|
K-WIRE 3.2 X 450MM GAMMA 1210-6450S
|
Facility
|
IP
|
$1,407.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3072438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$717.01 |
| Max. Negotiated Rate |
$1,346.22 |
| Rate for Payer: Aetna Commercial |
$1,316.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,258.42
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$775.54
|
| Rate for Payer: Cash Price |
$422.10
|
| Rate for Payer: Cigna Commercial |
$1,346.22
|
| Rate for Payer: Health EOS Commercial |
$1,302.32
|
| Rate for Payer: HFN Commercial |
$1,346.22
|
| Rate for Payer: Multiplan Commercial |
$1,170.62
|
| Rate for Payer: Preferred Network Access Commercial |
$1,346.22
|
| Rate for Payer: Quartz Beloit One Network |
$717.01
|
| Rate for Payer: Quartz Commercial |
$877.97
|
| Rate for Payer: WEA Trust Commercial |
$804.80
|
| Rate for Payer: WPS Commercial |
$1,083.81
|
|
|
K-WIRE 3.2 X 450MM GAMMA 1210-6450S
|
Facility
|
OP
|
$1,407.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
3072438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$409.72 |
| Max. Negotiated Rate |
$1,346.22 |
| Rate for Payer: Aetna Commercial |
$1,316.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,258.42
|
| Rate for Payer: Aetna Managed Medicare |
$409.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$951.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$731.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$702.37
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$775.54
|
| Rate for Payer: Cash Price |
$422.10
|
| Rate for Payer: Cigna Commercial |
$1,346.22
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$818.87
|
| Rate for Payer: Health EOS Commercial |
$1,302.32
|
| Rate for Payer: HFN Commercial |
$1,346.22
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,097.46
|
| Rate for Payer: Multiplan Commercial |
$1,170.62
|
| Rate for Payer: NAPHCARE Commercial |
$877.97
|
| Rate for Payer: Preferred Network Access Commercial |
$1,346.22
|
| Rate for Payer: Quartz Beloit One Network |
$717.01
|
| Rate for Payer: Quartz Commercial |
$951.13
|
| Rate for Payer: Quartz Medicare Advantage |
$877.97
|
| Rate for Payer: The Alliance Commercial |
$731.64
|
| Rate for Payer: WEA Trust Commercial |
$804.80
|
| Rate for Payer: WPS Commercial |
$1,083.81
|
|
|
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 |
$135.70 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Aetna Managed Medicare |
$135.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$315.02
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$242.32
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$232.63
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$271.21
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$363.48
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: NAPHCARE Commercial |
$290.78
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$315.02
|
| Rate for Payer: Quartz Medicare Advantage |
$290.78
|
| Rate for Payer: The Alliance Commercial |
$242.32
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
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 |
$237.47 |
| Max. Negotiated Rate |
$445.87 |
| Rate for Payer: Aetna Commercial |
$436.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$416.79
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$256.86
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$445.87
|
| Rate for Payer: Health EOS Commercial |
$431.33
|
| Rate for Payer: HFN Commercial |
$445.87
|
| Rate for Payer: Multiplan Commercial |
$387.71
|
| Rate for Payer: Preferred Network Access Commercial |
$445.87
|
| Rate for Payer: Quartz Beloit One Network |
$237.47
|
| Rate for Payer: Quartz Commercial |
$290.78
|
| Rate for Payer: WEA Trust Commercial |
$266.55
|
| Rate for Payer: WPS Commercial |
$358.96
|
|
|
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 |
$72.36 |
| Max. Negotiated Rate |
$135.87 |
| Rate for Payer: Aetna Commercial |
$132.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$127.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$78.27
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$135.87
|
| Rate for Payer: Health EOS Commercial |
$131.44
|
| Rate for Payer: HFN Commercial |
$135.87
|
| Rate for Payer: Multiplan Commercial |
$118.14
|
| Rate for Payer: Preferred Network Access Commercial |
$135.87
|
| Rate for Payer: Quartz Beloit One Network |
$72.36
|
| Rate for Payer: Quartz Commercial |
$88.61
|
| Rate for Payer: WEA Trust Commercial |
$81.22
|
| Rate for Payer: WPS Commercial |
$109.38
|
|
|
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 |
$41.35 |
| Max. Negotiated Rate |
$135.87 |
| Rate for Payer: Aetna Commercial |
$132.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$127.00
|
| Rate for Payer: Aetna Managed Medicare |
$41.35
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$95.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$73.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$70.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$78.27
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$135.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82.64
|
| Rate for Payer: Health EOS Commercial |
$131.44
|
| Rate for Payer: HFN Commercial |
$135.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$110.76
|
| Rate for Payer: Multiplan Commercial |
$118.14
|
| Rate for Payer: NAPHCARE Commercial |
$88.61
|
| Rate for Payer: Preferred Network Access Commercial |
$135.87
|
| Rate for Payer: Quartz Beloit One Network |
$72.36
|
| Rate for Payer: Quartz Commercial |
$95.99
|
| Rate for Payer: Quartz Medicare Advantage |
$88.61
|
| Rate for Payer: The Alliance Commercial |
$73.84
|
| Rate for Payer: WEA Trust Commercial |
$81.22
|
| Rate for Payer: WPS Commercial |
$109.38
|
|
|
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 |
$72.36 |
| Max. Negotiated Rate |
$135.87 |
| Rate for Payer: Aetna Commercial |
$132.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$127.00
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$78.27
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$135.87
|
| Rate for Payer: Health EOS Commercial |
$131.44
|
| Rate for Payer: HFN Commercial |
$135.87
|
| Rate for Payer: Multiplan Commercial |
$118.14
|
| Rate for Payer: Preferred Network Access Commercial |
$135.87
|
| Rate for Payer: Quartz Beloit One Network |
$72.36
|
| Rate for Payer: Quartz Commercial |
$88.61
|
| Rate for Payer: WEA Trust Commercial |
$81.22
|
| Rate for Payer: WPS Commercial |
$109.38
|
|
|
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 |
$41.35 |
| Max. Negotiated Rate |
$135.87 |
| Rate for Payer: Aetna Commercial |
$132.91
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$127.00
|
| Rate for Payer: Aetna Managed Medicare |
$41.35
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$95.99
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$73.84
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$70.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$78.27
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$135.87
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$82.64
|
| Rate for Payer: Health EOS Commercial |
$131.44
|
| Rate for Payer: HFN Commercial |
$135.87
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$110.76
|
| Rate for Payer: Multiplan Commercial |
$118.14
|
| Rate for Payer: NAPHCARE Commercial |
$88.61
|
| Rate for Payer: Preferred Network Access Commercial |
$135.87
|
| Rate for Payer: Quartz Beloit One Network |
$72.36
|
| Rate for Payer: Quartz Commercial |
$95.99
|
| Rate for Payer: Quartz Medicare Advantage |
$88.61
|
| Rate for Payer: The Alliance Commercial |
$73.84
|
| Rate for Payer: WEA Trust Commercial |
$81.22
|
| Rate for Payer: WPS Commercial |
$109.38
|
|
|
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 |
$69.31 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$127.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$121.64
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.96
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$130.12
|
| Rate for Payer: Health EOS Commercial |
$125.88
|
| Rate for Payer: HFN Commercial |
$130.12
|
| Rate for Payer: Multiplan Commercial |
$113.15
|
| Rate for Payer: Preferred Network Access Commercial |
$130.12
|
| Rate for Payer: Quartz Beloit One Network |
$69.31
|
| Rate for Payer: Quartz Commercial |
$84.86
|
| Rate for Payer: WEA Trust Commercial |
$77.79
|
| Rate for Payer: WPS Commercial |
$104.76
|
|
|
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 |
$39.60 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$127.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$121.64
|
| Rate for Payer: Aetna Managed Medicare |
$39.60
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$91.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$70.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$67.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$74.96
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cigna Commercial |
$130.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$79.15
|
| Rate for Payer: Health EOS Commercial |
$125.88
|
| Rate for Payer: HFN Commercial |
$130.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$106.08
|
| Rate for Payer: Multiplan Commercial |
$113.15
|
| Rate for Payer: NAPHCARE Commercial |
$84.86
|
| Rate for Payer: Preferred Network Access Commercial |
$130.12
|
| Rate for Payer: Quartz Beloit One Network |
$69.31
|
| Rate for Payer: Quartz Commercial |
$91.94
|
| Rate for Payer: Quartz Medicare Advantage |
$84.86
|
| Rate for Payer: The Alliance Commercial |
$70.72
|
| Rate for Payer: WEA Trust Commercial |
$77.79
|
| Rate for Payer: WPS Commercial |
$104.76
|
|
|
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 |
$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 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
|
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 .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 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 .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 .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
|
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 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 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
|
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 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 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
|
|
