|
K-WIRE 1.1MM X 100
|
Facility
|
IP
|
$535.00
|
|
| Hospital Charge Code |
2964738
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$511.89 |
| Rate for Payer: Aetna Commercial |
$500.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$478.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$294.89
|
| Rate for Payer: Cash Price |
$160.50
|
| Rate for Payer: Cigna Commercial |
$511.89
|
| Rate for Payer: Health EOS Commercial |
$495.20
|
| Rate for Payer: HFN Commercial |
$511.89
|
| Rate for Payer: Multiplan Commercial |
$445.12
|
| Rate for Payer: Preferred Network Access Commercial |
$511.89
|
| Rate for Payer: Quartz Beloit One Network |
$272.64
|
| Rate for Payer: Quartz Commercial |
$333.84
|
| Rate for Payer: WEA Trust Commercial |
$306.02
|
| Rate for Payer: WPS Commercial |
$412.11
|
|
|
K-WIRE 1.1X 150MM BLUNT/TROCAR DSDS1011
|
Facility
|
IP
|
$558.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5547331
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.36 |
| Max. Negotiated Rate |
$533.89 |
| Rate for Payer: Aetna Commercial |
$522.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$499.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$307.57
|
| Rate for Payer: Cash Price |
$167.40
|
| Rate for Payer: Cigna Commercial |
$533.89
|
| Rate for Payer: Health EOS Commercial |
$516.48
|
| Rate for Payer: HFN Commercial |
$533.89
|
| Rate for Payer: Multiplan Commercial |
$464.26
|
| Rate for Payer: Preferred Network Access Commercial |
$533.89
|
| Rate for Payer: Quartz Beloit One Network |
$284.36
|
| Rate for Payer: Quartz Commercial |
$348.19
|
| Rate for Payer: WEA Trust Commercial |
$319.18
|
| Rate for Payer: WPS Commercial |
$429.83
|
|
|
K-WIRE 1.1X 150MM BLUNT/TROCAR DSDS1011
|
Facility
|
OP
|
$558.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5547331
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.49 |
| Max. Negotiated Rate |
$533.89 |
| Rate for Payer: Aetna Commercial |
$522.29
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$499.08
|
| Rate for Payer: Aetna Managed Medicare |
$162.49
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$377.21
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$290.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$278.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$307.57
|
| Rate for Payer: Cash Price |
$167.40
|
| Rate for Payer: Cigna Commercial |
$533.89
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$324.76
|
| Rate for Payer: Health EOS Commercial |
$516.48
|
| Rate for Payer: HFN Commercial |
$533.89
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$435.24
|
| Rate for Payer: Multiplan Commercial |
$464.26
|
| Rate for Payer: NAPHCARE Commercial |
$348.19
|
| Rate for Payer: Preferred Network Access Commercial |
$533.89
|
| Rate for Payer: Quartz Beloit One Network |
$284.36
|
| Rate for Payer: Quartz Commercial |
$377.21
|
| Rate for Payer: Quartz Medicare Advantage |
$348.19
|
| Rate for Payer: The Alliance Commercial |
$290.16
|
| Rate for Payer: WEA Trust Commercial |
$319.18
|
| Rate for Payer: WPS Commercial |
$429.83
|
|
|
K-WIRE 1.1 X 150 SMOOTH 292.623
|
Facility
|
IP
|
$163.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.06 |
| Max. Negotiated Rate |
$155.96 |
| Rate for Payer: Aetna Commercial |
$152.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$145.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$89.85
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cigna Commercial |
$155.96
|
| Rate for Payer: Health EOS Commercial |
$150.87
|
| Rate for Payer: HFN Commercial |
$155.96
|
| Rate for Payer: Multiplan Commercial |
$135.62
|
| Rate for Payer: Preferred Network Access Commercial |
$155.96
|
| Rate for Payer: Quartz Beloit One Network |
$83.06
|
| Rate for Payer: Quartz Commercial |
$101.71
|
| Rate for Payer: WEA Trust Commercial |
$93.24
|
| Rate for Payer: WPS Commercial |
$125.56
|
|
|
K-WIRE 1.1 X 150 SMOOTH 292.623
|
Facility
|
OP
|
$163.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.47 |
| Max. Negotiated Rate |
$155.96 |
| Rate for Payer: Aetna Commercial |
$152.57
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$145.79
|
| Rate for Payer: Aetna Managed Medicare |
$47.47
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$110.19
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$84.76
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$81.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$89.85
|
| Rate for Payer: Cash Price |
$48.90
|
| Rate for Payer: Cigna Commercial |
$155.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$94.87
|
| Rate for Payer: Health EOS Commercial |
$150.87
|
| Rate for Payer: HFN Commercial |
$155.96
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$127.14
|
| Rate for Payer: Multiplan Commercial |
$135.62
|
| Rate for Payer: NAPHCARE Commercial |
$101.71
|
| Rate for Payer: Preferred Network Access Commercial |
$155.96
|
| Rate for Payer: Quartz Beloit One Network |
$83.06
|
| Rate for Payer: Quartz Commercial |
$110.19
|
| Rate for Payer: Quartz Medicare Advantage |
$101.71
|
| Rate for Payer: The Alliance Commercial |
$84.76
|
| Rate for Payer: WEA Trust Commercial |
$93.24
|
| Rate for Payer: WPS Commercial |
$125.56
|
|
|
K-WIRE 1.1 X 150 THREAD 292.622
|
Facility
|
IP
|
$177.00
|
|
| Hospital Charge Code |
2966613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.20 |
| Max. Negotiated Rate |
$169.35 |
| Rate for Payer: Aetna Commercial |
$165.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$158.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$97.56
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cigna Commercial |
$169.35
|
| Rate for Payer: Health EOS Commercial |
$163.83
|
| Rate for Payer: HFN Commercial |
$169.35
|
| Rate for Payer: Multiplan Commercial |
$147.26
|
| Rate for Payer: Preferred Network Access Commercial |
$169.35
|
| Rate for Payer: Quartz Beloit One Network |
$90.20
|
| Rate for Payer: Quartz Commercial |
$110.45
|
| Rate for Payer: WEA Trust Commercial |
$101.24
|
| Rate for Payer: WPS Commercial |
$136.34
|
|
|
K-WIRE 1.1 X 150 THREAD 292.622
|
Facility
|
OP
|
$177.00
|
|
| Hospital Charge Code |
2966613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.54 |
| Max. Negotiated Rate |
$169.35 |
| Rate for Payer: Aetna Commercial |
$165.67
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$158.31
|
| Rate for Payer: Aetna Managed Medicare |
$51.54
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$119.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$92.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$88.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$97.56
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cigna Commercial |
$169.35
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$103.01
|
| Rate for Payer: Health EOS Commercial |
$163.83
|
| Rate for Payer: HFN Commercial |
$169.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$138.06
|
| Rate for Payer: Multiplan Commercial |
$147.26
|
| Rate for Payer: NAPHCARE Commercial |
$110.45
|
| Rate for Payer: Preferred Network Access Commercial |
$169.35
|
| Rate for Payer: Quartz Beloit One Network |
$90.20
|
| Rate for Payer: Quartz Commercial |
$119.65
|
| Rate for Payer: Quartz Medicare Advantage |
$110.45
|
| Rate for Payer: The Alliance Commercial |
$92.04
|
| Rate for Payer: WEA Trust Commercial |
$101.24
|
| Rate for Payer: WPS Commercial |
$136.34
|
|
|
K-WIRE 1.25MM WITH THREADED TIP 292.600
|
Facility
|
OP
|
$654.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5771654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$190.44 |
| Max. Negotiated Rate |
$625.75 |
| Rate for Payer: Aetna Commercial |
$612.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$584.94
|
| Rate for Payer: Aetna Managed Medicare |
$190.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$442.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$340.08
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$326.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$360.48
|
| Rate for Payer: Cash Price |
$196.20
|
| Rate for Payer: Cigna Commercial |
$625.75
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$380.63
|
| Rate for Payer: Health EOS Commercial |
$605.34
|
| Rate for Payer: HFN Commercial |
$625.75
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$510.12
|
| Rate for Payer: Multiplan Commercial |
$544.13
|
| Rate for Payer: NAPHCARE Commercial |
$408.10
|
| Rate for Payer: Preferred Network Access Commercial |
$625.75
|
| Rate for Payer: Quartz Beloit One Network |
$333.28
|
| Rate for Payer: Quartz Commercial |
$442.10
|
| Rate for Payer: Quartz Medicare Advantage |
$408.10
|
| Rate for Payer: The Alliance Commercial |
$340.08
|
| Rate for Payer: WEA Trust Commercial |
$374.09
|
| Rate for Payer: WPS Commercial |
$503.78
|
|
|
K-WIRE 1.25MM WITH THREADED TIP 292.600
|
Facility
|
IP
|
$654.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5771654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$333.28 |
| Max. Negotiated Rate |
$625.75 |
| Rate for Payer: Aetna Commercial |
$612.14
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$584.94
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$360.48
|
| Rate for Payer: Cash Price |
$196.20
|
| Rate for Payer: Cigna Commercial |
$625.75
|
| Rate for Payer: Health EOS Commercial |
$605.34
|
| Rate for Payer: HFN Commercial |
$625.75
|
| Rate for Payer: Multiplan Commercial |
$544.13
|
| Rate for Payer: Preferred Network Access Commercial |
$625.75
|
| Rate for Payer: Quartz Beloit One Network |
$333.28
|
| Rate for Payer: Quartz Commercial |
$408.10
|
| Rate for Payer: WEA Trust Commercial |
$374.09
|
| Rate for Payer: WPS Commercial |
$503.78
|
|
|
K-WIRE 1.25MM X 150MM 390157
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5286742
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.32 |
| Max. Negotiated Rate |
$106.20 |
| Rate for Payer: Aetna Commercial |
$103.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$99.28
|
| Rate for Payer: Aetna Managed Medicare |
$32.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$75.04
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$57.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$55.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$61.18
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna Commercial |
$106.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$64.60
|
| Rate for Payer: Health EOS Commercial |
$102.74
|
| Rate for Payer: HFN Commercial |
$106.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$86.58
|
| Rate for Payer: Multiplan Commercial |
$92.35
|
| Rate for Payer: NAPHCARE Commercial |
$69.26
|
| Rate for Payer: Preferred Network Access Commercial |
$106.20
|
| Rate for Payer: Quartz Beloit One Network |
$56.57
|
| Rate for Payer: Quartz Commercial |
$75.04
|
| Rate for Payer: Quartz Medicare Advantage |
$69.26
|
| Rate for Payer: The Alliance Commercial |
$57.72
|
| Rate for Payer: WEA Trust Commercial |
$63.49
|
| Rate for Payer: WPS Commercial |
$85.50
|
|
|
K-WIRE 1.25MM X 150MM 390157
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5286742
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.57 |
| Max. Negotiated Rate |
$106.20 |
| Rate for Payer: Aetna Commercial |
$103.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$99.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$61.18
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna Commercial |
$106.20
|
| Rate for Payer: Health EOS Commercial |
$102.74
|
| Rate for Payer: HFN Commercial |
$106.20
|
| Rate for Payer: Multiplan Commercial |
$92.35
|
| Rate for Payer: Preferred Network Access Commercial |
$106.20
|
| Rate for Payer: Quartz Beloit One Network |
$56.57
|
| Rate for Payer: Quartz Commercial |
$69.26
|
| Rate for Payer: WEA Trust Commercial |
$63.49
|
| Rate for Payer: WPS Commercial |
$85.50
|
|
|
K-WIRE 1.25 NON-THREADED 900.721
|
Facility
|
OP
|
$452.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5264965
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.62 |
| Max. Negotiated Rate |
$432.47 |
| Rate for Payer: Aetna Commercial |
$423.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$404.27
|
| Rate for Payer: Aetna Managed Medicare |
$131.62
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$305.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$235.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$225.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$249.14
|
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Cigna Commercial |
$432.47
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$263.06
|
| Rate for Payer: Health EOS Commercial |
$418.37
|
| Rate for Payer: HFN Commercial |
$432.47
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$352.56
|
| Rate for Payer: Multiplan Commercial |
$376.06
|
| Rate for Payer: NAPHCARE Commercial |
$282.05
|
| Rate for Payer: Preferred Network Access Commercial |
$432.47
|
| Rate for Payer: Quartz Beloit One Network |
$230.34
|
| Rate for Payer: Quartz Commercial |
$305.55
|
| Rate for Payer: Quartz Medicare Advantage |
$282.05
|
| Rate for Payer: The Alliance Commercial |
$235.04
|
| Rate for Payer: WEA Trust Commercial |
$258.54
|
| Rate for Payer: WPS Commercial |
$348.18
|
|
|
K-WIRE 1.25 NON-THREADED 900.721
|
Facility
|
IP
|
$452.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5264965
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$432.47 |
| Rate for Payer: Aetna Commercial |
$423.07
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$404.27
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$249.14
|
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Cigna Commercial |
$432.47
|
| Rate for Payer: Health EOS Commercial |
$418.37
|
| Rate for Payer: HFN Commercial |
$432.47
|
| Rate for Payer: Multiplan Commercial |
$376.06
|
| Rate for Payer: Preferred Network Access Commercial |
$432.47
|
| Rate for Payer: Quartz Beloit One Network |
$230.34
|
| Rate for Payer: Quartz Commercial |
$282.05
|
| Rate for Payer: WEA Trust Commercial |
$258.54
|
| Rate for Payer: WPS Commercial |
$348.18
|
|
|
K-WIRE 1.25 THREADED 900.722
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966614
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.37 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Aetna Managed Medicare |
$57.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$133.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$102.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$98.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$114.65
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$153.66
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: NAPHCARE Commercial |
$122.93
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$133.17
|
| Rate for Payer: Quartz Medicare Advantage |
$122.93
|
| Rate for Payer: The Alliance Commercial |
$102.44
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 THREADED 900.722
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966614
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.39 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$122.93
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 TITANIUM 492.12
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.39 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$122.93
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 TITANIUM 492.12
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.37 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Aetna Managed Medicare |
$57.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$133.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$102.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$98.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$114.65
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$153.66
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: NAPHCARE Commercial |
$122.93
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$133.17
|
| Rate for Payer: Quartz Medicare Advantage |
$122.93
|
| Rate for Payer: The Alliance Commercial |
$102.44
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 TITANIUM 492.16
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.39 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$122.93
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 TITANIUM 492.16
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.37 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Aetna Managed Medicare |
$57.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$133.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$102.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$98.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$114.65
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$153.66
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: NAPHCARE Commercial |
$122.93
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$133.17
|
| Rate for Payer: Quartz Medicare Advantage |
$122.93
|
| Rate for Payer: The Alliance Commercial |
$102.44
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 X 150MM TROCAR POINT 292.12
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.37 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Aetna Managed Medicare |
$57.37
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$133.17
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$102.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$98.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$114.65
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$153.66
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: NAPHCARE Commercial |
$122.93
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$133.17
|
| Rate for Payer: Quartz Medicare Advantage |
$122.93
|
| Rate for Payer: The Alliance Commercial |
$102.44
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.25 X 150MM TROCAR POINT 292.12
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2966617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.39 |
| Max. Negotiated Rate |
$188.49 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$176.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$108.59
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cigna Commercial |
$188.49
|
| Rate for Payer: Health EOS Commercial |
$182.34
|
| Rate for Payer: HFN Commercial |
$188.49
|
| Rate for Payer: Multiplan Commercial |
$163.90
|
| Rate for Payer: Preferred Network Access Commercial |
$188.49
|
| Rate for Payer: Quartz Beloit One Network |
$100.39
|
| Rate for Payer: Quartz Commercial |
$122.93
|
| Rate for Payer: WEA Trust Commercial |
$112.68
|
| Rate for Payer: WPS Commercial |
$151.75
|
|
|
K-WIRE 1.2 X 150 390152
|
Facility
|
IP
|
$278.00
|
|
| Hospital Charge Code |
5349477
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$141.67 |
| Max. Negotiated Rate |
$265.99 |
| Rate for Payer: Aetna Commercial |
$260.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$248.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$153.23
|
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Cigna Commercial |
$265.99
|
| Rate for Payer: Health EOS Commercial |
$257.32
|
| Rate for Payer: HFN Commercial |
$265.99
|
| Rate for Payer: Multiplan Commercial |
$231.30
|
| Rate for Payer: Preferred Network Access Commercial |
$265.99
|
| Rate for Payer: Quartz Beloit One Network |
$141.67
|
| Rate for Payer: Quartz Commercial |
$173.47
|
| Rate for Payer: WEA Trust Commercial |
$159.02
|
| Rate for Payer: WPS Commercial |
$214.14
|
|
|
K-WIRE 1.2 X 150 390152
|
Facility
|
OP
|
$278.00
|
|
| Hospital Charge Code |
5349477
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.95 |
| Max. Negotiated Rate |
$265.99 |
| Rate for Payer: Aetna Commercial |
$260.21
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$248.64
|
| Rate for Payer: Aetna Managed Medicare |
$80.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$187.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$144.56
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$138.78
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$153.23
|
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Cigna Commercial |
$265.99
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$161.80
|
| Rate for Payer: Health EOS Commercial |
$257.32
|
| Rate for Payer: HFN Commercial |
$265.99
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$216.84
|
| Rate for Payer: Multiplan Commercial |
$231.30
|
| Rate for Payer: NAPHCARE Commercial |
$173.47
|
| Rate for Payer: Preferred Network Access Commercial |
$265.99
|
| Rate for Payer: Quartz Beloit One Network |
$141.67
|
| Rate for Payer: Quartz Commercial |
$187.93
|
| Rate for Payer: Quartz Medicare Advantage |
$173.47
|
| Rate for Payer: The Alliance Commercial |
$144.56
|
| Rate for Payer: WEA Trust Commercial |
$159.02
|
| Rate for Payer: WPS Commercial |
$214.14
|
|
|
K-WIRE 1.2 X 150MM 707091202
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
6166133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.95 |
| Max. Negotiated Rate |
$692.72 |
| Rate for Payer: Aetna Commercial |
$677.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$647.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$399.07
|
| Rate for Payer: Cash Price |
$217.20
|
| Rate for Payer: Cigna Commercial |
$692.72
|
| Rate for Payer: Health EOS Commercial |
$670.13
|
| Rate for Payer: HFN Commercial |
$692.72
|
| Rate for Payer: Multiplan Commercial |
$602.37
|
| Rate for Payer: Preferred Network Access Commercial |
$692.72
|
| Rate for Payer: Quartz Beloit One Network |
$368.95
|
| Rate for Payer: Quartz Commercial |
$451.78
|
| Rate for Payer: WEA Trust Commercial |
$414.13
|
| Rate for Payer: WPS Commercial |
$557.70
|
|
|
K-WIRE 1.2 X 150MM 707091202
|
Facility
|
OP
|
$724.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
6166133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$210.83 |
| Max. Negotiated Rate |
$692.72 |
| Rate for Payer: Aetna Commercial |
$677.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$647.55
|
| Rate for Payer: Aetna Managed Medicare |
$210.83
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$489.42
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$376.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$361.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$399.07
|
| Rate for Payer: Cash Price |
$217.20
|
| Rate for Payer: Cigna Commercial |
$692.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$421.37
|
| Rate for Payer: Health EOS Commercial |
$670.13
|
| Rate for Payer: HFN Commercial |
$692.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$564.72
|
| Rate for Payer: Multiplan Commercial |
$602.37
|
| Rate for Payer: NAPHCARE Commercial |
$451.78
|
| Rate for Payer: Preferred Network Access Commercial |
$692.72
|
| Rate for Payer: Quartz Beloit One Network |
$368.95
|
| Rate for Payer: Quartz Commercial |
$489.42
|
| Rate for Payer: Quartz Medicare Advantage |
$451.78
|
| Rate for Payer: The Alliance Commercial |
$376.48
|
| Rate for Payer: WEA Trust Commercial |
$414.13
|
| Rate for Payer: WPS Commercial |
$557.70
|
|
