|
DRILL BIT J-LATCH MATRIX 1.1MM X 44.5MM WITH 6MM STOP 03.503.246
|
Facility
IP
|
$1,299.00
|
|
| Hospital Charge Code |
5264664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.51 |
| Max. Negotiated Rate |
$1,195.08 |
| Rate for Payer: Aetna Commercial |
$1,169.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$688.47
|
| Rate for Payer: Cash Price |
$389.70
|
| Rate for Payer: Cigna Commercial |
$1,195.08
|
| Rate for Payer: Health EOS Commercial |
$1,156.11
|
| Rate for Payer: HFN Commercial |
$1,195.08
|
| Rate for Payer: Multiplan Commercial |
$1,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$779.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,195.08
|
| Rate for Payer: Quartz Beloit One Network |
$636.51
|
| Rate for Payer: Quartz Commercial |
$779.40
|
| Rate for Payer: WEA Trust Commercial |
$714.45
|
| Rate for Payer: WPS Commercial |
$962.17
|
|
|
DRILL BIT J-LATCH MATRIX 1.1MM X 44.5MM WITH 6MM STOP 03.503.246
|
Facility
OP
|
$1,299.00
|
|
| Hospital Charge Code |
5264664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.72 |
| Max. Negotiated Rate |
$5,196.00 |
| Rate for Payer: Aetna Commercial |
$1,169.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,117.14
|
| Rate for Payer: Aetna Managed Medicare |
$363.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$844.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$649.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$623.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$688.47
|
| Rate for Payer: Cash Price |
$389.70
|
| Rate for Payer: Cigna Commercial |
$1,195.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$726.92
|
| Rate for Payer: Health EOS Commercial |
$1,156.11
|
| Rate for Payer: HFN Commercial |
$1,195.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$974.25
|
| Rate for Payer: Multiplan Commercial |
$1,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$779.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,195.08
|
| Rate for Payer: Quartz Beloit One Network |
$636.51
|
| Rate for Payer: Quartz Commercial |
$844.35
|
| Rate for Payer: Quartz Medicare Advantage |
$779.40
|
| Rate for Payer: The Alliance Commercial |
$5,196.00
|
| Rate for Payer: WEA Trust Commercial |
$714.45
|
| Rate for Payer: WPS Commercial |
$962.17
|
|
|
DRILL BIT J-LATCH MATRIX 1.1MM X 44.5MM WITH 8MM STOP 03.503.248
|
Facility
OP
|
$1,299.00
|
|
| Hospital Charge Code |
5306788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.72 |
| Max. Negotiated Rate |
$5,196.00 |
| Rate for Payer: Aetna Commercial |
$1,169.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,117.14
|
| Rate for Payer: Aetna Managed Medicare |
$363.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$844.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$649.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$623.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$688.47
|
| Rate for Payer: Cash Price |
$389.70
|
| Rate for Payer: Cigna Commercial |
$1,195.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$726.92
|
| Rate for Payer: Health EOS Commercial |
$1,156.11
|
| Rate for Payer: HFN Commercial |
$1,195.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$974.25
|
| Rate for Payer: Multiplan Commercial |
$1,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$779.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,195.08
|
| Rate for Payer: Quartz Beloit One Network |
$636.51
|
| Rate for Payer: Quartz Commercial |
$844.35
|
| Rate for Payer: Quartz Medicare Advantage |
$779.40
|
| Rate for Payer: The Alliance Commercial |
$5,196.00
|
| Rate for Payer: WEA Trust Commercial |
$714.45
|
| Rate for Payer: WPS Commercial |
$962.17
|
|
|
DRILL BIT J-LATCH MATRIX 1.1MM X 44.5MM WITH 8MM STOP 03.503.248
|
Facility
IP
|
$1,299.00
|
|
| Hospital Charge Code |
5306788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.51 |
| Max. Negotiated Rate |
$1,195.08 |
| Rate for Payer: Aetna Commercial |
$1,169.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$688.47
|
| Rate for Payer: Cash Price |
$389.70
|
| Rate for Payer: Cigna Commercial |
$1,195.08
|
| Rate for Payer: Health EOS Commercial |
$1,156.11
|
| Rate for Payer: HFN Commercial |
$1,195.08
|
| Rate for Payer: Multiplan Commercial |
$1,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$779.40
|
| Rate for Payer: Preferred Network Access Commercial |
$1,195.08
|
| Rate for Payer: Quartz Beloit One Network |
$636.51
|
| Rate for Payer: Quartz Commercial |
$779.40
|
| Rate for Payer: WEA Trust Commercial |
$714.45
|
| Rate for Payer: WPS Commercial |
$962.17
|
|
|
DRILL BIT J-LATCH MATRIX 1.5MM X 125MM CALIBRATED 03.503.476
|
Facility
IP
|
$3,283.00
|
|
| Hospital Charge Code |
5831675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,608.67 |
| Max. Negotiated Rate |
$3,020.36 |
| Rate for Payer: Aetna Commercial |
$2,954.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,739.99
|
| Rate for Payer: Cash Price |
$984.90
|
| Rate for Payer: Cigna Commercial |
$3,020.36
|
| Rate for Payer: Health EOS Commercial |
$2,921.87
|
| Rate for Payer: HFN Commercial |
$3,020.36
|
| Rate for Payer: Multiplan Commercial |
$2,626.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,969.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,020.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,608.67
|
| Rate for Payer: Quartz Commercial |
$1,969.80
|
| Rate for Payer: WEA Trust Commercial |
$1,805.65
|
| Rate for Payer: WPS Commercial |
$2,431.72
|
|
|
DRILL BIT J-LATCH MATRIX 1.5MM X 125MM CALIBRATED 03.503.476
|
Facility
OP
|
$3,283.00
|
|
| Hospital Charge Code |
5831675
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$919.24 |
| Max. Negotiated Rate |
$13,132.00 |
| Rate for Payer: Aetna Commercial |
$2,954.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,823.38
|
| Rate for Payer: Aetna Managed Medicare |
$919.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,133.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,641.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,575.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,739.99
|
| Rate for Payer: Cash Price |
$984.90
|
| Rate for Payer: Cigna Commercial |
$3,020.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,837.17
|
| Rate for Payer: Health EOS Commercial |
$2,921.87
|
| Rate for Payer: HFN Commercial |
$3,020.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,462.25
|
| Rate for Payer: Multiplan Commercial |
$2,626.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,969.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,020.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,608.67
|
| Rate for Payer: Quartz Commercial |
$2,133.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,969.80
|
| Rate for Payer: The Alliance Commercial |
$13,132.00
|
| Rate for Payer: WEA Trust Commercial |
$1,805.65
|
| Rate for Payer: WPS Commercial |
$2,431.72
|
|
|
DRILL BIT J-LATCH MATRIX 1.5MM X 50MM WITH 6MM STOP 03.503.406
|
Facility
IP
|
$2,649.00
|
|
| Hospital Charge Code |
4038110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,298.01 |
| Max. Negotiated Rate |
$2,437.08 |
| Rate for Payer: Aetna Commercial |
$2,384.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,403.97
|
| Rate for Payer: Cash Price |
$794.70
|
| Rate for Payer: Cigna Commercial |
$2,437.08
|
| Rate for Payer: Health EOS Commercial |
$2,357.61
|
| Rate for Payer: HFN Commercial |
$2,437.08
|
| Rate for Payer: Multiplan Commercial |
$2,119.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,589.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,437.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,298.01
|
| Rate for Payer: Quartz Commercial |
$1,589.40
|
| Rate for Payer: WEA Trust Commercial |
$1,456.95
|
| Rate for Payer: WPS Commercial |
$1,962.11
|
|
|
DRILL BIT J-LATCH MATRIX 1.5MM X 50MM WITH 6MM STOP 03.503.406
|
Facility
OP
|
$2,649.00
|
|
| Hospital Charge Code |
4038110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$741.72 |
| Max. Negotiated Rate |
$10,596.00 |
| Rate for Payer: Aetna Commercial |
$2,384.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,278.14
|
| Rate for Payer: Aetna Managed Medicare |
$741.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,721.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,324.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,271.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,403.97
|
| Rate for Payer: Cash Price |
$794.70
|
| Rate for Payer: Cigna Commercial |
$2,437.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,482.38
|
| Rate for Payer: Health EOS Commercial |
$2,357.61
|
| Rate for Payer: HFN Commercial |
$2,437.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,986.75
|
| Rate for Payer: Multiplan Commercial |
$2,119.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,589.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,437.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,298.01
|
| Rate for Payer: Quartz Commercial |
$1,721.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,589.40
|
| Rate for Payer: The Alliance Commercial |
$10,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,456.95
|
| Rate for Payer: WPS Commercial |
$1,962.11
|
|
|
DRILL BIT J-LATCH MATRIX 1.8MM X 125MM 03.503.477
|
Facility
OP
|
$3,283.00
|
|
| Hospital Charge Code |
5831676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$919.24 |
| Max. Negotiated Rate |
$13,132.00 |
| Rate for Payer: Aetna Commercial |
$2,954.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,823.38
|
| Rate for Payer: Aetna Managed Medicare |
$919.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,133.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,641.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,575.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,739.99
|
| Rate for Payer: Cash Price |
$984.90
|
| Rate for Payer: Cigna Commercial |
$3,020.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,837.17
|
| Rate for Payer: Health EOS Commercial |
$2,921.87
|
| Rate for Payer: HFN Commercial |
$3,020.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,462.25
|
| Rate for Payer: Multiplan Commercial |
$2,626.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,969.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,020.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,608.67
|
| Rate for Payer: Quartz Commercial |
$2,133.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,969.80
|
| Rate for Payer: The Alliance Commercial |
$13,132.00
|
| Rate for Payer: WEA Trust Commercial |
$1,805.65
|
| Rate for Payer: WPS Commercial |
$2,431.72
|
|
|
DRILL BIT J-LATCH MATRIX 1.8MM X 125MM 03.503.477
|
Facility
IP
|
$3,283.00
|
|
| Hospital Charge Code |
5831676
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,608.67 |
| Max. Negotiated Rate |
$3,020.36 |
| Rate for Payer: Aetna Commercial |
$2,954.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,739.99
|
| Rate for Payer: Cash Price |
$984.90
|
| Rate for Payer: Cigna Commercial |
$3,020.36
|
| Rate for Payer: Health EOS Commercial |
$2,921.87
|
| Rate for Payer: HFN Commercial |
$3,020.36
|
| Rate for Payer: Multiplan Commercial |
$2,626.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,969.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,020.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,608.67
|
| Rate for Payer: Quartz Commercial |
$1,969.80
|
| Rate for Payer: WEA Trust Commercial |
$1,805.65
|
| Rate for Payer: WPS Commercial |
$2,431.72
|
|
|
DRILL BIT LONG ACUTRAK 2 AT2-L2525
|
Facility
IP
|
$3,149.00
|
|
| Hospital Charge Code |
2964136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,543.01 |
| Max. Negotiated Rate |
$2,897.08 |
| Rate for Payer: Aetna Commercial |
$2,834.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,668.97
|
| Rate for Payer: Cash Price |
$944.70
|
| Rate for Payer: Cigna Commercial |
$2,897.08
|
| Rate for Payer: Health EOS Commercial |
$2,802.61
|
| Rate for Payer: HFN Commercial |
$2,897.08
|
| Rate for Payer: Multiplan Commercial |
$2,519.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,897.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,543.01
|
| Rate for Payer: Quartz Commercial |
$1,889.40
|
| Rate for Payer: WEA Trust Commercial |
$1,731.95
|
| Rate for Payer: WPS Commercial |
$2,332.46
|
|
|
DRILL BIT LONG ACUTRAK 2 AT2-L2525
|
Facility
OP
|
$3,149.00
|
|
| Hospital Charge Code |
2964136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$881.72 |
| Max. Negotiated Rate |
$12,596.00 |
| Rate for Payer: Aetna Commercial |
$2,834.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,708.14
|
| Rate for Payer: Aetna Managed Medicare |
$881.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,046.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,574.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,511.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,668.97
|
| Rate for Payer: Cash Price |
$944.70
|
| Rate for Payer: Cigna Commercial |
$2,897.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,762.18
|
| Rate for Payer: Health EOS Commercial |
$2,802.61
|
| Rate for Payer: HFN Commercial |
$2,897.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,361.75
|
| Rate for Payer: Multiplan Commercial |
$2,519.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,889.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,897.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,543.01
|
| Rate for Payer: Quartz Commercial |
$2,046.85
|
| Rate for Payer: Quartz Medicare Advantage |
$1,889.40
|
| Rate for Payer: The Alliance Commercial |
$12,596.00
|
| Rate for Payer: WEA Trust Commercial |
$1,731.95
|
| Rate for Payer: WPS Commercial |
$2,332.46
|
|
|
DRILL BIT MATRIX 1.25MM 03.503.121
|
Facility
OP
|
$1,466.00
|
|
| Hospital Charge Code |
5298652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$410.48 |
| Max. Negotiated Rate |
$5,864.00 |
| Rate for Payer: Aetna Commercial |
$1,319.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,260.76
|
| Rate for Payer: Aetna Managed Medicare |
$410.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$952.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$733.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$703.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$776.98
|
| Rate for Payer: Cash Price |
$439.80
|
| Rate for Payer: Cigna Commercial |
$1,348.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$820.37
|
| Rate for Payer: Health EOS Commercial |
$1,304.74
|
| Rate for Payer: HFN Commercial |
$1,348.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,099.50
|
| Rate for Payer: Multiplan Commercial |
$1,172.80
|
| Rate for Payer: NAPHCARE Commercial |
$879.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,348.72
|
| Rate for Payer: Quartz Beloit One Network |
$718.34
|
| Rate for Payer: Quartz Commercial |
$952.90
|
| Rate for Payer: Quartz Medicare Advantage |
$879.60
|
| Rate for Payer: The Alliance Commercial |
$5,864.00
|
| Rate for Payer: WEA Trust Commercial |
$806.30
|
| Rate for Payer: WPS Commercial |
$1,085.87
|
|
|
DRILL BIT MATRIX 1.25MM 03.503.121
|
Facility
IP
|
$1,466.00
|
|
| Hospital Charge Code |
5298652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$718.34 |
| Max. Negotiated Rate |
$1,348.72 |
| Rate for Payer: Aetna Commercial |
$1,319.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$776.98
|
| Rate for Payer: Cash Price |
$439.80
|
| Rate for Payer: Cigna Commercial |
$1,348.72
|
| Rate for Payer: Health EOS Commercial |
$1,304.74
|
| Rate for Payer: HFN Commercial |
$1,348.72
|
| Rate for Payer: Multiplan Commercial |
$1,172.80
|
| Rate for Payer: NAPHCARE Commercial |
$879.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,348.72
|
| Rate for Payer: Quartz Beloit One Network |
$718.34
|
| Rate for Payer: Quartz Commercial |
$879.60
|
| Rate for Payer: WEA Trust Commercial |
$806.30
|
| Rate for Payer: WPS Commercial |
$1,085.87
|
|
|
DRILL BIT MEMOFIX 1.7MM MS2610
|
Facility
OP
|
$4,878.00
|
|
| Hospital Charge Code |
5521016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,365.84 |
| Max. Negotiated Rate |
$19,512.00 |
| Rate for Payer: Aetna Commercial |
$4,390.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,195.08
|
| Rate for Payer: Aetna Managed Medicare |
$1,365.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,170.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,439.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,341.44
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,585.34
|
| Rate for Payer: Cash Price |
$1,463.40
|
| Rate for Payer: Cigna Commercial |
$4,487.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,729.73
|
| Rate for Payer: Health EOS Commercial |
$4,341.42
|
| Rate for Payer: HFN Commercial |
$4,487.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,658.50
|
| Rate for Payer: Multiplan Commercial |
$3,902.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,926.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,487.76
|
| Rate for Payer: Quartz Beloit One Network |
$2,390.22
|
| Rate for Payer: Quartz Commercial |
$3,170.70
|
| Rate for Payer: Quartz Medicare Advantage |
$2,926.80
|
| Rate for Payer: The Alliance Commercial |
$19,512.00
|
| Rate for Payer: WEA Trust Commercial |
$2,682.90
|
| Rate for Payer: WPS Commercial |
$3,613.13
|
|
|
DRILL BIT MEMOFIX 1.7MM MS2610
|
Facility
IP
|
$4,878.00
|
|
| Hospital Charge Code |
5521016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,390.22 |
| Max. Negotiated Rate |
$4,487.76 |
| Rate for Payer: Aetna Commercial |
$4,390.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,585.34
|
| Rate for Payer: Cash Price |
$1,463.40
|
| Rate for Payer: Cigna Commercial |
$4,487.76
|
| Rate for Payer: Health EOS Commercial |
$4,341.42
|
| Rate for Payer: HFN Commercial |
$4,487.76
|
| Rate for Payer: Multiplan Commercial |
$3,902.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,926.80
|
| Rate for Payer: Preferred Network Access Commercial |
$4,487.76
|
| Rate for Payer: Quartz Beloit One Network |
$2,390.22
|
| Rate for Payer: Quartz Commercial |
$2,926.80
|
| Rate for Payer: WEA Trust Commercial |
$2,682.90
|
| Rate for Payer: WPS Commercial |
$3,613.13
|
|
|
DRILL BIT MINI 1.8MM 80MM QC 317.861
|
Facility
OP
|
$792.00
|
|
| Hospital Charge Code |
4508846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.76 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$681.12
|
| Rate for Payer: Aetna Managed Medicare |
$221.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$514.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$396.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$380.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$419.76
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cigna Commercial |
$728.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$443.20
|
| Rate for Payer: Health EOS Commercial |
$704.88
|
| Rate for Payer: HFN Commercial |
$728.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$594.00
|
| Rate for Payer: Multiplan Commercial |
$633.60
|
| Rate for Payer: NAPHCARE Commercial |
$475.20
|
| Rate for Payer: Preferred Network Access Commercial |
$728.64
|
| Rate for Payer: Quartz Beloit One Network |
$388.08
|
| Rate for Payer: Quartz Commercial |
$514.80
|
| Rate for Payer: Quartz Medicare Advantage |
$475.20
|
| Rate for Payer: The Alliance Commercial |
$3,168.00
|
| Rate for Payer: WEA Trust Commercial |
$435.60
|
| Rate for Payer: WPS Commercial |
$586.63
|
|
|
DRILL BIT MINI 1.8MM 80MM QC 317.861
|
Facility
IP
|
$792.00
|
|
| Hospital Charge Code |
4508846
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$388.08 |
| Max. Negotiated Rate |
$728.64 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$419.76
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cigna Commercial |
$728.64
|
| Rate for Payer: Health EOS Commercial |
$704.88
|
| Rate for Payer: HFN Commercial |
$728.64
|
| Rate for Payer: Multiplan Commercial |
$633.60
|
| Rate for Payer: NAPHCARE Commercial |
$475.20
|
| Rate for Payer: Preferred Network Access Commercial |
$728.64
|
| Rate for Payer: Quartz Beloit One Network |
$388.08
|
| Rate for Payer: Quartz Commercial |
$475.20
|
| Rate for Payer: WEA Trust Commercial |
$435.60
|
| Rate for Payer: WPS Commercial |
$586.63
|
|
|
DRILL BIT MINI 2.4MM 80MM QC 317.871
|
Facility
IP
|
$792.00
|
|
| Hospital Charge Code |
4508847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$388.08 |
| Max. Negotiated Rate |
$728.64 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$419.76
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cigna Commercial |
$728.64
|
| Rate for Payer: Health EOS Commercial |
$704.88
|
| Rate for Payer: HFN Commercial |
$728.64
|
| Rate for Payer: Multiplan Commercial |
$633.60
|
| Rate for Payer: NAPHCARE Commercial |
$475.20
|
| Rate for Payer: Preferred Network Access Commercial |
$728.64
|
| Rate for Payer: Quartz Beloit One Network |
$388.08
|
| Rate for Payer: Quartz Commercial |
$475.20
|
| Rate for Payer: WEA Trust Commercial |
$435.60
|
| Rate for Payer: WPS Commercial |
$586.63
|
|
|
DRILL BIT MINI 2.4MM 80MM QC 317.871
|
Facility
OP
|
$792.00
|
|
| Hospital Charge Code |
4508847
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.76 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$681.12
|
| Rate for Payer: Aetna Managed Medicare |
$221.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$514.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$396.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$380.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$419.76
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cigna Commercial |
$728.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$443.20
|
| Rate for Payer: Health EOS Commercial |
$704.88
|
| Rate for Payer: HFN Commercial |
$728.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$594.00
|
| Rate for Payer: Multiplan Commercial |
$633.60
|
| Rate for Payer: NAPHCARE Commercial |
$475.20
|
| Rate for Payer: Preferred Network Access Commercial |
$728.64
|
| Rate for Payer: Quartz Beloit One Network |
$388.08
|
| Rate for Payer: Quartz Commercial |
$514.80
|
| Rate for Payer: Quartz Medicare Advantage |
$475.20
|
| Rate for Payer: The Alliance Commercial |
$3,168.00
|
| Rate for Payer: WEA Trust Commercial |
$435.60
|
| Rate for Payer: WPS Commercial |
$586.63
|
|
|
DRILL BIT MINI LONG ACUTRAK 2 AT2M-L1813
|
Facility
IP
|
$3,168.00
|
|
| Hospital Charge Code |
2964140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,552.32 |
| Max. Negotiated Rate |
$2,914.56 |
| Rate for Payer: Aetna Commercial |
$2,851.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,679.04
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cigna Commercial |
$2,914.56
|
| Rate for Payer: Health EOS Commercial |
$2,819.52
|
| Rate for Payer: HFN Commercial |
$2,914.56
|
| Rate for Payer: Multiplan Commercial |
$2,534.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,900.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,914.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,552.32
|
| Rate for Payer: Quartz Commercial |
$1,900.80
|
| Rate for Payer: WEA Trust Commercial |
$1,742.40
|
| Rate for Payer: WPS Commercial |
$2,346.54
|
|
|
DRILL BIT MINI LONG ACUTRAK 2 AT2M-L1813
|
Facility
OP
|
$3,168.00
|
|
| Hospital Charge Code |
2964140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$887.04 |
| Max. Negotiated Rate |
$12,672.00 |
| Rate for Payer: Aetna Commercial |
$2,851.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,724.48
|
| Rate for Payer: Aetna Managed Medicare |
$887.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,059.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,584.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,520.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,679.04
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cigna Commercial |
$2,914.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,772.81
|
| Rate for Payer: Health EOS Commercial |
$2,819.52
|
| Rate for Payer: HFN Commercial |
$2,914.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,376.00
|
| Rate for Payer: Multiplan Commercial |
$2,534.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,900.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,914.56
|
| Rate for Payer: Quartz Beloit One Network |
$1,552.32
|
| Rate for Payer: Quartz Commercial |
$2,059.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,900.80
|
| Rate for Payer: The Alliance Commercial |
$12,672.00
|
| Rate for Payer: WEA Trust Commercial |
$1,742.40
|
| Rate for Payer: WPS Commercial |
$2,346.54
|
|
|
DRILL BIT OLECRANON OSTEOTOMY
|
Facility
OP
|
$5,137.00
|
|
| Hospital Charge Code |
2966217
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,438.36 |
| Max. Negotiated Rate |
$20,548.00 |
| Rate for Payer: Aetna Commercial |
$4,623.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,417.82
|
| Rate for Payer: Aetna Managed Medicare |
$1,438.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,339.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,568.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,465.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,722.61
|
| Rate for Payer: Cash Price |
$1,541.10
|
| Rate for Payer: Cigna Commercial |
$4,726.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,874.67
|
| Rate for Payer: Health EOS Commercial |
$4,571.93
|
| Rate for Payer: HFN Commercial |
$4,726.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,852.75
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,082.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,726.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,517.13
|
| Rate for Payer: Quartz Commercial |
$3,339.05
|
| Rate for Payer: Quartz Medicare Advantage |
$3,082.20
|
| Rate for Payer: The Alliance Commercial |
$20,548.00
|
| Rate for Payer: WEA Trust Commercial |
$2,825.35
|
| Rate for Payer: WPS Commercial |
$3,804.98
|
|
|
DRILL BIT OLECRANON OSTEOTOMY
|
Facility
IP
|
$5,137.00
|
|
| Hospital Charge Code |
2966217
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,517.13 |
| Max. Negotiated Rate |
$4,726.04 |
| Rate for Payer: Aetna Commercial |
$4,623.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,722.61
|
| Rate for Payer: Cash Price |
$1,541.10
|
| Rate for Payer: Cigna Commercial |
$4,726.04
|
| Rate for Payer: Health EOS Commercial |
$4,571.93
|
| Rate for Payer: HFN Commercial |
$4,726.04
|
| Rate for Payer: Multiplan Commercial |
$4,109.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,082.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,726.04
|
| Rate for Payer: Quartz Beloit One Network |
$2,517.13
|
| Rate for Payer: Quartz Commercial |
$3,082.20
|
| Rate for Payer: WEA Trust Commercial |
$2,825.35
|
| Rate for Payer: WPS Commercial |
$3,804.98
|
|
|
DRILL BIT OPENING 5.5MM 2358-2000
|
Facility
OP
|
$4,190.00
|
|
| Hospital Charge Code |
6171932
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,173.20 |
| Max. Negotiated Rate |
$16,760.00 |
| Rate for Payer: Aetna Commercial |
$3,771.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,603.40
|
| Rate for Payer: Aetna Managed Medicare |
$1,173.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,723.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,095.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,011.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,220.70
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Cigna Commercial |
$3,854.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,344.72
|
| Rate for Payer: Health EOS Commercial |
$3,729.10
|
| Rate for Payer: HFN Commercial |
$3,854.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,142.50
|
| Rate for Payer: Multiplan Commercial |
$3,352.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,514.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,854.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,053.10
|
| Rate for Payer: Quartz Commercial |
$2,723.50
|
| Rate for Payer: Quartz Medicare Advantage |
$2,514.00
|
| Rate for Payer: The Alliance Commercial |
$16,760.00
|
| Rate for Payer: WEA Trust Commercial |
$2,304.50
|
| Rate for Payer: WPS Commercial |
$3,103.53
|
|
