|
ANCHOR SUPER QUICKANCHOR PLUS DS 222984
|
Facility
|
OP
|
$5,230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5106880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,522.98 |
| Max. Negotiated Rate |
$5,004.06 |
| Rate for Payer: Aetna Commercial |
$4,895.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,677.71
|
| Rate for Payer: Aetna Managed Medicare |
$1,522.98
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,535.48
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,719.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,610.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,882.78
|
| Rate for Payer: Cash Price |
$1,569.00
|
| Rate for Payer: Cigna Commercial |
$5,004.06
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,043.86
|
| Rate for Payer: Health EOS Commercial |
$4,840.89
|
| Rate for Payer: HFN Commercial |
$5,004.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,079.40
|
| Rate for Payer: Multiplan Commercial |
$4,351.36
|
| Rate for Payer: NAPHCARE Commercial |
$3,263.52
|
| Rate for Payer: Preferred Network Access Commercial |
$5,004.06
|
| Rate for Payer: Quartz Beloit One Network |
$2,665.21
|
| Rate for Payer: Quartz Commercial |
$3,535.48
|
| Rate for Payer: Quartz Medicare Advantage |
$3,263.52
|
| Rate for Payer: The Alliance Commercial |
$2,719.60
|
| Rate for Payer: WEA Trust Commercial |
$2,991.56
|
| Rate for Payer: WPS Commercial |
$4,028.67
|
|
|
ANCHOR SUPER QUICKANCHOR PLUS DS 222984
|
Facility
|
IP
|
$5,230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5106880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,665.21 |
| Max. Negotiated Rate |
$5,004.06 |
| Rate for Payer: Aetna Commercial |
$4,895.28
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,677.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,882.78
|
| Rate for Payer: Cash Price |
$1,569.00
|
| Rate for Payer: Cigna Commercial |
$5,004.06
|
| Rate for Payer: Health EOS Commercial |
$4,840.89
|
| Rate for Payer: HFN Commercial |
$5,004.06
|
| Rate for Payer: Multiplan Commercial |
$4,351.36
|
| Rate for Payer: Preferred Network Access Commercial |
$5,004.06
|
| Rate for Payer: Quartz Beloit One Network |
$2,665.21
|
| Rate for Payer: Quartz Commercial |
$3,263.52
|
| Rate for Payer: WEA Trust Commercial |
$2,991.56
|
| Rate for Payer: WPS Commercial |
$4,028.67
|
|
|
ANCHOR SWIVELOCK 3.5 X 8.5MM FRK EYELET AR-8978P
|
Facility
|
IP
|
$4,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,471.56 |
| Max. Negotiated Rate |
$4,640.48 |
| Rate for Payer: Aetna Commercial |
$4,539.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,337.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,673.32
|
| Rate for Payer: Cash Price |
$1,455.00
|
| Rate for Payer: Cigna Commercial |
$4,640.48
|
| Rate for Payer: Health EOS Commercial |
$4,489.16
|
| Rate for Payer: HFN Commercial |
$4,640.48
|
| Rate for Payer: Multiplan Commercial |
$4,035.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,640.48
|
| Rate for Payer: Quartz Beloit One Network |
$2,471.56
|
| Rate for Payer: Quartz Commercial |
$3,026.40
|
| Rate for Payer: WEA Trust Commercial |
$2,774.20
|
| Rate for Payer: WPS Commercial |
$3,735.95
|
|
|
ANCHOR SWIVELOCK 3.5 X 8.5MM FRK EYELET AR-8978P
|
Facility
|
OP
|
$4,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,412.32 |
| Max. Negotiated Rate |
$4,640.48 |
| Rate for Payer: Aetna Commercial |
$4,539.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,337.84
|
| Rate for Payer: Aetna Managed Medicare |
$1,412.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,278.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,522.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,421.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,673.32
|
| Rate for Payer: Cash Price |
$1,455.00
|
| Rate for Payer: Cigna Commercial |
$4,640.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,822.70
|
| Rate for Payer: Health EOS Commercial |
$4,489.16
|
| Rate for Payer: HFN Commercial |
$4,640.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,783.00
|
| Rate for Payer: Multiplan Commercial |
$4,035.20
|
| Rate for Payer: NAPHCARE Commercial |
$3,026.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,640.48
|
| Rate for Payer: Quartz Beloit One Network |
$2,471.56
|
| Rate for Payer: Quartz Commercial |
$3,278.60
|
| Rate for Payer: Quartz Medicare Advantage |
$3,026.40
|
| Rate for Payer: The Alliance Commercial |
$2,522.00
|
| Rate for Payer: WEA Trust Commercial |
$2,774.20
|
| Rate for Payer: WPS Commercial |
$3,735.95
|
|
|
ANCHOR SWIVELOCK 4.75 X 19.1 AR-2324BCC
|
Facility
|
IP
|
$6,273.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,196.72 |
| Max. Negotiated Rate |
$6,002.01 |
| Rate for Payer: Aetna Commercial |
$5,871.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,610.57
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,457.68
|
| Rate for Payer: Cash Price |
$1,881.90
|
| Rate for Payer: Cigna Commercial |
$6,002.01
|
| Rate for Payer: Health EOS Commercial |
$5,806.29
|
| Rate for Payer: HFN Commercial |
$6,002.01
|
| Rate for Payer: Multiplan Commercial |
$5,219.14
|
| Rate for Payer: Preferred Network Access Commercial |
$6,002.01
|
| Rate for Payer: Quartz Beloit One Network |
$3,196.72
|
| Rate for Payer: Quartz Commercial |
$3,914.35
|
| Rate for Payer: WEA Trust Commercial |
$3,588.16
|
| Rate for Payer: WPS Commercial |
$4,832.09
|
|
|
ANCHOR SWIVELOCK 4.75 X 19.1 AR-2324BCC
|
Facility
|
OP
|
$6,273.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2964674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,826.70 |
| Max. Negotiated Rate |
$6,002.01 |
| Rate for Payer: Aetna Commercial |
$5,871.53
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,610.57
|
| Rate for Payer: Aetna Managed Medicare |
$1,826.70
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,240.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,261.96
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,131.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,457.68
|
| Rate for Payer: Cash Price |
$1,881.90
|
| Rate for Payer: Cigna Commercial |
$6,002.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,650.89
|
| Rate for Payer: Health EOS Commercial |
$5,806.29
|
| Rate for Payer: HFN Commercial |
$6,002.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,892.94
|
| Rate for Payer: Multiplan Commercial |
$5,219.14
|
| Rate for Payer: NAPHCARE Commercial |
$3,914.35
|
| Rate for Payer: Preferred Network Access Commercial |
$6,002.01
|
| Rate for Payer: Quartz Beloit One Network |
$3,196.72
|
| Rate for Payer: Quartz Commercial |
$4,240.55
|
| Rate for Payer: Quartz Medicare Advantage |
$3,914.35
|
| Rate for Payer: The Alliance Commercial |
$3,261.96
|
| Rate for Payer: WEA Trust Commercial |
$3,588.16
|
| Rate for Payer: WPS Commercial |
$4,832.09
|
|
|
ANCHOR SWIVELOCK 8 X 19.5 TENODESIS BIO-COMPOSITE AR-1662BC-8
|
Facility
|
IP
|
$5,907.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3661498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,010.21 |
| Max. Negotiated Rate |
$5,651.82 |
| Rate for Payer: Aetna Commercial |
$5,528.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,283.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,255.94
|
| Rate for Payer: Cash Price |
$1,772.10
|
| Rate for Payer: Cigna Commercial |
$5,651.82
|
| Rate for Payer: Health EOS Commercial |
$5,467.52
|
| Rate for Payer: HFN Commercial |
$5,651.82
|
| Rate for Payer: Multiplan Commercial |
$4,914.62
|
| Rate for Payer: Preferred Network Access Commercial |
$5,651.82
|
| Rate for Payer: Quartz Beloit One Network |
$3,010.21
|
| Rate for Payer: Quartz Commercial |
$3,685.97
|
| Rate for Payer: WEA Trust Commercial |
$3,378.80
|
| Rate for Payer: WPS Commercial |
$4,550.16
|
|
|
ANCHOR SWIVELOCK 8 X 19.5 TENODESIS BIO-COMPOSITE AR-1662BC-8
|
Facility
|
OP
|
$5,907.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
3661498
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,720.12 |
| Max. Negotiated Rate |
$5,651.82 |
| Rate for Payer: Aetna Commercial |
$5,528.95
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,283.22
|
| Rate for Payer: Aetna Managed Medicare |
$1,720.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,993.13
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,071.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,948.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,255.94
|
| Rate for Payer: Cash Price |
$1,772.10
|
| Rate for Payer: Cigna Commercial |
$5,651.82
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,437.87
|
| Rate for Payer: Health EOS Commercial |
$5,467.52
|
| Rate for Payer: HFN Commercial |
$5,651.82
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,607.46
|
| Rate for Payer: Multiplan Commercial |
$4,914.62
|
| Rate for Payer: NAPHCARE Commercial |
$3,685.97
|
| Rate for Payer: Preferred Network Access Commercial |
$5,651.82
|
| Rate for Payer: Quartz Beloit One Network |
$3,010.21
|
| Rate for Payer: Quartz Commercial |
$3,993.13
|
| Rate for Payer: Quartz Medicare Advantage |
$3,685.97
|
| Rate for Payer: The Alliance Commercial |
$3,071.64
|
| Rate for Payer: WEA Trust Commercial |
$3,378.80
|
| Rate for Payer: WPS Commercial |
$4,550.16
|
|
|
ANCHOR SWIVELOCK BC 3.9 X 17.9MM AR-2326BCC
|
Facility
|
OP
|
$3,972.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6217170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,156.65 |
| Max. Negotiated Rate |
$3,800.41 |
| Rate for Payer: Aetna Commercial |
$3,717.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,552.56
|
| Rate for Payer: Aetna Managed Medicare |
$1,156.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,685.07
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,065.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,982.82
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,189.37
|
| Rate for Payer: Cash Price |
$1,191.60
|
| Rate for Payer: Cigna Commercial |
$3,800.41
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,311.70
|
| Rate for Payer: Health EOS Commercial |
$3,676.48
|
| Rate for Payer: HFN Commercial |
$3,800.41
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,098.16
|
| Rate for Payer: Multiplan Commercial |
$3,304.70
|
| Rate for Payer: NAPHCARE Commercial |
$2,478.53
|
| Rate for Payer: Preferred Network Access Commercial |
$3,800.41
|
| Rate for Payer: Quartz Beloit One Network |
$2,024.13
|
| Rate for Payer: Quartz Commercial |
$2,685.07
|
| Rate for Payer: Quartz Medicare Advantage |
$2,478.53
|
| Rate for Payer: The Alliance Commercial |
$2,065.44
|
| Rate for Payer: WEA Trust Commercial |
$2,271.98
|
| Rate for Payer: WPS Commercial |
$3,059.63
|
|
|
ANCHOR SWIVELOCK BC 3.9 X 17.9MM AR-2326BCC
|
Facility
|
IP
|
$3,972.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6217170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,024.13 |
| Max. Negotiated Rate |
$3,800.41 |
| Rate for Payer: Aetna Commercial |
$3,717.79
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,552.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,189.37
|
| Rate for Payer: Cash Price |
$1,191.60
|
| Rate for Payer: Cigna Commercial |
$3,800.41
|
| Rate for Payer: Health EOS Commercial |
$3,676.48
|
| Rate for Payer: HFN Commercial |
$3,800.41
|
| Rate for Payer: Multiplan Commercial |
$3,304.70
|
| Rate for Payer: Preferred Network Access Commercial |
$3,800.41
|
| Rate for Payer: Quartz Beloit One Network |
$2,024.13
|
| Rate for Payer: Quartz Commercial |
$2,478.53
|
| Rate for Payer: WEA Trust Commercial |
$2,271.98
|
| Rate for Payer: WPS Commercial |
$3,059.63
|
|
|
ANCHOR SWIVELOCK BC 4.75 X 19.1 DOUBLE-LOAD AR-2324BCT-2
|
Facility
|
OP
|
$4,521.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563711
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,316.52 |
| Max. Negotiated Rate |
$4,325.69 |
| Rate for Payer: Aetna Commercial |
$4,231.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,043.58
|
| Rate for Payer: Aetna Managed Medicare |
$1,316.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,056.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,350.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,256.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,491.98
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Cigna Commercial |
$4,325.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,631.22
|
| Rate for Payer: Health EOS Commercial |
$4,184.64
|
| Rate for Payer: HFN Commercial |
$4,325.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,526.38
|
| Rate for Payer: Multiplan Commercial |
$3,761.47
|
| Rate for Payer: NAPHCARE Commercial |
$2,821.10
|
| Rate for Payer: Preferred Network Access Commercial |
$4,325.69
|
| Rate for Payer: Quartz Beloit One Network |
$2,303.90
|
| Rate for Payer: Quartz Commercial |
$3,056.20
|
| Rate for Payer: Quartz Medicare Advantage |
$2,821.10
|
| Rate for Payer: The Alliance Commercial |
$2,350.92
|
| Rate for Payer: WEA Trust Commercial |
$2,586.01
|
| Rate for Payer: WPS Commercial |
$3,482.53
|
|
|
ANCHOR SWIVELOCK BC 4.75 X 19.1 DOUBLE-LOAD AR-2324BCT-2
|
Facility
|
IP
|
$4,521.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563711
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,303.90 |
| Max. Negotiated Rate |
$4,325.69 |
| Rate for Payer: Aetna Commercial |
$4,231.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,043.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,491.98
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Cigna Commercial |
$4,325.69
|
| Rate for Payer: Health EOS Commercial |
$4,184.64
|
| Rate for Payer: HFN Commercial |
$4,325.69
|
| Rate for Payer: Multiplan Commercial |
$3,761.47
|
| Rate for Payer: Preferred Network Access Commercial |
$4,325.69
|
| Rate for Payer: Quartz Beloit One Network |
$2,303.90
|
| Rate for Payer: Quartz Commercial |
$2,821.10
|
| Rate for Payer: WEA Trust Commercial |
$2,586.01
|
| Rate for Payer: WPS Commercial |
$3,482.53
|
|
|
ANCHOR SWIVELOCK BC 5.5MM X 19.1MM DOUBLE-LOAD AR-2323BCT-2
|
Facility
|
OP
|
$4,521.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563712
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,316.52 |
| Max. Negotiated Rate |
$4,325.69 |
| Rate for Payer: Aetna Commercial |
$4,231.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,043.58
|
| Rate for Payer: Aetna Managed Medicare |
$1,316.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,056.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,350.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,256.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,491.98
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Cigna Commercial |
$4,325.69
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,631.22
|
| Rate for Payer: Health EOS Commercial |
$4,184.64
|
| Rate for Payer: HFN Commercial |
$4,325.69
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,526.38
|
| Rate for Payer: Multiplan Commercial |
$3,761.47
|
| Rate for Payer: NAPHCARE Commercial |
$2,821.10
|
| Rate for Payer: Preferred Network Access Commercial |
$4,325.69
|
| Rate for Payer: Quartz Beloit One Network |
$2,303.90
|
| Rate for Payer: Quartz Commercial |
$3,056.20
|
| Rate for Payer: Quartz Medicare Advantage |
$2,821.10
|
| Rate for Payer: The Alliance Commercial |
$2,350.92
|
| Rate for Payer: WEA Trust Commercial |
$2,586.01
|
| Rate for Payer: WPS Commercial |
$3,482.53
|
|
|
ANCHOR SWIVELOCK BC 5.5MM X 19.1MM DOUBLE-LOAD AR-2323BCT-2
|
Facility
|
IP
|
$4,521.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5563712
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,303.90 |
| Max. Negotiated Rate |
$4,325.69 |
| Rate for Payer: Aetna Commercial |
$4,231.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,043.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,491.98
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Cigna Commercial |
$4,325.69
|
| Rate for Payer: Health EOS Commercial |
$4,184.64
|
| Rate for Payer: HFN Commercial |
$4,325.69
|
| Rate for Payer: Multiplan Commercial |
$3,761.47
|
| Rate for Payer: Preferred Network Access Commercial |
$4,325.69
|
| Rate for Payer: Quartz Beloit One Network |
$2,303.90
|
| Rate for Payer: Quartz Commercial |
$2,821.10
|
| Rate for Payer: WEA Trust Commercial |
$2,586.01
|
| Rate for Payer: WPS Commercial |
$3,482.53
|
|
|
ANCHOR SWIVELOCK DX 3.5 X 13.5MM AR-8979P
|
Facility
|
OP
|
$4,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,412.32 |
| Max. Negotiated Rate |
$4,640.48 |
| Rate for Payer: Aetna Commercial |
$4,539.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,337.84
|
| Rate for Payer: Aetna Managed Medicare |
$1,412.32
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,278.60
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,522.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,421.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,673.32
|
| Rate for Payer: Cash Price |
$1,455.00
|
| Rate for Payer: Cigna Commercial |
$4,640.48
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,822.70
|
| Rate for Payer: Health EOS Commercial |
$4,489.16
|
| Rate for Payer: HFN Commercial |
$4,640.48
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,783.00
|
| Rate for Payer: Multiplan Commercial |
$4,035.20
|
| Rate for Payer: NAPHCARE Commercial |
$3,026.40
|
| Rate for Payer: Preferred Network Access Commercial |
$4,640.48
|
| Rate for Payer: Quartz Beloit One Network |
$2,471.56
|
| Rate for Payer: Quartz Commercial |
$3,278.60
|
| Rate for Payer: Quartz Medicare Advantage |
$3,026.40
|
| Rate for Payer: The Alliance Commercial |
$2,522.00
|
| Rate for Payer: WEA Trust Commercial |
$2,774.20
|
| Rate for Payer: WPS Commercial |
$3,735.95
|
|
|
ANCHOR SWIVELOCK DX 3.5 X 13.5MM AR-8979P
|
Facility
|
IP
|
$4,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4632647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,471.56 |
| Max. Negotiated Rate |
$4,640.48 |
| Rate for Payer: Aetna Commercial |
$4,539.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,337.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,673.32
|
| Rate for Payer: Cash Price |
$1,455.00
|
| Rate for Payer: Cigna Commercial |
$4,640.48
|
| Rate for Payer: Health EOS Commercial |
$4,489.16
|
| Rate for Payer: HFN Commercial |
$4,640.48
|
| Rate for Payer: Multiplan Commercial |
$4,035.20
|
| Rate for Payer: Preferred Network Access Commercial |
$4,640.48
|
| Rate for Payer: Quartz Beloit One Network |
$2,471.56
|
| Rate for Payer: Quartz Commercial |
$3,026.40
|
| Rate for Payer: WEA Trust Commercial |
$2,774.20
|
| Rate for Payer: WPS Commercial |
$3,735.95
|
|
|
ANCHOR SWIVELOCK DX KNOTLESS BC 4.75MM AR-8980BC
|
Facility
|
IP
|
$4,057.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6175723
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,067.45 |
| Max. Negotiated Rate |
$3,881.74 |
| Rate for Payer: Aetna Commercial |
$3,797.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,628.58
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,236.22
|
| Rate for Payer: Cash Price |
$1,217.10
|
| Rate for Payer: Cigna Commercial |
$3,881.74
|
| Rate for Payer: Health EOS Commercial |
$3,755.16
|
| Rate for Payer: HFN Commercial |
$3,881.74
|
| Rate for Payer: Multiplan Commercial |
$3,375.42
|
| Rate for Payer: Preferred Network Access Commercial |
$3,881.74
|
| Rate for Payer: Quartz Beloit One Network |
$2,067.45
|
| Rate for Payer: Quartz Commercial |
$2,531.57
|
| Rate for Payer: WEA Trust Commercial |
$2,320.60
|
| Rate for Payer: WPS Commercial |
$3,125.11
|
|
|
ANCHOR SWIVELOCK DX KNOTLESS BC 4.75MM AR-8980BC
|
Facility
|
OP
|
$4,057.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6175723
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,181.40 |
| Max. Negotiated Rate |
$3,881.74 |
| Rate for Payer: Aetna Commercial |
$3,797.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,628.58
|
| Rate for Payer: Aetna Managed Medicare |
$1,181.40
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,742.53
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,109.64
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,025.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,236.22
|
| Rate for Payer: Cash Price |
$1,217.10
|
| Rate for Payer: Cigna Commercial |
$3,881.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,361.17
|
| Rate for Payer: Health EOS Commercial |
$3,755.16
|
| Rate for Payer: HFN Commercial |
$3,881.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,164.46
|
| Rate for Payer: Multiplan Commercial |
$3,375.42
|
| Rate for Payer: NAPHCARE Commercial |
$2,531.57
|
| Rate for Payer: Preferred Network Access Commercial |
$3,881.74
|
| Rate for Payer: Quartz Beloit One Network |
$2,067.45
|
| Rate for Payer: Quartz Commercial |
$2,742.53
|
| Rate for Payer: Quartz Medicare Advantage |
$2,531.57
|
| Rate for Payer: The Alliance Commercial |
$2,109.64
|
| Rate for Payer: WEA Trust Commercial |
$2,320.60
|
| Rate for Payer: WPS Commercial |
$3,125.11
|
|
|
ANCHOR SWIVELOCK KNOTLESS 4.75MM SELF-PUNCH AR-2324KBCSP
|
Facility
|
OP
|
$4,501.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,310.77 |
| Max. Negotiated Rate |
$4,306.81 |
| Rate for Payer: Aetna Commercial |
$4,213.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,025.93
|
| Rate for Payer: Aetna Managed Medicare |
$1,310.77
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,042.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,340.66
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,247.03
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,481.09
|
| Rate for Payer: Cash Price |
$1,350.38
|
| Rate for Payer: Cigna Commercial |
$4,306.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,619.73
|
| Rate for Payer: Health EOS Commercial |
$4,166.37
|
| Rate for Payer: HFN Commercial |
$4,306.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,510.98
|
| Rate for Payer: Multiplan Commercial |
$3,745.05
|
| Rate for Payer: NAPHCARE Commercial |
$2,808.79
|
| Rate for Payer: Preferred Network Access Commercial |
$4,306.81
|
| Rate for Payer: Quartz Beloit One Network |
$2,293.84
|
| Rate for Payer: Quartz Commercial |
$3,042.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,808.79
|
| Rate for Payer: The Alliance Commercial |
$2,340.66
|
| Rate for Payer: WEA Trust Commercial |
$2,574.72
|
| Rate for Payer: WPS Commercial |
$3,467.32
|
|
|
ANCHOR SWIVELOCK KNOTLESS 4.75MM SELF-PUNCH AR-2324KBCSP
|
Facility
|
IP
|
$4,501.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6246202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,293.84 |
| Max. Negotiated Rate |
$4,306.81 |
| Rate for Payer: Aetna Commercial |
$4,213.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,025.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,481.09
|
| Rate for Payer: Cash Price |
$1,350.38
|
| Rate for Payer: Cigna Commercial |
$4,306.81
|
| Rate for Payer: Health EOS Commercial |
$4,166.37
|
| Rate for Payer: HFN Commercial |
$4,306.81
|
| Rate for Payer: Multiplan Commercial |
$3,745.05
|
| Rate for Payer: Preferred Network Access Commercial |
$4,306.81
|
| Rate for Payer: Quartz Beloit One Network |
$2,293.84
|
| Rate for Payer: Quartz Commercial |
$2,808.79
|
| Rate for Payer: WEA Trust Commercial |
$2,574.72
|
| Rate for Payer: WPS Commercial |
$3,467.32
|
|
|
ANCHOR SWIVELOCK KNOTLESS W/ TAPE 4.75MM AR-2324KBCCT
|
Facility
|
IP
|
$4,065.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611600
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,071.52 |
| Max. Negotiated Rate |
$3,889.39 |
| Rate for Payer: Aetna Commercial |
$3,804.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,635.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,240.63
|
| Rate for Payer: Cash Price |
$1,219.50
|
| Rate for Payer: Cigna Commercial |
$3,889.39
|
| Rate for Payer: Health EOS Commercial |
$3,762.56
|
| Rate for Payer: HFN Commercial |
$3,889.39
|
| Rate for Payer: Multiplan Commercial |
$3,382.08
|
| Rate for Payer: Preferred Network Access Commercial |
$3,889.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,071.52
|
| Rate for Payer: Quartz Commercial |
$2,536.56
|
| Rate for Payer: WEA Trust Commercial |
$2,325.18
|
| Rate for Payer: WPS Commercial |
$3,131.27
|
|
|
ANCHOR SWIVELOCK KNOTLESS W/ TAPE 4.75MM AR-2324KBCCT
|
Facility
|
OP
|
$4,065.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611600
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,183.73 |
| Max. Negotiated Rate |
$3,889.39 |
| Rate for Payer: Aetna Commercial |
$3,804.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,635.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,183.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,747.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,113.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,029.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,240.63
|
| Rate for Payer: Cash Price |
$1,219.50
|
| Rate for Payer: Cigna Commercial |
$3,889.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,365.83
|
| Rate for Payer: Health EOS Commercial |
$3,762.56
|
| Rate for Payer: HFN Commercial |
$3,889.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,170.70
|
| Rate for Payer: Multiplan Commercial |
$3,382.08
|
| Rate for Payer: NAPHCARE Commercial |
$2,536.56
|
| Rate for Payer: Preferred Network Access Commercial |
$3,889.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,071.52
|
| Rate for Payer: Quartz Commercial |
$2,747.94
|
| Rate for Payer: Quartz Medicare Advantage |
$2,536.56
|
| Rate for Payer: The Alliance Commercial |
$2,113.80
|
| Rate for Payer: WEA Trust Commercial |
$2,325.18
|
| Rate for Payer: WPS Commercial |
$3,131.27
|
|
|
ANCHOR SWIVELOCK KNOTLESS W/ TIGER TAPE 4.75MM AR-2324KBCCTT
|
Facility
|
IP
|
$4,065.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611605
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,071.52 |
| Max. Negotiated Rate |
$3,889.39 |
| Rate for Payer: Aetna Commercial |
$3,804.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,635.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,240.63
|
| Rate for Payer: Cash Price |
$1,219.50
|
| Rate for Payer: Cigna Commercial |
$3,889.39
|
| Rate for Payer: Health EOS Commercial |
$3,762.56
|
| Rate for Payer: HFN Commercial |
$3,889.39
|
| Rate for Payer: Multiplan Commercial |
$3,382.08
|
| Rate for Payer: Preferred Network Access Commercial |
$3,889.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,071.52
|
| Rate for Payer: Quartz Commercial |
$2,536.56
|
| Rate for Payer: WEA Trust Commercial |
$2,325.18
|
| Rate for Payer: WPS Commercial |
$3,131.27
|
|
|
ANCHOR SWIVELOCK KNOTLESS W/ TIGER TAPE 4.75MM AR-2324KBCCTT
|
Facility
|
OP
|
$4,065.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5611605
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,183.73 |
| Max. Negotiated Rate |
$3,889.39 |
| Rate for Payer: Aetna Commercial |
$3,804.84
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,635.74
|
| Rate for Payer: Aetna Managed Medicare |
$1,183.73
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,747.94
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,113.80
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,029.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,240.63
|
| Rate for Payer: Cash Price |
$1,219.50
|
| Rate for Payer: Cigna Commercial |
$3,889.39
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,365.83
|
| Rate for Payer: Health EOS Commercial |
$3,762.56
|
| Rate for Payer: HFN Commercial |
$3,889.39
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,170.70
|
| Rate for Payer: Multiplan Commercial |
$3,382.08
|
| Rate for Payer: NAPHCARE Commercial |
$2,536.56
|
| Rate for Payer: Preferred Network Access Commercial |
$3,889.39
|
| Rate for Payer: Quartz Beloit One Network |
$2,071.52
|
| Rate for Payer: Quartz Commercial |
$2,747.94
|
| Rate for Payer: Quartz Medicare Advantage |
$2,536.56
|
| Rate for Payer: The Alliance Commercial |
$2,113.80
|
| Rate for Payer: WEA Trust Commercial |
$2,325.18
|
| Rate for Payer: WPS Commercial |
$3,131.27
|
|
|
ANCHOR SWIVELOCK PEEK 5.5 X 19.1MM AR-2323PSLC
|
Facility
|
IP
|
$5,091.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4520131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,594.37 |
| Max. Negotiated Rate |
$4,871.07 |
| Rate for Payer: Aetna Commercial |
$4,765.18
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,553.39
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,806.16
|
| Rate for Payer: Cash Price |
$1,527.30
|
| Rate for Payer: Cigna Commercial |
$4,871.07
|
| Rate for Payer: Health EOS Commercial |
$4,712.23
|
| Rate for Payer: HFN Commercial |
$4,871.07
|
| Rate for Payer: Multiplan Commercial |
$4,235.71
|
| Rate for Payer: Preferred Network Access Commercial |
$4,871.07
|
| Rate for Payer: Quartz Beloit One Network |
$2,594.37
|
| Rate for Payer: Quartz Commercial |
$3,176.78
|
| Rate for Payer: WEA Trust Commercial |
$2,912.05
|
| Rate for Payer: WPS Commercial |
$3,921.60
|
|
