|
DRILL BIT 2.0 X 85MM JACOBS CHUCK 310.20
|
Facility
|
IP
|
$935.00
|
|
| Hospital Charge Code |
5563412
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$476.48 |
| Max. Negotiated Rate |
$894.61 |
| Rate for Payer: Aetna Commercial |
$875.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$836.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$515.37
|
| Rate for Payer: Cash Price |
$280.50
|
| Rate for Payer: Cigna Commercial |
$894.61
|
| Rate for Payer: Health EOS Commercial |
$865.44
|
| Rate for Payer: HFN Commercial |
$894.61
|
| Rate for Payer: Multiplan Commercial |
$777.92
|
| Rate for Payer: Preferred Network Access Commercial |
$894.61
|
| Rate for Payer: Quartz Beloit One Network |
$476.48
|
| Rate for Payer: Quartz Commercial |
$583.44
|
| Rate for Payer: WEA Trust Commercial |
$534.82
|
| Rate for Payer: WPS Commercial |
$720.23
|
|
|
DRILL BIT 2.2MM CANNULATED DSDS0022
|
Facility
|
OP
|
$2,602.00
|
|
| Hospital Charge Code |
6165647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$757.70 |
| Max. Negotiated Rate |
$2,489.59 |
| Rate for Payer: Aetna Commercial |
$2,435.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,327.23
|
| Rate for Payer: Aetna Managed Medicare |
$757.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,758.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,353.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,298.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,434.22
|
| Rate for Payer: Cash Price |
$780.60
|
| Rate for Payer: Cigna Commercial |
$2,489.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,514.36
|
| Rate for Payer: Health EOS Commercial |
$2,408.41
|
| Rate for Payer: HFN Commercial |
$2,489.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,029.56
|
| Rate for Payer: Multiplan Commercial |
$2,164.86
|
| Rate for Payer: NAPHCARE Commercial |
$1,623.65
|
| Rate for Payer: Preferred Network Access Commercial |
$2,489.59
|
| Rate for Payer: Quartz Beloit One Network |
$1,325.98
|
| Rate for Payer: Quartz Commercial |
$1,758.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,623.65
|
| Rate for Payer: The Alliance Commercial |
$1,353.04
|
| Rate for Payer: WEA Trust Commercial |
$1,488.34
|
| Rate for Payer: WPS Commercial |
$2,004.32
|
|
|
DRILL BIT 2.2MM CANNULATED DSDS0022
|
Facility
|
IP
|
$2,602.00
|
|
| Hospital Charge Code |
6165647
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,325.98 |
| Max. Negotiated Rate |
$2,489.59 |
| Rate for Payer: Aetna Commercial |
$2,435.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,327.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,434.22
|
| Rate for Payer: Cash Price |
$780.60
|
| Rate for Payer: Cigna Commercial |
$2,489.59
|
| Rate for Payer: Health EOS Commercial |
$2,408.41
|
| Rate for Payer: HFN Commercial |
$2,489.59
|
| Rate for Payer: Multiplan Commercial |
$2,164.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,489.59
|
| Rate for Payer: Quartz Beloit One Network |
$1,325.98
|
| Rate for Payer: Quartz Commercial |
$1,623.65
|
| Rate for Payer: WEA Trust Commercial |
$1,488.34
|
| Rate for Payer: WPS Commercial |
$2,004.32
|
|
|
DRILL BIT 2.3MM ACUMED QUICK COUPLING 80-0627
|
Facility
|
OP
|
$2,266.00
|
|
| Hospital Charge Code |
5547305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$659.86 |
| Max. Negotiated Rate |
$2,168.11 |
| Rate for Payer: Aetna Commercial |
$2,120.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,026.71
|
| Rate for Payer: Aetna Managed Medicare |
$659.86
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,531.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,178.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,131.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,249.02
|
| Rate for Payer: Cash Price |
$679.80
|
| Rate for Payer: Cigna Commercial |
$2,168.11
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,318.81
|
| Rate for Payer: Health EOS Commercial |
$2,097.41
|
| Rate for Payer: HFN Commercial |
$2,168.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,767.48
|
| Rate for Payer: Multiplan Commercial |
$1,885.31
|
| Rate for Payer: NAPHCARE Commercial |
$1,413.98
|
| Rate for Payer: Preferred Network Access Commercial |
$2,168.11
|
| Rate for Payer: Quartz Beloit One Network |
$1,154.75
|
| Rate for Payer: Quartz Commercial |
$1,531.82
|
| Rate for Payer: Quartz Medicare Advantage |
$1,413.98
|
| Rate for Payer: The Alliance Commercial |
$1,178.32
|
| Rate for Payer: WEA Trust Commercial |
$1,296.15
|
| Rate for Payer: WPS Commercial |
$1,745.50
|
|
|
DRILL BIT 2.3MM ACUMED QUICK COUPLING 80-0627
|
Facility
|
IP
|
$2,266.00
|
|
| Hospital Charge Code |
5547305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,154.75 |
| Max. Negotiated Rate |
$2,168.11 |
| Rate for Payer: Aetna Commercial |
$2,120.98
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,026.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,249.02
|
| Rate for Payer: Cash Price |
$679.80
|
| Rate for Payer: Cigna Commercial |
$2,168.11
|
| Rate for Payer: Health EOS Commercial |
$2,097.41
|
| Rate for Payer: HFN Commercial |
$2,168.11
|
| Rate for Payer: Multiplan Commercial |
$1,885.31
|
| Rate for Payer: Preferred Network Access Commercial |
$2,168.11
|
| Rate for Payer: Quartz Beloit One Network |
$1,154.75
|
| Rate for Payer: Quartz Commercial |
$1,413.98
|
| Rate for Payer: WEA Trust Commercial |
$1,296.15
|
| Rate for Payer: WPS Commercial |
$1,745.50
|
|
|
DRILL BIT 2.4MM CLX CLX-072-24
|
Facility
|
IP
|
$3,458.00
|
|
| Hospital Charge Code |
5787648
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,762.20 |
| Max. Negotiated Rate |
$3,308.61 |
| Rate for Payer: Aetna Commercial |
$3,236.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,092.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,906.05
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cigna Commercial |
$3,308.61
|
| Rate for Payer: Health EOS Commercial |
$3,200.72
|
| Rate for Payer: HFN Commercial |
$3,308.61
|
| Rate for Payer: Multiplan Commercial |
$2,877.06
|
| Rate for Payer: Preferred Network Access Commercial |
$3,308.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,762.20
|
| Rate for Payer: Quartz Commercial |
$2,157.79
|
| Rate for Payer: WEA Trust Commercial |
$1,977.98
|
| Rate for Payer: WPS Commercial |
$2,663.70
|
|
|
DRILL BIT 2.4MM CLX CLX-072-24
|
Facility
|
OP
|
$3,458.00
|
|
| Hospital Charge Code |
5787648
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,006.97 |
| Max. Negotiated Rate |
$3,308.61 |
| Rate for Payer: Aetna Commercial |
$3,236.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,092.84
|
| Rate for Payer: Aetna Managed Medicare |
$1,006.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,337.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,798.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,726.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,906.05
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cigna Commercial |
$3,308.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,012.56
|
| Rate for Payer: Health EOS Commercial |
$3,200.72
|
| Rate for Payer: HFN Commercial |
$3,308.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,697.24
|
| Rate for Payer: Multiplan Commercial |
$2,877.06
|
| Rate for Payer: NAPHCARE Commercial |
$2,157.79
|
| Rate for Payer: Preferred Network Access Commercial |
$3,308.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,762.20
|
| Rate for Payer: Quartz Commercial |
$2,337.61
|
| Rate for Payer: Quartz Medicare Advantage |
$2,157.79
|
| Rate for Payer: The Alliance Commercial |
$1,798.16
|
| Rate for Payer: WEA Trust Commercial |
$1,977.98
|
| Rate for Payer: WPS Commercial |
$2,663.70
|
|
|
DRILL BIT 2.4MM M.I.B. 317-24-001
|
Facility
|
IP
|
$2,585.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
5506860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,317.32 |
| Max. Negotiated Rate |
$2,473.33 |
| Rate for Payer: Aetna Commercial |
$2,419.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,312.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,424.85
|
| Rate for Payer: Cash Price |
$775.50
|
| Rate for Payer: Cigna Commercial |
$2,473.33
|
| Rate for Payer: Health EOS Commercial |
$2,392.68
|
| Rate for Payer: HFN Commercial |
$2,473.33
|
| Rate for Payer: Multiplan Commercial |
$2,150.72
|
| Rate for Payer: Preferred Network Access Commercial |
$2,473.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,317.32
|
| Rate for Payer: Quartz Commercial |
$1,613.04
|
| Rate for Payer: WEA Trust Commercial |
$1,478.62
|
| Rate for Payer: WPS Commercial |
$1,991.23
|
|
|
DRILL BIT 2.4MM M.I.B. 317-24-001
|
Facility
|
OP
|
$2,585.00
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
5506860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$752.75 |
| Max. Negotiated Rate |
$2,473.33 |
| Rate for Payer: Aetna Commercial |
$2,419.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,312.02
|
| Rate for Payer: Aetna Managed Medicare |
$752.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,747.46
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,344.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,290.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,424.85
|
| Rate for Payer: Cash Price |
$775.50
|
| Rate for Payer: Cigna Commercial |
$2,473.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,504.47
|
| Rate for Payer: Health EOS Commercial |
$2,392.68
|
| Rate for Payer: HFN Commercial |
$2,473.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,016.30
|
| Rate for Payer: Multiplan Commercial |
$2,150.72
|
| Rate for Payer: NAPHCARE Commercial |
$1,613.04
|
| Rate for Payer: Preferred Network Access Commercial |
$2,473.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,317.32
|
| Rate for Payer: Quartz Commercial |
$1,747.46
|
| Rate for Payer: Quartz Medicare Advantage |
$1,613.04
|
| Rate for Payer: The Alliance Commercial |
$1,344.20
|
| Rate for Payer: WEA Trust Commercial |
$1,478.62
|
| Rate for Payer: WPS Commercial |
$1,991.23
|
|
|
DRILL BIT 2.4MM STD MID-FOOT MFT-072-24
|
Facility
|
OP
|
$3,458.00
|
|
| Hospital Charge Code |
4028661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,006.97 |
| Max. Negotiated Rate |
$3,308.61 |
| Rate for Payer: Aetna Commercial |
$3,236.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,092.84
|
| Rate for Payer: Aetna Managed Medicare |
$1,006.97
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,337.61
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,798.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,726.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,906.05
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cigna Commercial |
$3,308.61
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,012.56
|
| Rate for Payer: Health EOS Commercial |
$3,200.72
|
| Rate for Payer: HFN Commercial |
$3,308.61
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,697.24
|
| Rate for Payer: Multiplan Commercial |
$2,877.06
|
| Rate for Payer: NAPHCARE Commercial |
$2,157.79
|
| Rate for Payer: Preferred Network Access Commercial |
$3,308.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,762.20
|
| Rate for Payer: Quartz Commercial |
$2,337.61
|
| Rate for Payer: Quartz Medicare Advantage |
$2,157.79
|
| Rate for Payer: The Alliance Commercial |
$1,798.16
|
| Rate for Payer: WEA Trust Commercial |
$1,977.98
|
| Rate for Payer: WPS Commercial |
$2,663.70
|
|
|
DRILL BIT 2.4MM STD MID-FOOT MFT-072-24
|
Facility
|
IP
|
$3,458.00
|
|
| Hospital Charge Code |
4028661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,762.20 |
| Max. Negotiated Rate |
$3,308.61 |
| Rate for Payer: Aetna Commercial |
$3,236.69
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,092.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,906.05
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cigna Commercial |
$3,308.61
|
| Rate for Payer: Health EOS Commercial |
$3,200.72
|
| Rate for Payer: HFN Commercial |
$3,308.61
|
| Rate for Payer: Multiplan Commercial |
$2,877.06
|
| Rate for Payer: Preferred Network Access Commercial |
$3,308.61
|
| Rate for Payer: Quartz Beloit One Network |
$1,762.20
|
| Rate for Payer: Quartz Commercial |
$2,157.79
|
| Rate for Payer: WEA Trust Commercial |
$1,977.98
|
| Rate for Payer: WPS Commercial |
$2,663.70
|
|
|
DRILL BIT 2.4MM X 122MM AO COUPLING STRYKER 703696
|
Facility
|
IP
|
$2,794.00
|
|
| Hospital Charge Code |
5458926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,423.82 |
| Max. Negotiated Rate |
$2,673.30 |
| Rate for Payer: Aetna Commercial |
$2,615.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,498.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,540.05
|
| Rate for Payer: Cash Price |
$838.20
|
| Rate for Payer: Cigna Commercial |
$2,673.30
|
| Rate for Payer: Health EOS Commercial |
$2,586.13
|
| Rate for Payer: HFN Commercial |
$2,673.30
|
| Rate for Payer: Multiplan Commercial |
$2,324.61
|
| Rate for Payer: Preferred Network Access Commercial |
$2,673.30
|
| Rate for Payer: Quartz Beloit One Network |
$1,423.82
|
| Rate for Payer: Quartz Commercial |
$1,743.46
|
| Rate for Payer: WEA Trust Commercial |
$1,598.17
|
| Rate for Payer: WPS Commercial |
$2,152.22
|
|
|
DRILL BIT 2.4MM X 122MM AO COUPLING STRYKER 703696
|
Facility
|
OP
|
$2,794.00
|
|
| Hospital Charge Code |
5458926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$813.61 |
| Max. Negotiated Rate |
$2,673.30 |
| Rate for Payer: Aetna Commercial |
$2,615.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,498.95
|
| Rate for Payer: Aetna Managed Medicare |
$813.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,888.74
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,452.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,394.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,540.05
|
| Rate for Payer: Cash Price |
$838.20
|
| Rate for Payer: Cigna Commercial |
$2,673.30
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,626.11
|
| Rate for Payer: Health EOS Commercial |
$2,586.13
|
| Rate for Payer: HFN Commercial |
$2,673.30
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,179.32
|
| Rate for Payer: Multiplan Commercial |
$2,324.61
|
| Rate for Payer: NAPHCARE Commercial |
$1,743.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,673.30
|
| Rate for Payer: Quartz Beloit One Network |
$1,423.82
|
| Rate for Payer: Quartz Commercial |
$1,888.74
|
| Rate for Payer: Quartz Medicare Advantage |
$1,743.46
|
| Rate for Payer: The Alliance Commercial |
$1,452.88
|
| Rate for Payer: WEA Trust Commercial |
$1,598.17
|
| Rate for Payer: WPS Commercial |
$2,152.22
|
|
|
DRILL BIT 2.4 X 100MM 310.530
|
Facility
|
OP
|
$2,318.00
|
|
| Hospital Charge Code |
2966184
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$2,217.86 |
| Rate for Payer: Aetna Commercial |
$2,169.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,073.22
|
| Rate for Payer: Aetna Managed Medicare |
$675.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,566.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,205.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,157.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,277.68
|
| Rate for Payer: Cash Price |
$695.40
|
| Rate for Payer: Cigna Commercial |
$2,217.86
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,349.08
|
| Rate for Payer: Health EOS Commercial |
$2,145.54
|
| Rate for Payer: HFN Commercial |
$2,217.86
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,808.04
|
| Rate for Payer: Multiplan Commercial |
$1,928.58
|
| Rate for Payer: NAPHCARE Commercial |
$1,446.43
|
| Rate for Payer: Preferred Network Access Commercial |
$2,217.86
|
| Rate for Payer: Quartz Beloit One Network |
$1,181.25
|
| Rate for Payer: Quartz Commercial |
$1,566.97
|
| Rate for Payer: Quartz Medicare Advantage |
$1,446.43
|
| Rate for Payer: The Alliance Commercial |
$1,205.36
|
| Rate for Payer: WEA Trust Commercial |
$1,325.90
|
| Rate for Payer: WPS Commercial |
$1,785.56
|
|
|
DRILL BIT 2.4 X 100MM 310.530
|
Facility
|
IP
|
$2,318.00
|
|
| Hospital Charge Code |
2966184
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,181.25 |
| Max. Negotiated Rate |
$2,217.86 |
| Rate for Payer: Aetna Commercial |
$2,169.65
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,073.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,277.68
|
| Rate for Payer: Cash Price |
$695.40
|
| Rate for Payer: Cigna Commercial |
$2,217.86
|
| Rate for Payer: Health EOS Commercial |
$2,145.54
|
| Rate for Payer: HFN Commercial |
$2,217.86
|
| Rate for Payer: Multiplan Commercial |
$1,928.58
|
| Rate for Payer: Preferred Network Access Commercial |
$2,217.86
|
| Rate for Payer: Quartz Beloit One Network |
$1,181.25
|
| Rate for Payer: Quartz Commercial |
$1,446.43
|
| Rate for Payer: WEA Trust Commercial |
$1,325.90
|
| Rate for Payer: WPS Commercial |
$1,785.56
|
|
|
DRILL BIT 2.4x186 QUICK COUPLE
|
Facility
|
OP
|
$2,856.00
|
|
| Hospital Charge Code |
2966185
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$831.67 |
| Max. Negotiated Rate |
$2,732.62 |
| Rate for Payer: Aetna Commercial |
$2,673.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,554.41
|
| Rate for Payer: Aetna Managed Medicare |
$831.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,930.66
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,485.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,425.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,574.23
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cigna Commercial |
$2,732.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,662.19
|
| Rate for Payer: Health EOS Commercial |
$2,643.51
|
| Rate for Payer: HFN Commercial |
$2,732.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,227.68
|
| Rate for Payer: Multiplan Commercial |
$2,376.19
|
| Rate for Payer: NAPHCARE Commercial |
$1,782.14
|
| Rate for Payer: Preferred Network Access Commercial |
$2,732.62
|
| Rate for Payer: Quartz Beloit One Network |
$1,455.42
|
| Rate for Payer: Quartz Commercial |
$1,930.66
|
| Rate for Payer: Quartz Medicare Advantage |
$1,782.14
|
| Rate for Payer: The Alliance Commercial |
$1,485.12
|
| Rate for Payer: WEA Trust Commercial |
$1,633.63
|
| Rate for Payer: WPS Commercial |
$2,199.98
|
|
|
DRILL BIT 2.4x186 QUICK COUPLE
|
Facility
|
IP
|
$2,856.00
|
|
| Hospital Charge Code |
2966185
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,455.42 |
| Max. Negotiated Rate |
$2,732.62 |
| Rate for Payer: Aetna Commercial |
$2,673.22
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,554.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,574.23
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cigna Commercial |
$2,732.62
|
| Rate for Payer: Health EOS Commercial |
$2,643.51
|
| Rate for Payer: HFN Commercial |
$2,732.62
|
| Rate for Payer: Multiplan Commercial |
$2,376.19
|
| Rate for Payer: Preferred Network Access Commercial |
$2,732.62
|
| Rate for Payer: Quartz Beloit One Network |
$1,455.42
|
| Rate for Payer: Quartz Commercial |
$1,782.14
|
| Rate for Payer: WEA Trust Commercial |
$1,633.63
|
| Rate for Payer: WPS Commercial |
$2,199.98
|
|
|
DRILL BIT 2.5MM
|
Facility
|
IP
|
$2,747.00
|
|
| Hospital Charge Code |
3072633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,399.87 |
| Max. Negotiated Rate |
$2,628.33 |
| Rate for Payer: Aetna Commercial |
$2,571.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,456.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,514.15
|
| Rate for Payer: Cash Price |
$824.10
|
| Rate for Payer: Cigna Commercial |
$2,628.33
|
| Rate for Payer: Health EOS Commercial |
$2,542.62
|
| Rate for Payer: HFN Commercial |
$2,628.33
|
| Rate for Payer: Multiplan Commercial |
$2,285.50
|
| Rate for Payer: Preferred Network Access Commercial |
$2,628.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,399.87
|
| Rate for Payer: Quartz Commercial |
$1,714.13
|
| Rate for Payer: WEA Trust Commercial |
$1,571.28
|
| Rate for Payer: WPS Commercial |
$2,116.01
|
|
|
DRILL BIT 2.5MM
|
Facility
|
OP
|
$2,747.00
|
|
| Hospital Charge Code |
3072633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$799.93 |
| Max. Negotiated Rate |
$2,628.33 |
| Rate for Payer: Aetna Commercial |
$2,571.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,456.92
|
| Rate for Payer: Aetna Managed Medicare |
$799.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,856.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,428.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,371.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,514.15
|
| Rate for Payer: Cash Price |
$824.10
|
| Rate for Payer: Cigna Commercial |
$2,628.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,598.75
|
| Rate for Payer: Health EOS Commercial |
$2,542.62
|
| Rate for Payer: HFN Commercial |
$2,628.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,142.66
|
| Rate for Payer: Multiplan Commercial |
$2,285.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,714.13
|
| Rate for Payer: Preferred Network Access Commercial |
$2,628.33
|
| Rate for Payer: Quartz Beloit One Network |
$1,399.87
|
| Rate for Payer: Quartz Commercial |
$1,856.97
|
| Rate for Payer: Quartz Medicare Advantage |
$1,714.13
|
| Rate for Payer: The Alliance Commercial |
$1,428.44
|
| Rate for Payer: WEA Trust Commercial |
$1,571.28
|
| Rate for Payer: WPS Commercial |
$2,116.01
|
|
|
DRILL BIT 2.5MM AR-8943-30
|
Facility
|
IP
|
$1,357.00
|
|
| Hospital Charge Code |
4594700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$691.53 |
| Max. Negotiated Rate |
$1,298.38 |
| Rate for Payer: Aetna Commercial |
$1,270.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,213.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$747.98
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,298.38
|
| Rate for Payer: Health EOS Commercial |
$1,256.04
|
| Rate for Payer: HFN Commercial |
$1,298.38
|
| Rate for Payer: Multiplan Commercial |
$1,129.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,298.38
|
| Rate for Payer: Quartz Beloit One Network |
$691.53
|
| Rate for Payer: Quartz Commercial |
$846.77
|
| Rate for Payer: WEA Trust Commercial |
$776.20
|
| Rate for Payer: WPS Commercial |
$1,045.30
|
|
|
DRILL BIT 2.5MM AR-8943-30
|
Facility
|
OP
|
$1,357.00
|
|
| Hospital Charge Code |
4594700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.16 |
| Max. Negotiated Rate |
$1,298.38 |
| Rate for Payer: Aetna Commercial |
$1,270.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,213.70
|
| Rate for Payer: Aetna Managed Medicare |
$395.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$917.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$705.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$677.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$747.98
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,298.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$789.77
|
| Rate for Payer: Health EOS Commercial |
$1,256.04
|
| Rate for Payer: HFN Commercial |
$1,298.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,058.46
|
| Rate for Payer: Multiplan Commercial |
$1,129.02
|
| Rate for Payer: NAPHCARE Commercial |
$846.77
|
| Rate for Payer: Preferred Network Access Commercial |
$1,298.38
|
| Rate for Payer: Quartz Beloit One Network |
$691.53
|
| Rate for Payer: Quartz Commercial |
$917.33
|
| Rate for Payer: Quartz Medicare Advantage |
$846.77
|
| Rate for Payer: The Alliance Commercial |
$705.64
|
| Rate for Payer: WEA Trust Commercial |
$776.20
|
| Rate for Payer: WPS Commercial |
$1,045.30
|
|
|
DRILL BIT 2.5MM CALIBRATED 95MM 03.113.023
|
Facility
|
OP
|
$1,373.00
|
|
| Hospital Charge Code |
4268749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$399.82 |
| Max. Negotiated Rate |
$1,313.69 |
| Rate for Payer: Aetna Commercial |
$1,285.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.01
|
| Rate for Payer: Aetna Managed Medicare |
$399.82
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$928.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$713.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$685.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$756.80
|
| Rate for Payer: Cash Price |
$411.90
|
| Rate for Payer: Cigna Commercial |
$1,313.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$799.09
|
| Rate for Payer: Health EOS Commercial |
$1,270.85
|
| Rate for Payer: HFN Commercial |
$1,313.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,070.94
|
| Rate for Payer: Multiplan Commercial |
$1,142.34
|
| Rate for Payer: NAPHCARE Commercial |
$856.75
|
| Rate for Payer: Preferred Network Access Commercial |
$1,313.69
|
| Rate for Payer: Quartz Beloit One Network |
$699.68
|
| Rate for Payer: Quartz Commercial |
$928.15
|
| Rate for Payer: Quartz Medicare Advantage |
$856.75
|
| Rate for Payer: The Alliance Commercial |
$713.96
|
| Rate for Payer: WEA Trust Commercial |
$785.36
|
| Rate for Payer: WPS Commercial |
$1,057.62
|
|
|
DRILL BIT 2.5MM CALIBRATED 95MM 03.113.023
|
Facility
|
IP
|
$1,373.00
|
|
| Hospital Charge Code |
4268749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$699.68 |
| Max. Negotiated Rate |
$1,313.69 |
| Rate for Payer: Aetna Commercial |
$1,285.13
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,228.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$756.80
|
| Rate for Payer: Cash Price |
$411.90
|
| Rate for Payer: Cigna Commercial |
$1,313.69
|
| Rate for Payer: Health EOS Commercial |
$1,270.85
|
| Rate for Payer: HFN Commercial |
$1,313.69
|
| Rate for Payer: Multiplan Commercial |
$1,142.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,313.69
|
| Rate for Payer: Quartz Beloit One Network |
$699.68
|
| Rate for Payer: Quartz Commercial |
$856.75
|
| Rate for Payer: WEA Trust Commercial |
$785.36
|
| Rate for Payer: WPS Commercial |
$1,057.62
|
|
|
DRILL BIT 2.5MM CALIBRATED AR-8916-06
|
Facility
|
OP
|
$1,086.00
|
|
| Hospital Charge Code |
5384974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$316.24 |
| Max. Negotiated Rate |
$1,039.08 |
| Rate for Payer: Aetna Commercial |
$1,016.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$971.32
|
| Rate for Payer: Aetna Managed Medicare |
$316.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$734.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$564.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$542.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$598.60
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Cigna Commercial |
$1,039.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$632.05
|
| Rate for Payer: Health EOS Commercial |
$1,005.20
|
| Rate for Payer: HFN Commercial |
$1,039.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$847.08
|
| Rate for Payer: Multiplan Commercial |
$903.55
|
| Rate for Payer: NAPHCARE Commercial |
$677.66
|
| Rate for Payer: Preferred Network Access Commercial |
$1,039.08
|
| Rate for Payer: Quartz Beloit One Network |
$553.43
|
| Rate for Payer: Quartz Commercial |
$734.14
|
| Rate for Payer: Quartz Medicare Advantage |
$677.66
|
| Rate for Payer: The Alliance Commercial |
$564.72
|
| Rate for Payer: WEA Trust Commercial |
$621.19
|
| Rate for Payer: WPS Commercial |
$836.55
|
|
|
DRILL BIT 2.5MM CALIBRATED AR-8916-06
|
Facility
|
IP
|
$1,086.00
|
|
| Hospital Charge Code |
5384974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$553.43 |
| Max. Negotiated Rate |
$1,039.08 |
| Rate for Payer: Aetna Commercial |
$1,016.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$971.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$598.60
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Cigna Commercial |
$1,039.08
|
| Rate for Payer: Health EOS Commercial |
$1,005.20
|
| Rate for Payer: HFN Commercial |
$1,039.08
|
| Rate for Payer: Multiplan Commercial |
$903.55
|
| Rate for Payer: Preferred Network Access Commercial |
$1,039.08
|
| Rate for Payer: Quartz Beloit One Network |
$553.43
|
| Rate for Payer: Quartz Commercial |
$677.66
|
| Rate for Payer: WEA Trust Commercial |
$621.19
|
| Rate for Payer: WPS Commercial |
$836.55
|
|
