rate for Payer: Quartz Beloit One Network |
$444.92
|
| Rate for Payer: Quartz Commercial |
$590.20
|
| Rate for Payer: Quartz Medicare Advantage |
$544.80
|
| Rate for Payer: The Alliance Commercial |
$3,632.00
|
| Rate for Payer: WEA Trust Commercial |
$499.40
|
| Rate for Payer: WPS Commercial |
$672.56
|
|
|
DRILL BIT 2.5MM X 180MM CALIBRATED TWIST 700351
|
Facility
OP
|
$1,467.00
|
|
| Hospital Charge Code |
6198987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$410.76 |
| Max. Negotiated Rate |
$5,868.00 |
| Rate for Payer: Aetna Commercial |
$1,320.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,261.62
|
| Rate for Payer: Aetna Managed Medicare |
$410.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$953.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$733.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$704.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$777.51
|
| Rate for Payer: Cash Price |
$440.10
|
| Rate for Payer: Cigna Commercial |
$1,349.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$820.93
|
| Rate for Payer: Health EOS Commercial |
$1,305.63
|
| Rate for Payer: HFN Commercial |
$1,349.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,100.25
|
| Rate for Payer: Multiplan Commercial |
$1,173.60
|
| Rate for Payer: NAPHCARE Commercial |
$880.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,349.64
|
| Rate for Payer: Quartz Beloit One Network |
$718.83
|
| Rate for Payer: Quartz Commercial |
$953.55
|
| Rate for Payer: Quartz Medicare Advantage |
$880.20
|
| Rate for Payer: The Alliance Commercial |
$5,868.00
|
| Rate for Payer: WEA Trust Commercial |
$806.85
|
| Rate for Payer: WPS Commercial |
$1,086.61
|
|
|
DRILL BIT 2.5MM X 180MM CALIBRATED TWIST 700351
|
Facility
IP
|
$1,467.00
|
|
| Hospital Charge Code |
6198987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$718.83 |
| Max. Negotiated Rate |
$1,349.64 |
| Rate for Payer: Aetna Commercial |
$1,320.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$777.51
|
| Rate for Payer: Cash Price |
$440.10
|
| Rate for Payer: Cigna Commercial |
$1,349.64
|
| Rate for Payer: Health EOS Commercial |
$1,305.63
|
| Rate for Payer: HFN Commercial |
$1,349.64
|
| Rate for Payer: Multiplan Commercial |
$1,173.60
|
| Rate for Payer: NAPHCARE Commercial |
$880.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,349.64
|
| Rate for Payer: Quartz Beloit One Network |
$718.83
|
| Rate for Payer: Quartz Commercial |
$880.20
|
| Rate for Payer: WEA Trust Commercial |
$806.85
|
| Rate for Payer: WPS Commercial |
$1,086.61
|
|
|
DRILL BIT 2.5MM X 230MM 700355
|
Facility
IP
|
$2,068.00
|
|
| Hospital Charge Code |
3983345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,013.32 |
| Max. Negotiated Rate |
$1,902.56 |
| Rate for Payer: Aetna Commercial |
$1,861.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,096.04
|
| Rate for Payer: Cash Price |
$620.40
|
| Rate for Payer: Cigna Commercial |
$1,902.56
|
| Rate for Payer: Health EOS Commercial |
$1,840.52
|
| Rate for Payer: HFN Commercial |
$1,902.56
|
| Rate for Payer: Multiplan Commercial |
$1,654.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,240.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,902.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,013.32
|
| Rate for Payer: Quartz Commercial |
$1,240.80
|
| Rate for Payer: WEA Trust Commercial |
$1,137.40
|
| Rate for Payer: WPS Commercial |
$1,531.77
|
|
|
DRILL BIT 2.5MM X 230MM 700355
|
Facility
OP
|
$2,068.00
|
|
| Hospital Charge Code |
3983345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$579.04 |
| Max. Negotiated Rate |
$8,272.00 |
| Rate for Payer: Aetna Commercial |
$1,861.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,778.48
|
| Rate for Payer: Aetna Managed Medicare |
$579.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,344.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,034.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$992.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,096.04
|
| Rate for Payer: Cash Price |
$620.40
|
| Rate for Payer: Cigna Commercial |
$1,902.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,157.25
|
| Rate for Payer: Health EOS Commercial |
$1,840.52
|
| Rate for Payer: HFN Commercial |
$1,902.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,551.00
|
| Rate for Payer: Multiplan Commercial |
$1,654.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,240.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,902.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,013.32
|
| Rate for Payer: Quartz Commercial |
$1,344.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,240.80
|
| Rate for Payer: The Alliance Commercial |
$8,272.00
|
| Rate for Payer: WEA Trust Commercial |
$1,137.40
|
| Rate for Payer: WPS Commercial |
$1,531.77
|
|
|
DRILL BIT 2.5 X 110 QUICK COUPLING 310.25
|
Facility
OP
|
$1,325.00
|
|
| Hospital Charge Code |
2966186
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$371.00 |
| Max. Negotiated Rate |
$5,300.00 |
| Rate for Payer: Aetna Commercial |
$1,192.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,139.50
|
| Rate for Payer: Aetna Managed Medicare |
$371.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$861.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$662.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$636.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$702.25
|
| Rate for Payer: Cash Price |
$397.50
|
| Rate for Payer: Cigna Commercial |
$1,219.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$741.47
|
| Rate for Payer: Health EOS Commercial |
$1,179.25
|
| Rate for Payer: HFN Commercial |
$1,219.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$993.75
|
| Rate for Payer: Multiplan Commercial |
$1,060.00
|
| Rate for Payer: NAPHCARE Commercial |
$795.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,219.00
|
| Rate for Payer: Quartz Beloit One Network |
$649.25
|
| Rate for Payer: Quartz Commercial |
$861.25
|
| Rate for Payer: Quartz Medicare Advantage |
$795.00
|
| Rate for Payer: The Alliance Commercial |
$5,300.00
|
| Rate for Payer: WEA Trust Commercial |
$728.75
|
| Rate for Payer: WPS Commercial |
$981.43
|
|
|
DRILL BIT 2.5 X 110 QUICK COUPLING 310.25
|
Facility
IP
|
$1,325.00
|
|
| Hospital Charge Code |
2966186
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$649.25 |
| Max. Negotiated Rate |
$1,219.00 |
| Rate for Payer: Aetna Commercial |
$1,192.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$702.25
|
| Rate for Payer: Cash Price |
$397.50
|
| Rate for Payer: Cigna Commercial |
$1,219.00
|
| Rate for Payer: Health EOS Commercial |
$1,179.25
|
| Rate for Payer: HFN Commercial |
$1,219.00
|
| Rate for Payer: Multiplan Commercial |
$1,060.00
|
| Rate for Payer: NAPHCARE Commercial |
$795.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,219.00
|
| Rate for Payer: Quartz Beloit One Network |
$649.25
|
| Rate for Payer: Quartz Commercial |
$795.00
|
| Rate for Payer: WEA Trust Commercial |
$728.75
|
| Rate for Payer: WPS Commercial |
$981.43
|
|
|
DRILL BIT 2.5 X 135 QUICK COUPLE 03.133.102
|
Facility
OP
|
$1,736.00
|
|
| Hospital Charge Code |
6180415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$486.08 |
| Max. Negotiated Rate |
$6,944.00 |
| Rate for Payer: Aetna Commercial |
$1,562.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,492.96
|
| Rate for Payer: Aetna Managed Medicare |
$486.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,128.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$868.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$833.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$920.08
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cigna Commercial |
$1,597.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$971.47
|
| Rate for Payer: Health EOS Commercial |
$1,545.04
|
| Rate for Payer: HFN Commercial |
$1,597.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,302.00
|
| Rate for Payer: Multiplan Commercial |
$1,388.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,041.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,597.12
|
| Rate for Payer: Quartz Beloit One Network |
$850.64
|
| Rate for Payer: Quartz Commercial |
$1,128.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,041.60
|
| Rate for Payer: The Alliance Commercial |
$6,944.00
|
| Rate for Payer: WEA Trust Commercial |
$954.80
|
| Rate for Payer: WPS Commercial |
$1,285.86
|
|
|
DRILL BIT 2.5 X 135 QUICK COUPLE 03.133.102
|
Facility
IP
|
$1,736.00
|
|
| Hospital Charge Code |
6180415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$850.64 |
| Max. Negotiated Rate |
$1,597.12 |
| Rate for Payer: Aetna Commercial |
$1,562.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$920.08
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cigna Commercial |
$1,597.12
|
| Rate for Payer: Health EOS Commercial |
$1,545.04
|
| Rate for Payer: HFN Commercial |
$1,597.12
|
| Rate for Payer: Multiplan Commercial |
$1,388.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,041.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,597.12
|
| Rate for Payer: Quartz Beloit One Network |
$850.64
|
| Rate for Payer: Quartz Commercial |
$1,041.60
|
| Rate for Payer: WEA Trust Commercial |
$954.80
|
| Rate for Payer: WPS Commercial |
$1,285.86
|
|
|
DRILL BIT 2.5 X 180 QUICK COUPLE 310.23
|
Facility
IP
|
$1,482.00
|
|
| Hospital Charge Code |
2966187
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$726.18 |
| Max. Negotiated Rate |
$1,363.44 |
| Rate for Payer: Aetna Commercial |
$1,333.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$785.46
|
| Rate for Payer: Cash Price |
$444.60
|
| Rate for Payer: Cigna Commercial |
$1,363.44
|
| Rate for Payer: Health EOS Commercial |
$1,318.98
|
| Rate for Payer: HFN Commercial |
$1,363.44
|
| Rate for Payer: Multiplan Commercial |
$1,185.60
|
| Rate for Payer: NAPHCARE Commercial |
$889.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,363.44
|
| Rate for Payer: Quartz Beloit One Network |
$726.18
|
| Rate for Payer: Quartz Commercial |
$889.20
|
| Rate for Payer: WEA Trust Commercial |
$815.10
|
| Rate for Payer: WPS Commercial |
$1,097.72
|
|
|
DRILL BIT 2.5 X 180 QUICK COUPLE 310.23
|
Facility
OP
|
$1,482.00
|
|
| Hospital Charge Code |
2966187
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$414.96 |
| Max. Negotiated Rate |
$5,928.00 |
| Rate for Payer: Aetna Commercial |
$1,333.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,274.52
|
| Rate for Payer: Aetna Managed Medicare |
$414.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$963.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$741.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$711.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$785.46
|
| Rate for Payer: Cash Price |
$444.60
|
| Rate for Payer: Cigna Commercial |
$1,363.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$829.33
|
| Rate for Payer: Health EOS Commercial |
$1,318.98
|
| Rate for Payer: HFN Commercial |
$1,363.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,111.50
|
| Rate for Payer: Multiplan Commercial |
$1,185.60
|
| Rate for Payer: NAPHCARE Commercial |
$889.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,363.44
|
| Rate for Payer: Quartz Beloit One Network |
$726.18
|
| Rate for Payer: Quartz Commercial |
$963.30
|
| Rate for Payer: Quartz Medicare Advantage |
$889.20
|
| Rate for Payer: The Alliance Commercial |
$5,928.00
|
| Rate for Payer: WEA Trust Commercial |
$815.10
|
| Rate for Payer: WPS Commercial |
$1,097.72
|
|
|
DRILL BIT 2.5 X 216MM NON- LOCK SHORT 705025
|
Facility
OP
|
$1,886.00
|
|
| Hospital Charge Code |
5458924
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$528.08 |
| Max. Negotiated Rate |
$7,544.00 |
| Rate for Payer: Aetna Commercial |
$1,697.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,621.96
|
| Rate for Payer: Aetna Managed Medicare |
$528.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,225.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$943.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$905.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$999.58
|
| Rate for Payer: Cash Price |
$565.80
|
| Rate for Payer: Cigna Commercial |
$1,735.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,055.41
|
| Rate for Payer: Health EOS Commercial |
$1,678.54
|
| Rate for Payer: HFN Commercial |
$1,735.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,414.50
|
| Rate for Payer: Multiplan Commercial |
$1,508.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,131.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,735.12
|
| Rate for Payer: Quartz Beloit One Network |
$924.14
|
| Rate for Payer: Quartz Commercial |
$1,225.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,131.60
|
| Rate for Payer: The Alliance Commercial |
$7,544.00
|
| Rate for Payer: WEA Trust Commercial |
$1,037.30
|
| Rate for Payer: WPS Commercial |
$1,396.96
|
|
|
DRILL BIT 2.5 X 216MM NON- LOCK SHORT 705025
|
Facility
IP
|
$1,886.00
|
|
| Hospital Charge Code |
5458924
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$924.14 |
| Max. Negotiated Rate |
$1,735.12 |
| Rate for Payer: Aetna Commercial |
$1,697.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$999.58
|
| Rate for Payer: Cash Price |
$565.80
|
| Rate for Payer: Cigna Commercial |
$1,735.12
|
| Rate for Payer: Health EOS Commercial |
$1,678.54
|
| Rate for Payer: HFN Commercial |
$1,735.12
|
| Rate for Payer: Multiplan Commercial |
$1,508.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,131.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,735.12
|
| Rate for Payer: Quartz Beloit One Network |
$924.14
|
| Rate for Payer: Quartz Commercial |
$1,131.60
|
| Rate for Payer: WEA Trust Commercial |
$1,037.30
|
| Rate for Payer: WPS Commercial |
$1,396.96
|
|
|
DRILL BIT 2.5 X 60MM ORTHOLOC 58850025
|
Facility
IP
|
$2,788.00
|
|
| Hospital Charge Code |
5459085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,366.12 |
| Max. Negotiated Rate |
$2,564.96 |
| Rate for Payer: Aetna Commercial |
$2,509.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,477.64
|
| Rate for Payer: Cash Price |
$836.40
|
| Rate for Payer: Cigna Commercial |
$2,564.96
|
| Rate for Payer: Health EOS Commercial |
$2,481.32
|
| Rate for Payer: HFN Commercial |
$2,564.96
|
| Rate for Payer: Multiplan Commercial |
$2,230.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,672.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,564.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,366.12
|
| Rate for Payer: Quartz Commercial |
$1,672.80
|
| Rate for Payer: WEA Trust Commercial |
$1,533.40
|
| Rate for Payer: WPS Commercial |
$2,065.07
|
|
|
DRILL BIT 2.5 X 60MM ORTHOLOC 58850025
|
Facility
OP
|
$2,788.00
|
|
| Hospital Charge Code |
5459085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.64 |
| Max. Negotiated Rate |
$11,152.00 |
| Rate for Payer: Aetna Commercial |
$2,509.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,397.68
|
| Rate for Payer: Aetna Managed Medicare |
$780.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,812.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,394.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,338.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,477.64
|
| Rate for Payer: Cash Price |
$836.40
|
| Rate for Payer: Cigna Commercial |
$2,564.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,560.16
|
| Rate for Payer: Health EOS Commercial |
$2,481.32
|
| Rate for Payer: HFN Commercial |
$2,564.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,091.00
|
| Rate for Payer: Multiplan Commercial |
$2,230.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,672.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,564.96
|
| Rate for Payer: Quartz Beloit One Network |
$1,366.12
|
| Rate for Payer: Quartz Commercial |
$1,812.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,672.80
|
| Rate for Payer: The Alliance Commercial |
$11,152.00
|
| Rate for Payer: WEA Trust Commercial |
$1,533.40
|
| Rate for Payer: WPS Commercial |
$2,065.07
|
|
|
DRILL BIT 2.5 X 60MM ORTHOLOC 58880025
|
Facility
IP
|
$2,251.00
|
|
| Hospital Charge Code |
5458984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,102.99 |
| Max. Negotiated Rate |
$2,070.92 |
| Rate for Payer: Aetna Commercial |
$2,025.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,193.03
|
| Rate for Payer: Cash Price |
$675.30
|
| Rate for Payer: Cigna Commercial |
$2,070.92
|
| Rate for Payer: Health EOS Commercial |
$2,003.39
|
| Rate for Payer: HFN Commercial |
$2,070.92
|
| Rate for Payer: Multiplan Commercial |
$1,800.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,350.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,070.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,102.99
|
| Rate for Payer: Quartz Commercial |
$1,350.60
|
| Rate for Payer: WEA Trust Commercial |
$1,238.05
|
| Rate for Payer: WPS Commercial |
$1,667.32
|
|
|
DRILL BIT 2.5 X 60MM ORTHOLOC 58880025
|
Facility
OP
|
$2,251.00
|
|
| Hospital Charge Code |
5458984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$630.28 |
| Max. Negotiated Rate |
$9,004.00 |
| Rate for Payer: Aetna Commercial |
$2,025.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,935.86
|
| Rate for Payer: Aetna Managed Medicare |
$630.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,463.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,125.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,080.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,193.03
|
| Rate for Payer: Cash Price |
$675.30
|
| Rate for Payer: Cigna Commercial |
$2,070.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,259.66
|
| Rate for Payer: Health EOS Commercial |
$2,003.39
|
| Rate for Payer: HFN Commercial |
$2,070.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,688.25
|
| Rate for Payer: Multiplan Commercial |
$1,800.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,350.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,070.92
|
| Rate for Payer: Quartz Beloit One Network |
$1,102.99
|
| Rate for Payer: Quartz Commercial |
$1,463.15
|
| Rate for Payer: Quartz Medicare Advantage |
$1,350.60
|
| Rate for Payer: The Alliance Commercial |
$9,004.00
|
| Rate for Payer: WEA Trust Commercial |
$1,238.05
|
| Rate for Payer: WPS Commercial |
$1,667.32
|
|
|
DRILL BIT 2.6MM CANNULATED AR-8943-02
|
Facility
IP
|
$2,330.00
|
|
| Hospital Charge Code |
5415067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,141.70 |
| Max. Negotiated Rate |
$2,143.60 |
| Rate for Payer: Aetna Commercial |
$2,097.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,234.90
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cigna Commercial |
$2,143.60
|
| Rate for Payer: Health EOS Commercial |
$2,073.70
|
| Rate for Payer: HFN Commercial |
$2,143.60
|
| Rate for Payer: Multiplan Commercial |
$1,864.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,398.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,143.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,141.70
|
| Rate for Payer: Quartz Commercial |
$1,398.00
|
| Rate for Payer: WEA Trust Commercial |
$1,281.50
|
| Rate for Payer: WPS Commercial |
$1,725.83
|
|
|
DRILL BIT 2.6MM CANNULATED AR-8943-02
|
Facility
OP
|
$2,330.00
|
|
| Hospital Charge Code |
5415067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$652.40 |
| Max. Negotiated Rate |
$9,320.00 |
| Rate for Payer: Aetna Commercial |
$2,097.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,003.80
|
| Rate for Payer: Aetna Managed Medicare |
$652.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,514.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,165.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,118.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,234.90
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cigna Commercial |
$2,143.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,303.87
|
| Rate for Payer: Health EOS Commercial |
$2,073.70
|
| Rate for Payer: HFN Commercial |
$2,143.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,747.50
|
| Rate for Payer: Multiplan Commercial |
$1,864.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,398.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,143.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,141.70
|
| Rate for Payer: Quartz Commercial |
$1,514.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,398.00
|
| Rate for Payer: The Alliance Commercial |
$9,320.00
|
| Rate for Payer: WEA Trust Commercial |
$1,281.50
|
| Rate for Payer: WPS Commercial |
$1,725.83
|
|
|
DRILL BIT 2.6MM CANNULATED T15 HEXALOBE QC AR-8943-12
|
Facility
OP
|
$2,154.00
|
|
| Hospital Charge Code |
6174844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$603.12 |
| Max. Negotiated Rate |
$8,616.00 |
| Rate for Payer: Aetna Commercial |
$1,938.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,852.44
|
| Rate for Payer: Aetna Managed Medicare |
$603.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,400.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,077.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,033.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,141.62
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Cigna Commercial |
$1,981.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,205.38
|
| Rate for Payer: Health EOS Commercial |
$1,917.06
|
| Rate for Payer: HFN Commercial |
$1,981.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,615.50
|
| Rate for Payer: Multiplan Commercial |
$1,723.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,292.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,981.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,055.46
|
| Rate for Payer: Quartz Commercial |
$1,400.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,292.40
|
| Rate for Payer: The Alliance Commercial |
$8,616.00
|
| Rate for Payer: WEA Trust Commercial |
$1,184.70
|
| Rate for Payer: WPS Commercial |
$1,595.47
|
|
|
DRILL BIT 2.6MM CANNULATED T15 HEXALOBE QC AR-8943-12
|
Facility
IP
|
$2,154.00
|
|
| Hospital Charge Code |
6174844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,055.46 |
| Max. Negotiated Rate |
$1,981.68 |
| Rate for Payer: Aetna Commercial |
$1,938.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,141.62
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Cigna Commercial |
$1,981.68
|
| Rate for Payer: Health EOS Commercial |
$1,917.06
|
| Rate for Payer: HFN Commercial |
$1,981.68
|
| Rate for Payer: Multiplan Commercial |
$1,723.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,292.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,981.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,055.46
|
| Rate for Payer: Quartz Commercial |
$1,292.40
|
| Rate for Payer: WEA Trust Commercial |
$1,184.70
|
| Rate for Payer: WPS Commercial |
$1,595.47
|
|
|
DRILL BIT 2.6MM SPADE PILOT 214-00-015
|
Facility
OP
|
$2,660.00
|
|
| Hospital Charge Code |
5496694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$744.80 |
| Max. Negotiated Rate |
$10,640.00 |
| Rate for Payer: Aetna Commercial |
$2,394.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,287.60
|
| Rate for Payer: Aetna Managed Medicare |
$744.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,729.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,330.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,276.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.80
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,447.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,488.54
|
| Rate for Payer: Health EOS Commercial |
$2,367.40
|
| Rate for Payer: HFN Commercial |
$2,447.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,995.00
|
| Rate for Payer: Multiplan Commercial |
$2,128.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,596.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,447.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.40
|
| Rate for Payer: Quartz Commercial |
$1,729.00
|
| Rate for Payer: Quartz Medicare Advantage |
$1,596.00
|
| Rate for Payer: The Alliance Commercial |
$10,640.00
|
| Rate for Payer: WEA Trust Commercial |
$1,463.00
|
| Rate for Payer: WPS Commercial |
$1,970.26
|
|
|
DRILL BIT 2.6MM SPADE PILOT 214-00-015
|
Facility
IP
|
$2,660.00
|
|
| Hospital Charge Code |
5496694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,303.40 |
| Max. Negotiated Rate |
$2,447.20 |
| Rate for Payer: Aetna Commercial |
$2,394.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.80
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,447.20
|
| Rate for Payer: Health EOS Commercial |
$2,367.40
|
| Rate for Payer: HFN Commercial |
$2,447.20
|
| Rate for Payer: Multiplan Commercial |
$2,128.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,596.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,447.20
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.40
|
| Rate for Payer: Quartz Commercial |
$1,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,463.00
|
| Rate for Payer: WPS Commercial |
$1,970.26
|
|
