|
DRILL CALIBRATED, 4.0MM X 280MM S0219-100
|
Facility
OP
|
$2,929.00
|
|
| Hospital Charge Code |
6232144
|
|
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 CALIBRATED, 4.0MM X 280MM S0219-100
|
Facility
IP
|
$2,929.00
|
|
| Hospital Charge Code |
6232144
|
|
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 FLIP CUTTER III AR-1204FF
|
Facility
OP
|
$4,415.00
|
|
| Hospital Charge Code |
5547218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,236.20 |
| Max. Negotiated Rate |
$17,660.00 |
| Rate for Payer: Aetna Commercial |
$3,973.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,796.90
|
| Rate for Payer: Aetna Managed Medicare |
$1,236.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,869.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,207.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,119.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,339.95
|
| Rate for Payer: Cash Price |
$1,324.50
|
| Rate for Payer: Cigna Commercial |
$4,061.80
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,470.63
|
| Rate for Payer: Health EOS Commercial |
$3,929.35
|
| Rate for Payer: HFN Commercial |
$4,061.80
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,311.25
|
| Rate for Payer: Multiplan Commercial |
$3,532.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,649.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,061.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,163.35
|
| Rate for Payer: Quartz Commercial |
$2,869.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,649.00
|
| Rate for Payer: The Alliance Commercial |
$17,660.00
|
| Rate for Payer: WEA Trust Commercial |
$2,428.25
|
| Rate for Payer: WPS Commercial |
$3,270.19
|
|
|
DRILL FLIP CUTTER III AR-1204FF
|
Facility
IP
|
$4,415.00
|
|
| Hospital Charge Code |
5547218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,163.35 |
| Max. Negotiated Rate |
$4,061.80 |
| Rate for Payer: Aetna Commercial |
$3,973.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,339.95
|
| Rate for Payer: Cash Price |
$1,324.50
|
| Rate for Payer: Cigna Commercial |
$4,061.80
|
| Rate for Payer: Health EOS Commercial |
$3,929.35
|
| Rate for Payer: HFN Commercial |
$4,061.80
|
| Rate for Payer: Multiplan Commercial |
$3,532.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,649.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,061.80
|
| Rate for Payer: Quartz Beloit One Network |
$2,163.35
|
| Rate for Payer: Quartz Commercial |
$2,649.00
|
| Rate for Payer: WEA Trust Commercial |
$2,428.25
|
| Rate for Payer: WPS Commercial |
$3,270.19
|
|
|
DRILL FREEHAND 4.2 X 130MM IMN 2351-4213S
|
Facility
IP
|
$2,764.00
|
|
| Hospital Charge Code |
5599786
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,354.36 |
| Max. Negotiated Rate |
$2,542.88 |
| Rate for Payer: Aetna Commercial |
$2,487.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,464.92
|
| Rate for Payer: Cash Price |
$829.20
|
| Rate for Payer: Cigna Commercial |
$2,542.88
|
| Rate for Payer: Health EOS Commercial |
$2,459.96
|
| Rate for Payer: HFN Commercial |
$2,542.88
|
| Rate for Payer: Multiplan Commercial |
$2,211.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,658.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,542.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,354.36
|
| Rate for Payer: Quartz Commercial |
$1,658.40
|
| Rate for Payer: WEA Trust Commercial |
$1,520.20
|
| Rate for Payer: WPS Commercial |
$2,047.29
|
|
|
DRILL FREEHAND 4.2 X 130MM IMN 2351-4213S
|
Facility
OP
|
$2,764.00
|
|
| Hospital Charge Code |
5599786
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$773.92 |
| Max. Negotiated Rate |
$11,056.00 |
| Rate for Payer: Aetna Commercial |
$2,487.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,377.04
|
| Rate for Payer: Aetna Managed Medicare |
$773.92
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,796.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,382.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,326.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,464.92
|
| Rate for Payer: Cash Price |
$829.20
|
| Rate for Payer: Cigna Commercial |
$2,542.88
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,546.73
|
| Rate for Payer: Health EOS Commercial |
$2,459.96
|
| Rate for Payer: HFN Commercial |
$2,542.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,073.00
|
| Rate for Payer: Multiplan Commercial |
$2,211.20
|
| Rate for Payer: NAPHCARE Commercial |
$1,658.40
|
| Rate for Payer: Preferred Network Access Commercial |
$2,542.88
|
| Rate for Payer: Quartz Beloit One Network |
$1,354.36
|
| Rate for Payer: Quartz Commercial |
$1,796.60
|
| Rate for Payer: Quartz Medicare Advantage |
$1,658.40
|
| Rate for Payer: The Alliance Commercial |
$11,056.00
|
| Rate for Payer: WEA Trust Commercial |
$1,520.20
|
| Rate for Payer: WPS Commercial |
$2,047.29
|
|
|
DRILL FREEHAND 4.2 X 185MM IMN 2351-4218S
|
Facility
IP
|
$1,692.00
|
|
| Hospital Charge Code |
6151668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$829.08 |
| Max. Negotiated Rate |
$1,556.64 |
| Rate for Payer: Aetna Commercial |
$1,522.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$896.76
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cigna Commercial |
$1,556.64
|
| Rate for Payer: Health EOS Commercial |
$1,505.88
|
| Rate for Payer: HFN Commercial |
$1,556.64
|
| Rate for Payer: Multiplan Commercial |
$1,353.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,015.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,556.64
|
| Rate for Payer: Quartz Beloit One Network |
$829.08
|
| Rate for Payer: Quartz Commercial |
$1,015.20
|
| Rate for Payer: WEA Trust Commercial |
$930.60
|
| Rate for Payer: WPS Commercial |
$1,253.26
|
|
|
DRILL FREEHAND 4.2 X 185MM IMN 2351-4218S
|
Facility
OP
|
$1,692.00
|
|
| Hospital Charge Code |
6151668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$473.76 |
| Max. Negotiated Rate |
$6,768.00 |
| Rate for Payer: Aetna Commercial |
$1,522.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,455.12
|
| Rate for Payer: Aetna Managed Medicare |
$473.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,099.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$846.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$812.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$896.76
|
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cigna Commercial |
$1,556.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$946.84
|
| Rate for Payer: Health EOS Commercial |
$1,505.88
|
| Rate for Payer: HFN Commercial |
$1,556.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,269.00
|
| Rate for Payer: Multiplan Commercial |
$1,353.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,015.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,556.64
|
| Rate for Payer: Quartz Beloit One Network |
$829.08
|
| Rate for Payer: Quartz Commercial |
$1,099.80
|
| Rate for Payer: Quartz Medicare Advantage |
$1,015.20
|
| Rate for Payer: The Alliance Commercial |
$6,768.00
|
| Rate for Payer: WEA Trust Commercial |
$930.60
|
| Rate for Payer: WPS Commercial |
$1,253.26
|
|
|
DRILL GUIDE 1.5MTHREADED
|
Facility
IP
|
$3,527.00
|
|
| Hospital Charge Code |
2966218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,728.23 |
| Max. Negotiated Rate |
$3,244.84 |
| Rate for Payer: Aetna Commercial |
$3,174.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,869.31
|
| Rate for Payer: Cash Price |
$1,058.10
|
| Rate for Payer: Cigna Commercial |
$3,244.84
|
| Rate for Payer: Health EOS Commercial |
$3,139.03
|
| Rate for Payer: HFN Commercial |
$3,244.84
|
| Rate for Payer: Multiplan Commercial |
$2,821.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,116.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,244.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,728.23
|
| Rate for Payer: Quartz Commercial |
$2,116.20
|
| Rate for Payer: WEA Trust Commercial |
$1,939.85
|
| Rate for Payer: WPS Commercial |
$2,612.45
|
|
|
DRILL GUIDE 1.5MTHREADED
|
Facility
OP
|
$3,527.00
|
|
| Hospital Charge Code |
2966218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$987.56 |
| Max. Negotiated Rate |
$14,108.00 |
| Rate for Payer: Aetna Commercial |
$3,174.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,033.22
|
| Rate for Payer: Aetna Managed Medicare |
$987.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,292.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,763.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,692.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,869.31
|
| Rate for Payer: Cash Price |
$1,058.10
|
| Rate for Payer: Cigna Commercial |
$3,244.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,973.71
|
| Rate for Payer: Health EOS Commercial |
$3,139.03
|
| Rate for Payer: HFN Commercial |
$3,244.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,645.25
|
| Rate for Payer: Multiplan Commercial |
$2,821.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,116.20
|
| Rate for Payer: Preferred Network Access Commercial |
$3,244.84
|
| Rate for Payer: Quartz Beloit One Network |
$1,728.23
|
| Rate for Payer: Quartz Commercial |
$2,292.55
|
| Rate for Payer: Quartz Medicare Advantage |
$2,116.20
|
| Rate for Payer: The Alliance Commercial |
$14,108.00
|
| Rate for Payer: WEA Trust Commercial |
$1,939.85
|
| Rate for Payer: WPS Commercial |
$2,612.45
|
|
|
DRILL GUIDE 1.8 SHORT THREAD 323.035
|
Facility
IP
|
$1,748.00
|
|
| Hospital Charge Code |
2966607
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$856.52 |
| Max. Negotiated Rate |
$1,608.16 |
| Rate for Payer: Aetna Commercial |
$1,573.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$926.44
|
| Rate for Payer: Cash Price |
$524.40
|
| Rate for Payer: Cigna Commercial |
$1,608.16
|
| Rate for Payer: Health EOS Commercial |
$1,555.72
|
| Rate for Payer: HFN Commercial |
$1,608.16
|
| Rate for Payer: Multiplan Commercial |
$1,398.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,048.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,608.16
|
| Rate for Payer: Quartz Beloit One Network |
$856.52
|
| Rate for Payer: Quartz Commercial |
$1,048.80
|
| Rate for Payer: WEA Trust Commercial |
$961.40
|
| Rate for Payer: WPS Commercial |
$1,294.74
|
|
|
DRILL GUIDE 1.8 SHORT THREAD 323.035
|
Facility
OP
|
$1,748.00
|
|
| Hospital Charge Code |
2966607
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$489.44 |
| Max. Negotiated Rate |
$6,992.00 |
| Rate for Payer: Aetna Commercial |
$1,573.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,503.28
|
| Rate for Payer: Aetna Managed Medicare |
$489.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,136.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$874.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$839.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$926.44
|
| Rate for Payer: Cash Price |
$524.40
|
| Rate for Payer: Cigna Commercial |
$1,608.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$978.18
|
| Rate for Payer: Health EOS Commercial |
$1,555.72
|
| Rate for Payer: HFN Commercial |
$1,608.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,311.00
|
| Rate for Payer: Multiplan Commercial |
$1,398.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,048.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,608.16
|
| Rate for Payer: Quartz Beloit One Network |
$856.52
|
| Rate for Payer: Quartz Commercial |
$1,136.20
|
| Rate for Payer: Quartz Medicare Advantage |
$1,048.80
|
| Rate for Payer: The Alliance Commercial |
$6,992.00
|
| Rate for Payer: WEA Trust Commercial |
$961.40
|
| Rate for Payer: WPS Commercial |
$1,294.74
|
|
|
DRILL GUIDE 2.5/1.7MM AR-8916-23
|
Facility
OP
|
$4,404.00
|
|
| Hospital Charge Code |
5599763
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,233.12 |
| Max. Negotiated Rate |
$17,616.00 |
| Rate for Payer: Aetna Commercial |
$3,963.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,787.44
|
| Rate for Payer: Aetna Managed Medicare |
$1,233.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,862.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,202.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,113.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,334.12
|
| Rate for Payer: Cash Price |
$1,321.20
|
| Rate for Payer: Cigna Commercial |
$4,051.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,464.48
|
| Rate for Payer: Health EOS Commercial |
$3,919.56
|
| Rate for Payer: HFN Commercial |
$4,051.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,303.00
|
| Rate for Payer: Multiplan Commercial |
$3,523.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,642.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,051.68
|
| Rate for Payer: Quartz Beloit One Network |
$2,157.96
|
| Rate for Payer: Quartz Commercial |
$2,862.60
|
| Rate for Payer: Quartz Medicare Advantage |
$2,642.40
|
| Rate for Payer: The Alliance Commercial |
$17,616.00
|
| Rate for Payer: WEA Trust Commercial |
$2,422.20
|
| Rate for Payer: WPS Commercial |
$3,262.04
|
|
|
DRILL GUIDE 2.5/1.7MM AR-8916-23
|
Facility
IP
|
$4,404.00
|
|
| Hospital Charge Code |
5599763
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,157.96 |
| Max. Negotiated Rate |
$4,051.68 |
| Rate for Payer: Aetna Commercial |
$3,963.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,334.12
|
| Rate for Payer: Cash Price |
$1,321.20
|
| Rate for Payer: Cigna Commercial |
$4,051.68
|
| Rate for Payer: Health EOS Commercial |
$3,919.56
|
| Rate for Payer: HFN Commercial |
$4,051.68
|
| Rate for Payer: Multiplan Commercial |
$3,523.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,642.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,051.68
|
| Rate for Payer: Quartz Beloit One Network |
$2,157.96
|
| Rate for Payer: Quartz Commercial |
$2,642.40
|
| Rate for Payer: WEA Trust Commercial |
$2,422.20
|
| Rate for Payer: WPS Commercial |
$3,262.04
|
|
|
DRILL GUIDE INTERFRAF M.I.B. 317-00-005
|
Facility
OP
|
$2,516.00
|
|
| Hospital Charge Code |
5506863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$704.48 |
| Max. Negotiated Rate |
$10,064.00 |
| Rate for Payer: Aetna Commercial |
$2,264.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,163.76
|
| Rate for Payer: Aetna Managed Medicare |
$704.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,635.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,258.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,207.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,333.48
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cigna Commercial |
$2,314.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,407.95
|
| Rate for Payer: Health EOS Commercial |
$2,239.24
|
| Rate for Payer: HFN Commercial |
$2,314.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,887.00
|
| Rate for Payer: Multiplan Commercial |
$2,012.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,509.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,314.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.84
|
| Rate for Payer: Quartz Commercial |
$1,635.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,509.60
|
| Rate for Payer: The Alliance Commercial |
$10,064.00
|
| Rate for Payer: WEA Trust Commercial |
$1,383.80
|
| Rate for Payer: WPS Commercial |
$1,863.60
|
|
|
DRILL GUIDE INTERFRAF M.I.B. 317-00-005
|
Facility
IP
|
$2,516.00
|
|
| Hospital Charge Code |
5506863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,232.84 |
| Max. Negotiated Rate |
$2,314.72 |
| Rate for Payer: Aetna Commercial |
$2,264.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,333.48
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cigna Commercial |
$2,314.72
|
| Rate for Payer: Health EOS Commercial |
$2,239.24
|
| Rate for Payer: HFN Commercial |
$2,314.72
|
| Rate for Payer: Multiplan Commercial |
$2,012.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,509.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,314.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.84
|
| Rate for Payer: Quartz Commercial |
$1,509.60
|
| Rate for Payer: WEA Trust Commercial |
$1,383.80
|
| Rate for Payer: WPS Commercial |
$1,863.60
|
|
|
DRILL GUIDE PULL REDUCTION DEVICE 4.3 PERC 03.120.023
|
Facility
IP
|
$4,804.00
|
|
| Hospital Charge Code |
3072544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,353.96 |
| Max. Negotiated Rate |
$4,419.68 |
| Rate for Payer: Aetna Commercial |
$4,323.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,546.12
|
| Rate for Payer: Cash Price |
$1,441.20
|
| Rate for Payer: Cigna Commercial |
$4,419.68
|
| Rate for Payer: Health EOS Commercial |
$4,275.56
|
| Rate for Payer: HFN Commercial |
$4,419.68
|
| Rate for Payer: Multiplan Commercial |
$3,843.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,882.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,419.68
|
| Rate for Payer: Quartz Beloit One Network |
$2,353.96
|
| Rate for Payer: Quartz Commercial |
$2,882.40
|
| Rate for Payer: WEA Trust Commercial |
$2,642.20
|
| Rate for Payer: WPS Commercial |
$3,558.32
|
|
|
DRILL GUIDE PULL REDUCTION DEVICE 4.3 PERC 03.120.023
|
Facility
OP
|
$4,804.00
|
|
| Hospital Charge Code |
3072544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,345.12 |
| Max. Negotiated Rate |
$19,216.00 |
| Rate for Payer: Aetna Commercial |
$4,323.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,131.44
|
| Rate for Payer: Aetna Managed Medicare |
$1,345.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,122.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,402.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,305.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,546.12
|
| Rate for Payer: Cash Price |
$1,441.20
|
| Rate for Payer: Cigna Commercial |
$4,419.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,688.32
|
| Rate for Payer: Health EOS Commercial |
$4,275.56
|
| Rate for Payer: HFN Commercial |
$4,419.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,603.00
|
| Rate for Payer: Multiplan Commercial |
$3,843.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,882.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,419.68
|
| Rate for Payer: Quartz Beloit One Network |
$2,353.96
|
| Rate for Payer: Quartz Commercial |
$3,122.60
|
| Rate for Payer: Quartz Medicare Advantage |
$2,882.40
|
| Rate for Payer: The Alliance Commercial |
$19,216.00
|
| Rate for Payer: WEA Trust Commercial |
$2,642.20
|
| Rate for Payer: WPS Commercial |
$3,558.32
|
|
|
DRILL GUIDE THREADED M.I.B. 317-00-004
|
Facility
OP
|
$2,516.00
|
|
| Hospital Charge Code |
5506861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$704.48 |
| Max. Negotiated Rate |
$10,064.00 |
| Rate for Payer: Aetna Commercial |
$2,264.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,163.76
|
| Rate for Payer: Aetna Managed Medicare |
$704.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,635.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,258.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,207.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,333.48
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cigna Commercial |
$2,314.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,407.95
|
| Rate for Payer: Health EOS Commercial |
$2,239.24
|
| Rate for Payer: HFN Commercial |
$2,314.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,887.00
|
| Rate for Payer: Multiplan Commercial |
$2,012.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,509.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,314.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.84
|
| Rate for Payer: Quartz Commercial |
$1,635.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,509.60
|
| Rate for Payer: The Alliance Commercial |
$10,064.00
|
| Rate for Payer: WEA Trust Commercial |
$1,383.80
|
| Rate for Payer: WPS Commercial |
$1,863.60
|
|
|
DRILL GUIDE THREADED M.I.B. 317-00-004
|
Facility
IP
|
$2,516.00
|
|
| Hospital Charge Code |
5506861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,232.84 |
| Max. Negotiated Rate |
$2,314.72 |
| Rate for Payer: Aetna Commercial |
$2,264.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,333.48
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cigna Commercial |
$2,314.72
|
| Rate for Payer: Health EOS Commercial |
$2,239.24
|
| Rate for Payer: HFN Commercial |
$2,314.72
|
| Rate for Payer: Multiplan Commercial |
$2,012.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,509.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,314.72
|
| Rate for Payer: Quartz Beloit One Network |
$1,232.84
|
| Rate for Payer: Quartz Commercial |
$1,509.60
|
| Rate for Payer: WEA Trust Commercial |
$1,383.80
|
| Rate for Payer: WPS Commercial |
$1,863.60
|
|
|
DRILL KIT ERGO GPS 3.2MM STERILE 531-55-88
|
Facility
IP
|
$2,500.70
|
|
| Hospital Charge Code |
6248149
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,225.34 |
| Max. Negotiated Rate |
$2,300.64 |
| Rate for Payer: Aetna Commercial |
$2,250.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,325.37
|
| Rate for Payer: Cash Price |
$750.21
|
| Rate for Payer: Cigna Commercial |
$2,300.64
|
| Rate for Payer: Health EOS Commercial |
$2,225.62
|
| Rate for Payer: HFN Commercial |
$2,300.64
|
| Rate for Payer: Multiplan Commercial |
$2,000.56
|
| Rate for Payer: NAPHCARE Commercial |
$1,500.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,300.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,225.34
|
| Rate for Payer: Quartz Commercial |
$1,500.42
|
| Rate for Payer: WEA Trust Commercial |
$1,375.38
|
| Rate for Payer: WPS Commercial |
$1,852.27
|
|
|
DRILL KIT ERGO GPS 3.2MM STERILE 531-55-88
|
Facility
OP
|
$2,500.70
|
|
| Hospital Charge Code |
6248149
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$700.20 |
| Max. Negotiated Rate |
$10,002.80 |
| Rate for Payer: Aetna Commercial |
$2,250.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,150.60
|
| Rate for Payer: Aetna Managed Medicare |
$700.20
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,625.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,250.35
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,200.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,325.37
|
| Rate for Payer: Cash Price |
$750.21
|
| Rate for Payer: Cigna Commercial |
$2,300.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,399.39
|
| Rate for Payer: Health EOS Commercial |
$2,225.62
|
| Rate for Payer: HFN Commercial |
$2,300.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,875.52
|
| Rate for Payer: Multiplan Commercial |
$2,000.56
|
| Rate for Payer: NAPHCARE Commercial |
$1,500.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,300.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,225.34
|
| Rate for Payer: Quartz Commercial |
$1,625.46
|
| Rate for Payer: Quartz Medicare Advantage |
$1,500.42
|
| Rate for Payer: The Alliance Commercial |
$10,002.80
|
| Rate for Payer: WEA Trust Commercial |
$1,375.38
|
| Rate for Payer: WPS Commercial |
$1,852.27
|
|
|
DRILL LOCKING 4.2 X 360MM IMN 2351-4236S
|
Facility
OP
|
$3,030.00
|
|
| Hospital Charge Code |
5599784
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$848.40 |
| Max. Negotiated Rate |
$12,120.00 |
| Rate for Payer: Aetna Commercial |
$2,727.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,605.80
|
| Rate for Payer: Aetna Managed Medicare |
$848.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,969.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,515.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,454.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,605.90
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,787.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,695.59
|
| Rate for Payer: Health EOS Commercial |
$2,696.70
|
| Rate for Payer: HFN Commercial |
$2,787.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,272.50
|
| Rate for Payer: Multiplan Commercial |
$2,424.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,818.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,787.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,484.70
|
| Rate for Payer: Quartz Commercial |
$1,969.50
|
| Rate for Payer: Quartz Medicare Advantage |
$1,818.00
|
| Rate for Payer: The Alliance Commercial |
$12,120.00
|
| Rate for Payer: WEA Trust Commercial |
$1,666.50
|
| Rate for Payer: WPS Commercial |
$2,244.32
|
|
|
DRILL LOCKING 4.2 X 360MM IMN 2351-4236S
|
Facility
IP
|
$3,030.00
|
|
| Hospital Charge Code |
5599784
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,484.70 |
| Max. Negotiated Rate |
$2,787.60 |
| Rate for Payer: Aetna Commercial |
$2,727.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,605.90
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: Cigna Commercial |
$2,787.60
|
| Rate for Payer: Health EOS Commercial |
$2,696.70
|
| Rate for Payer: HFN Commercial |
$2,787.60
|
| Rate for Payer: Multiplan Commercial |
$2,424.00
|
| Rate for Payer: NAPHCARE Commercial |
$1,818.00
|
| Rate for Payer: Preferred Network Access Commercial |
$2,787.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,484.70
|
| Rate for Payer: Quartz Commercial |
$1,818.00
|
| Rate for Payer: WEA Trust Commercial |
$1,666.50
|
| Rate for Payer: WPS Commercial |
$2,244.32
|
|
|
DRILL LONG MINI
|
Facility
IP
|
$2,758.00
|
|
| Hospital Charge Code |
2967894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,351.42 |
| Max. Negotiated Rate |
$2,537.36 |
| Rate for Payer: Aetna Commercial |
$2,482.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,461.74
|
| Rate for Payer: Cash Price |
$827.40
|
| Rate for Payer: Cigna Commercial |
$2,537.36
|
| Rate for Payer: Health EOS Commercial |
$2,454.62
|
| Rate for Payer: HFN Commercial |
$2,537.36
|
| Rate for Payer: Multiplan Commercial |
$2,206.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,654.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,537.36
|
| Rate for Payer: Quartz Beloit One Network |
$1,351.42
|
| Rate for Payer: Quartz Commercial |
$1,654.80
|
| Rate for Payer: WEA Trust Commercial |
$1,516.90
|
| Rate for Payer: WPS Commercial |
$2,042.85
|
|
