|
DRILL PIN BICEPS BUTTON 3.2MM AR-2263
|
Facility
|
OP
|
$2,112.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5617625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$615.01 |
| Max. Negotiated Rate |
$2,020.76 |
| Rate for Payer: Aetna Commercial |
$1,976.83
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,888.97
|
| Rate for Payer: Aetna Managed Medicare |
$615.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,427.71
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,098.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,054.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,164.13
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cigna Commercial |
$2,020.76
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,229.18
|
| Rate for Payer: Health EOS Commercial |
$1,954.87
|
| Rate for Payer: HFN Commercial |
$2,020.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,647.36
|
| Rate for Payer: Multiplan Commercial |
$1,757.18
|
| Rate for Payer: NAPHCARE Commercial |
$1,317.89
|
| Rate for Payer: Preferred Network Access Commercial |
$2,020.76
|
| Rate for Payer: Quartz Beloit One Network |
$1,076.28
|
| Rate for Payer: Quartz Commercial |
$1,427.71
|
| Rate for Payer: Quartz Medicare Advantage |
$1,317.89
|
| Rate for Payer: The Alliance Commercial |
$1,098.24
|
| Rate for Payer: WEA Trust Commercial |
$1,208.06
|
| Rate for Payer: WPS Commercial |
$1,626.87
|
|
|
DRILL PIN HEADLESS TROCAR 00-5901-020-00
|
Facility
|
OP
|
$4,331.00
|
|
| Hospital Charge Code |
3110200
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,261.19 |
| Max. Negotiated Rate |
$4,143.90 |
| Rate for Payer: Aetna Commercial |
$4,053.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,873.65
|
| Rate for Payer: Aetna Managed Medicare |
$1,261.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,927.76
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,252.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,162.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,387.25
|
| Rate for Payer: Cash Price |
$1,299.30
|
| Rate for Payer: Cigna Commercial |
$4,143.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,520.64
|
| Rate for Payer: Health EOS Commercial |
$4,008.77
|
| Rate for Payer: HFN Commercial |
$4,143.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,378.18
|
| Rate for Payer: Multiplan Commercial |
$3,603.39
|
| Rate for Payer: NAPHCARE Commercial |
$2,702.54
|
| Rate for Payer: Preferred Network Access Commercial |
$4,143.90
|
| Rate for Payer: Quartz Beloit One Network |
$2,207.08
|
| Rate for Payer: Quartz Commercial |
$2,927.76
|
| Rate for Payer: Quartz Medicare Advantage |
$2,702.54
|
| Rate for Payer: The Alliance Commercial |
$2,252.12
|
| Rate for Payer: WEA Trust Commercial |
$2,477.33
|
| Rate for Payer: WPS Commercial |
$3,336.17
|
|
|
DRILL PIN HEADLESS TROCAR 00-5901-020-00
|
Facility
|
IP
|
$4,331.00
|
|
| Hospital Charge Code |
3110200
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,207.08 |
| Max. Negotiated Rate |
$4,143.90 |
| Rate for Payer: Aetna Commercial |
$4,053.82
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,873.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,387.25
|
| Rate for Payer: Cash Price |
$1,299.30
|
| Rate for Payer: Cigna Commercial |
$4,143.90
|
| Rate for Payer: Health EOS Commercial |
$4,008.77
|
| Rate for Payer: HFN Commercial |
$4,143.90
|
| Rate for Payer: Multiplan Commercial |
$3,603.39
|
| Rate for Payer: Preferred Network Access Commercial |
$4,143.90
|
| Rate for Payer: Quartz Beloit One Network |
$2,207.08
|
| Rate for Payer: Quartz Commercial |
$2,702.54
|
| Rate for Payer: WEA Trust Commercial |
$2,477.33
|
| Rate for Payer: WPS Commercial |
$3,336.17
|
|
|
DRILL PIN TRANSFIX
|
Facility
|
OP
|
$2,660.00
|
|
| Hospital Charge Code |
2964679
|
|
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 PIN TRANSFIX
|
Facility
|
IP
|
$2,660.00
|
|
| Hospital Charge Code |
2964679
|
|
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 REAMER 2.9/5.0 MM
|
Facility
|
IP
|
$4,727.00
|
|
| Hospital Charge Code |
2966224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,408.88 |
| Max. Negotiated Rate |
$4,522.79 |
| Rate for Payer: Aetna Commercial |
$4,424.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,227.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,605.52
|
| Rate for Payer: Cash Price |
$1,418.10
|
| Rate for Payer: Cigna Commercial |
$4,522.79
|
| Rate for Payer: Health EOS Commercial |
$4,375.31
|
| Rate for Payer: HFN Commercial |
$4,522.79
|
| Rate for Payer: Multiplan Commercial |
$3,932.86
|
| Rate for Payer: Preferred Network Access Commercial |
$4,522.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,408.88
|
| Rate for Payer: Quartz Commercial |
$2,949.65
|
| Rate for Payer: WEA Trust Commercial |
$2,703.84
|
| Rate for Payer: WPS Commercial |
$3,641.21
|
|
|
DRILL REAMER 2.9/5.0 MM
|
Facility
|
OP
|
$4,727.00
|
|
| Hospital Charge Code |
2966224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$4,522.79 |
| Rate for Payer: Aetna Commercial |
$4,424.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,227.83
|
| Rate for Payer: Aetna Managed Medicare |
$1,376.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,195.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,458.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,359.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,605.52
|
| Rate for Payer: Cash Price |
$1,418.10
|
| Rate for Payer: Cigna Commercial |
$4,522.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,751.11
|
| Rate for Payer: Health EOS Commercial |
$4,375.31
|
| Rate for Payer: HFN Commercial |
$4,522.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,687.06
|
| Rate for Payer: Multiplan Commercial |
$3,932.86
|
| Rate for Payer: NAPHCARE Commercial |
$2,949.65
|
| Rate for Payer: Preferred Network Access Commercial |
$4,522.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,408.88
|
| Rate for Payer: Quartz Commercial |
$3,195.45
|
| Rate for Payer: Quartz Medicare Advantage |
$2,949.65
|
| Rate for Payer: The Alliance Commercial |
$2,458.04
|
| Rate for Payer: WEA Trust Commercial |
$2,703.84
|
| Rate for Payer: WPS Commercial |
$3,641.21
|
|
|
DRILL REAMER 3.9/6.0
|
Facility
|
OP
|
$4,727.00
|
|
| Hospital Charge Code |
2966225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$4,522.79 |
| Rate for Payer: Aetna Commercial |
$4,424.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,227.83
|
| Rate for Payer: Aetna Managed Medicare |
$1,376.50
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,195.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,458.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,359.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,605.52
|
| Rate for Payer: Cash Price |
$1,418.10
|
| Rate for Payer: Cigna Commercial |
$4,522.79
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,751.11
|
| Rate for Payer: Health EOS Commercial |
$4,375.31
|
| Rate for Payer: HFN Commercial |
$4,522.79
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,687.06
|
| Rate for Payer: Multiplan Commercial |
$3,932.86
|
| Rate for Payer: NAPHCARE Commercial |
$2,949.65
|
| Rate for Payer: Preferred Network Access Commercial |
$4,522.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,408.88
|
| Rate for Payer: Quartz Commercial |
$3,195.45
|
| Rate for Payer: Quartz Medicare Advantage |
$2,949.65
|
| Rate for Payer: The Alliance Commercial |
$2,458.04
|
| Rate for Payer: WEA Trust Commercial |
$2,703.84
|
| Rate for Payer: WPS Commercial |
$3,641.21
|
|
|
DRILL REAMER 3.9/6.0
|
Facility
|
IP
|
$4,727.00
|
|
| Hospital Charge Code |
2966225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,408.88 |
| Max. Negotiated Rate |
$4,522.79 |
| Rate for Payer: Aetna Commercial |
$4,424.47
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,227.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,605.52
|
| Rate for Payer: Cash Price |
$1,418.10
|
| Rate for Payer: Cigna Commercial |
$4,522.79
|
| Rate for Payer: Health EOS Commercial |
$4,375.31
|
| Rate for Payer: HFN Commercial |
$4,522.79
|
| Rate for Payer: Multiplan Commercial |
$3,932.86
|
| Rate for Payer: Preferred Network Access Commercial |
$4,522.79
|
| Rate for Payer: Quartz Beloit One Network |
$2,408.88
|
| Rate for Payer: Quartz Commercial |
$2,949.65
|
| Rate for Payer: WEA Trust Commercial |
$2,703.84
|
| Rate for Payer: WPS Commercial |
$3,641.21
|
|
|
DRILL SHAFT FLEXIBLE 25MM FLEXMETRIC 116136
|
Facility
|
IP
|
$2,669.00
|
|
| Hospital Charge Code |
5415957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,360.12 |
| Max. Negotiated Rate |
$2,553.70 |
| Rate for Payer: Aetna Commercial |
$2,498.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,387.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,471.15
|
| Rate for Payer: Cash Price |
$800.70
|
| Rate for Payer: Cigna Commercial |
$2,553.70
|
| Rate for Payer: Health EOS Commercial |
$2,470.43
|
| Rate for Payer: HFN Commercial |
$2,553.70
|
| Rate for Payer: Multiplan Commercial |
$2,220.61
|
| Rate for Payer: Preferred Network Access Commercial |
$2,553.70
|
| Rate for Payer: Quartz Beloit One Network |
$1,360.12
|
| Rate for Payer: Quartz Commercial |
$1,665.46
|
| Rate for Payer: WEA Trust Commercial |
$1,526.67
|
| Rate for Payer: WPS Commercial |
$2,055.93
|
|
|
DRILL SHAFT FLEXIBLE 25MM FLEXMETRIC 116136
|
Facility
|
OP
|
$2,669.00
|
|
| Hospital Charge Code |
5415957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$777.21 |
| Max. Negotiated Rate |
$2,553.70 |
| Rate for Payer: Aetna Commercial |
$2,498.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,387.15
|
| Rate for Payer: Aetna Managed Medicare |
$777.21
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,804.24
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,387.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,332.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,471.15
|
| Rate for Payer: Cash Price |
$800.70
|
| Rate for Payer: Cigna Commercial |
$2,553.70
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,553.36
|
| Rate for Payer: Health EOS Commercial |
$2,470.43
|
| Rate for Payer: HFN Commercial |
$2,553.70
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,081.82
|
| Rate for Payer: Multiplan Commercial |
$2,220.61
|
| Rate for Payer: NAPHCARE Commercial |
$1,665.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,553.70
|
| Rate for Payer: Quartz Beloit One Network |
$1,360.12
|
| Rate for Payer: Quartz Commercial |
$1,804.24
|
| Rate for Payer: Quartz Medicare Advantage |
$1,665.46
|
| Rate for Payer: The Alliance Commercial |
$1,387.88
|
| Rate for Payer: WEA Trust Commercial |
$1,526.67
|
| Rate for Payer: WPS Commercial |
$2,055.93
|
|
|
DRILL SHAFT FLEXIBLE 40MM FLEXMETRIC 116138
|
Facility
|
OP
|
$2,462.00
|
|
| Hospital Charge Code |
5415034
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$716.93 |
| Max. Negotiated Rate |
$2,355.64 |
| Rate for Payer: Aetna Commercial |
$2,304.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,202.01
|
| Rate for Payer: Aetna Managed Medicare |
$716.93
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,664.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,280.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,229.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,357.05
|
| Rate for Payer: Cash Price |
$738.60
|
| Rate for Payer: Cigna Commercial |
$2,355.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,432.88
|
| Rate for Payer: Health EOS Commercial |
$2,278.83
|
| Rate for Payer: HFN Commercial |
$2,355.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,920.36
|
| Rate for Payer: Multiplan Commercial |
$2,048.38
|
| Rate for Payer: NAPHCARE Commercial |
$1,536.29
|
| Rate for Payer: Preferred Network Access Commercial |
$2,355.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,254.64
|
| Rate for Payer: Quartz Commercial |
$1,664.31
|
| Rate for Payer: Quartz Medicare Advantage |
$1,536.29
|
| Rate for Payer: The Alliance Commercial |
$1,280.24
|
| Rate for Payer: WEA Trust Commercial |
$1,408.26
|
| Rate for Payer: WPS Commercial |
$1,896.48
|
|
|
DRILL SHAFT FLEXIBLE 40MM FLEXMETRIC 116138
|
Facility
|
IP
|
$2,462.00
|
|
| Hospital Charge Code |
5415034
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,254.64 |
| Max. Negotiated Rate |
$2,355.64 |
| Rate for Payer: Aetna Commercial |
$2,304.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,202.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,357.05
|
| Rate for Payer: Cash Price |
$738.60
|
| Rate for Payer: Cigna Commercial |
$2,355.64
|
| Rate for Payer: Health EOS Commercial |
$2,278.83
|
| Rate for Payer: HFN Commercial |
$2,355.64
|
| Rate for Payer: Multiplan Commercial |
$2,048.38
|
| Rate for Payer: Preferred Network Access Commercial |
$2,355.64
|
| Rate for Payer: Quartz Beloit One Network |
$1,254.64
|
| Rate for Payer: Quartz Commercial |
$1,536.29
|
| Rate for Payer: WEA Trust Commercial |
$1,408.26
|
| Rate for Payer: WPS Commercial |
$1,896.48
|
|
|
DRILL SLEEVE 2.8MM 323.054
|
Facility
|
OP
|
$2,165.00
|
|
| Hospital Charge Code |
2966608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$630.45 |
| Max. Negotiated Rate |
$2,071.47 |
| Rate for Payer: Aetna Commercial |
$2,026.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,936.38
|
| Rate for Payer: Aetna Managed Medicare |
$630.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,463.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,125.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,080.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,193.35
|
| Rate for Payer: Cash Price |
$649.50
|
| Rate for Payer: Cigna Commercial |
$2,071.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,260.03
|
| Rate for Payer: Health EOS Commercial |
$2,003.92
|
| Rate for Payer: HFN Commercial |
$2,071.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,688.70
|
| Rate for Payer: Multiplan Commercial |
$1,801.28
|
| Rate for Payer: NAPHCARE Commercial |
$1,350.96
|
| Rate for Payer: Preferred Network Access Commercial |
$2,071.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,103.28
|
| Rate for Payer: Quartz Commercial |
$1,463.54
|
| Rate for Payer: Quartz Medicare Advantage |
$1,350.96
|
| Rate for Payer: The Alliance Commercial |
$1,125.80
|
| Rate for Payer: WEA Trust Commercial |
$1,238.38
|
| Rate for Payer: WPS Commercial |
$1,667.70
|
|
|
DRILL SLEEVE 2.8MM 323.054
|
Facility
|
IP
|
$2,165.00
|
|
| Hospital Charge Code |
2966608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,103.28 |
| Max. Negotiated Rate |
$2,071.47 |
| Rate for Payer: Aetna Commercial |
$2,026.44
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,936.38
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,193.35
|
| Rate for Payer: Cash Price |
$649.50
|
| Rate for Payer: Cigna Commercial |
$2,071.47
|
| Rate for Payer: Health EOS Commercial |
$2,003.92
|
| Rate for Payer: HFN Commercial |
$2,071.47
|
| Rate for Payer: Multiplan Commercial |
$1,801.28
|
| Rate for Payer: Preferred Network Access Commercial |
$2,071.47
|
| Rate for Payer: Quartz Beloit One Network |
$1,103.28
|
| Rate for Payer: Quartz Commercial |
$1,350.96
|
| Rate for Payer: WEA Trust Commercial |
$1,238.38
|
| Rate for Payer: WPS Commercial |
$1,667.70
|
|
|
DRILL SLEEVE 3.5 FLIPCUTTER
|
Facility
|
IP
|
$3,019.00
|
|
| Hospital Charge Code |
2964680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,538.48 |
| Max. Negotiated Rate |
$2,888.58 |
| Rate for Payer: Aetna Commercial |
$2,825.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,700.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,664.07
|
| Rate for Payer: Cash Price |
$905.70
|
| Rate for Payer: Cigna Commercial |
$2,888.58
|
| Rate for Payer: Health EOS Commercial |
$2,794.39
|
| Rate for Payer: HFN Commercial |
$2,888.58
|
| Rate for Payer: Multiplan Commercial |
$2,511.81
|
| Rate for Payer: Preferred Network Access Commercial |
$2,888.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,538.48
|
| Rate for Payer: Quartz Commercial |
$1,883.86
|
| Rate for Payer: WEA Trust Commercial |
$1,726.87
|
| Rate for Payer: WPS Commercial |
$2,325.54
|
|
|
DRILL SLEEVE 3.5 FLIPCUTTER
|
Facility
|
OP
|
$3,019.00
|
|
| Hospital Charge Code |
2964680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$879.13 |
| Max. Negotiated Rate |
$2,888.58 |
| Rate for Payer: Aetna Commercial |
$2,825.78
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,700.19
|
| Rate for Payer: Aetna Managed Medicare |
$879.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,040.84
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,569.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,507.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,664.07
|
| Rate for Payer: Cash Price |
$905.70
|
| Rate for Payer: Cigna Commercial |
$2,888.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,757.06
|
| Rate for Payer: Health EOS Commercial |
$2,794.39
|
| Rate for Payer: HFN Commercial |
$2,888.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,354.82
|
| Rate for Payer: Multiplan Commercial |
$2,511.81
|
| Rate for Payer: NAPHCARE Commercial |
$1,883.86
|
| Rate for Payer: Preferred Network Access Commercial |
$2,888.58
|
| Rate for Payer: Quartz Beloit One Network |
$1,538.48
|
| Rate for Payer: Quartz Commercial |
$2,040.84
|
| Rate for Payer: Quartz Medicare Advantage |
$1,883.86
|
| Rate for Payer: The Alliance Commercial |
$1,569.88
|
| Rate for Payer: WEA Trust Commercial |
$1,726.87
|
| Rate for Payer: WPS Commercial |
$2,325.54
|
|
|
DRILL SPEEDGUIDE 2.0MM X 30MM 703891
|
Facility
|
IP
|
$1,462.00
|
|
| Hospital Charge Code |
6172081
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$745.04 |
| Max. Negotiated Rate |
$1,398.84 |
| Rate for Payer: Aetna Commercial |
$1,368.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,307.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$805.85
|
| Rate for Payer: Cash Price |
$438.60
|
| Rate for Payer: Cigna Commercial |
$1,398.84
|
| Rate for Payer: Health EOS Commercial |
$1,353.23
|
| Rate for Payer: HFN Commercial |
$1,398.84
|
| Rate for Payer: Multiplan Commercial |
$1,216.38
|
| Rate for Payer: Preferred Network Access Commercial |
$1,398.84
|
| Rate for Payer: Quartz Beloit One Network |
$745.04
|
| Rate for Payer: Quartz Commercial |
$912.29
|
| Rate for Payer: WEA Trust Commercial |
$836.26
|
| Rate for Payer: WPS Commercial |
$1,126.18
|
|
|
DRILL SPEEDGUIDE 2.0MM X 30MM 703891
|
Facility
|
OP
|
$1,462.00
|
|
| Hospital Charge Code |
6172081
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$425.73 |
| Max. Negotiated Rate |
$1,398.84 |
| Rate for Payer: Aetna Commercial |
$1,368.43
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,307.61
|
| Rate for Payer: Aetna Managed Medicare |
$425.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$988.31
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$760.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$729.83
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$805.85
|
| Rate for Payer: Cash Price |
$438.60
|
| Rate for Payer: Cigna Commercial |
$1,398.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$850.88
|
| Rate for Payer: Health EOS Commercial |
$1,353.23
|
| Rate for Payer: HFN Commercial |
$1,398.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,140.36
|
| Rate for Payer: Multiplan Commercial |
$1,216.38
|
| Rate for Payer: NAPHCARE Commercial |
$912.29
|
| Rate for Payer: Preferred Network Access Commercial |
$1,398.84
|
| Rate for Payer: Quartz Beloit One Network |
$745.04
|
| Rate for Payer: Quartz Commercial |
$988.31
|
| Rate for Payer: Quartz Medicare Advantage |
$912.29
|
| Rate for Payer: The Alliance Commercial |
$760.24
|
| Rate for Payer: WEA Trust Commercial |
$836.26
|
| Rate for Payer: WPS Commercial |
$1,126.18
|
|
|
DRILL SPEEDGUIDE 2.6MM X 30MM 703894
|
Facility
|
OP
|
$1,388.00
|
|
| Hospital Charge Code |
6049674
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.19 |
| Max. Negotiated Rate |
$1,328.04 |
| Rate for Payer: Aetna Commercial |
$1,299.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,241.43
|
| Rate for Payer: Aetna Managed Medicare |
$404.19
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$938.29
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$721.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$692.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$765.07
|
| Rate for Payer: Cash Price |
$416.40
|
| Rate for Payer: Cigna Commercial |
$1,328.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$807.82
|
| Rate for Payer: Health EOS Commercial |
$1,284.73
|
| Rate for Payer: HFN Commercial |
$1,328.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,082.64
|
| Rate for Payer: Multiplan Commercial |
$1,154.82
|
| Rate for Payer: NAPHCARE Commercial |
$866.11
|
| Rate for Payer: Preferred Network Access Commercial |
$1,328.04
|
| Rate for Payer: Quartz Beloit One Network |
$707.32
|
| Rate for Payer: Quartz Commercial |
$938.29
|
| Rate for Payer: Quartz Medicare Advantage |
$866.11
|
| Rate for Payer: The Alliance Commercial |
$721.76
|
| Rate for Payer: WEA Trust Commercial |
$793.94
|
| Rate for Payer: WPS Commercial |
$1,069.18
|
|
|
DRILL SPEEDGUIDE 2.6MM X 30MM 703894
|
Facility
|
IP
|
$1,388.00
|
|
| Hospital Charge Code |
6049674
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$707.32 |
| Max. Negotiated Rate |
$1,328.04 |
| Rate for Payer: Aetna Commercial |
$1,299.17
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,241.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$765.07
|
| Rate for Payer: Cash Price |
$416.40
|
| Rate for Payer: Cigna Commercial |
$1,328.04
|
| Rate for Payer: Health EOS Commercial |
$1,284.73
|
| Rate for Payer: HFN Commercial |
$1,328.04
|
| Rate for Payer: Multiplan Commercial |
$1,154.82
|
| Rate for Payer: Preferred Network Access Commercial |
$1,328.04
|
| Rate for Payer: Quartz Beloit One Network |
$707.32
|
| Rate for Payer: Quartz Commercial |
$866.11
|
| Rate for Payer: WEA Trust Commercial |
$793.94
|
| Rate for Payer: WPS Commercial |
$1,069.18
|
|
|
DRILL SPEEDGUIDE 3.0MM 70-3933
|
Facility
|
OP
|
$2,557.00
|
|
| Hospital Charge Code |
3791363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$744.60 |
| Max. Negotiated Rate |
$2,446.54 |
| Rate for Payer: Aetna Commercial |
$2,393.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,286.98
|
| Rate for Payer: Aetna Managed Medicare |
$744.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,728.53
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,329.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,276.45
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.42
|
| Rate for Payer: Cash Price |
$767.10
|
| Rate for Payer: Cigna Commercial |
$2,446.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,488.17
|
| Rate for Payer: Health EOS Commercial |
$2,366.76
|
| Rate for Payer: HFN Commercial |
$2,446.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,994.46
|
| Rate for Payer: Multiplan Commercial |
$2,127.42
|
| Rate for Payer: NAPHCARE Commercial |
$1,595.57
|
| Rate for Payer: Preferred Network Access Commercial |
$2,446.54
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.05
|
| Rate for Payer: Quartz Commercial |
$1,728.53
|
| Rate for Payer: Quartz Medicare Advantage |
$1,595.57
|
| Rate for Payer: The Alliance Commercial |
$1,329.64
|
| Rate for Payer: WEA Trust Commercial |
$1,462.60
|
| Rate for Payer: WPS Commercial |
$1,969.66
|
|
|
DRILL SPEEDGUIDE 3.0MM 70-3933
|
Facility
|
IP
|
$2,557.00
|
|
| Hospital Charge Code |
3791363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,303.05 |
| Max. Negotiated Rate |
$2,446.54 |
| Rate for Payer: Aetna Commercial |
$2,393.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,286.98
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,409.42
|
| Rate for Payer: Cash Price |
$767.10
|
| Rate for Payer: Cigna Commercial |
$2,446.54
|
| Rate for Payer: Health EOS Commercial |
$2,366.76
|
| Rate for Payer: HFN Commercial |
$2,446.54
|
| Rate for Payer: Multiplan Commercial |
$2,127.42
|
| Rate for Payer: Preferred Network Access Commercial |
$2,446.54
|
| Rate for Payer: Quartz Beloit One Network |
$1,303.05
|
| Rate for Payer: Quartz Commercial |
$1,595.57
|
| Rate for Payer: WEA Trust Commercial |
$1,462.60
|
| Rate for Payer: WPS Commercial |
$1,969.66
|
|
|
DRILL STOP SMART TOE 2.0
|
Facility
|
OP
|
$1,742.00
|
|
| Hospital Charge Code |
3072481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$507.27 |
| Max. Negotiated Rate |
$1,666.75 |
| Rate for Payer: Aetna Commercial |
$1,630.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,558.04
|
| Rate for Payer: Aetna Managed Medicare |
$507.27
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,177.59
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$905.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$869.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$960.19
|
| Rate for Payer: Cash Price |
$522.60
|
| Rate for Payer: Cigna Commercial |
$1,666.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,013.84
|
| Rate for Payer: Health EOS Commercial |
$1,612.40
|
| Rate for Payer: HFN Commercial |
$1,666.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,358.76
|
| Rate for Payer: Multiplan Commercial |
$1,449.34
|
| Rate for Payer: NAPHCARE Commercial |
$1,087.01
|
| Rate for Payer: Preferred Network Access Commercial |
$1,666.75
|
| Rate for Payer: Quartz Beloit One Network |
$887.72
|
| Rate for Payer: Quartz Commercial |
$1,177.59
|
| Rate for Payer: Quartz Medicare Advantage |
$1,087.01
|
| Rate for Payer: The Alliance Commercial |
$905.84
|
| Rate for Payer: WEA Trust Commercial |
$996.42
|
| Rate for Payer: WPS Commercial |
$1,341.86
|
|
|
DRILL STOP SMART TOE 2.0
|
Facility
|
IP
|
$1,742.00
|
|
| Hospital Charge Code |
3072481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$887.72 |
| Max. Negotiated Rate |
$1,666.75 |
| Rate for Payer: Aetna Commercial |
$1,630.51
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,558.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$960.19
|
| Rate for Payer: Cash Price |
$522.60
|
| Rate for Payer: Cigna Commercial |
$1,666.75
|
| Rate for Payer: Health EOS Commercial |
$1,612.40
|
| Rate for Payer: HFN Commercial |
$1,666.75
|
| Rate for Payer: Multiplan Commercial |
$1,449.34
|
| Rate for Payer: Preferred Network Access Commercial |
$1,666.75
|
| Rate for Payer: Quartz Beloit One Network |
$887.72
|
| Rate for Payer: Quartz Commercial |
$1,087.01
|
| Rate for Payer: WEA Trust Commercial |
$996.42
|
| Rate for Payer: WPS Commercial |
$1,341.86
|
|
