|
DRILL BIT 2.6 X 135MM SCALED 703691
|
Facility
OP
|
$1,400.00
|
|
| Hospital Charge Code |
5547411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$392.00 |
| Max. Negotiated Rate |
$5,600.00 |
| Rate for Payer: Aetna Commercial |
$1,260.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,204.00
|
| Rate for Payer: Aetna Managed Medicare |
$392.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$910.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$700.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$672.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$742.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$1,288.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$783.44
|
| Rate for Payer: Health EOS Commercial |
$1,246.00
|
| Rate for Payer: HFN Commercial |
$1,288.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,050.00
|
| Rate for Payer: Multiplan Commercial |
$1,120.00
|
| Rate for Payer: NAPHCARE Commercial |
$840.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,288.00
|
| Rate for Payer: Quartz Beloit One Network |
$686.00
|
| Rate for Payer: Quartz Commercial |
$910.00
|
| Rate for Payer: Quartz Medicare Advantage |
$840.00
|
| Rate for Payer: The Alliance Commercial |
$5,600.00
|
| Rate for Payer: WEA Trust Commercial |
$770.00
|
| Rate for Payer: WPS Commercial |
$1,036.98
|
|
|
DRILL BIT 2.6 X 135MM SCALED 703691
|
Facility
IP
|
$1,400.00
|
|
| Hospital Charge Code |
5547411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$686.00 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$1,260.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$742.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$1,288.00
|
| Rate for Payer: Health EOS Commercial |
$1,246.00
|
| Rate for Payer: HFN Commercial |
$1,288.00
|
| Rate for Payer: Multiplan Commercial |
$1,120.00
|
| Rate for Payer: NAPHCARE Commercial |
$840.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,288.00
|
| Rate for Payer: Quartz Beloit One Network |
$686.00
|
| Rate for Payer: Quartz Commercial |
$840.00
|
| Rate for Payer: WEA Trust Commercial |
$770.00
|
| Rate for Payer: WPS Commercial |
$1,036.98
|
|
|
DRILL BIT 2.7 AR-8827D-01
|
Facility
IP
|
$1,357.00
|
|
| Hospital Charge Code |
5454700
|
|
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 2.7 AR-8827D-01
|
Facility
OP
|
$1,357.00
|
|
| Hospital Charge Code |
5454700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$379.96 |
| Max. Negotiated Rate |
$5,428.00 |
| Rate for Payer: Aetna Commercial |
$1,221.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,167.02
|
| Rate for Payer: Aetna Managed Medicare |
$379.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$882.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$678.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$651.36
|
| 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: Dean Health DHI/DHP/ASO |
$759.38
|
| Rate for Payer: Health EOS Commercial |
$1,207.73
|
| Rate for Payer: HFN Commercial |
$1,248.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,017.75
|
| 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 |
$882.05
|
| Rate for Payer: Quartz Medicare Advantage |
$814.20
|
| Rate for Payer: The Alliance Commercial |
$5,428.00
|
| Rate for Payer: WEA Trust Commercial |
$746.35
|
| Rate for Payer: WPS Commercial |
$1,005.13
|
|
|
DRILL BIT 2.7 CANN 310.67
|
Facility
OP
|
$5,710.00
|
|
| Hospital Charge Code |
2966188
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,598.80 |
| Max. Negotiated Rate |
$22,840.00 |
| Rate for Payer: Aetna Commercial |
$5,139.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,910.60
|
| Rate for Payer: Aetna Managed Medicare |
$1,598.80
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,711.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,855.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,740.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,026.30
|
| Rate for Payer: Cash Price |
$1,713.00
|
| Rate for Payer: Cigna Commercial |
$5,253.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,195.32
|
| Rate for Payer: Health EOS Commercial |
$5,081.90
|
| Rate for Payer: HFN Commercial |
$5,253.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,282.50
|
| Rate for Payer: Multiplan Commercial |
$4,568.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,426.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,253.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,797.90
|
| Rate for Payer: Quartz Commercial |
$3,711.50
|
| Rate for Payer: Quartz Medicare Advantage |
$3,426.00
|
| Rate for Payer: The Alliance Commercial |
$22,840.00
|
| Rate for Payer: WEA Trust Commercial |
$3,140.50
|
| Rate for Payer: WPS Commercial |
$4,229.40
|
|
|
DRILL BIT 2.7 CANN 310.67
|
Facility
IP
|
$5,710.00
|
|
| Hospital Charge Code |
2966188
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,797.90 |
| Max. Negotiated Rate |
$5,253.20 |
| Rate for Payer: Aetna Commercial |
$5,139.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,026.30
|
| Rate for Payer: Cash Price |
$1,713.00
|
| Rate for Payer: Cigna Commercial |
$5,253.20
|
| Rate for Payer: Health EOS Commercial |
$5,081.90
|
| Rate for Payer: HFN Commercial |
$5,253.20
|
| Rate for Payer: Multiplan Commercial |
$4,568.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,426.00
|
| Rate for Payer: Preferred Network Access Commercial |
$5,253.20
|
| Rate for Payer: Quartz Beloit One Network |
$2,797.90
|
| Rate for Payer: Quartz Commercial |
$3,426.00
|
| Rate for Payer: WEA Trust Commercial |
$3,140.50
|
| Rate for Payer: WPS Commercial |
$4,229.40
|
|
|
DRILL BIT 2.7 CANN TORNIER ZPCDR27
|
Facility
OP
|
$1,647.00
|
|
| Hospital Charge Code |
2967355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$461.16 |
| Max. Negotiated Rate |
$6,588.00 |
| Rate for Payer: Aetna Commercial |
$1,482.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,416.42
|
| Rate for Payer: Aetna Managed Medicare |
$461.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,070.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$823.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$790.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$872.91
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,515.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$921.66
|
| Rate for Payer: Health EOS Commercial |
$1,465.83
|
| Rate for Payer: HFN Commercial |
$1,515.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,235.25
|
| Rate for Payer: Multiplan Commercial |
$1,317.60
|
| Rate for Payer: NAPHCARE Commercial |
$988.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,515.24
|
| Rate for Payer: Quartz Beloit One Network |
$807.03
|
| Rate for Payer: Quartz Commercial |
$1,070.55
|
| Rate for Payer: Quartz Medicare Advantage |
$988.20
|
| Rate for Payer: The Alliance Commercial |
$6,588.00
|
| Rate for Payer: WEA Trust Commercial |
$905.85
|
| Rate for Payer: WPS Commercial |
$1,219.93
|
|
|
DRILL BIT 2.7 CANN TORNIER ZPCDR27
|
Facility
IP
|
$1,647.00
|
|
| Hospital Charge Code |
2967355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$807.03 |
| Max. Negotiated Rate |
$1,515.24 |
| Rate for Payer: Aetna Commercial |
$1,482.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$872.91
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,515.24
|
| Rate for Payer: Health EOS Commercial |
$1,465.83
|
| Rate for Payer: HFN Commercial |
$1,515.24
|
| Rate for Payer: Multiplan Commercial |
$1,317.60
|
| Rate for Payer: NAPHCARE Commercial |
$988.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,515.24
|
| Rate for Payer: Quartz Beloit One Network |
$807.03
|
| Rate for Payer: Quartz Commercial |
$988.20
|
| Rate for Payer: WEA Trust Commercial |
$905.85
|
| Rate for Payer: WPS Commercial |
$1,219.93
|
|
|
DRILL BIT 2.7MM 3-FLUTED 315.28
|
Facility
IP
|
$1,882.00
|
|
| Hospital Charge Code |
2966190
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$922.18 |
| Max. Negotiated Rate |
$1,731.44 |
| Rate for Payer: Aetna Commercial |
$1,693.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.46
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,731.44
|
| Rate for Payer: Health EOS Commercial |
$1,674.98
|
| Rate for Payer: HFN Commercial |
$1,731.44
|
| Rate for Payer: Multiplan Commercial |
$1,505.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,129.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,731.44
|
| Rate for Payer: Quartz Beloit One Network |
$922.18
|
| Rate for Payer: Quartz Commercial |
$1,129.20
|
| Rate for Payer: WEA Trust Commercial |
$1,035.10
|
| Rate for Payer: WPS Commercial |
$1,394.00
|
|
|
DRILL BIT 2.7MM 3-FLUTED 315.28
|
Facility
OP
|
$1,882.00
|
|
| Hospital Charge Code |
2966190
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$526.96 |
| Max. Negotiated Rate |
$7,528.00 |
| Rate for Payer: Aetna Commercial |
$1,693.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,618.52
|
| Rate for Payer: Aetna Managed Medicare |
$526.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,223.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$941.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$903.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$997.46
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,731.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,053.17
|
| Rate for Payer: Health EOS Commercial |
$1,674.98
|
| Rate for Payer: HFN Commercial |
$1,731.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,411.50
|
| Rate for Payer: Multiplan Commercial |
$1,505.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,129.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,731.44
|
| Rate for Payer: Quartz Beloit One Network |
$922.18
|
| Rate for Payer: Quartz Commercial |
$1,223.30
|
| Rate for Payer: Quartz Medicare Advantage |
$1,129.20
|
| Rate for Payer: The Alliance Commercial |
$7,528.00
|
| Rate for Payer: WEA Trust Commercial |
$1,035.10
|
| Rate for Payer: WPS Commercial |
$1,394.00
|
|
|
DRILL BIT 2.7MM AO FITTING 705250
|
Facility
OP
|
$3,723.00
|
|
| Hospital Charge Code |
5286747
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,042.44 |
| Max. Negotiated Rate |
$14,892.00 |
| Rate for Payer: Aetna Commercial |
$3,350.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,201.78
|
| Rate for Payer: Aetna Managed Medicare |
$1,042.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,419.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,861.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,787.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,973.19
|
| Rate for Payer: Cash Price |
$1,116.90
|
| Rate for Payer: Cigna Commercial |
$3,425.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,083.39
|
| Rate for Payer: Health EOS Commercial |
$3,313.47
|
| Rate for Payer: HFN Commercial |
$3,425.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,792.25
|
| Rate for Payer: Multiplan Commercial |
$2,978.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,233.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,425.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,824.27
|
| Rate for Payer: Quartz Commercial |
$2,419.95
|
| Rate for Payer: Quartz Medicare Advantage |
$2,233.80
|
| Rate for Payer: The Alliance Commercial |
$14,892.00
|
| Rate for Payer: WEA Trust Commercial |
$2,047.65
|
| Rate for Payer: WPS Commercial |
$2,757.63
|
|
|
DRILL BIT 2.7MM AO FITTING 705250
|
Facility
IP
|
$3,723.00
|
|
| Hospital Charge Code |
5286747
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,824.27 |
| Max. Negotiated Rate |
$3,425.16 |
| Rate for Payer: Aetna Commercial |
$3,350.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,973.19
|
| Rate for Payer: Cash Price |
$1,116.90
|
| Rate for Payer: Cigna Commercial |
$3,425.16
|
| Rate for Payer: Health EOS Commercial |
$3,313.47
|
| Rate for Payer: HFN Commercial |
$3,425.16
|
| Rate for Payer: Multiplan Commercial |
$2,978.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,233.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,425.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,824.27
|
| Rate for Payer: Quartz Commercial |
$2,233.80
|
| Rate for Payer: WEA Trust Commercial |
$2,047.65
|
| Rate for Payer: WPS Commercial |
$2,757.63
|
|
|
DRILL BIT 2.7MM X12.7CM 7/64 00-2318-027-06
|
Facility
IP
|
$874.00
|
|
| Hospital Charge Code |
5264630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$428.26 |
| Max. Negotiated Rate |
$804.08 |
| Rate for Payer: Aetna Commercial |
$786.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$463.22
|
| Rate for Payer: Cash Price |
$262.20
|
| Rate for Payer: Cigna Commercial |
$804.08
|
| Rate for Payer: Health EOS Commercial |
$777.86
|
| Rate for Payer: HFN Commercial |
$804.08
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: NAPHCARE Commercial |
$524.40
|
| Rate for Payer: Preferred Network Access Commercial |
$804.08
|
| Rate for Payer: Quartz Beloit One Network |
$428.26
|
| Rate for Payer: Quartz Commercial |
$524.40
|
| Rate for Payer: WEA Trust Commercial |
$480.70
|
| Rate for Payer: WPS Commercial |
$647.37
|
|
|
DRILL BIT 2.7MM X12.7CM 7/64 00-2318-027-06
|
Facility
OP
|
$874.00
|
|
| Hospital Charge Code |
5264630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$244.72 |
| Max. Negotiated Rate |
$3,496.00 |
| Rate for Payer: Aetna Commercial |
$786.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$751.64
|
| Rate for Payer: Aetna Managed Medicare |
$244.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$568.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$437.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$419.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$463.22
|
| Rate for Payer: Cash Price |
$262.20
|
| Rate for Payer: Cigna Commercial |
$804.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$489.09
|
| Rate for Payer: Health EOS Commercial |
$777.86
|
| Rate for Payer: HFN Commercial |
$804.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$655.50
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: NAPHCARE Commercial |
$524.40
|
| Rate for Payer: Preferred Network Access Commercial |
$804.08
|
| Rate for Payer: Quartz Beloit One Network |
$428.26
|
| Rate for Payer: Quartz Commercial |
$568.10
|
| Rate for Payer: Quartz Medicare Advantage |
$524.40
|
| Rate for Payer: The Alliance Commercial |
$3,496.00
|
| Rate for Payer: WEA Trust Commercial |
$480.70
|
| Rate for Payer: WPS Commercial |
$647.37
|
|
|
DRILL BIT 2.7 SOLID TORNIER ZPWSDR27
|
Facility
OP
|
$1,190.00
|
|
| Hospital Charge Code |
2967356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$333.20 |
| Max. Negotiated Rate |
$4,760.00 |
| Rate for Payer: Aetna Commercial |
$1,071.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,023.40
|
| Rate for Payer: Aetna Managed Medicare |
$333.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$773.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$595.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$571.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$630.70
|
| Rate for Payer: Cash Price |
$357.00
|
| Rate for Payer: Cigna Commercial |
$1,094.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$665.92
|
| Rate for Payer: Health EOS Commercial |
$1,059.10
|
| Rate for Payer: HFN Commercial |
$1,094.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$892.50
|
| Rate for Payer: Multiplan Commercial |
$952.00
|
| Rate for Payer: NAPHCARE Commercial |
$714.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,094.80
|
| Rate for Payer: Quartz Beloit One Network |
$583.10
|
| Rate for Payer: Quartz Commercial |
$773.50
|
| Rate for Payer: Quartz Medicare Advantage |
$714.00
|
| Rate for Payer: The Alliance Commercial |
$4,760.00
|
| Rate for Payer: WEA Trust Commercial |
$654.50
|
| Rate for Payer: WPS Commercial |
$881.43
|
|
|
DRILL BIT 2.7 SOLID TORNIER ZPWSDR27
|
Facility
IP
|
$1,190.00
|
|
| Hospital Charge Code |
2967356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$583.10 |
| Max. Negotiated Rate |
$1,094.80 |
| Rate for Payer: Aetna Commercial |
$1,071.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$630.70
|
| Rate for Payer: Cash Price |
$357.00
|
| Rate for Payer: Cigna Commercial |
$1,094.80
|
| Rate for Payer: Health EOS Commercial |
$1,059.10
|
| Rate for Payer: HFN Commercial |
$1,094.80
|
| Rate for Payer: Multiplan Commercial |
$952.00
|
| Rate for Payer: NAPHCARE Commercial |
$714.00
|
| Rate for Payer: Preferred Network Access Commercial |
$1,094.80
|
| Rate for Payer: Quartz Beloit One Network |
$583.10
|
| Rate for Payer: Quartz Commercial |
$714.00
|
| Rate for Payer: WEA Trust Commercial |
$654.50
|
| Rate for Payer: WPS Commercial |
$881.43
|
|
|
DRILL BIT 2.7 X 100MM QUICK COUPLE 310.26
|
Facility
IP
|
$899.00
|
|
| Hospital Charge Code |
3529517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$440.51 |
| Max. Negotiated Rate |
$827.08 |
| Rate for Payer: Aetna Commercial |
$809.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$476.47
|
| Rate for Payer: Cash Price |
$269.70
|
| Rate for Payer: Cigna Commercial |
$827.08
|
| Rate for Payer: Health EOS Commercial |
$800.11
|
| Rate for Payer: HFN Commercial |
$827.08
|
| Rate for Payer: Multiplan Commercial |
$719.20
|
| Rate for Payer: NAPHCARE Commercial |
$539.40
|
| Rate for Payer: Preferred Network Access Commercial |
$827.08
|
| Rate for Payer: Quartz Beloit One Network |
$440.51
|
| Rate for Payer: Quartz Commercial |
$539.40
|
| Rate for Payer: WEA Trust Commercial |
$494.45
|
| Rate for Payer: WPS Commercial |
$665.89
|
|
|
DRILL BIT 2.7 X 100MM QUICK COUPLE 310.26
|
Facility
OP
|
$899.00
|
|
| Hospital Charge Code |
3529517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.72 |
| Max. Negotiated Rate |
$3,596.00 |
| Rate for Payer: Aetna Commercial |
$809.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$773.14
|
| Rate for Payer: Aetna Managed Medicare |
$251.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$584.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$449.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$431.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$476.47
|
| Rate for Payer: Cash Price |
$269.70
|
| Rate for Payer: Cigna Commercial |
$827.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$503.08
|
| Rate for Payer: Health EOS Commercial |
$800.11
|
| Rate for Payer: HFN Commercial |
$827.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$674.25
|
| Rate for Payer: Multiplan Commercial |
$719.20
|
| Rate for Payer: NAPHCARE Commercial |
$539.40
|
| Rate for Payer: Preferred Network Access Commercial |
$827.08
|
| Rate for Payer: Quartz Beloit One Network |
$440.51
|
| Rate for Payer: Quartz Commercial |
$584.35
|
| Rate for Payer: Quartz Medicare Advantage |
$539.40
|
| Rate for Payer: The Alliance Commercial |
$3,596.00
|
| Rate for Payer: WEA Trust Commercial |
$494.45
|
| Rate for Payer: WPS Commercial |
$665.89
|
|
|
DRILL BIT 2.7 X 125MM #310.28
|
Facility
IP
|
$1,427.00
|
|
| Hospital Charge Code |
2966189
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$699.23 |
| Max. Negotiated Rate |
$1,312.84 |
| Rate for Payer: Aetna Commercial |
$1,284.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$756.31
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,312.84
|
| Rate for Payer: Health EOS Commercial |
$1,270.03
|
| Rate for Payer: HFN Commercial |
$1,312.84
|
| Rate for Payer: Multiplan Commercial |
$1,141.60
|
| Rate for Payer: NAPHCARE Commercial |
$856.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,312.84
|
| Rate for Payer: Quartz Beloit One Network |
$699.23
|
| Rate for Payer: Quartz Commercial |
$856.20
|
| Rate for Payer: WEA Trust Commercial |
$784.85
|
| Rate for Payer: WPS Commercial |
$1,056.98
|
|
|
DRILL BIT 2.7 X 125MM #310.28
|
Facility
OP
|
$1,427.00
|
|
| Hospital Charge Code |
2966189
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$399.56 |
| Max. Negotiated Rate |
$5,708.00 |
| Rate for Payer: Aetna Commercial |
$1,284.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,227.22
|
| Rate for Payer: Aetna Managed Medicare |
$399.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$927.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$713.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$684.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$756.31
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,312.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$798.55
|
| Rate for Payer: Health EOS Commercial |
$1,270.03
|
| Rate for Payer: HFN Commercial |
$1,312.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,070.25
|
| Rate for Payer: Multiplan Commercial |
$1,141.60
|
| Rate for Payer: NAPHCARE Commercial |
$856.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,312.84
|
| Rate for Payer: Quartz Beloit One Network |
$699.23
|
| Rate for Payer: Quartz Commercial |
$927.55
|
| Rate for Payer: Quartz Medicare Advantage |
$856.20
|
| Rate for Payer: The Alliance Commercial |
$5,708.00
|
| Rate for Payer: WEA Trust Commercial |
$784.85
|
| Rate for Payer: WPS Commercial |
$1,056.98
|
|
|
DRILL BIT 2.8 ACUMED QUICK COUPLER 80-0318
|
Facility
OP
|
$1,444.00
|
|
| Hospital Charge Code |
2967386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.32 |
| Max. Negotiated Rate |
$5,776.00 |
| Rate for Payer: Aetna Commercial |
$1,299.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,241.84
|
| Rate for Payer: Aetna Managed Medicare |
$404.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$938.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$722.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$693.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$765.32
|
| Rate for Payer: Cash Price |
$433.20
|
| Rate for Payer: Cigna Commercial |
$1,328.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$808.06
|
| Rate for Payer: Health EOS Commercial |
$1,285.16
|
| Rate for Payer: HFN Commercial |
$1,328.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,083.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.20
|
| Rate for Payer: NAPHCARE Commercial |
$866.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,328.48
|
| Rate for Payer: Quartz Beloit One Network |
$707.56
|
| Rate for Payer: Quartz Commercial |
$938.60
|
| Rate for Payer: Quartz Medicare Advantage |
$866.40
|
| Rate for Payer: The Alliance Commercial |
$5,776.00
|
| Rate for Payer: WEA Trust Commercial |
$794.20
|
| Rate for Payer: WPS Commercial |
$1,069.57
|
|
|
DRILL BIT 2.8 ACUMED QUICK COUPLER 80-0318
|
Facility
IP
|
$1,444.00
|
|
| Hospital Charge Code |
2967386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$707.56 |
| Max. Negotiated Rate |
$1,328.48 |
| Rate for Payer: Aetna Commercial |
$1,299.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$765.32
|
| Rate for Payer: Cash Price |
$433.20
|
| Rate for Payer: Cigna Commercial |
$1,328.48
|
| Rate for Payer: Health EOS Commercial |
$1,285.16
|
| Rate for Payer: HFN Commercial |
$1,328.48
|
| Rate for Payer: Multiplan Commercial |
$1,155.20
|
| Rate for Payer: NAPHCARE Commercial |
$866.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,328.48
|
| Rate for Payer: Quartz Beloit One Network |
$707.56
|
| Rate for Payer: Quartz Commercial |
$866.40
|
| Rate for Payer: WEA Trust Commercial |
$794.20
|
| Rate for Payer: WPS Commercial |
$1,069.57
|
|
|
DRILL BIT 2.8MM ACUMED QUICK COUPLING 80-0387
|
Facility
OP
|
$1,647.00
|
|
| Hospital Charge Code |
2967385
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$461.16 |
| Max. Negotiated Rate |
$6,588.00 |
| Rate for Payer: Aetna Commercial |
$1,482.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,416.42
|
| Rate for Payer: Aetna Managed Medicare |
$461.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,070.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$823.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$790.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$872.91
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,515.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$921.66
|
| Rate for Payer: Health EOS Commercial |
$1,465.83
|
| Rate for Payer: HFN Commercial |
$1,515.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,235.25
|
| Rate for Payer: Multiplan Commercial |
$1,317.60
|
| Rate for Payer: NAPHCARE Commercial |
$988.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,515.24
|
| Rate for Payer: Quartz Beloit One Network |
$807.03
|
| Rate for Payer: Quartz Commercial |
$1,070.55
|
| Rate for Payer: Quartz Medicare Advantage |
$988.20
|
| Rate for Payer: The Alliance Commercial |
$6,588.00
|
| Rate for Payer: WEA Trust Commercial |
$905.85
|
| Rate for Payer: WPS Commercial |
$1,219.93
|
|
|
DRILL BIT 2.8MM ACUMED QUICK COUPLING 80-0387
|
Facility
IP
|
$1,647.00
|
|
| Hospital Charge Code |
2967385
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$807.03 |
| Max. Negotiated Rate |
$1,515.24 |
| Rate for Payer: Aetna Commercial |
$1,482.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$872.91
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,515.24
|
| Rate for Payer: Health EOS Commercial |
$1,465.83
|
| Rate for Payer: HFN Commercial |
$1,515.24
|
| Rate for Payer: Multiplan Commercial |
$1,317.60
|
| Rate for Payer: NAPHCARE Commercial |
$988.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,515.24
|
| Rate for Payer: Quartz Beloit One Network |
$807.03
|
| Rate for Payer: Quartz Commercial |
$988.20
|
| Rate for Payer: WEA Trust Commercial |
$905.85
|
| Rate for Payer: WPS Commercial |
$1,219.93
|
|
|
DRILL BIT 2.8MM CALIBRATED 95MM 03.113.024
|
Facility
OP
|
$1,556.00
|
|
| Hospital Charge Code |
3265479
|
|
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
|
|
