|
DRILL BIT 2.6MM CANNULATED AR-8943-02
|
Facility
|
OP
|
$2,330.00
|
|
| Hospital Charge Code |
5415067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$678.50 |
| Max. Negotiated Rate |
$2,229.34 |
| Rate for Payer: Aetna Commercial |
$2,180.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,083.95
|
| Rate for Payer: Aetna Managed Medicare |
$678.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,575.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,211.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,163.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,284.30
|
| Rate for Payer: Cash Price |
$699.00
|
| Rate for Payer: Cigna Commercial |
$2,229.34
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,356.06
|
| Rate for Payer: Health EOS Commercial |
$2,156.65
|
| Rate for Payer: HFN Commercial |
$2,229.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,817.40
|
| Rate for Payer: Multiplan Commercial |
$1,938.56
|
| Rate for Payer: NAPHCARE Commercial |
$1,453.92
|
| Rate for Payer: Preferred Network Access Commercial |
$2,229.34
|
| Rate for Payer: Quartz Beloit One Network |
$1,187.37
|
| Rate for Payer: Quartz Commercial |
$1,575.08
|
| Rate for Payer: Quartz Medicare Advantage |
$1,453.92
|
| Rate for Payer: The Alliance Commercial |
$1,211.60
|
| Rate for Payer: WEA Trust Commercial |
$1,332.76
|
| Rate for Payer: WPS Commercial |
$1,794.80
|
|
|
DRILL BIT 2.6MM CANNULATED T15 HEXALOBE QC AR-8943-12
|
Facility
|
OP
|
$2,154.00
|
|
| Hospital Charge Code |
6174844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$627.24 |
| Max. Negotiated Rate |
$2,060.95 |
| Rate for Payer: Aetna Commercial |
$2,016.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,926.54
|
| Rate for Payer: Aetna Managed Medicare |
$627.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,456.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,120.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,075.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,187.28
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Cigna Commercial |
$2,060.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,253.63
|
| Rate for Payer: Health EOS Commercial |
$1,993.74
|
| Rate for Payer: HFN Commercial |
$2,060.95
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,680.12
|
| Rate for Payer: Multiplan Commercial |
$1,792.13
|
| Rate for Payer: NAPHCARE Commercial |
$1,344.10
|
| Rate for Payer: Preferred Network Access Commercial |
$2,060.95
|
| Rate for Payer: Quartz Beloit One Network |
$1,097.68
|
| Rate for Payer: Quartz Commercial |
$1,456.10
|
| Rate for Payer: Quartz Medicare Advantage |
$1,344.10
|
| Rate for Payer: The Alliance Commercial |
$1,120.08
|
| Rate for Payer: WEA Trust Commercial |
$1,232.09
|
| Rate for Payer: WPS Commercial |
$1,659.23
|
|
|
DRILL BIT 2.6MM CANNULATED T15 HEXALOBE QC AR-8943-12
|
Facility
|
IP
|
$2,154.00
|
|
| Hospital Charge Code |
6174844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,097.68 |
| Max. Negotiated Rate |
$2,060.95 |
| Rate for Payer: Aetna Commercial |
$2,016.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,926.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,187.28
|
| Rate for Payer: Cash Price |
$646.20
|
| Rate for Payer: Cigna Commercial |
$2,060.95
|
| Rate for Payer: Health EOS Commercial |
$1,993.74
|
| Rate for Payer: HFN Commercial |
$2,060.95
|
| Rate for Payer: Multiplan Commercial |
$1,792.13
|
| Rate for Payer: Preferred Network Access Commercial |
$2,060.95
|
| Rate for Payer: Quartz Beloit One Network |
$1,097.68
|
| Rate for Payer: Quartz Commercial |
$1,344.10
|
| Rate for Payer: WEA Trust Commercial |
$1,232.09
|
| Rate for Payer: WPS Commercial |
$1,659.23
|
|
|
DRILL BIT 2.6MM SPADE PILOT 214-00-015
|
Facility
|
IP
|
$2,660.00
|
|
| Hospital Charge Code |
5496694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,355.54 |
| Max. Negotiated Rate |
$2,545.09 |
| Rate for Payer: Aetna Commercial |
$2,489.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,379.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.19
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,545.09
|
| Rate for Payer: Health EOS Commercial |
$2,462.10
|
| Rate for Payer: HFN Commercial |
$2,545.09
|
| Rate for Payer: Multiplan Commercial |
$2,213.12
|
| Rate for Payer: Preferred Network Access Commercial |
$2,545.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,355.54
|
| Rate for Payer: Quartz Commercial |
$1,659.84
|
| Rate for Payer: WEA Trust Commercial |
$1,521.52
|
| Rate for Payer: WPS Commercial |
$2,049.00
|
|
|
DRILL BIT 2.6MM SPADE PILOT 214-00-015
|
Facility
|
OP
|
$2,660.00
|
|
| Hospital Charge Code |
5496694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$774.59 |
| Max. Negotiated Rate |
$2,545.09 |
| Rate for Payer: Aetna Commercial |
$2,489.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,379.10
|
| Rate for Payer: Aetna Managed Medicare |
$774.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,798.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,383.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,327.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,466.19
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$2,545.09
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,548.12
|
| Rate for Payer: Health EOS Commercial |
$2,462.10
|
| Rate for Payer: HFN Commercial |
$2,545.09
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,074.80
|
| Rate for Payer: Multiplan Commercial |
$2,213.12
|
| Rate for Payer: NAPHCARE Commercial |
$1,659.84
|
| Rate for Payer: Preferred Network Access Commercial |
$2,545.09
|
| Rate for Payer: Quartz Beloit One Network |
$1,355.54
|
| Rate for Payer: Quartz Commercial |
$1,798.16
|
| Rate for Payer: Quartz Medicare Advantage |
$1,659.84
|
| Rate for Payer: The Alliance Commercial |
$1,383.20
|
| Rate for Payer: WEA Trust Commercial |
$1,521.52
|
| Rate for Payer: WPS Commercial |
$2,049.00
|
|
|
DRILL BIT 2.6 X 135MM SCALED 703691
|
Facility
|
IP
|
$1,400.00
|
|
| Hospital Charge Code |
5547411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$713.44 |
| Max. Negotiated Rate |
$1,339.52 |
| Rate for Payer: Aetna Commercial |
$1,310.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,252.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$771.68
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$1,339.52
|
| Rate for Payer: Health EOS Commercial |
$1,295.84
|
| Rate for Payer: HFN Commercial |
$1,339.52
|
| Rate for Payer: Multiplan Commercial |
$1,164.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,339.52
|
| Rate for Payer: Quartz Beloit One Network |
$713.44
|
| Rate for Payer: Quartz Commercial |
$873.60
|
| Rate for Payer: WEA Trust Commercial |
$800.80
|
| Rate for Payer: WPS Commercial |
$1,078.42
|
|
|
DRILL BIT 2.6 X 135MM SCALED 703691
|
Facility
|
OP
|
$1,400.00
|
|
| Hospital Charge Code |
5547411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$407.68 |
| Max. Negotiated Rate |
$1,339.52 |
| Rate for Payer: Aetna Commercial |
$1,310.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,252.16
|
| Rate for Payer: Aetna Managed Medicare |
$407.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$946.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$728.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$698.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$771.68
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$1,339.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$814.80
|
| Rate for Payer: Health EOS Commercial |
$1,295.84
|
| Rate for Payer: HFN Commercial |
$1,339.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,092.00
|
| Rate for Payer: Multiplan Commercial |
$1,164.80
|
| Rate for Payer: NAPHCARE Commercial |
$873.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,339.52
|
| Rate for Payer: Quartz Beloit One Network |
$713.44
|
| Rate for Payer: Quartz Commercial |
$946.40
|
| Rate for Payer: Quartz Medicare Advantage |
$873.60
|
| Rate for Payer: The Alliance Commercial |
$728.00
|
| Rate for Payer: WEA Trust Commercial |
$800.80
|
| Rate for Payer: WPS Commercial |
$1,078.42
|
|
|
DRILL BIT 2.7 AR-8827D-01
|
Facility
|
IP
|
$1,357.00
|
|
| Hospital Charge Code |
5454700
|
|
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 2.7 AR-8827D-01
|
Facility
|
OP
|
$1,357.00
|
|
| Hospital Charge Code |
5454700
|
|
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 2.7 CANN 310.67
|
Facility
|
OP
|
$5,710.00
|
|
| Hospital Charge Code |
2966188
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,662.75 |
| Max. Negotiated Rate |
$5,463.33 |
| Rate for Payer: Aetna Commercial |
$5,344.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,107.02
|
| Rate for Payer: Aetna Managed Medicare |
$1,662.75
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,859.96
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,969.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,850.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,147.35
|
| Rate for Payer: Cash Price |
$1,713.00
|
| Rate for Payer: Cigna Commercial |
$5,463.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,323.22
|
| Rate for Payer: Health EOS Commercial |
$5,285.18
|
| Rate for Payer: HFN Commercial |
$5,463.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,453.80
|
| Rate for Payer: Multiplan Commercial |
$4,750.72
|
| Rate for Payer: NAPHCARE Commercial |
$3,563.04
|
| Rate for Payer: Preferred Network Access Commercial |
$5,463.33
|
| Rate for Payer: Quartz Beloit One Network |
$2,909.82
|
| Rate for Payer: Quartz Commercial |
$3,859.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,563.04
|
| Rate for Payer: The Alliance Commercial |
$2,969.20
|
| Rate for Payer: WEA Trust Commercial |
$3,266.12
|
| Rate for Payer: WPS Commercial |
$4,398.41
|
|
|
DRILL BIT 2.7 CANN 310.67
|
Facility
|
IP
|
$5,710.00
|
|
| Hospital Charge Code |
2966188
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,909.82 |
| Max. Negotiated Rate |
$5,463.33 |
| Rate for Payer: Aetna Commercial |
$5,344.56
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,107.02
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,147.35
|
| Rate for Payer: Cash Price |
$1,713.00
|
| Rate for Payer: Cigna Commercial |
$5,463.33
|
| Rate for Payer: Health EOS Commercial |
$5,285.18
|
| Rate for Payer: HFN Commercial |
$5,463.33
|
| Rate for Payer: Multiplan Commercial |
$4,750.72
|
| Rate for Payer: Preferred Network Access Commercial |
$5,463.33
|
| Rate for Payer: Quartz Beloit One Network |
$2,909.82
|
| Rate for Payer: Quartz Commercial |
$3,563.04
|
| Rate for Payer: WEA Trust Commercial |
$3,266.12
|
| Rate for Payer: WPS Commercial |
$4,398.41
|
|
|
DRILL BIT 2.7 CANN TORNIER ZPCDR27
|
Facility
|
OP
|
$1,647.00
|
|
| Hospital Charge Code |
2967355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$479.61 |
| Max. Negotiated Rate |
$1,575.85 |
| Rate for Payer: Aetna Commercial |
$1,541.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,473.08
|
| Rate for Payer: Aetna Managed Medicare |
$479.61
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,113.37
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$856.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$822.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$907.83
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,575.85
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$958.55
|
| Rate for Payer: Health EOS Commercial |
$1,524.46
|
| Rate for Payer: HFN Commercial |
$1,575.85
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,284.66
|
| Rate for Payer: Multiplan Commercial |
$1,370.30
|
| Rate for Payer: NAPHCARE Commercial |
$1,027.73
|
| Rate for Payer: Preferred Network Access Commercial |
$1,575.85
|
| Rate for Payer: Quartz Beloit One Network |
$839.31
|
| Rate for Payer: Quartz Commercial |
$1,113.37
|
| Rate for Payer: Quartz Medicare Advantage |
$1,027.73
|
| Rate for Payer: The Alliance Commercial |
$856.44
|
| Rate for Payer: WEA Trust Commercial |
$942.08
|
| Rate for Payer: WPS Commercial |
$1,268.68
|
|
|
DRILL BIT 2.7 CANN TORNIER ZPCDR27
|
Facility
|
IP
|
$1,647.00
|
|
| Hospital Charge Code |
2967355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$839.31 |
| Max. Negotiated Rate |
$1,575.85 |
| Rate for Payer: Aetna Commercial |
$1,541.59
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,473.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$907.83
|
| Rate for Payer: Cash Price |
$494.10
|
| Rate for Payer: Cigna Commercial |
$1,575.85
|
| Rate for Payer: Health EOS Commercial |
$1,524.46
|
| Rate for Payer: HFN Commercial |
$1,575.85
|
| Rate for Payer: Multiplan Commercial |
$1,370.30
|
| Rate for Payer: Preferred Network Access Commercial |
$1,575.85
|
| Rate for Payer: Quartz Beloit One Network |
$839.31
|
| Rate for Payer: Quartz Commercial |
$1,027.73
|
| Rate for Payer: WEA Trust Commercial |
$942.08
|
| Rate for Payer: WPS Commercial |
$1,268.68
|
|
|
DRILL BIT 2.7MM 3-FLUTED 315.28
|
Facility
|
IP
|
$1,882.00
|
|
| Hospital Charge Code |
2966190
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$959.07 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,174.37
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
|
DRILL BIT 2.7MM 3-FLUTED 315.28
|
Facility
|
OP
|
$1,882.00
|
|
| Hospital Charge Code |
2966190
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$548.04 |
| Max. Negotiated Rate |
$1,800.70 |
| Rate for Payer: Aetna Commercial |
$1,761.55
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,683.26
|
| Rate for Payer: Aetna Managed Medicare |
$548.04
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,272.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$978.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$939.49
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,037.36
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cigna Commercial |
$1,800.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,095.32
|
| Rate for Payer: Health EOS Commercial |
$1,741.98
|
| Rate for Payer: HFN Commercial |
$1,800.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,467.96
|
| Rate for Payer: Multiplan Commercial |
$1,565.82
|
| Rate for Payer: NAPHCARE Commercial |
$1,174.37
|
| Rate for Payer: Preferred Network Access Commercial |
$1,800.70
|
| Rate for Payer: Quartz Beloit One Network |
$959.07
|
| Rate for Payer: Quartz Commercial |
$1,272.23
|
| Rate for Payer: Quartz Medicare Advantage |
$1,174.37
|
| Rate for Payer: The Alliance Commercial |
$978.64
|
| Rate for Payer: WEA Trust Commercial |
$1,076.50
|
| Rate for Payer: WPS Commercial |
$1,449.70
|
|
|
DRILL BIT 2.7MM AO FITTING 705250
|
Facility
|
OP
|
$3,723.00
|
|
| Hospital Charge Code |
5286747
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,084.14 |
| Max. Negotiated Rate |
$3,562.17 |
| Rate for Payer: Aetna Commercial |
$3,484.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,329.85
|
| Rate for Payer: Aetna Managed Medicare |
$1,084.14
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,516.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,935.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,858.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,052.12
|
| Rate for Payer: Cash Price |
$1,116.90
|
| Rate for Payer: Cigna Commercial |
$3,562.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,166.79
|
| Rate for Payer: Health EOS Commercial |
$3,446.01
|
| Rate for Payer: HFN Commercial |
$3,562.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,903.94
|
| Rate for Payer: Multiplan Commercial |
$3,097.54
|
| Rate for Payer: NAPHCARE Commercial |
$2,323.15
|
| Rate for Payer: Preferred Network Access Commercial |
$3,562.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,897.24
|
| Rate for Payer: Quartz Commercial |
$2,516.75
|
| Rate for Payer: Quartz Medicare Advantage |
$2,323.15
|
| Rate for Payer: The Alliance Commercial |
$1,935.96
|
| Rate for Payer: WEA Trust Commercial |
$2,129.56
|
| Rate for Payer: WPS Commercial |
$2,867.83
|
|
|
DRILL BIT 2.7MM AO FITTING 705250
|
Facility
|
IP
|
$3,723.00
|
|
| Hospital Charge Code |
5286747
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,897.24 |
| Max. Negotiated Rate |
$3,562.17 |
| Rate for Payer: Aetna Commercial |
$3,484.73
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,329.85
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,052.12
|
| Rate for Payer: Cash Price |
$1,116.90
|
| Rate for Payer: Cigna Commercial |
$3,562.17
|
| Rate for Payer: Health EOS Commercial |
$3,446.01
|
| Rate for Payer: HFN Commercial |
$3,562.17
|
| Rate for Payer: Multiplan Commercial |
$3,097.54
|
| Rate for Payer: Preferred Network Access Commercial |
$3,562.17
|
| Rate for Payer: Quartz Beloit One Network |
$1,897.24
|
| Rate for Payer: Quartz Commercial |
$2,323.15
|
| Rate for Payer: WEA Trust Commercial |
$2,129.56
|
| Rate for Payer: WPS Commercial |
$2,867.83
|
|
|
DRILL BIT 2.7MM X12.7CM 7/64 00-2318-027-06
|
Facility
|
OP
|
$874.00
|
|
| Hospital Charge Code |
5264630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.51 |
| Max. Negotiated Rate |
$836.24 |
| Rate for Payer: Aetna Commercial |
$818.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$781.71
|
| Rate for Payer: Aetna Managed Medicare |
$254.51
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$590.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$454.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$436.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$481.75
|
| Rate for Payer: Cash Price |
$262.20
|
| Rate for Payer: Cigna Commercial |
$836.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$508.67
|
| Rate for Payer: Health EOS Commercial |
$808.97
|
| Rate for Payer: HFN Commercial |
$836.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$681.72
|
| Rate for Payer: Multiplan Commercial |
$727.17
|
| Rate for Payer: NAPHCARE Commercial |
$545.38
|
| Rate for Payer: Preferred Network Access Commercial |
$836.24
|
| Rate for Payer: Quartz Beloit One Network |
$445.39
|
| Rate for Payer: Quartz Commercial |
$590.82
|
| Rate for Payer: Quartz Medicare Advantage |
$545.38
|
| Rate for Payer: The Alliance Commercial |
$454.48
|
| Rate for Payer: WEA Trust Commercial |
$499.93
|
| Rate for Payer: WPS Commercial |
$673.24
|
|
|
DRILL BIT 2.7MM X12.7CM 7/64 00-2318-027-06
|
Facility
|
IP
|
$874.00
|
|
| Hospital Charge Code |
5264630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.39 |
| Max. Negotiated Rate |
$836.24 |
| Rate for Payer: Aetna Commercial |
$818.06
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$781.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$481.75
|
| Rate for Payer: Cash Price |
$262.20
|
| Rate for Payer: Cigna Commercial |
$836.24
|
| Rate for Payer: Health EOS Commercial |
$808.97
|
| Rate for Payer: HFN Commercial |
$836.24
|
| Rate for Payer: Multiplan Commercial |
$727.17
|
| Rate for Payer: Preferred Network Access Commercial |
$836.24
|
| Rate for Payer: Quartz Beloit One Network |
$445.39
|
| Rate for Payer: Quartz Commercial |
$545.38
|
| Rate for Payer: WEA Trust Commercial |
$499.93
|
| Rate for Payer: WPS Commercial |
$673.24
|
|
|
DRILL BIT 2.7 SOLID TORNIER ZPWSDR27
|
Facility
|
IP
|
$1,190.00
|
|
| Hospital Charge Code |
2967356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$606.42 |
| Max. Negotiated Rate |
$1,138.59 |
| Rate for Payer: Aetna Commercial |
$1,113.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,064.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$655.93
|
| Rate for Payer: Cash Price |
$357.00
|
| Rate for Payer: Cigna Commercial |
$1,138.59
|
| Rate for Payer: Health EOS Commercial |
$1,101.46
|
| Rate for Payer: HFN Commercial |
$1,138.59
|
| Rate for Payer: Multiplan Commercial |
$990.08
|
| Rate for Payer: Preferred Network Access Commercial |
$1,138.59
|
| Rate for Payer: Quartz Beloit One Network |
$606.42
|
| Rate for Payer: Quartz Commercial |
$742.56
|
| Rate for Payer: WEA Trust Commercial |
$680.68
|
| Rate for Payer: WPS Commercial |
$916.66
|
|
|
DRILL BIT 2.7 SOLID TORNIER ZPWSDR27
|
Facility
|
OP
|
$1,190.00
|
|
| Hospital Charge Code |
2967356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$346.53 |
| Max. Negotiated Rate |
$1,138.59 |
| Rate for Payer: Aetna Commercial |
$1,113.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,064.34
|
| Rate for Payer: Aetna Managed Medicare |
$346.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$804.44
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$618.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$594.05
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$655.93
|
| Rate for Payer: Cash Price |
$357.00
|
| Rate for Payer: Cigna Commercial |
$1,138.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$692.58
|
| Rate for Payer: Health EOS Commercial |
$1,101.46
|
| Rate for Payer: HFN Commercial |
$1,138.59
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$928.20
|
| Rate for Payer: Multiplan Commercial |
$990.08
|
| Rate for Payer: NAPHCARE Commercial |
$742.56
|
| Rate for Payer: Preferred Network Access Commercial |
$1,138.59
|
| Rate for Payer: Quartz Beloit One Network |
$606.42
|
| Rate for Payer: Quartz Commercial |
$804.44
|
| Rate for Payer: Quartz Medicare Advantage |
$742.56
|
| Rate for Payer: The Alliance Commercial |
$618.80
|
| Rate for Payer: WEA Trust Commercial |
$680.68
|
| Rate for Payer: WPS Commercial |
$916.66
|
|
|
DRILL BIT 2.7 X 100MM QUICK COUPLE 310.26
|
Facility
|
OP
|
$899.00
|
|
| Hospital Charge Code |
3529517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$261.79 |
| Max. Negotiated Rate |
$860.16 |
| Rate for Payer: Aetna Commercial |
$841.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$804.07
|
| Rate for Payer: Aetna Managed Medicare |
$261.79
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$607.72
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$467.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$448.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$495.53
|
| Rate for Payer: Cash Price |
$269.70
|
| Rate for Payer: Cigna Commercial |
$860.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$523.22
|
| Rate for Payer: Health EOS Commercial |
$832.11
|
| Rate for Payer: HFN Commercial |
$860.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$701.22
|
| Rate for Payer: Multiplan Commercial |
$747.97
|
| Rate for Payer: NAPHCARE Commercial |
$560.98
|
| Rate for Payer: Preferred Network Access Commercial |
$860.16
|
| Rate for Payer: Quartz Beloit One Network |
$458.13
|
| Rate for Payer: Quartz Commercial |
$607.72
|
| Rate for Payer: Quartz Medicare Advantage |
$560.98
|
| Rate for Payer: The Alliance Commercial |
$467.48
|
| Rate for Payer: WEA Trust Commercial |
$514.23
|
| Rate for Payer: WPS Commercial |
$692.50
|
|
|
DRILL BIT 2.7 X 100MM QUICK COUPLE 310.26
|
Facility
|
IP
|
$899.00
|
|
| Hospital Charge Code |
3529517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$458.13 |
| Max. Negotiated Rate |
$860.16 |
| Rate for Payer: Aetna Commercial |
$841.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$804.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$495.53
|
| Rate for Payer: Cash Price |
$269.70
|
| Rate for Payer: Cigna Commercial |
$860.16
|
| Rate for Payer: Health EOS Commercial |
$832.11
|
| Rate for Payer: HFN Commercial |
$860.16
|
| Rate for Payer: Multiplan Commercial |
$747.97
|
| Rate for Payer: Preferred Network Access Commercial |
$860.16
|
| Rate for Payer: Quartz Beloit One Network |
$458.13
|
| Rate for Payer: Quartz Commercial |
$560.98
|
| Rate for Payer: WEA Trust Commercial |
$514.23
|
| Rate for Payer: WPS Commercial |
$692.50
|
|
|
DRILL BIT 2.7 X 125MM #310.28
|
Facility
|
IP
|
$1,427.00
|
|
| Hospital Charge Code |
2966189
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$727.20 |
| Max. Negotiated Rate |
$1,365.35 |
| Rate for Payer: Aetna Commercial |
$1,335.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,276.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$786.56
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,365.35
|
| Rate for Payer: Health EOS Commercial |
$1,320.83
|
| Rate for Payer: HFN Commercial |
$1,365.35
|
| Rate for Payer: Multiplan Commercial |
$1,187.26
|
| Rate for Payer: Preferred Network Access Commercial |
$1,365.35
|
| Rate for Payer: Quartz Beloit One Network |
$727.20
|
| Rate for Payer: Quartz Commercial |
$890.45
|
| Rate for Payer: WEA Trust Commercial |
$816.24
|
| Rate for Payer: WPS Commercial |
$1,099.22
|
|
|
DRILL BIT 2.7 X 125MM #310.28
|
Facility
|
OP
|
$1,427.00
|
|
| Hospital Charge Code |
2966189
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$415.54 |
| Max. Negotiated Rate |
$1,365.35 |
| Rate for Payer: Aetna Commercial |
$1,335.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,276.31
|
| Rate for Payer: Aetna Managed Medicare |
$415.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$964.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$742.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$712.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$786.56
|
| Rate for Payer: Cash Price |
$428.10
|
| Rate for Payer: Cigna Commercial |
$1,365.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$830.51
|
| Rate for Payer: Health EOS Commercial |
$1,320.83
|
| Rate for Payer: HFN Commercial |
$1,365.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,113.06
|
| Rate for Payer: Multiplan Commercial |
$1,187.26
|
| Rate for Payer: NAPHCARE Commercial |
$890.45
|
| Rate for Payer: Preferred Network Access Commercial |
$1,365.35
|
| Rate for Payer: Quartz Beloit One Network |
$727.20
|
| Rate for Payer: Quartz Commercial |
$964.65
|
| Rate for Payer: Quartz Medicare Advantage |
$890.45
|
| Rate for Payer: The Alliance Commercial |
$742.04
|
| Rate for Payer: WEA Trust Commercial |
$816.24
|
| Rate for Payer: WPS Commercial |
$1,099.22
|
|
