|
DRILL BIT CANN 2.0 X 145MM QUICK COUPLING 03.333.101
|
Facility
IP
|
$2,147.87
|
|
| Hospital Charge Code |
6248163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,052.46 |
| Max. Negotiated Rate |
$1,976.04 |
| Rate for Payer: Aetna Commercial |
$1,933.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,138.37
|
| Rate for Payer: Cash Price |
$644.36
|
| Rate for Payer: Cigna Commercial |
$1,976.04
|
| Rate for Payer: Health EOS Commercial |
$1,911.60
|
| Rate for Payer: HFN Commercial |
$1,976.04
|
| Rate for Payer: Multiplan Commercial |
$1,718.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,288.72
|
| Rate for Payer: Preferred Network Access Commercial |
$1,976.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,052.46
|
| Rate for Payer: Quartz Commercial |
$1,288.72
|
| Rate for Payer: WEA Trust Commercial |
$1,181.33
|
| Rate for Payer: WPS Commercial |
$1,590.93
|
|
|
DRILL BIT CANN 2.0 X 145MM QUICK COUPLING 03.333.101
|
Facility
OP
|
$2,147.87
|
|
| Hospital Charge Code |
6248163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$601.40 |
| Max. Negotiated Rate |
$8,591.48 |
| Rate for Payer: Aetna Commercial |
$1,933.08
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,847.17
|
| Rate for Payer: Aetna Managed Medicare |
$601.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,396.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,073.94
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,030.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,138.37
|
| Rate for Payer: Cash Price |
$644.36
|
| Rate for Payer: Cigna Commercial |
$1,976.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,201.95
|
| Rate for Payer: Health EOS Commercial |
$1,911.60
|
| Rate for Payer: HFN Commercial |
$1,976.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,610.90
|
| Rate for Payer: Multiplan Commercial |
$1,718.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,288.72
|
| Rate for Payer: Preferred Network Access Commercial |
$1,976.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,052.46
|
| Rate for Payer: Quartz Commercial |
$1,396.12
|
| Rate for Payer: Quartz Medicare Advantage |
$1,288.72
|
| Rate for Payer: The Alliance Commercial |
$8,591.48
|
| Rate for Payer: WEA Trust Commercial |
$1,181.33
|
| Rate for Payer: WPS Commercial |
$1,590.93
|
|
|
DRILL BIT CANN 2.1MM (GREEN) IS1113
|
Facility
IP
|
$2,756.00
|
|
| Hospital Charge Code |
5659624
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,350.44 |
| Max. Negotiated Rate |
$2,535.52 |
| Rate for Payer: Aetna Commercial |
$2,480.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,460.68
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cigna Commercial |
$2,535.52
|
| Rate for Payer: Health EOS Commercial |
$2,452.84
|
| Rate for Payer: HFN Commercial |
$2,535.52
|
| Rate for Payer: Multiplan Commercial |
$2,204.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,653.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,535.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,350.44
|
| Rate for Payer: Quartz Commercial |
$1,653.60
|
| Rate for Payer: WEA Trust Commercial |
$1,515.80
|
| Rate for Payer: WPS Commercial |
$2,041.37
|
|
|
DRILL BIT CANN 2.1MM (GREEN) IS1113
|
Facility
OP
|
$2,756.00
|
|
| Hospital Charge Code |
5659624
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$771.68 |
| Max. Negotiated Rate |
$11,024.00 |
| Rate for Payer: Aetna Commercial |
$2,480.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,370.16
|
| Rate for Payer: Aetna Managed Medicare |
$771.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,791.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,322.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,460.68
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cigna Commercial |
$2,535.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,542.26
|
| Rate for Payer: Health EOS Commercial |
$2,452.84
|
| Rate for Payer: HFN Commercial |
$2,535.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,067.00
|
| Rate for Payer: Multiplan Commercial |
$2,204.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,653.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,535.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,350.44
|
| Rate for Payer: Quartz Commercial |
$1,791.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,653.60
|
| Rate for Payer: The Alliance Commercial |
$11,024.00
|
| Rate for Payer: WEA Trust Commercial |
$1,515.80
|
| Rate for Payer: WPS Commercial |
$2,041.37
|
|
|
DRILL BIT CANN 2.4MM & PASSING WIRE AR-1594D-24
|
Facility
OP
|
$2,929.00
|
|
| Hospital Charge Code |
6220125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$820.12 |
| Max. Negotiated Rate |
$11,716.00 |
| Rate for Payer: Aetna Commercial |
$2,636.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,518.94
|
| Rate for Payer: Aetna Managed Medicare |
$820.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,903.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,464.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,405.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,552.37
|
| Rate for Payer: Cash Price |
$878.70
|
| Rate for Payer: Cigna Commercial |
$2,694.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,639.07
|
| Rate for Payer: Health EOS Commercial |
$2,606.81
|
| Rate for Payer: HFN Commercial |
$2,694.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,196.75
|
| Rate for Payer: Multiplan Commercial |
$2,343.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,757.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,694.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,435.21
|
| Rate for Payer: Quartz Commercial |
$1,903.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,757.40
|
| Rate for Payer: The Alliance Commercial |
$11,716.00
|
| Rate for Payer: WEA Trust Commercial |
$1,610.95
|
| Rate for Payer: WPS Commercial |
$2,169.51
|
|
|
DRILL BIT CANN 2.4MM & PASSING WIRE AR-1594D-24
|
Facility
IP
|
$2,929.00
|
|
| Hospital Charge Code |
6220125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,435.21 |
| Max. Negotiated Rate |
$2,694.68 |
| Rate for Payer: Aetna Commercial |
$2,636.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,552.37
|
| Rate for Payer: Cash Price |
$878.70
|
| Rate for Payer: Cigna Commercial |
$2,694.68
|
| Rate for Payer: Health EOS Commercial |
$2,606.81
|
| Rate for Payer: HFN Commercial |
$2,694.68
|
| Rate for Payer: Multiplan Commercial |
$2,343.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,757.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,694.68
|
| Rate for Payer: Quartz Beloit One Network |
$1,435.21
|
| Rate for Payer: Quartz Commercial |
$1,757.40
|
| Rate for Payer: WEA Trust Commercial |
$1,610.95
|
| Rate for Payer: WPS Commercial |
$2,169.51
|
|
|
DRILL BIT CANN 2.6MM IS1114
|
Facility
OP
|
$1,986.00
|
|
| Hospital Charge Code |
6171785
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$556.08 |
| Max. Negotiated Rate |
$7,944.00 |
| Rate for Payer: Aetna Commercial |
$1,787.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,707.96
|
| Rate for Payer: Aetna Managed Medicare |
$556.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,290.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$993.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$953.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,052.58
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cigna Commercial |
$1,827.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,111.37
|
| Rate for Payer: Health EOS Commercial |
$1,767.54
|
| Rate for Payer: HFN Commercial |
$1,827.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,489.50
|
| Rate for Payer: Multiplan Commercial |
$1,588.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,827.12
|
| Rate for Payer: Quartz Beloit One Network |
$973.14
|
| Rate for Payer: Quartz Commercial |
$1,290.90
|
| Rate for Payer: Quartz Medicare Advantage |
$1,191.60
|
| Rate for Payer: The Alliance Commercial |
$7,944.00
|
| Rate for Payer: WEA Trust Commercial |
$1,092.30
|
| Rate for Payer: WPS Commercial |
$1,471.03
|
|
|
DRILL BIT CANN 2.6MM IS1114
|
Facility
IP
|
$1,986.00
|
|
| Hospital Charge Code |
6171785
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.14 |
| Max. Negotiated Rate |
$1,827.12 |
| Rate for Payer: Aetna Commercial |
$1,787.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,052.58
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cigna Commercial |
$1,827.12
|
| Rate for Payer: Health EOS Commercial |
$1,767.54
|
| Rate for Payer: HFN Commercial |
$1,827.12
|
| Rate for Payer: Multiplan Commercial |
$1,588.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,191.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,827.12
|
| Rate for Payer: Quartz Beloit One Network |
$973.14
|
| Rate for Payer: Quartz Commercial |
$1,191.60
|
| Rate for Payer: WEA Trust Commercial |
$1,092.30
|
| Rate for Payer: WPS Commercial |
$1,471.03
|
|
|
DRILL BIT CANN 2.7MM AO COUPLING STRYKER 702449
|
Facility
IP
|
$2,212.00
|
|
| Hospital Charge Code |
5415593
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,083.88 |
| Max. Negotiated Rate |
$2,035.04 |
| Rate for Payer: Aetna Commercial |
$1,990.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,172.36
|
| Rate for Payer: Cash Price |
$663.60
|
| Rate for Payer: Cigna Commercial |
$2,035.04
|
| Rate for Payer: Health EOS Commercial |
$1,968.68
|
| Rate for Payer: HFN Commercial |
$2,035.04
|
| Rate for Payer: Multiplan Commercial |
$1,769.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,327.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,035.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,083.88
|
| Rate for Payer: Quartz Commercial |
$1,327.20
|
| Rate for Payer: WEA Trust Commercial |
$1,216.60
|
| Rate for Payer: WPS Commercial |
$1,638.43
|
|
|
DRILL BIT CANN 2.7MM AO COUPLING STRYKER 702449
|
Facility
OP
|
$2,212.00
|
|
| Hospital Charge Code |
5415593
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$619.36 |
| Max. Negotiated Rate |
$8,848.00 |
| Rate for Payer: Aetna Commercial |
$1,990.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,902.32
|
| Rate for Payer: Aetna Managed Medicare |
$619.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,437.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,106.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,061.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,172.36
|
| Rate for Payer: Cash Price |
$663.60
|
| Rate for Payer: Cigna Commercial |
$2,035.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,237.84
|
| Rate for Payer: Health EOS Commercial |
$1,968.68
|
| Rate for Payer: HFN Commercial |
$2,035.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,659.00
|
| Rate for Payer: Multiplan Commercial |
$1,769.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,327.20
|
| Rate for Payer: Preferred Network Access Commercial |
$2,035.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,083.88
|
| Rate for Payer: Quartz Commercial |
$1,437.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,327.20
|
| Rate for Payer: The Alliance Commercial |
$8,848.00
|
| Rate for Payer: WEA Trust Commercial |
$1,216.60
|
| Rate for Payer: WPS Commercial |
$1,638.43
|
|
|
DRILL BIT CANN 3.0 X 170MM WITH CALIBRATIONS AO 705357
|
Facility
OP
|
$1,468.00
|
|
| Hospital Charge Code |
6166131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$411.04 |
| Max. Negotiated Rate |
$5,872.00 |
| Rate for Payer: Aetna Managed Medicare |
$411.04
|
| Rate for Payer: Aetna Commercial |
$1,321.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,262.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$954.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$734.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$704.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$778.04
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$1,350.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$821.49
|
| Rate for Payer: Health EOS Commercial |
$1,306.52
|
| Rate for Payer: HFN Commercial |
$1,350.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,101.00
|
| Rate for Payer: Multiplan Commercial |
$1,174.40
|
| Rate for Payer: NAPHCARE Commercial |
$880.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,350.56
|
| Rate for Payer: Quartz Beloit One Network |
$719.32
|
| Rate for Payer: Quartz Commercial |
$954.20
|
| Rate for Payer: Quartz Medicare Advantage |
$880.80
|
| Rate for Payer: The Alliance Commercial |
$5,872.00
|
| Rate for Payer: WEA Trust Commercial |
$807.40
|
| Rate for Payer: WPS Commercial |
$1,087.35
|
|
|
DRILL BIT CANN 3.0 X 170MM WITH CALIBRATIONS AO 705357
|
Facility
IP
|
$1,468.00
|
|
| Hospital Charge Code |
6166131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$719.32 |
| Max. Negotiated Rate |
$1,350.56 |
| Rate for Payer: Aetna Commercial |
$1,321.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$778.04
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$1,350.56
|
| Rate for Payer: Health EOS Commercial |
$1,306.52
|
| Rate for Payer: HFN Commercial |
$1,350.56
|
| Rate for Payer: Multiplan Commercial |
$1,174.40
|
| Rate for Payer: NAPHCARE Commercial |
$880.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,350.56
|
| Rate for Payer: Quartz Beloit One Network |
$719.32
|
| Rate for Payer: Quartz Commercial |
$880.80
|
| Rate for Payer: WEA Trust Commercial |
$807.40
|
| Rate for Payer: WPS Commercial |
$1,087.35
|
|
|
DRILL BIT CANN 3.0 X 60MM ORTHOLOC 58850030
|
Facility
IP
|
$1,948.00
|
|
| Hospital Charge Code |
6173852
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$954.52 |
| Max. Negotiated Rate |
$1,792.16 |
| Rate for Payer: Aetna Commercial |
$1,753.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,032.44
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cigna Commercial |
$1,792.16
|
| Rate for Payer: Health EOS Commercial |
$1,733.72
|
| Rate for Payer: HFN Commercial |
$1,792.16
|
| Rate for Payer: Multiplan Commercial |
$1,558.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,168.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,792.16
|
| Rate for Payer: Quartz Beloit One Network |
$954.52
|
| Rate for Payer: Quartz Commercial |
$1,168.80
|
| Rate for Payer: WEA Trust Commercial |
$1,071.40
|
| Rate for Payer: WPS Commercial |
$1,442.88
|
|
|
DRILL BIT CANN 3.0 X 60MM ORTHOLOC 58850030
|
Facility
OP
|
$1,948.00
|
|
| Hospital Charge Code |
6173852
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$545.44 |
| Max. Negotiated Rate |
$7,792.00 |
| Rate for Payer: Aetna Commercial |
$1,753.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,675.28
|
| Rate for Payer: Aetna Managed Medicare |
$545.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,266.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$974.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$935.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,032.44
|
| Rate for Payer: Cash Price |
$584.40
|
| Rate for Payer: Cigna Commercial |
$1,792.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,090.10
|
| Rate for Payer: Health EOS Commercial |
$1,733.72
|
| Rate for Payer: HFN Commercial |
$1,792.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,461.00
|
| Rate for Payer: Multiplan Commercial |
$1,558.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,168.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,792.16
|
| Rate for Payer: Quartz Beloit One Network |
$954.52
|
| Rate for Payer: Quartz Commercial |
$1,266.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,168.80
|
| Rate for Payer: The Alliance Commercial |
$7,792.00
|
| Rate for Payer: WEA Trust Commercial |
$1,071.40
|
| Rate for Payer: WPS Commercial |
$1,442.88
|
|
|
DRILL BIT CANN 3.2MM 170/140MM 310.65
|
Facility
OP
|
$5,121.00
|
|
| Hospital Charge Code |
3375505
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,433.88 |
| Max. Negotiated Rate |
$20,484.00 |
| Rate for Payer: Aetna Commercial |
$4,608.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,404.06
|
| Rate for Payer: Aetna Managed Medicare |
$1,433.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,328.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,560.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,458.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,714.13
|
| Rate for Payer: Cash Price |
$1,536.30
|
| Rate for Payer: Cigna Commercial |
$4,711.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,865.71
|
| Rate for Payer: Health EOS Commercial |
$4,557.69
|
| Rate for Payer: HFN Commercial |
$4,711.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,840.75
|
| Rate for Payer: Multiplan Commercial |
$4,096.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,072.60
|
| Rate for Payer: Preferred Network Access Commercial |
$4,711.32
|
| Rate for Payer: Quartz Beloit One Network |
$2,509.29
|
| Rate for Payer: Quartz Commercial |
$3,328.65
|
| Rate for Payer: Quartz Medicare Advantage |
$3,072.60
|
| Rate for Payer: The Alliance Commercial |
$20,484.00
|
| Rate for Payer: WEA Trust Commercial |
$2,816.55
|
| Rate for Payer: WPS Commercial |
$3,793.12
|
|
|
DRILL BIT CANN 3.2MM 170/140MM 310.65
|
Facility
IP
|
$5,121.00
|
|
| Hospital Charge Code |
3375505
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,509.29 |
| Max. Negotiated Rate |
$4,711.32 |
| Rate for Payer: Aetna Commercial |
$4,608.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,714.13
|
| Rate for Payer: Cash Price |
$1,536.30
|
| Rate for Payer: Cigna Commercial |
$4,711.32
|
| Rate for Payer: Health EOS Commercial |
$4,557.69
|
| Rate for Payer: HFN Commercial |
$4,711.32
|
| Rate for Payer: Multiplan Commercial |
$4,096.80
|
| Rate for Payer: NAPHCARE Commercial |
$3,072.60
|
| Rate for Payer: Preferred Network Access Commercial |
$4,711.32
|
| Rate for Payer: Quartz Beloit One Network |
$2,509.29
|
| Rate for Payer: Quartz Commercial |
$3,072.60
|
| Rate for Payer: WEA Trust Commercial |
$2,816.55
|
| Rate for Payer: WPS Commercial |
$3,793.12
|
|
|
DRILL BIT CANN 4.3MM X 200MM 310.634
|
Facility
OP
|
$513.00
|
|
| Hospital Charge Code |
3937334
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.64 |
| Max. Negotiated Rate |
$2,052.00 |
| Rate for Payer: Aetna Commercial |
$461.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$441.18
|
| Rate for Payer: Aetna Managed Medicare |
$143.64
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$333.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$256.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$246.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$271.89
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Cigna Commercial |
$471.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$287.07
|
| Rate for Payer: Health EOS Commercial |
$456.57
|
| Rate for Payer: HFN Commercial |
$471.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$384.75
|
| Rate for Payer: Multiplan Commercial |
$410.40
|
| Rate for Payer: NAPHCARE Commercial |
$307.80
|
| Rate for Payer: Preferred Network Access Commercial |
$471.96
|
| Rate for Payer: Quartz Beloit One Network |
$251.37
|
| Rate for Payer: Quartz Commercial |
$333.45
|
| Rate for Payer: Quartz Medicare Advantage |
$307.80
|
| Rate for Payer: The Alliance Commercial |
$2,052.00
|
| Rate for Payer: WEA Trust Commercial |
$282.15
|
| Rate for Payer: WPS Commercial |
$379.98
|
|
|
DRILL BIT CANN 4.3MM X 200MM 310.634
|
Facility
IP
|
$513.00
|
|
| Hospital Charge Code |
3937334
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.37 |
| Max. Negotiated Rate |
$471.96 |
| Rate for Payer: Aetna Commercial |
$461.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$271.89
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Cigna Commercial |
$471.96
|
| Rate for Payer: Health EOS Commercial |
$456.57
|
| Rate for Payer: HFN Commercial |
$471.96
|
| Rate for Payer: Multiplan Commercial |
$410.40
|
| Rate for Payer: NAPHCARE Commercial |
$307.80
|
| Rate for Payer: Preferred Network Access Commercial |
$471.96
|
| Rate for Payer: Quartz Beloit One Network |
$251.37
|
| Rate for Payer: Quartz Commercial |
$307.80
|
| Rate for Payer: WEA Trust Commercial |
$282.15
|
| Rate for Payer: WPS Commercial |
$379.98
|
|
|
DRILL BIT CANN 5.0 300MM LARGE 310.63
|
Facility
OP
|
$5,192.00
|
|
| Hospital Charge Code |
2966213
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,453.76 |
| Max. Negotiated Rate |
$20,768.00 |
| Rate for Payer: Aetna Commercial |
$4,672.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,465.12
|
| Rate for Payer: Aetna Managed Medicare |
$1,453.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,374.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,596.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,492.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,751.76
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cigna Commercial |
$4,776.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,905.44
|
| Rate for Payer: Health EOS Commercial |
$4,620.88
|
| Rate for Payer: HFN Commercial |
$4,776.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,894.00
|
| Rate for Payer: Multiplan Commercial |
$4,153.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,115.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,776.64
|
| Rate for Payer: Quartz Beloit One Network |
$2,544.08
|
| Rate for Payer: Quartz Commercial |
$3,374.80
|
| Rate for Payer: Quartz Medicare Advantage |
$3,115.20
|
| Rate for Payer: The Alliance Commercial |
$20,768.00
|
| Rate for Payer: WEA Trust Commercial |
$2,855.60
|
| Rate for Payer: WPS Commercial |
$3,845.71
|
|
|
DRILL BIT CANN 5.0 300MM LARGE 310.63
|
Facility
IP
|
$5,192.00
|
|
| Hospital Charge Code |
2966213
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,544.08 |
| Max. Negotiated Rate |
$4,776.64 |
| Rate for Payer: Aetna Commercial |
$4,672.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,751.76
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cigna Commercial |
$4,776.64
|
| Rate for Payer: Health EOS Commercial |
$4,620.88
|
| Rate for Payer: HFN Commercial |
$4,776.64
|
| Rate for Payer: Multiplan Commercial |
$4,153.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,115.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,776.64
|
| Rate for Payer: Quartz Beloit One Network |
$2,544.08
|
| Rate for Payer: Quartz Commercial |
$3,115.20
|
| Rate for Payer: WEA Trust Commercial |
$2,855.60
|
| Rate for Payer: WPS Commercial |
$3,845.71
|
|
|
DRILL BIT CANN 5.0MM AR-8770-02
|
Facility
OP
|
$2,174.00
|
|
| Hospital Charge Code |
6234123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$608.72 |
| Max. Negotiated Rate |
$8,696.00 |
| Rate for Payer: Aetna Commercial |
$1,956.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,869.64
|
| Rate for Payer: Aetna Managed Medicare |
$608.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,413.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,087.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,043.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,152.22
|
| Rate for Payer: Cash Price |
$652.20
|
| Rate for Payer: Cigna Commercial |
$2,000.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,216.57
|
| Rate for Payer: Health EOS Commercial |
$1,934.86
|
| Rate for Payer: HFN Commercial |
$2,000.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,630.50
|
| Rate for Payer: Multiplan Commercial |
$1,739.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,304.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,000.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,065.26
|
| Rate for Payer: Quartz Commercial |
$1,413.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,304.40
|
| Rate for Payer: The Alliance Commercial |
$8,696.00
|
| Rate for Payer: WEA Trust Commercial |
$1,195.70
|
| Rate for Payer: WPS Commercial |
$1,610.28
|
|
|
DRILL BIT CANN 5.0MM AR-8770-02
|
Facility
IP
|
$2,174.00
|
|
| Hospital Charge Code |
6234123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,065.26 |
| Max. Negotiated Rate |
$2,000.08 |
| Rate for Payer: Aetna Commercial |
$1,956.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,152.22
|
| Rate for Payer: Cash Price |
$652.20
|
| Rate for Payer: Cigna Commercial |
$2,000.08
|
| Rate for Payer: Health EOS Commercial |
$1,934.86
|
| Rate for Payer: HFN Commercial |
$2,000.08
|
| Rate for Payer: Multiplan Commercial |
$1,739.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,304.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,000.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,065.26
|
| Rate for Payer: Quartz Commercial |
$1,304.40
|
| Rate for Payer: WEA Trust Commercial |
$1,195.70
|
| Rate for Payer: WPS Commercial |
$1,610.28
|
|
|
DRILL BIT CANN 5.0 X 200MM QUICK COUPLING 310.632
|
Facility
OP
|
$2,715.00
|
|
| Hospital Charge Code |
4289891
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$10,860.00 |
| Rate for Payer: The Alliance Commercial |
$10,860.00
|
| Rate for Payer: Aetna Commercial |
$2,443.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,334.90
|
| Rate for Payer: Aetna Managed Medicare |
$760.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,764.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,357.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,303.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,438.95
|
| Rate for Payer: Cash Price |
$814.50
|
| Rate for Payer: Cigna Commercial |
$2,497.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,519.31
|
| Rate for Payer: Health EOS Commercial |
$2,416.35
|
| Rate for Payer: HFN Commercial |
$2,497.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,036.25
|
| Rate for Payer: Multiplan Commercial |
$2,172.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,629.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,497.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,330.35
|
| Rate for Payer: Quartz Commercial |
$1,764.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,629.00
|
| Rate for Payer: WEA Trust Commercial |
$1,493.25
|
| Rate for Payer: WPS Commercial |
$2,011.00
|
|
|
DRILL BIT CANN 5.0 X 200MM QUICK COUPLING 310.632
|
Facility
IP
|
$2,715.00
|
|
| Hospital Charge Code |
4289891
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,330.35 |
| Max. Negotiated Rate |
$2,497.80 |
| Rate for Payer: Aetna Commercial |
$2,443.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,438.95
|
| Rate for Payer: Cash Price |
$814.50
|
| Rate for Payer: Cigna Commercial |
$2,497.80
|
| Rate for Payer: Health EOS Commercial |
$2,416.35
|
| Rate for Payer: HFN Commercial |
$2,497.80
|
| Rate for Payer: Multiplan Commercial |
$2,172.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,629.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,497.80
|
| Rate for Payer: Quartz Beloit One Network |
$1,330.35
|
| Rate for Payer: Quartz Commercial |
$1,629.00
|
| Rate for Payer: WEA Trust Commercial |
$1,493.25
|
| Rate for Payer: WPS Commercial |
$2,011.00
|
|
|
DRILL BIT CANN 5.0 X 215MM LARGE QUICK COUPLING 03.333.104
|
Facility
OP
|
$4,396.86
|
|
| Hospital Charge Code |
6248159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,231.12 |
| Max. Negotiated Rate |
$17,587.44 |
| Rate for Payer: Aetna Commercial |
$3,957.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,781.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,231.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,857.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,198.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,110.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,330.34
|
| Rate for Payer: Cash Price |
$1,319.06
|
| Rate for Payer: Cigna Commercial |
$4,045.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,460.48
|
| Rate for Payer: Health EOS Commercial |
$3,913.21
|
| Rate for Payer: HFN Commercial |
$4,045.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,297.64
|
| Rate for Payer: Multiplan Commercial |
$3,517.49
|
| Rate for Payer: NAPHCARE Commercial |
$2,638.12
|
| Rate for Payer: Preferred Network Access Commercial |
$4,045.11
|
| Rate for Payer: Quartz Beloit One Network |
$2,154.46
|
| Rate for Payer: Quartz Commercial |
$2,857.96
|
| Rate for Payer: Quartz Medicare Advantage |
$2,638.12
|
| Rate for Payer: The Alliance Commercial |
$17,587.44
|
| Rate for Payer: WEA Trust Commercial |
$2,418.27
|
| Rate for Payer: WPS Commercial |
$3,256.75
|
|
