|
ANATOMIC RAD HEAD STEM 9*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 9*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 9*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 9*4.0MM
|
Facility
|
IP
|
$7,910.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,028.30 |
| Max. Negotiated Rate |
$7,593.60 |
| Rate for Payer: Aetna Commercial |
$6,090.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,169.80
|
| Rate for Payer: Cash Price |
$3,955.00
|
| Rate for Payer: Cigna Commercial |
$6,565.30
|
| Rate for Payer: First Health Commercial |
$7,514.50
|
| Rate for Payer: Humana Commercial |
$6,723.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,486.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,837.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,373.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,960.80
|
| Rate for Payer: Ohio Health Group HMO |
$5,932.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,582.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,028.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,452.10
|
| Rate for Payer: PHCS Commercial |
$7,593.60
|
| Rate for Payer: United Healthcare All Payer |
$6,960.80
|
|
|
ANATOMIC RAD HEAD STEM 9*4.0MM
|
Facility
|
OP
|
$7,910.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,028.30 |
| Max. Negotiated Rate |
$7,593.60 |
| Rate for Payer: Aetna Commercial |
$6,090.70
|
| Rate for Payer: Anthem Medicaid |
$2,720.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,169.80
|
| Rate for Payer: Cash Price |
$3,955.00
|
| Rate for Payer: Cigna Commercial |
$6,565.30
|
| Rate for Payer: First Health Commercial |
$7,514.50
|
| Rate for Payer: Humana Commercial |
$6,723.50
|
| Rate for Payer: Humana KY Medicaid |
$2,720.25
|
| Rate for Payer: Kentucky WC Medicaid |
$2,747.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,486.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,837.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,373.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,774.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,960.80
|
| Rate for Payer: Ohio Health Group HMO |
$5,932.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,582.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,028.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,452.10
|
| Rate for Payer: PHCS Commercial |
$7,593.60
|
| Rate for Payer: United Healthcare All Payer |
$6,960.80
|
|
|
ANATOMIC RAD HEAD STEM 9*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 9*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 HED STEM 10*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 HED STEM 10*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 HED STEM 10*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 HED STEM 10*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 HED STEM 10*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 HED STEM 10*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
|
|
|
ANAT SHOULDER REM HEAD 14*40
|
Facility
|
IP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 14*40
|
Facility
|
OP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem Medicaid |
$3,661.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Humana KY Medicaid |
$3,661.66
|
| Rate for Payer: Kentucky WC Medicaid |
$3,698.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,735.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 15*42
|
Facility
|
IP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 15*42
|
Facility
|
OP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem Medicaid |
$3,661.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Humana KY Medicaid |
$3,661.66
|
| Rate for Payer: Kentucky WC Medicaid |
$3,698.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,735.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 16*44
|
Facility
|
IP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 16*44
|
Facility
|
OP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem Medicaid |
$3,661.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Humana KY Medicaid |
$3,661.66
|
| Rate for Payer: Kentucky WC Medicaid |
$3,698.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,735.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 16*46
|
Facility
|
OP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem Medicaid |
$3,661.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Humana KY Medicaid |
$3,661.66
|
| Rate for Payer: Kentucky WC Medicaid |
$3,698.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,735.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 16*46
|
Facility
|
IP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 17*48
|
Facility
|
OP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem Medicaid |
$3,661.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Humana KY Medicaid |
$3,661.66
|
| Rate for Payer: Kentucky WC Medicaid |
$3,698.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,735.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 17*48
|
Facility
|
IP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 18*50
|
Facility
|
IP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
|
ANAT SHOULDER REM HEAD 18*50
|
Facility
|
OP
|
$10,647.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,384.17 |
| Max. Negotiated Rate |
$10,221.55 |
| Rate for Payer: Aetna Commercial |
$8,198.54
|
| Rate for Payer: Anthem Medicaid |
$3,661.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,305.01
|
| Rate for Payer: Cash Price |
$5,323.73
|
| Rate for Payer: Cigna Commercial |
$8,837.38
|
| Rate for Payer: First Health Commercial |
$10,115.08
|
| Rate for Payer: Humana Commercial |
$9,050.33
|
| Rate for Payer: Humana KY Medicaid |
$3,661.66
|
| Rate for Payer: Kentucky WC Medicaid |
$3,698.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,730.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,857.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,194.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,735.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,369.76
|
| Rate for Payer: Ohio Health Group HMO |
$7,985.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,129.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,384.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,300.71
|
| Rate for Payer: PHCS Commercial |
$10,221.55
|
| Rate for Payer: United Healthcare All Payer |
$9,369.76
|
|
