|
ANCHOR MICROFIX QUICKANCHOR 212855
|
Facility
OP
|
$4,552.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,274.56 |
| Max. Negotiated Rate |
$4,187.84 |
| Rate for Payer: Aetna Commercial |
$4,096.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,914.72
|
| Rate for Payer: Aetna Managed Medicare |
$1,274.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,958.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,276.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,184.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,412.56
|
| Rate for Payer: Cash Price |
$1,365.60
|
| Rate for Payer: Cigna Commercial |
$4,187.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,547.30
|
| Rate for Payer: Health EOS Commercial |
$4,051.28
|
| Rate for Payer: HFN Commercial |
$4,187.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,414.00
|
| Rate for Payer: Multiplan Commercial |
$3,641.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,731.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,187.84
|
| Rate for Payer: Quartz Beloit One Network |
$2,230.48
|
| Rate for Payer: Quartz Commercial |
$2,958.80
|
| Rate for Payer: Quartz Medicare Advantage |
$2,731.20
|
| Rate for Payer: WEA Trust Commercial |
$2,503.60
|
| Rate for Payer: WPS Commercial |
$3,371.67
|
|
|
ANCHOR MINILOK QUICKANCHOR 2-0 212851
|
Facility
IP
|
$4,283.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,098.67 |
| Max. Negotiated Rate |
$3,940.36 |
| Rate for Payer: Aetna Commercial |
$3,854.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,269.99
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cigna Commercial |
$3,940.36
|
| Rate for Payer: Health EOS Commercial |
$3,811.87
|
| Rate for Payer: HFN Commercial |
$3,940.36
|
| Rate for Payer: Multiplan Commercial |
$3,426.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,569.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,940.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,098.67
|
| Rate for Payer: Quartz Commercial |
$2,569.80
|
| Rate for Payer: WEA Trust Commercial |
$2,355.65
|
| Rate for Payer: WPS Commercial |
$3,172.42
|
|
|
ANCHOR MINILOK QUICKANCHOR 2-0 212851
|
Facility
OP
|
$4,283.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,199.24 |
| Max. Negotiated Rate |
$3,940.36 |
| Rate for Payer: Aetna Commercial |
$3,854.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,683.38
|
| Rate for Payer: Aetna Managed Medicare |
$1,199.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,783.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,141.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,055.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,269.99
|
| Rate for Payer: Cash Price |
$1,284.90
|
| Rate for Payer: Cigna Commercial |
$3,940.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,396.77
|
| Rate for Payer: Health EOS Commercial |
$3,811.87
|
| Rate for Payer: HFN Commercial |
$3,940.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,212.25
|
| Rate for Payer: Multiplan Commercial |
$3,426.40
|
| Rate for Payer: NAPHCARE Commercial |
$2,569.80
|
| Rate for Payer: Preferred Network Access Commercial |
$3,940.36
|
| Rate for Payer: Quartz Beloit One Network |
$2,098.67
|
| Rate for Payer: Quartz Commercial |
$2,783.95
|
| Rate for Payer: Quartz Medicare Advantage |
$2,569.80
|
| Rate for Payer: WEA Trust Commercial |
$2,355.65
|
| Rate for Payer: WPS Commercial |
$3,172.42
|
|
|
ANCHOR MINI PUSHLOCK 2.5MM X 8MM BIO AR-8825B
|
Facility
OP
|
$3,799.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5384925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,063.72 |
| Max. Negotiated Rate |
$3,495.08 |
| Rate for Payer: Aetna Commercial |
$3,419.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,267.14
|
| Rate for Payer: Aetna Managed Medicare |
$1,063.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,469.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,899.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,823.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,013.47
|
| Rate for Payer: Cash Price |
$1,139.70
|
| Rate for Payer: Cigna Commercial |
$3,495.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,125.92
|
| Rate for Payer: Health EOS Commercial |
$3,381.11
|
| Rate for Payer: HFN Commercial |
$3,495.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,849.25
|
| Rate for Payer: Multiplan Commercial |
$3,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,279.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,495.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,861.51
|
| Rate for Payer: Quartz Commercial |
$2,469.35
|
| Rate for Payer: Quartz Medicare Advantage |
$2,279.40
|
| Rate for Payer: WEA Trust Commercial |
$2,089.45
|
| Rate for Payer: WPS Commercial |
$2,813.92
|
|
|
ANCHOR MINI PUSHLOCK 2.5MM X 8MM BIO AR-8825B
|
Facility
IP
|
$3,799.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5384925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,861.51 |
| Max. Negotiated Rate |
$3,495.08 |
| Rate for Payer: Aetna Commercial |
$3,419.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,013.47
|
| Rate for Payer: Cash Price |
$1,139.70
|
| Rate for Payer: Cigna Commercial |
$3,495.08
|
| Rate for Payer: Health EOS Commercial |
$3,381.11
|
| Rate for Payer: HFN Commercial |
$3,495.08
|
| Rate for Payer: Multiplan Commercial |
$3,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,279.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,495.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,861.51
|
| Rate for Payer: Quartz Commercial |
$2,279.40
|
| Rate for Payer: WEA Trust Commercial |
$2,089.45
|
| Rate for Payer: WPS Commercial |
$2,813.92
|
|
|
ANCHOR MINI PUSHLOCK PEEK AR-8825P
|
Facility
OP
|
$3,799.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5627630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,063.72 |
| Max. Negotiated Rate |
$3,495.08 |
| Rate for Payer: Aetna Commercial |
$3,419.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,267.14
|
| Rate for Payer: Aetna Managed Medicare |
$1,063.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,469.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,899.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,823.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,013.47
|
| Rate for Payer: Cash Price |
$1,139.70
|
| Rate for Payer: Cigna Commercial |
$3,495.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,125.92
|
| Rate for Payer: Health EOS Commercial |
$3,381.11
|
| Rate for Payer: HFN Commercial |
$3,495.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,849.25
|
| Rate for Payer: Multiplan Commercial |
$3,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,279.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,495.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,861.51
|
| Rate for Payer: Quartz Commercial |
$2,469.35
|
| Rate for Payer: Quartz Medicare Advantage |
$2,279.40
|
| Rate for Payer: WEA Trust Commercial |
$2,089.45
|
| Rate for Payer: WPS Commercial |
$2,813.92
|
|
|
ANCHOR MINI PUSHLOCK PEEK AR-8825P
|
Facility
IP
|
$3,799.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5627630
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,861.51 |
| Max. Negotiated Rate |
$3,495.08 |
| Rate for Payer: Aetna Commercial |
$3,419.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,013.47
|
| Rate for Payer: Cash Price |
$1,139.70
|
| Rate for Payer: Cigna Commercial |
$3,495.08
|
| Rate for Payer: Health EOS Commercial |
$3,381.11
|
| Rate for Payer: HFN Commercial |
$3,495.08
|
| Rate for Payer: Multiplan Commercial |
$3,039.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,279.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,495.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,861.51
|
| Rate for Payer: Quartz Commercial |
$2,279.40
|
| Rate for Payer: WEA Trust Commercial |
$2,089.45
|
| Rate for Payer: WPS Commercial |
$2,813.92
|
|
|
ANCHOR PUSHLOCK 2.4MM HIP PEEK AR-2924PHS
|
Facility
IP
|
$4,005.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5414768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,962.45 |
| Max. Negotiated Rate |
$3,684.60 |
| Rate for Payer: Aetna Commercial |
$3,604.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,122.65
|
| Rate for Payer: Cash Price |
$1,201.50
|
| Rate for Payer: Cigna Commercial |
$3,684.60
|
| Rate for Payer: Health EOS Commercial |
$3,564.45
|
| Rate for Payer: HFN Commercial |
$3,684.60
|
| Rate for Payer: Multiplan Commercial |
$3,204.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,403.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,684.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,962.45
|
| Rate for Payer: Quartz Commercial |
$2,403.00
|
| Rate for Payer: WEA Trust Commercial |
$2,202.75
|
| Rate for Payer: WPS Commercial |
$2,966.50
|
|
|
ANCHOR PUSHLOCK 2.4MM HIP PEEK AR-2924PHS
|
Facility
OP
|
$4,005.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5414768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,121.40 |
| Max. Negotiated Rate |
$3,684.60 |
| Rate for Payer: Aetna Commercial |
$3,604.50
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,444.30
|
| Rate for Payer: Aetna Managed Medicare |
$1,121.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,603.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,002.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,922.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,122.65
|
| Rate for Payer: Cash Price |
$1,201.50
|
| Rate for Payer: Cigna Commercial |
$3,684.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,241.20
|
| Rate for Payer: Health EOS Commercial |
$3,564.45
|
| Rate for Payer: HFN Commercial |
$3,684.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,003.75
|
| Rate for Payer: Multiplan Commercial |
$3,204.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,403.00
|
| Rate for Payer: Preferred Network Access Commercial |
$3,684.60
|
| Rate for Payer: Quartz Beloit One Network |
$1,962.45
|
| Rate for Payer: Quartz Commercial |
$2,603.25
|
| Rate for Payer: Quartz Medicare Advantage |
$2,403.00
|
| Rate for Payer: WEA Trust Commercial |
$2,202.75
|
| Rate for Payer: WPS Commercial |
$2,966.50
|
|
|
ANCHOR PUSHLOCK 2.9MM AR-1923BC
|
Facility
OP
|
$4,970.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3072505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,391.60 |
| Max. Negotiated Rate |
$4,572.40 |
| Rate for Payer: Aetna Commercial |
$4,473.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,274.20
|
| Rate for Payer: Aetna Managed Medicare |
$1,391.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,230.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,485.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,385.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,634.10
|
| Rate for Payer: Cash Price |
$1,491.00
|
| Rate for Payer: Cigna Commercial |
$4,572.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,781.21
|
| Rate for Payer: Health EOS Commercial |
$4,423.30
|
| Rate for Payer: HFN Commercial |
$4,572.40
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,727.50
|
| Rate for Payer: Multiplan Commercial |
$3,976.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,982.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,572.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,435.30
|
| Rate for Payer: Quartz Commercial |
$3,230.50
|
| Rate for Payer: Quartz Medicare Advantage |
$2,982.00
|
| Rate for Payer: WEA Trust Commercial |
$2,733.50
|
| Rate for Payer: WPS Commercial |
$3,681.28
|
|
|
ANCHOR PUSHLOCK 2.9MM AR-1923BC
|
Facility
IP
|
$4,970.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3072505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,435.30 |
| Max. Negotiated Rate |
$4,572.40 |
| Rate for Payer: Aetna Commercial |
$4,473.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,634.10
|
| Rate for Payer: Cash Price |
$1,491.00
|
| Rate for Payer: Cigna Commercial |
$4,572.40
|
| Rate for Payer: Health EOS Commercial |
$4,423.30
|
| Rate for Payer: HFN Commercial |
$4,572.40
|
| Rate for Payer: Multiplan Commercial |
$3,976.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,982.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,572.40
|
| Rate for Payer: Quartz Beloit One Network |
$2,435.30
|
| Rate for Payer: Quartz Commercial |
$2,982.00
|
| Rate for Payer: WEA Trust Commercial |
$2,733.50
|
| Rate for Payer: WPS Commercial |
$3,681.28
|
|
|
ANCHOR PUSHLOCK 2.9MMSHORT AR-2923BC
|
Facility
OP
|
$3,934.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,101.52 |
| Max. Negotiated Rate |
$3,619.28 |
| Rate for Payer: Aetna Commercial |
$3,540.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,383.24
|
| Rate for Payer: Aetna Managed Medicare |
$1,101.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,557.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,967.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,888.32
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,085.02
|
| Rate for Payer: Cash Price |
$1,180.20
|
| Rate for Payer: Cigna Commercial |
$3,619.28
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,201.47
|
| Rate for Payer: Health EOS Commercial |
$3,501.26
|
| Rate for Payer: HFN Commercial |
$3,619.28
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,950.50
|
| Rate for Payer: Multiplan Commercial |
$3,147.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,360.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,619.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,927.66
|
| Rate for Payer: Quartz Commercial |
$2,557.10
|
| Rate for Payer: Quartz Medicare Advantage |
$2,360.40
|
| Rate for Payer: WEA Trust Commercial |
$2,163.70
|
| Rate for Payer: WPS Commercial |
$2,913.91
|
|
|
ANCHOR PUSHLOCK 2.9MMSHORT AR-2923BC
|
Facility
IP
|
$3,934.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5349153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,927.66 |
| Max. Negotiated Rate |
$3,619.28 |
| Rate for Payer: Aetna Commercial |
$3,540.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,085.02
|
| Rate for Payer: Cash Price |
$1,180.20
|
| Rate for Payer: Cigna Commercial |
$3,619.28
|
| Rate for Payer: Health EOS Commercial |
$3,501.26
|
| Rate for Payer: HFN Commercial |
$3,619.28
|
| Rate for Payer: Multiplan Commercial |
$3,147.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,360.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,619.28
|
| Rate for Payer: Quartz Beloit One Network |
$1,927.66
|
| Rate for Payer: Quartz Commercial |
$2,360.40
|
| Rate for Payer: WEA Trust Commercial |
$2,163.70
|
| Rate for Payer: WPS Commercial |
$2,913.91
|
|
|
ANCHOR PUSHLOCK 3.5MM BIO AR-1926B
|
Facility
OP
|
$4,472.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,252.16 |
| Max. Negotiated Rate |
$4,114.24 |
| Rate for Payer: Aetna Commercial |
$4,024.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,845.92
|
| Rate for Payer: Aetna Managed Medicare |
$1,252.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,906.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,236.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,146.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,370.16
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cigna Commercial |
$4,114.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,502.53
|
| Rate for Payer: Health EOS Commercial |
$3,980.08
|
| Rate for Payer: HFN Commercial |
$4,114.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,354.00
|
| Rate for Payer: Multiplan Commercial |
$3,577.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,683.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,114.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,191.28
|
| Rate for Payer: Quartz Commercial |
$2,906.80
|
| Rate for Payer: Quartz Medicare Advantage |
$2,683.20
|
| Rate for Payer: WEA Trust Commercial |
$2,459.60
|
| Rate for Payer: WPS Commercial |
$3,312.41
|
|
|
ANCHOR PUSHLOCK 3.5MM BIO AR-1926B
|
Facility
IP
|
$4,472.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,191.28 |
| Max. Negotiated Rate |
$4,114.24 |
| Rate for Payer: Aetna Commercial |
$4,024.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,370.16
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cigna Commercial |
$4,114.24
|
| Rate for Payer: Health EOS Commercial |
$3,980.08
|
| Rate for Payer: HFN Commercial |
$4,114.24
|
| Rate for Payer: Multiplan Commercial |
$3,577.60
|
| Rate for Payer: NAPHCARE Commercial |
$2,683.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,114.24
|
| Rate for Payer: Quartz Beloit One Network |
$2,191.28
|
| Rate for Payer: Quartz Commercial |
$2,683.20
|
| Rate for Payer: WEA Trust Commercial |
$2,459.60
|
| Rate for Payer: WPS Commercial |
$3,312.41
|
|
|
ANCHOR PUSHLOCK 3.5MM BIO SELF-PUNCHING AR-1926BCSP
|
Facility
OP
|
$4,469.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6226126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,251.32 |
| Max. Negotiated Rate |
$4,111.48 |
| Rate for Payer: Aetna Commercial |
$4,022.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,843.34
|
| Rate for Payer: Aetna Managed Medicare |
$1,251.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,904.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,234.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,145.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,368.57
|
| Rate for Payer: Cash Price |
$1,340.70
|
| Rate for Payer: Cigna Commercial |
$4,111.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,500.85
|
| Rate for Payer: Health EOS Commercial |
$3,977.41
|
| Rate for Payer: HFN Commercial |
$4,111.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,351.75
|
| Rate for Payer: Multiplan Commercial |
$3,575.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,681.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,111.48
|
| Rate for Payer: Quartz Beloit One Network |
$2,189.81
|
| Rate for Payer: Quartz Commercial |
$2,904.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,681.40
|
| Rate for Payer: WEA Trust Commercial |
$2,457.95
|
| Rate for Payer: WPS Commercial |
$3,310.19
|
|
|
ANCHOR PUSHLOCK 3.5MM BIO SELF-PUNCHING AR-1926BCSP
|
Facility
IP
|
$4,469.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6226126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,189.81 |
| Max. Negotiated Rate |
$4,111.48 |
| Rate for Payer: Aetna Commercial |
$4,022.10
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,368.57
|
| Rate for Payer: Cash Price |
$1,340.70
|
| Rate for Payer: Cigna Commercial |
$4,111.48
|
| Rate for Payer: Health EOS Commercial |
$3,977.41
|
| Rate for Payer: HFN Commercial |
$4,111.48
|
| Rate for Payer: Multiplan Commercial |
$3,575.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,681.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,111.48
|
| Rate for Payer: Quartz Beloit One Network |
$2,189.81
|
| Rate for Payer: Quartz Commercial |
$2,681.40
|
| Rate for Payer: WEA Trust Commercial |
$2,457.95
|
| Rate for Payer: WPS Commercial |
$3,310.19
|
|
|
ANCHOR SUPER QUICKANCHOR PLUS DS 222984
|
Facility
OP
|
$5,230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5106880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,464.40 |
| Max. Negotiated Rate |
$4,811.60 |
| Rate for Payer: Aetna Commercial |
$4,707.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,497.80
|
| Rate for Payer: Aetna Managed Medicare |
$1,464.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,399.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,615.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,510.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,771.90
|
| Rate for Payer: Cash Price |
$1,569.00
|
| Rate for Payer: Cigna Commercial |
$4,811.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,926.71
|
| Rate for Payer: Health EOS Commercial |
$4,654.70
|
| Rate for Payer: HFN Commercial |
$4,811.60
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,922.50
|
| Rate for Payer: Multiplan Commercial |
$4,184.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,138.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,811.60
|
| Rate for Payer: Quartz Beloit One Network |
$2,562.70
|
| Rate for Payer: Quartz Commercial |
$3,399.50
|
| Rate for Payer: Quartz Medicare Advantage |
$3,138.00
|
| Rate for Payer: WEA Trust Commercial |
$2,876.50
|
| Rate for Payer: WPS Commercial |
$3,873.86
|
|
|
ANCHOR SUPER QUICKANCHOR PLUS DS 222984
|
Facility
IP
|
$5,230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5106880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,562.70 |
| Max. Negotiated Rate |
$4,811.60 |
| Rate for Payer: Aetna Commercial |
$4,707.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,771.90
|
| Rate for Payer: Cash Price |
$1,569.00
|
| Rate for Payer: Cigna Commercial |
$4,811.60
|
| Rate for Payer: Health EOS Commercial |
$4,654.70
|
| Rate for Payer: HFN Commercial |
$4,811.60
|
| Rate for Payer: Multiplan Commercial |
$4,184.00
|
| Rate for Payer: NAPHCARE Commercial |
$3,138.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,811.60
|
| Rate for Payer: Quartz Beloit One Network |
$2,562.70
|
| Rate for Payer: Quartz Commercial |
$3,138.00
|
| Rate for Payer: WEA Trust Commercial |
$2,876.50
|
| Rate for Payer: WPS Commercial |
$3,873.86
|
|
|
ANCHOR SWIVELOCK 3.5 X 8.5MM FRK EYELET AR-8978P
|
Facility
OP
|
$4,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,358.00 |
| Max. Negotiated Rate |
$4,462.00 |
| Rate for Payer: Aetna Commercial |
$4,365.00
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,171.00
|
| Rate for Payer: Aetna Managed Medicare |
$1,358.00
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,152.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,425.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,328.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,570.50
|
| Rate for Payer: Cash Price |
$1,455.00
|
| Rate for Payer: Cigna Commercial |
$4,462.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,714.06
|
| Rate for Payer: Health EOS Commercial |
$4,316.50
|
| Rate for Payer: HFN Commercial |
$4,462.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,637.50
|
| Rate for Payer: Multiplan Commercial |
$3,880.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,910.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,462.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,376.50
|
| Rate for Payer: Quartz Commercial |
$3,152.50
|
| Rate for Payer: Quartz Medicare Advantage |
$2,910.00
|
| Rate for Payer: WEA Trust Commercial |
$2,667.50
|
| Rate for Payer: WPS Commercial |
$3,592.40
|
|
|
ANCHOR SWIVELOCK 3.5 X 8.5MM FRK EYELET AR-8978P
|
Facility
IP
|
$4,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,376.50 |
| Max. Negotiated Rate |
$4,462.00 |
| Rate for Payer: Aetna Commercial |
$4,365.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,570.50
|
| Rate for Payer: Cash Price |
$1,455.00
|
| Rate for Payer: Cigna Commercial |
$4,462.00
|
| Rate for Payer: Health EOS Commercial |
$4,316.50
|
| Rate for Payer: HFN Commercial |
$4,462.00
|
| Rate for Payer: Multiplan Commercial |
$3,880.00
|
| Rate for Payer: NAPHCARE Commercial |
$2,910.00
|
| Rate for Payer: Preferred Network Access Commercial |
$4,462.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,376.50
|
| Rate for Payer: Quartz Commercial |
$2,910.00
|
| Rate for Payer: WEA Trust Commercial |
$2,667.50
|
| Rate for Payer: WPS Commercial |
$3,592.40
|
|
|
ANCHOR SWIVELOCK 4.75 X 19.1 AR-2324BCC
|
Facility
IP
|
$6,273.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,073.77 |
| Max. Negotiated Rate |
$5,771.16 |
| Rate for Payer: Aetna Commercial |
$5,645.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,324.69
|
| Rate for Payer: Cash Price |
$1,881.90
|
| Rate for Payer: Cigna Commercial |
$5,771.16
|
| Rate for Payer: Health EOS Commercial |
$5,582.97
|
| Rate for Payer: HFN Commercial |
$5,771.16
|
| Rate for Payer: Multiplan Commercial |
$5,018.40
|
| Rate for Payer: NAPHCARE Commercial |
$3,763.80
|
| Rate for Payer: Preferred Network Access Commercial |
$5,771.16
|
| Rate for Payer: Quartz Beloit One Network |
$3,073.77
|
| Rate for Payer: Quartz Commercial |
$3,763.80
|
| Rate for Payer: WEA Trust Commercial |
$3,450.15
|
| Rate for Payer: WPS Commercial |
$4,646.41
|
|
|
ANCHOR SWIVELOCK 4.75 X 19.1 AR-2324BCC
|
Facility
OP
|
$6,273.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,756.44 |
| Max. Negotiated Rate |
$5,771.16 |
| Rate for Payer: Aetna Commercial |
$5,645.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,394.78
|
| Rate for Payer: Aetna Managed Medicare |
$1,756.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,077.45
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,136.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,011.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,324.69
|
| Rate for Payer: Cash Price |
$1,881.90
|
| Rate for Payer: Cigna Commercial |
$5,771.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,510.37
|
| Rate for Payer: Health EOS Commercial |
$5,582.97
|
| Rate for Payer: HFN Commercial |
$5,771.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,704.75
|
| Rate for Payer: Multiplan Commercial |
$5,018.40
|
| Rate for Payer: NAPHCARE Commercial |
$3,763.80
|
| Rate for Payer: Preferred Network Access Commercial |
$5,771.16
|
| Rate for Payer: Quartz Beloit One Network |
$3,073.77
|
| Rate for Payer: Quartz Commercial |
$4,077.45
|
| Rate for Payer: Quartz Medicare Advantage |
$3,763.80
|
| Rate for Payer: WEA Trust Commercial |
$3,450.15
|
| Rate for Payer: WPS Commercial |
$4,646.41
|
|
|
ANCHOR SWIVELOCK 8 X 19.5 TENODESIS BIO-COMPOSITE AR-1662BC-8
|
Facility
IP
|
$5,907.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3661498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,894.43 |
| Max. Negotiated Rate |
$5,434.44 |
| Rate for Payer: Aetna Commercial |
$5,316.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,130.71
|
| Rate for Payer: Cash Price |
$1,772.10
|
| Rate for Payer: Cigna Commercial |
$5,434.44
|
| Rate for Payer: Health EOS Commercial |
$5,257.23
|
| Rate for Payer: HFN Commercial |
$5,434.44
|
| Rate for Payer: Multiplan Commercial |
$4,725.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,544.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,434.44
|
| Rate for Payer: Quartz Beloit One Network |
$2,894.43
|
| Rate for Payer: Quartz Commercial |
$3,544.20
|
| Rate for Payer: WEA Trust Commercial |
$3,248.85
|
| Rate for Payer: WPS Commercial |
$4,375.31
|
|
|
ANCHOR SWIVELOCK 8 X 19.5 TENODESIS BIO-COMPOSITE AR-1662BC-8
|
Facility
OP
|
$5,907.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3661498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,653.96 |
| Max. Negotiated Rate |
$5,434.44 |
| Rate for Payer: Aetna Commercial |
$5,316.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,080.02
|
| Rate for Payer: Aetna Managed Medicare |
$1,653.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,839.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,953.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,835.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,130.71
|
| Rate for Payer: Cash Price |
$1,772.10
|
| Rate for Payer: Cigna Commercial |
$5,434.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,305.56
|
| Rate for Payer: Health EOS Commercial |
$5,257.23
|
| Rate for Payer: HFN Commercial |
$5,434.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,430.25
|
| Rate for Payer: Multiplan Commercial |
$4,725.60
|
| Rate for Payer: NAPHCARE Commercial |
$3,544.20
|
| Rate for Payer: Preferred Network Access Commercial |
$5,434.44
|
| Rate for Payer: Quartz Beloit One Network |
$2,894.43
|
| Rate for Payer: Quartz Commercial |
$3,839.55
|
| Rate for Payer: Quartz Medicare Advantage |
$3,544.20
|
| Rate for Payer: WEA Trust Commercial |
$3,248.85
|
| Rate for Payer: WPS Commercial |
$4,375.31
|
|
