|
K-WIRE 4.0 MM NON-THREAD STRYKER KN1117
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
6171786
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$428.72 |
| Rate for Payer: Aetna Commercial |
$419.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$400.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$246.98
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$428.72
|
| Rate for Payer: Health EOS Commercial |
$414.74
|
| Rate for Payer: HFN Commercial |
$428.72
|
| Rate for Payer: Multiplan Commercial |
$372.80
|
| Rate for Payer: NAPHCARE Commercial |
$279.60
|
| Rate for Payer: Preferred Network Access Commercial |
$428.72
|
| Rate for Payer: Quartz Beloit One Network |
$228.34
|
| Rate for Payer: Quartz Commercial |
$279.60
|
| Rate for Payer: WEA Trust Commercial |
$256.30
|
| Rate for Payer: WPS Commercial |
$345.17
|
|
|
K-WIRE 4.0 MM NON-THREAD STRYKER KN1117
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
6171786
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.48 |
| Max. Negotiated Rate |
$1,864.00 |
| Rate for Payer: Aetna Commercial |
$419.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$400.76
|
| Rate for Payer: Aetna Managed Medicare |
$130.48
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$302.90
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$233.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$223.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$246.98
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$428.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$260.77
|
| Rate for Payer: Health EOS Commercial |
$414.74
|
| Rate for Payer: HFN Commercial |
$428.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$349.50
|
| Rate for Payer: Multiplan Commercial |
$372.80
|
| Rate for Payer: NAPHCARE Commercial |
$279.60
|
| Rate for Payer: Preferred Network Access Commercial |
$428.72
|
| Rate for Payer: Quartz Beloit One Network |
$228.34
|
| Rate for Payer: Quartz Commercial |
$302.90
|
| Rate for Payer: Quartz Medicare Advantage |
$279.60
|
| Rate for Payer: The Alliance Commercial |
$1,864.00
|
| Rate for Payer: WEA Trust Commercial |
$256.30
|
| Rate for Payer: WPS Commercial |
$345.17
|
|
|
K-WIRE 6 X .035 PLAIN DOUBLE-ENDED TROCAR POINT 00018604400
|
Facility
|
IP
|
$142.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2967418
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.58 |
| Max. Negotiated Rate |
$130.64 |
| Rate for Payer: Aetna Commercial |
$127.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$122.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$75.26
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$130.64
|
| Rate for Payer: Health EOS Commercial |
$126.38
|
| Rate for Payer: HFN Commercial |
$130.64
|
| Rate for Payer: Multiplan Commercial |
$113.60
|
| Rate for Payer: NAPHCARE Commercial |
$85.20
|
| Rate for Payer: Preferred Network Access Commercial |
$130.64
|
| Rate for Payer: Quartz Beloit One Network |
$69.58
|
| Rate for Payer: Quartz Commercial |
$85.20
|
| Rate for Payer: WEA Trust Commercial |
$78.10
|
| Rate for Payer: WPS Commercial |
$105.18
|
|
|
K-WIRE 6 X .035 PLAIN DOUBLE-ENDED TROCAR POINT 00018604400
|
Facility
|
OP
|
$142.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2967418
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.76 |
| Max. Negotiated Rate |
$568.00 |
| Rate for Payer: Aetna Commercial |
$127.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$122.12
|
| Rate for Payer: Aetna Managed Medicare |
$39.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$92.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$71.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$68.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$75.26
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$130.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$79.46
|
| Rate for Payer: Health EOS Commercial |
$126.38
|
| Rate for Payer: HFN Commercial |
$130.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$106.50
|
| Rate for Payer: Multiplan Commercial |
$113.60
|
| Rate for Payer: NAPHCARE Commercial |
$85.20
|
| Rate for Payer: Preferred Network Access Commercial |
$130.64
|
| Rate for Payer: Quartz Beloit One Network |
$69.58
|
| Rate for Payer: Quartz Commercial |
$92.30
|
| Rate for Payer: Quartz Medicare Advantage |
$85.20
|
| Rate for Payer: The Alliance Commercial |
$568.00
|
| Rate for Payer: WEA Trust Commercial |
$78.10
|
| Rate for Payer: WPS Commercial |
$105.18
|
|
|
K-WIRE 6 X .045 PLAIN SINGLE-END DIAMOND TIP 00018602712
|
Facility
|
IP
|
$142.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2967419
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.58 |
| Max. Negotiated Rate |
$130.64 |
| Rate for Payer: Aetna Commercial |
$127.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$122.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$75.26
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$130.64
|
| Rate for Payer: Health EOS Commercial |
$126.38
|
| Rate for Payer: HFN Commercial |
$130.64
|
| Rate for Payer: Multiplan Commercial |
$113.60
|
| Rate for Payer: NAPHCARE Commercial |
$85.20
|
| Rate for Payer: Preferred Network Access Commercial |
$130.64
|
| Rate for Payer: Quartz Beloit One Network |
$69.58
|
| Rate for Payer: Quartz Commercial |
$85.20
|
| Rate for Payer: WEA Trust Commercial |
$78.10
|
| Rate for Payer: WPS Commercial |
$105.18
|
|
|
K-WIRE 6 X .045 PLAIN SINGLE-END DIAMOND TIP 00018602712
|
Facility
|
OP
|
$142.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2967419
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.76 |
| Max. Negotiated Rate |
$568.00 |
| Rate for Payer: Aetna Commercial |
$127.80
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$122.12
|
| Rate for Payer: Aetna Managed Medicare |
$39.76
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$92.30
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$71.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$68.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$75.26
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$130.64
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$79.46
|
| Rate for Payer: Health EOS Commercial |
$126.38
|
| Rate for Payer: HFN Commercial |
$130.64
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$106.50
|
| Rate for Payer: Multiplan Commercial |
$113.60
|
| Rate for Payer: NAPHCARE Commercial |
$85.20
|
| Rate for Payer: Preferred Network Access Commercial |
$130.64
|
| Rate for Payer: Quartz Beloit One Network |
$69.58
|
| Rate for Payer: Quartz Commercial |
$92.30
|
| Rate for Payer: Quartz Medicare Advantage |
$85.20
|
| Rate for Payer: The Alliance Commercial |
$568.00
|
| Rate for Payer: WEA Trust Commercial |
$78.10
|
| Rate for Payer: WPS Commercial |
$105.18
|
|
|
K-WIRE 6 X .062 PLAIN 00018609000
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2967420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.64 |
| Max. Negotiated Rate |
$125.12 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$116.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.08
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$125.12
|
| Rate for Payer: Health EOS Commercial |
$121.04
|
| Rate for Payer: HFN Commercial |
$125.12
|
| Rate for Payer: Multiplan Commercial |
$108.80
|
| Rate for Payer: NAPHCARE Commercial |
$81.60
|
| Rate for Payer: Preferred Network Access Commercial |
$125.12
|
| Rate for Payer: Quartz Beloit One Network |
$66.64
|
| Rate for Payer: Quartz Commercial |
$81.60
|
| Rate for Payer: WEA Trust Commercial |
$74.80
|
| Rate for Payer: WPS Commercial |
$100.74
|
|
|
K-WIRE 6 X .062 PLAIN 00018609000
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
2967420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.08 |
| Max. Negotiated Rate |
$544.00 |
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$116.96
|
| Rate for Payer: Aetna Managed Medicare |
$38.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$88.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$68.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$65.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$72.08
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$125.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$76.11
|
| Rate for Payer: Health EOS Commercial |
$121.04
|
| Rate for Payer: HFN Commercial |
$125.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$102.00
|
| Rate for Payer: Multiplan Commercial |
$108.80
|
| Rate for Payer: NAPHCARE Commercial |
$81.60
|
| Rate for Payer: Preferred Network Access Commercial |
$125.12
|
| Rate for Payer: Quartz Beloit One Network |
$66.64
|
| Rate for Payer: Quartz Commercial |
$88.40
|
| Rate for Payer: Quartz Medicare Advantage |
$81.60
|
| Rate for Payer: The Alliance Commercial |
$544.00
|
| Rate for Payer: WEA Trust Commercial |
$74.80
|
| Rate for Payer: WPS Commercial |
$100.74
|
|
|
K-WIRE 8.6MM X 120MM AR-8610K-25
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5415161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.32 |
| Max. Negotiated Rate |
$1,276.00 |
| Rate for Payer: Aetna Commercial |
$287.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$274.34
|
| Rate for Payer: Aetna Managed Medicare |
$89.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$207.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$159.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$153.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$169.07
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Cigna Commercial |
$293.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$178.51
|
| Rate for Payer: Health EOS Commercial |
$283.91
|
| Rate for Payer: HFN Commercial |
$293.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$239.25
|
| Rate for Payer: Multiplan Commercial |
$255.20
|
| Rate for Payer: NAPHCARE Commercial |
$191.40
|
| Rate for Payer: Preferred Network Access Commercial |
$293.48
|
| Rate for Payer: Quartz Beloit One Network |
$156.31
|
| Rate for Payer: Quartz Commercial |
$207.35
|
| Rate for Payer: Quartz Medicare Advantage |
$191.40
|
| Rate for Payer: The Alliance Commercial |
$1,276.00
|
| Rate for Payer: WEA Trust Commercial |
$175.45
|
| Rate for Payer: WPS Commercial |
$236.28
|
|
|
K-WIRE 8.6MM X 120MM AR-8610K-25
|
Facility
|
IP
|
$319.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5415161
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.31 |
| Max. Negotiated Rate |
$293.48 |
| Rate for Payer: Aetna Commercial |
$287.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$274.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$169.07
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Cigna Commercial |
$293.48
|
| Rate for Payer: Health EOS Commercial |
$283.91
|
| Rate for Payer: HFN Commercial |
$293.48
|
| Rate for Payer: Multiplan Commercial |
$255.20
|
| Rate for Payer: NAPHCARE Commercial |
$191.40
|
| Rate for Payer: Preferred Network Access Commercial |
$293.48
|
| Rate for Payer: Quartz Beloit One Network |
$156.31
|
| Rate for Payer: Quartz Commercial |
$191.40
|
| Rate for Payer: WEA Trust Commercial |
$175.45
|
| Rate for Payer: WPS Commercial |
$236.28
|
|
|
K-WIRE .9MM X 70MM MARKED TROCAR TIP AGK09070M
|
Facility
|
OP
|
$777.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5286740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$217.56 |
| Max. Negotiated Rate |
$3,108.00 |
| Rate for Payer: Aetna Commercial |
$699.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$668.22
|
| Rate for Payer: Aetna Managed Medicare |
$217.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$505.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$388.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$372.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$411.81
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cigna Commercial |
$714.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$434.81
|
| Rate for Payer: Health EOS Commercial |
$691.53
|
| Rate for Payer: HFN Commercial |
$714.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$582.75
|
| Rate for Payer: Multiplan Commercial |
$621.60
|
| Rate for Payer: NAPHCARE Commercial |
$466.20
|
| Rate for Payer: Preferred Network Access Commercial |
$714.84
|
| Rate for Payer: Quartz Beloit One Network |
$380.73
|
| Rate for Payer: Quartz Commercial |
$505.05
|
| Rate for Payer: Quartz Medicare Advantage |
$466.20
|
| Rate for Payer: The Alliance Commercial |
$3,108.00
|
| Rate for Payer: WEA Trust Commercial |
$427.35
|
| Rate for Payer: WPS Commercial |
$575.52
|
|
|
K-WIRE .9MM X 70MM MARKED TROCAR TIP AGK09070M
|
Facility
|
IP
|
$777.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5286740
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$380.73 |
| Max. Negotiated Rate |
$714.84 |
| Rate for Payer: Aetna Commercial |
$699.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$668.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$411.81
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cigna Commercial |
$714.84
|
| Rate for Payer: Health EOS Commercial |
$691.53
|
| Rate for Payer: HFN Commercial |
$714.84
|
| Rate for Payer: Multiplan Commercial |
$621.60
|
| Rate for Payer: NAPHCARE Commercial |
$466.20
|
| Rate for Payer: Preferred Network Access Commercial |
$714.84
|
| Rate for Payer: Quartz Beloit One Network |
$380.73
|
| Rate for Payer: Quartz Commercial |
$466.20
|
| Rate for Payer: WEA Trust Commercial |
$427.35
|
| Rate for Payer: WPS Commercial |
$575.52
|
|
|
K-WIRE 9 X .035 PLAIN
|
Facility
|
IP
|
$108.00
|
|
| Hospital Charge Code |
2967421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.92 |
| Max. Negotiated Rate |
$99.36 |
| Rate for Payer: Aetna Commercial |
$97.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.24
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$99.36
|
| Rate for Payer: Health EOS Commercial |
$96.12
|
| Rate for Payer: HFN Commercial |
$99.36
|
| Rate for Payer: Multiplan Commercial |
$86.40
|
| Rate for Payer: NAPHCARE Commercial |
$64.80
|
| Rate for Payer: Preferred Network Access Commercial |
$99.36
|
| Rate for Payer: Quartz Beloit One Network |
$52.92
|
| Rate for Payer: Quartz Commercial |
$64.80
|
| Rate for Payer: WEA Trust Commercial |
$59.40
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
K-WIRE 9 X .035 PLAIN
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
2967421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.24 |
| Max. Negotiated Rate |
$432.00 |
| Rate for Payer: Aetna Commercial |
$97.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.88
|
| Rate for Payer: Aetna Managed Medicare |
$30.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.24
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$99.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.44
|
| Rate for Payer: Health EOS Commercial |
$96.12
|
| Rate for Payer: HFN Commercial |
$99.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$86.40
|
| Rate for Payer: NAPHCARE Commercial |
$64.80
|
| Rate for Payer: Preferred Network Access Commercial |
$99.36
|
| Rate for Payer: Quartz Beloit One Network |
$52.92
|
| Rate for Payer: Quartz Commercial |
$70.20
|
| Rate for Payer: Quartz Medicare Advantage |
$64.80
|
| Rate for Payer: The Alliance Commercial |
$432.00
|
| Rate for Payer: WEA Trust Commercial |
$59.40
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
K-WIRE 9 X .045 PLAIN
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
2967422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.24 |
| Max. Negotiated Rate |
$432.00 |
| Rate for Payer: Aetna Commercial |
$97.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.88
|
| Rate for Payer: Aetna Managed Medicare |
$30.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$70.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$54.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$51.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.24
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$99.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$60.44
|
| Rate for Payer: Health EOS Commercial |
$96.12
|
| Rate for Payer: HFN Commercial |
$99.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$86.40
|
| Rate for Payer: NAPHCARE Commercial |
$64.80
|
| Rate for Payer: Preferred Network Access Commercial |
$99.36
|
| Rate for Payer: Quartz Beloit One Network |
$52.92
|
| Rate for Payer: Quartz Commercial |
$70.20
|
| Rate for Payer: Quartz Medicare Advantage |
$64.80
|
| Rate for Payer: The Alliance Commercial |
$432.00
|
| Rate for Payer: WEA Trust Commercial |
$59.40
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
K-WIRE 9 X .045 PLAIN
|
Facility
|
IP
|
$108.00
|
|
| Hospital Charge Code |
2967422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.92 |
| Max. Negotiated Rate |
$99.36 |
| Rate for Payer: Aetna Commercial |
$97.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$57.24
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$99.36
|
| Rate for Payer: Health EOS Commercial |
$96.12
|
| Rate for Payer: HFN Commercial |
$99.36
|
| Rate for Payer: Multiplan Commercial |
$86.40
|
| Rate for Payer: NAPHCARE Commercial |
$64.80
|
| Rate for Payer: Preferred Network Access Commercial |
$99.36
|
| Rate for Payer: Quartz Beloit One Network |
$52.92
|
| Rate for Payer: Quartz Commercial |
$64.80
|
| Rate for Payer: WEA Trust Commercial |
$59.40
|
| Rate for Payer: WPS Commercial |
$80.00
|
|
|
K-WIRE 9 X .062 PLAIN
|
Facility
|
IP
|
$111.00
|
|
| Hospital Charge Code |
2967423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.39 |
| Max. Negotiated Rate |
$102.12 |
| Rate for Payer: Aetna Commercial |
$99.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$95.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$58.83
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna Commercial |
$102.12
|
| Rate for Payer: Health EOS Commercial |
$98.79
|
| Rate for Payer: HFN Commercial |
$102.12
|
| Rate for Payer: Multiplan Commercial |
$88.80
|
| Rate for Payer: NAPHCARE Commercial |
$66.60
|
| Rate for Payer: Preferred Network Access Commercial |
$102.12
|
| Rate for Payer: Quartz Beloit One Network |
$54.39
|
| Rate for Payer: Quartz Commercial |
$66.60
|
| Rate for Payer: WEA Trust Commercial |
$61.05
|
| Rate for Payer: WPS Commercial |
$82.22
|
|
|
K-WIRE 9 X .062 PLAIN
|
Facility
|
OP
|
$111.00
|
|
| Hospital Charge Code |
2967423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.08 |
| Max. Negotiated Rate |
$444.00 |
| Rate for Payer: Aetna Commercial |
$99.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$95.46
|
| Rate for Payer: Aetna Managed Medicare |
$31.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$72.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$55.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$53.28
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$58.83
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna Commercial |
$102.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$62.12
|
| Rate for Payer: Health EOS Commercial |
$98.79
|
| Rate for Payer: HFN Commercial |
$102.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$83.25
|
| Rate for Payer: Multiplan Commercial |
$88.80
|
| Rate for Payer: NAPHCARE Commercial |
$66.60
|
| Rate for Payer: Preferred Network Access Commercial |
$102.12
|
| Rate for Payer: Quartz Beloit One Network |
$54.39
|
| Rate for Payer: Quartz Commercial |
$72.15
|
| Rate for Payer: Quartz Medicare Advantage |
$66.60
|
| Rate for Payer: The Alliance Commercial |
$444.00
|
| Rate for Payer: WEA Trust Commercial |
$61.05
|
| Rate for Payer: WPS Commercial |
$82.22
|
|
|
K-WIRE BB-TAK LARGE SMOOTH AR-8970-09
|
Facility
|
OP
|
$1,797.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5603781
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$503.16 |
| Max. Negotiated Rate |
$7,188.00 |
| Rate for Payer: Aetna Commercial |
$1,617.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,545.42
|
| Rate for Payer: Aetna Managed Medicare |
$503.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,168.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$898.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$862.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$952.41
|
| Rate for Payer: Cash Price |
$539.10
|
| Rate for Payer: Cigna Commercial |
$1,653.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,005.60
|
| Rate for Payer: Health EOS Commercial |
$1,599.33
|
| Rate for Payer: HFN Commercial |
$1,653.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,347.75
|
| Rate for Payer: Multiplan Commercial |
$1,437.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,078.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,653.24
|
| Rate for Payer: Quartz Beloit One Network |
$880.53
|
| Rate for Payer: Quartz Commercial |
$1,168.05
|
| Rate for Payer: Quartz Medicare Advantage |
$1,078.20
|
| Rate for Payer: The Alliance Commercial |
$7,188.00
|
| Rate for Payer: WEA Trust Commercial |
$988.35
|
| Rate for Payer: WPS Commercial |
$1,331.04
|
|
|
K-WIRE BB-TAK LARGE SMOOTH AR-8970-09
|
Facility
|
IP
|
$1,797.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5603781
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$880.53 |
| Max. Negotiated Rate |
$1,653.24 |
| Rate for Payer: Aetna Commercial |
$1,617.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,545.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$952.41
|
| Rate for Payer: Cash Price |
$539.10
|
| Rate for Payer: Cigna Commercial |
$1,653.24
|
| Rate for Payer: Health EOS Commercial |
$1,599.33
|
| Rate for Payer: HFN Commercial |
$1,653.24
|
| Rate for Payer: Multiplan Commercial |
$1,437.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,078.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,653.24
|
| Rate for Payer: Quartz Beloit One Network |
$880.53
|
| Rate for Payer: Quartz Commercial |
$1,078.20
|
| Rate for Payer: WEA Trust Commercial |
$988.35
|
| Rate for Payer: WPS Commercial |
$1,331.04
|
|
|
K-WIRE BB-TAK LARGE THREADED AR-8970-09T
|
Facility
|
OP
|
$1,997.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5603782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$559.16 |
| Max. Negotiated Rate |
$7,988.00 |
| Rate for Payer: Aetna Commercial |
$1,797.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,717.42
|
| Rate for Payer: Aetna Managed Medicare |
$559.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,298.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$998.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$958.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,058.41
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,837.24
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,117.52
|
| Rate for Payer: Health EOS Commercial |
$1,777.33
|
| Rate for Payer: HFN Commercial |
$1,837.24
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,497.75
|
| Rate for Payer: Multiplan Commercial |
$1,597.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,198.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,837.24
|
| Rate for Payer: Quartz Beloit One Network |
$978.53
|
| Rate for Payer: Quartz Commercial |
$1,298.05
|
| Rate for Payer: Quartz Medicare Advantage |
$1,198.20
|
| Rate for Payer: The Alliance Commercial |
$7,988.00
|
| Rate for Payer: WEA Trust Commercial |
$1,098.35
|
| Rate for Payer: WPS Commercial |
$1,479.18
|
|
|
K-WIRE BB-TAK LARGE THREADED AR-8970-09T
|
Facility
|
IP
|
$1,997.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5603782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$978.53 |
| Max. Negotiated Rate |
$1,837.24 |
| Rate for Payer: Aetna Commercial |
$1,797.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,717.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,058.41
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,837.24
|
| Rate for Payer: Health EOS Commercial |
$1,777.33
|
| Rate for Payer: HFN Commercial |
$1,837.24
|
| Rate for Payer: Multiplan Commercial |
$1,597.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,198.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,837.24
|
| Rate for Payer: Quartz Beloit One Network |
$978.53
|
| Rate for Payer: Quartz Commercial |
$1,198.20
|
| Rate for Payer: WEA Trust Commercial |
$1,098.35
|
| Rate for Payer: WPS Commercial |
$1,479.18
|
|
|
K-WIRE BB-TAK SMOOTH AR-13226
|
Facility
|
OP
|
$799.00
|
|
| Hospital Charge Code |
5200631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$223.72 |
| Max. Negotiated Rate |
$3,196.00 |
| Rate for Payer: Aetna Commercial |
$719.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$687.14
|
| Rate for Payer: Aetna Managed Medicare |
$223.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$519.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$399.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$383.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$423.47
|
| Rate for Payer: Cash Price |
$239.70
|
| Rate for Payer: Cigna Commercial |
$735.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$447.12
|
| Rate for Payer: Health EOS Commercial |
$711.11
|
| Rate for Payer: HFN Commercial |
$735.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$599.25
|
| Rate for Payer: Multiplan Commercial |
$639.20
|
| Rate for Payer: NAPHCARE Commercial |
$479.40
|
| Rate for Payer: Preferred Network Access Commercial |
$735.08
|
| Rate for Payer: Quartz Beloit One Network |
$391.51
|
| Rate for Payer: Quartz Commercial |
$519.35
|
| Rate for Payer: Quartz Medicare Advantage |
$479.40
|
| Rate for Payer: The Alliance Commercial |
$3,196.00
|
| Rate for Payer: WEA Trust Commercial |
$439.45
|
| Rate for Payer: WPS Commercial |
$591.82
|
|
|
K-WIRE BB-TAK SMOOTH AR-13226
|
Facility
|
IP
|
$799.00
|
|
| Hospital Charge Code |
5200631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$391.51 |
| Max. Negotiated Rate |
$735.08 |
| Rate for Payer: Aetna Commercial |
$719.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$687.14
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$423.47
|
| Rate for Payer: Cash Price |
$239.70
|
| Rate for Payer: Cigna Commercial |
$735.08
|
| Rate for Payer: Health EOS Commercial |
$711.11
|
| Rate for Payer: HFN Commercial |
$735.08
|
| Rate for Payer: Multiplan Commercial |
$639.20
|
| Rate for Payer: NAPHCARE Commercial |
$479.40
|
| Rate for Payer: Preferred Network Access Commercial |
$735.08
|
| Rate for Payer: Quartz Beloit One Network |
$391.51
|
| Rate for Payer: Quartz Commercial |
$479.40
|
| Rate for Payer: WEA Trust Commercial |
$439.45
|
| Rate for Payer: WPS Commercial |
$591.82
|
|
|
K-WIRE BB-TAK THREADED AR-13226T
|
Facility
|
OP
|
$1,357.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5521079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$379.96 |
| Max. Negotiated Rate |
$5,428.00 |
| Rate for Payer: Aetna Commercial |
$1,221.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,167.02
|
| Rate for Payer: Aetna Managed Medicare |
$379.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$882.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$678.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$651.36
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$719.21
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,248.44
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$759.38
|
| Rate for Payer: Health EOS Commercial |
$1,207.73
|
| Rate for Payer: HFN Commercial |
$1,248.44
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,017.75
|
| Rate for Payer: Multiplan Commercial |
$1,085.60
|
| Rate for Payer: NAPHCARE Commercial |
$814.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,248.44
|
| Rate for Payer: Quartz Beloit One Network |
$664.93
|
| Rate for Payer: Quartz Commercial |
$882.05
|
| Rate for Payer: Quartz Medicare Advantage |
$814.20
|
| Rate for Payer: The Alliance Commercial |
$5,428.00
|
| Rate for Payer: WEA Trust Commercial |
$746.35
|
| Rate for Payer: WPS Commercial |
$1,005.13
|
|
