|
ANATOMIC RAD HEAD STEM 6*2.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 6*2.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 6*4.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 6*4.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 6*6.0MM
|
Facility
|
OP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem Medicaid |
$3,016.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Humana KY Medicaid |
$3,016.48
|
| Rate for Payer: Kentucky WC Medicaid |
$3,047.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,077.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 6*6.0MM
|
Facility
|
IP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 6*8.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 6*8.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 7*0.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 7*0.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 7*2.0MM
|
Facility
|
OP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem Medicaid |
$3,016.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Humana KY Medicaid |
$3,016.48
|
| Rate for Payer: Kentucky WC Medicaid |
$3,047.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,077.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 7*2.0MM
|
Facility
|
IP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 7*4.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 7*4.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 7*8.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 7*8.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 8*0.0MM
|
Facility
|
OP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem Medicaid |
$3,016.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Humana KY Medicaid |
$3,016.48
|
| Rate for Payer: Kentucky WC Medicaid |
$3,047.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,077.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 8*0.0MM
|
Facility
|
IP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 8*2.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 8*2.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 8*4.0MM
|
Facility
|
IP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 8*4.0MM
|
Facility
|
OP
|
$8,771.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.28 |
| Max. Negotiated Rate |
$8,420.54 |
| Rate for Payer: Aetna Commercial |
$6,753.98
|
| Rate for Payer: Anthem Medicaid |
$3,016.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,841.69
|
| Rate for Payer: Cash Price |
$4,385.70
|
| Rate for Payer: Cigna Commercial |
$7,280.26
|
| Rate for Payer: First Health Commercial |
$8,332.83
|
| Rate for Payer: Humana Commercial |
$7,455.69
|
| Rate for Payer: Humana KY Medicaid |
$3,016.48
|
| Rate for Payer: Kentucky WC Medicaid |
$3,047.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,192.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,473.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,631.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,077.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,718.83
|
| Rate for Payer: Ohio Health Group HMO |
$6,578.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,140.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,719.13
|
| Rate for Payer: PHCS Commercial |
$8,420.54
|
| Rate for Payer: United Healthcare All Payer |
$7,718.83
|
|
|
ANATOMIC RAD HEAD STEM 8*8.0MM
|
Facility
|
OP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem Medicaid |
$2,675.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Humana KY Medicaid |
$2,675.06
|
| Rate for Payer: Kentucky WC Medicaid |
$2,702.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,728.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 8*8.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
|
ANATOMIC RAD HEAD STEM 9*0.0MM
|
Facility
|
IP
|
$7,778.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.22 |
| Max. Negotiated Rate |
$7,467.46 |
| Rate for Payer: Aetna Commercial |
$5,989.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,067.31
|
| Rate for Payer: Cash Price |
$3,889.30
|
| Rate for Payer: Cigna Commercial |
$6,456.24
|
| Rate for Payer: First Health Commercial |
$7,389.67
|
| Rate for Payer: Humana Commercial |
$6,611.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,378.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,740.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,333.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,845.17
|
| Rate for Payer: Ohio Health Group HMO |
$5,833.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,555.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,011.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,411.37
|
| Rate for Payer: PHCS Commercial |
$7,467.46
|
| Rate for Payer: United Healthcare All Payer |
$6,845.17
|
|
