|
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 2.7 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
|
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 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 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
|
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 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 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
|
|
|
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 2.8 165MM QUICK COUPLING 310.284
|
Facility
|
IP
|
$1,065.83
|
|
| Hospital Charge Code |
6246230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$543.15 |
| Max. Negotiated Rate |
$1,019.79 |
| Rate for Payer: Aetna Commercial |
$997.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$953.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$587.49
|
| Rate for Payer: Cash Price |
$319.75
|
| Rate for Payer: Cigna Commercial |
$1,019.79
|
| Rate for Payer: Health EOS Commercial |
$986.53
|
| Rate for Payer: HFN Commercial |
$1,019.79
|
| Rate for Payer: Multiplan Commercial |
$886.77
|
| Rate for Payer: Preferred Network Access Commercial |
$1,019.79
|
| Rate for Payer: Quartz Beloit One Network |
$543.15
|
| Rate for Payer: Quartz Commercial |
$665.08
|
| Rate for Payer: WEA Trust Commercial |
$609.65
|
| Rate for Payer: WPS Commercial |
$821.01
|
|
|
DRILL BIT 2.8 165MM QUICK COUPLING 310.284
|
Facility
|
OP
|
$1,065.83
|
|
| Hospital Charge Code |
6246230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$310.37 |
| Max. Negotiated Rate |
$1,019.79 |
| Rate for Payer: Aetna Commercial |
$997.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$953.28
|
| Rate for Payer: Aetna Managed Medicare |
$310.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$720.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$554.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$532.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$587.49
|
| Rate for Payer: Cash Price |
$319.75
|
| Rate for Payer: Cigna Commercial |
$1,019.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$620.31
|
| Rate for Payer: Health EOS Commercial |
$986.53
|
| Rate for Payer: HFN Commercial |
$1,019.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$831.35
|
| Rate for Payer: Multiplan Commercial |
$886.77
|
| Rate for Payer: NAPHCARE Commercial |
$665.08
|
| Rate for Payer: Preferred Network Access Commercial |
$1,019.79
|
| Rate for Payer: Quartz Beloit One Network |
$543.15
|
| Rate for Payer: Quartz Commercial |
$720.50
|
| Rate for Payer: Quartz Medicare Advantage |
$665.08
|
| Rate for Payer: The Alliance Commercial |
$554.23
|
| Rate for Payer: WEA Trust Commercial |
$609.65
|
| Rate for Payer: WPS Commercial |
$821.01
|
|
|
DRILL BIT 2.8 ACUMED QUICK COUPLER 80-0318
|
Facility
|
IP
|
$1,444.00
|
|
| Hospital Charge Code |
2967386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$735.86 |
| Max. Negotiated Rate |
$1,381.62 |
| Rate for Payer: Aetna Commercial |
$1,351.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,291.51
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$795.93
|
| Rate for Payer: Cash Price |
$433.20
|
| Rate for Payer: Cigna Commercial |
$1,381.62
|
| Rate for Payer: Health EOS Commercial |
$1,336.57
|
| Rate for Payer: HFN Commercial |
$1,381.62
|
| Rate for Payer: Multiplan Commercial |
$1,201.41
|
| Rate for Payer: Preferred Network Access Commercial |
$1,381.62
|
| Rate for Payer: Quartz Beloit One Network |
$735.86
|
| Rate for Payer: Quartz Commercial |
$901.06
|
| Rate for Payer: WEA Trust Commercial |
$825.97
|
| Rate for Payer: WPS Commercial |
$1,112.31
|
|
|
DRILL BIT 2.8 ACUMED QUICK COUPLER 80-0318
|
Facility
|
OP
|
$1,444.00
|
|
| Hospital Charge Code |
2967386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$420.49 |
| Max. Negotiated Rate |
$1,381.62 |
| Rate for Payer: Aetna Commercial |
$1,351.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,291.51
|
| Rate for Payer: Aetna Managed Medicare |
$420.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$976.14
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$750.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$720.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$795.93
|
| Rate for Payer: Cash Price |
$433.20
|
| Rate for Payer: Cigna Commercial |
$1,381.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$840.41
|
| Rate for Payer: Health EOS Commercial |
$1,336.57
|
| Rate for Payer: HFN Commercial |
$1,381.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,126.32
|
| Rate for Payer: Multiplan Commercial |
$1,201.41
|
| Rate for Payer: NAPHCARE Commercial |
$901.06
|
| Rate for Payer: Preferred Network Access Commercial |
$1,381.62
|
| Rate for Payer: Quartz Beloit One Network |
$735.86
|
| Rate for Payer: Quartz Commercial |
$976.14
|
| Rate for Payer: Quartz Medicare Advantage |
$901.06
|
| Rate for Payer: The Alliance Commercial |
$750.88
|
| Rate for Payer: WEA Trust Commercial |
$825.97
|
| Rate for Payer: WPS Commercial |
$1,112.31
|
|
|
DRILL BIT 2.8MM ACUMED QUICK COUPLING 80-0387
|
Facility
|
OP
|
$1,647.00
|
|
| Hospital Charge Code |
2967385
|
|
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 2.8MM ACUMED QUICK COUPLING 80-0387
|
Facility
|
IP
|
$1,647.00
|
|
| Hospital Charge Code |
2967385
|
|
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
|
|
