|
ANATOMIC RAD HEAD 28.0MM R
|
Facility
|
OP
|
$11,717.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,515.14 |
| Max. Negotiated Rate |
$11,248.44 |
| Rate for Payer: Aetna Commercial |
$9,022.19
|
| Rate for Payer: Anthem Medicaid |
$4,029.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,139.36
|
| Rate for Payer: Cash Price |
$5,858.56
|
| Rate for Payer: Cigna Commercial |
$9,725.22
|
| Rate for Payer: First Health Commercial |
$11,131.27
|
| Rate for Payer: Humana Commercial |
$9,959.56
|
| Rate for Payer: Humana KY Medicaid |
$4,029.52
|
| Rate for Payer: Kentucky WC Medicaid |
$4,070.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,608.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,647.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,515.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,110.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,311.07
|
| Rate for Payer: Ohio Health Group HMO |
$8,787.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,373.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,193.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,084.82
|
| Rate for Payer: PHCS Commercial |
$11,248.44
|
| Rate for Payer: United Healthcare All Payer |
$10,311.07
|
|
|
ANATOMIC RAD HEAD 28.0MM R
|
Facility
|
IP
|
$11,717.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,515.14 |
| Max. Negotiated Rate |
$11,248.44 |
| Rate for Payer: Aetna Commercial |
$9,022.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,139.36
|
| Rate for Payer: Cash Price |
$5,858.56
|
| Rate for Payer: Cigna Commercial |
$9,725.22
|
| Rate for Payer: First Health Commercial |
$11,131.27
|
| Rate for Payer: Humana Commercial |
$9,959.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,608.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,647.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,515.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,311.07
|
| Rate for Payer: Ohio Health Group HMO |
$8,787.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,373.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,193.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,084.82
|
| Rate for Payer: PHCS Commercial |
$11,248.44
|
| Rate for Payer: United Healthcare All Payer |
$10,311.07
|
|
|
ANATOMIC RAD HEAD STEM 10*2.0M
|
Facility
|
IP
|
$8,595.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,578.64 |
| Max. Negotiated Rate |
$8,251.63 |
| Rate for Payer: Aetna Commercial |
$6,618.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,704.45
|
| Rate for Payer: Cash Price |
$4,297.73
|
| Rate for Payer: Cigna Commercial |
$7,134.22
|
| Rate for Payer: First Health Commercial |
$8,165.68
|
| Rate for Payer: Humana Commercial |
$7,306.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,048.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,343.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,578.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,564.00
|
| Rate for Payer: Ohio Health Group HMO |
$6,446.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,876.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,478.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,930.86
|
| Rate for Payer: PHCS Commercial |
$8,251.63
|
| Rate for Payer: United Healthcare All Payer |
$7,564.00
|
|
|
ANATOMIC RAD HEAD STEM 10*2.0M
|
Facility
|
OP
|
$8,595.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,578.64 |
| Max. Negotiated Rate |
$8,251.63 |
| Rate for Payer: Aetna Commercial |
$6,618.50
|
| Rate for Payer: Anthem Medicaid |
$2,955.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,704.45
|
| Rate for Payer: Cash Price |
$4,297.73
|
| Rate for Payer: Cigna Commercial |
$7,134.22
|
| Rate for Payer: First Health Commercial |
$8,165.68
|
| Rate for Payer: Humana Commercial |
$7,306.13
|
| Rate for Payer: Humana KY Medicaid |
$2,955.98
|
| Rate for Payer: Kentucky WC Medicaid |
$2,986.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,048.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,343.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,578.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,015.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,564.00
|
| Rate for Payer: Ohio Health Group HMO |
$6,446.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,876.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,478.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,930.86
|
| Rate for Payer: PHCS Commercial |
$8,251.63
|
| Rate for Payer: United Healthcare All Payer |
$7,564.00
|
|
|
ANATOMIC RAD HEAD STEM 6*0.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*0.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*2.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*2.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*4.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*4.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*6.0MM
|
Facility
|
OP
|
$8,971.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,691.42 |
| Max. Negotiated Rate |
$8,612.54 |
| Rate for Payer: Aetna Commercial |
$6,907.98
|
| Rate for Payer: Anthem Medicaid |
$3,085.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,997.69
|
| Rate for Payer: Cash Price |
$4,485.70
|
| Rate for Payer: Cigna Commercial |
$7,446.26
|
| Rate for Payer: First Health Commercial |
$8,522.83
|
| Rate for Payer: Humana Commercial |
$7,625.69
|
| Rate for Payer: Humana KY Medicaid |
$3,085.26
|
| Rate for Payer: Kentucky WC Medicaid |
$3,116.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,356.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,620.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,691.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,147.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,894.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,728.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,177.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,805.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,190.27
|
| Rate for Payer: PHCS Commercial |
$8,612.54
|
| Rate for Payer: United Healthcare All Payer |
$7,894.83
|
|
|
ANATOMIC RAD HEAD STEM 6*6.0MM
|
Facility
|
IP
|
$8,971.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,691.42 |
| Max. Negotiated Rate |
$8,612.54 |
| Rate for Payer: Aetna Commercial |
$6,907.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,997.69
|
| Rate for Payer: Cash Price |
$4,485.70
|
| Rate for Payer: Cigna Commercial |
$7,446.26
|
| Rate for Payer: First Health Commercial |
$8,522.83
|
| Rate for Payer: Humana Commercial |
$7,625.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,356.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,620.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,691.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,894.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,728.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,177.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,805.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,190.27
|
| Rate for Payer: PHCS Commercial |
$8,612.54
|
| Rate for Payer: United Healthcare All Payer |
$7,894.83
|
|
|
ANATOMIC RAD HEAD STEM 6*8.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 6*8.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 7*0.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 7*0.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 7*2.0MM
|
Facility
|
IP
|
$8,971.40
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,691.42 |
| Max. Negotiated Rate |
$8,612.54 |
| Rate for Payer: Aetna Commercial |
$6,907.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,997.69
|
| Rate for Payer: Cash Price |
$4,485.70
|
| Rate for Payer: Cigna Commercial |
$7,446.26
|
| Rate for Payer: First Health Commercial |
$8,522.83
|
| Rate for Payer: Humana Commercial |
$7,625.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,356.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,620.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,691.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,894.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,728.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,177.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,805.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,190.27
|
| Rate for Payer: PHCS Commercial |
$8,612.54
|
| Rate for Payer: United Healthcare All Payer |
$7,894.83
|
|
|
ANATOMIC RAD HEAD STEM 7*2.0MM
|
Facility
|
OP
|
$8,971.40
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,691.42 |
| Max. Negotiated Rate |
$8,612.54 |
| Rate for Payer: Aetna Commercial |
$6,907.98
|
| Rate for Payer: Anthem Medicaid |
$3,085.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,997.69
|
| Rate for Payer: Cash Price |
$4,485.70
|
| Rate for Payer: Cigna Commercial |
$7,446.26
|
| Rate for Payer: First Health Commercial |
$8,522.83
|
| Rate for Payer: Humana Commercial |
$7,625.69
|
| Rate for Payer: Humana KY Medicaid |
$3,085.26
|
| Rate for Payer: Kentucky WC Medicaid |
$3,116.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,356.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,620.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,691.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,147.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,894.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,728.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,177.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,805.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,190.27
|
| Rate for Payer: PHCS Commercial |
$8,612.54
|
| Rate for Payer: United Healthcare All Payer |
$7,894.83
|
|
|
ANATOMIC RAD HEAD STEM 7*4.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 7*4.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 7*8.0MM
|
Facility
|
OP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem Medicaid |
$2,743.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Humana KY Medicaid |
$2,743.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,771.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,798.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 7*8.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
|
ANATOMIC RAD HEAD STEM 8*0.0MM
|
Facility
|
IP
|
$8,971.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,691.42 |
| Max. Negotiated Rate |
$8,612.54 |
| Rate for Payer: Aetna Commercial |
$6,907.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,997.69
|
| Rate for Payer: Cash Price |
$4,485.70
|
| Rate for Payer: Cigna Commercial |
$7,446.26
|
| Rate for Payer: First Health Commercial |
$8,522.83
|
| Rate for Payer: Humana Commercial |
$7,625.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,356.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,620.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,691.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,894.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,728.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,177.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,805.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,190.27
|
| Rate for Payer: PHCS Commercial |
$8,612.54
|
| Rate for Payer: United Healthcare All Payer |
$7,894.83
|
|
|
ANATOMIC RAD HEAD STEM 8*0.0MM
|
Facility
|
OP
|
$8,971.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,691.42 |
| Max. Negotiated Rate |
$8,612.54 |
| Rate for Payer: Aetna Commercial |
$6,907.98
|
| Rate for Payer: Anthem Medicaid |
$3,085.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,997.69
|
| Rate for Payer: Cash Price |
$4,485.70
|
| Rate for Payer: Cigna Commercial |
$7,446.26
|
| Rate for Payer: First Health Commercial |
$8,522.83
|
| Rate for Payer: Humana Commercial |
$7,625.69
|
| Rate for Payer: Humana KY Medicaid |
$3,085.26
|
| Rate for Payer: Kentucky WC Medicaid |
$3,116.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,356.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,620.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,691.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,147.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,894.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,728.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,177.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,805.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,190.27
|
| Rate for Payer: PHCS Commercial |
$8,612.54
|
| Rate for Payer: United Healthcare All Payer |
$7,894.83
|
|
|
ANATOMIC RAD HEAD STEM 8*2.0MM
|
Facility
|
IP
|
$7,978.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,393.58 |
| Max. Negotiated Rate |
$7,659.46 |
| Rate for Payer: Aetna Commercial |
$6,143.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,223.31
|
| Rate for Payer: Cash Price |
$3,989.30
|
| Rate for Payer: Cigna Commercial |
$6,622.24
|
| Rate for Payer: First Health Commercial |
$7,579.67
|
| Rate for Payer: Humana Commercial |
$6,781.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,542.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,888.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,393.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,021.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,983.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,382.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,941.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,505.23
|
| Rate for Payer: PHCS Commercial |
$7,659.46
|
| Rate for Payer: United Healthcare All Payer |
$7,021.17
|
|
