|
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 |
$92.89 |
| Max. Negotiated Rate |
$305.22 |
| Rate for Payer: Aetna Commercial |
$298.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$285.31
|
| Rate for Payer: Aetna Managed Medicare |
$92.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$215.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$165.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$159.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$175.83
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Cigna Commercial |
$305.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$185.66
|
| Rate for Payer: Health EOS Commercial |
$295.27
|
| Rate for Payer: HFN Commercial |
$305.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$248.82
|
| Rate for Payer: Multiplan Commercial |
$265.41
|
| Rate for Payer: NAPHCARE Commercial |
$199.06
|
| Rate for Payer: Preferred Network Access Commercial |
$305.22
|
| Rate for Payer: Quartz Beloit One Network |
$162.56
|
| Rate for Payer: Quartz Commercial |
$215.64
|
| Rate for Payer: Quartz Medicare Advantage |
$199.06
|
| Rate for Payer: The Alliance Commercial |
$165.88
|
| Rate for Payer: WEA Trust Commercial |
$182.47
|
| Rate for Payer: WPS Commercial |
$245.73
|
|
|
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 |
$395.96 |
| Max. Negotiated Rate |
$743.43 |
| Rate for Payer: Aetna Commercial |
$727.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$694.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$428.28
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cigna Commercial |
$743.43
|
| Rate for Payer: Health EOS Commercial |
$719.19
|
| Rate for Payer: HFN Commercial |
$743.43
|
| Rate for Payer: Multiplan Commercial |
$646.46
|
| Rate for Payer: Preferred Network Access Commercial |
$743.43
|
| Rate for Payer: Quartz Beloit One Network |
$395.96
|
| Rate for Payer: Quartz Commercial |
$484.85
|
| Rate for Payer: WEA Trust Commercial |
$444.44
|
| Rate for Payer: WPS Commercial |
$598.52
|
|
|
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 |
$226.26 |
| Max. Negotiated Rate |
$743.43 |
| Rate for Payer: Aetna Commercial |
$727.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$694.95
|
| Rate for Payer: Aetna Managed Medicare |
$226.26
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$525.25
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$404.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$387.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$428.28
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cigna Commercial |
$743.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$452.21
|
| Rate for Payer: Health EOS Commercial |
$719.19
|
| Rate for Payer: HFN Commercial |
$743.43
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$606.06
|
| Rate for Payer: Multiplan Commercial |
$646.46
|
| Rate for Payer: NAPHCARE Commercial |
$484.85
|
| Rate for Payer: Preferred Network Access Commercial |
$743.43
|
| Rate for Payer: Quartz Beloit One Network |
$395.96
|
| Rate for Payer: Quartz Commercial |
$525.25
|
| Rate for Payer: Quartz Medicare Advantage |
$484.85
|
| Rate for Payer: The Alliance Commercial |
$404.04
|
| Rate for Payer: WEA Trust Commercial |
$444.44
|
| Rate for Payer: WPS Commercial |
$598.52
|
|
|
K-WIRE 9 X .035 PLAIN
|
Facility
|
IP
|
$108.00
|
|
| Hospital Charge Code |
2967421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.04 |
| Max. Negotiated Rate |
$103.33 |
| Rate for Payer: Aetna Commercial |
$101.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$59.53
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$103.33
|
| Rate for Payer: Health EOS Commercial |
$99.96
|
| Rate for Payer: HFN Commercial |
$103.33
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: Preferred Network Access Commercial |
$103.33
|
| Rate for Payer: Quartz Beloit One Network |
$55.04
|
| Rate for Payer: Quartz Commercial |
$67.39
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$83.19
|
|
|
K-WIRE 9 X .035 PLAIN
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
2967421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.45 |
| Max. Negotiated Rate |
$103.33 |
| Rate for Payer: Aetna Commercial |
$101.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Aetna Managed Medicare |
$31.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$73.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$56.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$53.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$59.53
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$103.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$62.86
|
| Rate for Payer: Health EOS Commercial |
$99.96
|
| Rate for Payer: HFN Commercial |
$103.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.24
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: NAPHCARE Commercial |
$67.39
|
| Rate for Payer: Preferred Network Access Commercial |
$103.33
|
| Rate for Payer: Quartz Beloit One Network |
$55.04
|
| Rate for Payer: Quartz Commercial |
$73.01
|
| Rate for Payer: Quartz Medicare Advantage |
$67.39
|
| Rate for Payer: The Alliance Commercial |
$56.16
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$83.19
|
|
|
K-WIRE 9 X .045 PLAIN
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
2967422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.45 |
| Max. Negotiated Rate |
$103.33 |
| Rate for Payer: Aetna Commercial |
$101.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Aetna Managed Medicare |
$31.45
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$73.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$56.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$53.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$59.53
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$103.33
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$62.86
|
| Rate for Payer: Health EOS Commercial |
$99.96
|
| Rate for Payer: HFN Commercial |
$103.33
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$84.24
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: NAPHCARE Commercial |
$67.39
|
| Rate for Payer: Preferred Network Access Commercial |
$103.33
|
| Rate for Payer: Quartz Beloit One Network |
$55.04
|
| Rate for Payer: Quartz Commercial |
$73.01
|
| Rate for Payer: Quartz Medicare Advantage |
$67.39
|
| Rate for Payer: The Alliance Commercial |
$56.16
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$83.19
|
|
|
K-WIRE 9 X .045 PLAIN
|
Facility
|
IP
|
$108.00
|
|
| Hospital Charge Code |
2967422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.04 |
| Max. Negotiated Rate |
$103.33 |
| Rate for Payer: Aetna Commercial |
$101.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$96.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$59.53
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna Commercial |
$103.33
|
| Rate for Payer: Health EOS Commercial |
$99.96
|
| Rate for Payer: HFN Commercial |
$103.33
|
| Rate for Payer: Multiplan Commercial |
$89.86
|
| Rate for Payer: Preferred Network Access Commercial |
$103.33
|
| Rate for Payer: Quartz Beloit One Network |
$55.04
|
| Rate for Payer: Quartz Commercial |
$67.39
|
| Rate for Payer: WEA Trust Commercial |
$61.78
|
| Rate for Payer: WPS Commercial |
$83.19
|
|
|
K-WIRE 9 X .062 PLAIN
|
Facility
|
OP
|
$111.00
|
|
| Hospital Charge Code |
2967423
|
|
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 9 X .062 PLAIN
|
Facility
|
IP
|
$111.00
|
|
| Hospital Charge Code |
2967423
|
|
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 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 |
$915.75 |
| Max. Negotiated Rate |
$1,719.37 |
| Rate for Payer: Aetna Commercial |
$1,681.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,607.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$990.51
|
| Rate for Payer: Cash Price |
$539.10
|
| Rate for Payer: Cigna Commercial |
$1,719.37
|
| Rate for Payer: Health EOS Commercial |
$1,663.30
|
| Rate for Payer: HFN Commercial |
$1,719.37
|
| Rate for Payer: Multiplan Commercial |
$1,495.10
|
| Rate for Payer: Preferred Network Access Commercial |
$1,719.37
|
| Rate for Payer: Quartz Beloit One Network |
$915.75
|
| Rate for Payer: Quartz Commercial |
$1,121.33
|
| Rate for Payer: WEA Trust Commercial |
$1,027.88
|
| Rate for Payer: WPS Commercial |
$1,384.23
|
|
|
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 |
$523.29 |
| Max. Negotiated Rate |
$1,719.37 |
| Rate for Payer: Aetna Commercial |
$1,681.99
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,607.24
|
| Rate for Payer: Aetna Managed Medicare |
$523.29
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,214.77
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$934.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$897.06
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$990.51
|
| Rate for Payer: Cash Price |
$539.10
|
| Rate for Payer: Cigna Commercial |
$1,719.37
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,045.85
|
| Rate for Payer: Health EOS Commercial |
$1,663.30
|
| Rate for Payer: HFN Commercial |
$1,719.37
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,401.66
|
| Rate for Payer: Multiplan Commercial |
$1,495.10
|
| Rate for Payer: NAPHCARE Commercial |
$1,121.33
|
| Rate for Payer: Preferred Network Access Commercial |
$1,719.37
|
| Rate for Payer: Quartz Beloit One Network |
$915.75
|
| Rate for Payer: Quartz Commercial |
$1,214.77
|
| Rate for Payer: Quartz Medicare Advantage |
$1,121.33
|
| Rate for Payer: The Alliance Commercial |
$934.44
|
| Rate for Payer: WEA Trust Commercial |
$1,027.88
|
| Rate for Payer: WPS Commercial |
$1,384.23
|
|
|
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 |
$581.53 |
| Max. Negotiated Rate |
$1,910.73 |
| Rate for Payer: Aetna Commercial |
$1,869.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,786.12
|
| Rate for Payer: Aetna Managed Medicare |
$581.53
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,349.97
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,038.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$996.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,100.75
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,910.73
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,162.25
|
| Rate for Payer: Health EOS Commercial |
$1,848.42
|
| Rate for Payer: HFN Commercial |
$1,910.73
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,557.66
|
| Rate for Payer: Multiplan Commercial |
$1,661.50
|
| Rate for Payer: NAPHCARE Commercial |
$1,246.13
|
| Rate for Payer: Preferred Network Access Commercial |
$1,910.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,017.67
|
| Rate for Payer: Quartz Commercial |
$1,349.97
|
| Rate for Payer: Quartz Medicare Advantage |
$1,246.13
|
| Rate for Payer: The Alliance Commercial |
$1,038.44
|
| Rate for Payer: WEA Trust Commercial |
$1,142.28
|
| Rate for Payer: WPS Commercial |
$1,538.29
|
|
|
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 |
$1,017.67 |
| Max. Negotiated Rate |
$1,910.73 |
| Rate for Payer: Aetna Commercial |
$1,869.19
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,786.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,100.75
|
| Rate for Payer: Cash Price |
$599.10
|
| Rate for Payer: Cigna Commercial |
$1,910.73
|
| Rate for Payer: Health EOS Commercial |
$1,848.42
|
| Rate for Payer: HFN Commercial |
$1,910.73
|
| Rate for Payer: Multiplan Commercial |
$1,661.50
|
| Rate for Payer: Preferred Network Access Commercial |
$1,910.73
|
| Rate for Payer: Quartz Beloit One Network |
$1,017.67
|
| Rate for Payer: Quartz Commercial |
$1,246.13
|
| Rate for Payer: WEA Trust Commercial |
$1,142.28
|
| Rate for Payer: WPS Commercial |
$1,538.29
|
|
|
K-WIRE BB-TAK SMOOTH AR-13226
|
Facility
|
OP
|
$799.00
|
|
| Hospital Charge Code |
5200631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.67 |
| Max. Negotiated Rate |
$764.48 |
| Rate for Payer: Aetna Commercial |
$747.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$714.63
|
| Rate for Payer: Aetna Managed Medicare |
$232.67
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$540.12
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$415.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$398.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$440.41
|
| Rate for Payer: Cash Price |
$239.70
|
| Rate for Payer: Cigna Commercial |
$764.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$465.02
|
| Rate for Payer: Health EOS Commercial |
$739.55
|
| Rate for Payer: HFN Commercial |
$764.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$623.22
|
| Rate for Payer: Multiplan Commercial |
$664.77
|
| Rate for Payer: NAPHCARE Commercial |
$498.58
|
| Rate for Payer: Preferred Network Access Commercial |
$764.48
|
| Rate for Payer: Quartz Beloit One Network |
$407.17
|
| Rate for Payer: Quartz Commercial |
$540.12
|
| Rate for Payer: Quartz Medicare Advantage |
$498.58
|
| Rate for Payer: The Alliance Commercial |
$415.48
|
| Rate for Payer: WEA Trust Commercial |
$457.03
|
| Rate for Payer: WPS Commercial |
$615.47
|
|
|
K-WIRE BB-TAK SMOOTH AR-13226
|
Facility
|
IP
|
$799.00
|
|
| Hospital Charge Code |
5200631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$407.17 |
| Max. Negotiated Rate |
$764.48 |
| Rate for Payer: Aetna Commercial |
$747.86
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$714.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$440.41
|
| Rate for Payer: Cash Price |
$239.70
|
| Rate for Payer: Cigna Commercial |
$764.48
|
| Rate for Payer: Health EOS Commercial |
$739.55
|
| Rate for Payer: HFN Commercial |
$764.48
|
| Rate for Payer: Multiplan Commercial |
$664.77
|
| Rate for Payer: Preferred Network Access Commercial |
$764.48
|
| Rate for Payer: Quartz Beloit One Network |
$407.17
|
| Rate for Payer: Quartz Commercial |
$498.58
|
| Rate for Payer: WEA Trust Commercial |
$457.03
|
| Rate for Payer: WPS Commercial |
$615.47
|
|
|
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 |
$395.16 |
| Max. Negotiated Rate |
$1,298.38 |
| Rate for Payer: Aetna Commercial |
$1,270.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,213.70
|
| Rate for Payer: Aetna Managed Medicare |
$395.16
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$917.33
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$705.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$677.41
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$747.98
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,298.38
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$789.77
|
| Rate for Payer: Health EOS Commercial |
$1,256.04
|
| Rate for Payer: HFN Commercial |
$1,298.38
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,058.46
|
| Rate for Payer: Multiplan Commercial |
$1,129.02
|
| Rate for Payer: NAPHCARE Commercial |
$846.77
|
| Rate for Payer: Preferred Network Access Commercial |
$1,298.38
|
| Rate for Payer: Quartz Beloit One Network |
$691.53
|
| Rate for Payer: Quartz Commercial |
$917.33
|
| Rate for Payer: Quartz Medicare Advantage |
$846.77
|
| Rate for Payer: The Alliance Commercial |
$705.64
|
| Rate for Payer: WEA Trust Commercial |
$776.20
|
| Rate for Payer: WPS Commercial |
$1,045.30
|
|
|
K-WIRE BB-TAK THREADED AR-13226T
|
Facility
|
IP
|
$1,357.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
5521079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$691.53 |
| Max. Negotiated Rate |
$1,298.38 |
| Rate for Payer: Aetna Commercial |
$1,270.15
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,213.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$747.98
|
| Rate for Payer: Cash Price |
$407.10
|
| Rate for Payer: Cigna Commercial |
$1,298.38
|
| Rate for Payer: Health EOS Commercial |
$1,256.04
|
| Rate for Payer: HFN Commercial |
$1,298.38
|
| Rate for Payer: Multiplan Commercial |
$1,129.02
|
| Rate for Payer: Preferred Network Access Commercial |
$1,298.38
|
| Rate for Payer: Quartz Beloit One Network |
$691.53
|
| Rate for Payer: Quartz Commercial |
$846.77
|
| Rate for Payer: WEA Trust Commercial |
$776.20
|
| Rate for Payer: WPS Commercial |
$1,045.30
|
|
|
K-WIRE DBL ENDED .045 X 6 IN 210-40-006
|
Facility
|
IP
|
$381.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3693501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.16 |
| Max. Negotiated Rate |
$364.54 |
| Rate for Payer: Aetna Commercial |
$356.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$340.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$210.01
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cigna Commercial |
$364.54
|
| Rate for Payer: Health EOS Commercial |
$352.65
|
| Rate for Payer: HFN Commercial |
$364.54
|
| Rate for Payer: Multiplan Commercial |
$316.99
|
| Rate for Payer: Preferred Network Access Commercial |
$364.54
|
| Rate for Payer: Quartz Beloit One Network |
$194.16
|
| Rate for Payer: Quartz Commercial |
$237.74
|
| Rate for Payer: WEA Trust Commercial |
$217.93
|
| Rate for Payer: WPS Commercial |
$293.48
|
|
|
K-WIRE DBL ENDED .045 X 6 IN 210-40-006
|
Facility
|
OP
|
$381.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3693501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.95 |
| Max. Negotiated Rate |
$364.54 |
| Rate for Payer: Aetna Commercial |
$356.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$340.77
|
| Rate for Payer: Aetna Managed Medicare |
$110.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$257.56
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$198.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$190.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$210.01
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cigna Commercial |
$364.54
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$221.74
|
| Rate for Payer: Health EOS Commercial |
$352.65
|
| Rate for Payer: HFN Commercial |
$364.54
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$297.18
|
| Rate for Payer: Multiplan Commercial |
$316.99
|
| Rate for Payer: NAPHCARE Commercial |
$237.74
|
| Rate for Payer: Preferred Network Access Commercial |
$364.54
|
| Rate for Payer: Quartz Beloit One Network |
$194.16
|
| Rate for Payer: Quartz Commercial |
$257.56
|
| Rate for Payer: Quartz Medicare Advantage |
$237.74
|
| Rate for Payer: The Alliance Commercial |
$198.12
|
| Rate for Payer: WEA Trust Commercial |
$217.93
|
| Rate for Payer: WPS Commercial |
$293.48
|
|
|
K-WIRE GRIDLOCK PART THREAD .045 X 6 STD 210-40-004/5"
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3444835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.89 |
| Max. Negotiated Rate |
$305.22 |
| Rate for Payer: Aetna Commercial |
$298.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$285.31
|
| Rate for Payer: Aetna Managed Medicare |
$92.89
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$215.64
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$165.88
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$159.24
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$175.83
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Cigna Commercial |
$305.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$185.66
|
| Rate for Payer: Health EOS Commercial |
$295.27
|
| Rate for Payer: HFN Commercial |
$305.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$248.82
|
| Rate for Payer: Multiplan Commercial |
$265.41
|
| Rate for Payer: NAPHCARE Commercial |
$199.06
|
| Rate for Payer: Preferred Network Access Commercial |
$305.22
|
| Rate for Payer: Quartz Beloit One Network |
$162.56
|
| Rate for Payer: Quartz Commercial |
$215.64
|
| Rate for Payer: Quartz Medicare Advantage |
$199.06
|
| Rate for Payer: The Alliance Commercial |
$165.88
|
| Rate for Payer: WEA Trust Commercial |
$182.47
|
| Rate for Payer: WPS Commercial |
$245.73
|
|
|
K-WIRE GRIDLOCK PART THREAD .045 X 6 STD 210-40-004/5"
|
Facility
|
IP
|
$319.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3444835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.56 |
| Max. Negotiated Rate |
$305.22 |
| Rate for Payer: Aetna Commercial |
$298.58
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$285.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$175.83
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Cigna Commercial |
$305.22
|
| Rate for Payer: Health EOS Commercial |
$295.27
|
| Rate for Payer: HFN Commercial |
$305.22
|
| Rate for Payer: Multiplan Commercial |
$265.41
|
| Rate for Payer: Preferred Network Access Commercial |
$305.22
|
| Rate for Payer: Quartz Beloit One Network |
$162.56
|
| Rate for Payer: Quartz Commercial |
$199.06
|
| Rate for Payer: WEA Trust Commercial |
$182.47
|
| Rate for Payer: WPS Commercial |
$245.73
|
|
|
K-WIRE HEMI-CAP
|
Facility
|
OP
|
$1,630.00
|
|
| Hospital Charge Code |
2965214
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$474.66 |
| Max. Negotiated Rate |
$1,559.58 |
| Rate for Payer: Aetna Commercial |
$1,525.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,457.87
|
| Rate for Payer: Aetna Managed Medicare |
$474.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,101.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$847.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$813.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$898.46
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$1,559.58
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$948.66
|
| Rate for Payer: Health EOS Commercial |
$1,508.73
|
| Rate for Payer: HFN Commercial |
$1,559.58
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,271.40
|
| Rate for Payer: Multiplan Commercial |
$1,356.16
|
| Rate for Payer: NAPHCARE Commercial |
$1,017.12
|
| Rate for Payer: Preferred Network Access Commercial |
$1,559.58
|
| Rate for Payer: Quartz Beloit One Network |
$830.65
|
| Rate for Payer: Quartz Commercial |
$1,101.88
|
| Rate for Payer: Quartz Medicare Advantage |
$1,017.12
|
| Rate for Payer: The Alliance Commercial |
$847.60
|
| Rate for Payer: WEA Trust Commercial |
$932.36
|
| Rate for Payer: WPS Commercial |
$1,255.59
|
|
|
K-WIRE HEMI-CAP
|
Facility
|
IP
|
$1,630.00
|
|
| Hospital Charge Code |
2965214
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$830.65 |
| Max. Negotiated Rate |
$1,559.58 |
| Rate for Payer: Aetna Commercial |
$1,525.68
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,457.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$898.46
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$1,559.58
|
| Rate for Payer: Health EOS Commercial |
$1,508.73
|
| Rate for Payer: HFN Commercial |
$1,559.58
|
| Rate for Payer: Multiplan Commercial |
$1,356.16
|
| Rate for Payer: Preferred Network Access Commercial |
$1,559.58
|
| Rate for Payer: Quartz Beloit One Network |
$830.65
|
| Rate for Payer: Quartz Commercial |
$1,017.12
|
| Rate for Payer: WEA Trust Commercial |
$932.36
|
| Rate for Payer: WPS Commercial |
$1,255.59
|
|
|
K-WIRE PARTIALLY THREADED TRILLIANT 0.035 210-24-005
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3784164
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$324.36 |
| Rate for Payer: Aetna Commercial |
$317.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$186.86
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cigna Commercial |
$324.36
|
| Rate for Payer: Health EOS Commercial |
$313.78
|
| Rate for Payer: HFN Commercial |
$324.36
|
| Rate for Payer: Multiplan Commercial |
$282.05
|
| Rate for Payer: Preferred Network Access Commercial |
$324.36
|
| Rate for Payer: Quartz Beloit One Network |
$172.75
|
| Rate for Payer: Quartz Commercial |
$211.54
|
| Rate for Payer: WEA Trust Commercial |
$193.91
|
| Rate for Payer: WPS Commercial |
$261.13
|
|
|
K-WIRE PARTIALLY THREADED TRILLIANT 0.035 210-24-005
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3784164
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.72 |
| Max. Negotiated Rate |
$324.36 |
| Rate for Payer: Aetna Commercial |
$317.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$303.20
|
| Rate for Payer: Aetna Managed Medicare |
$98.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$229.16
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$176.28
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$169.23
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$186.86
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cigna Commercial |
$324.36
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$197.30
|
| Rate for Payer: Health EOS Commercial |
$313.78
|
| Rate for Payer: HFN Commercial |
$324.36
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$264.42
|
| Rate for Payer: Multiplan Commercial |
$282.05
|
| Rate for Payer: NAPHCARE Commercial |
$211.54
|
| Rate for Payer: Preferred Network Access Commercial |
$324.36
|
| Rate for Payer: Quartz Beloit One Network |
$172.75
|
| Rate for Payer: Quartz Commercial |
$229.16
|
| Rate for Payer: Quartz Medicare Advantage |
$211.54
|
| Rate for Payer: The Alliance Commercial |
$176.28
|
| Rate for Payer: WEA Trust Commercial |
$193.91
|
| Rate for Payer: WPS Commercial |
$261.13
|
|
