|
G2 TIBIAL WDGE SZ 5-6 71423023
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423023
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423027
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423027
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423031
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423031
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423051
|
Facility
|
OP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem Medicaid |
$2,962.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Humana KY Medicaid |
$2,962.88
|
| Rate for Payer: Kentucky WC Medicaid |
$2,993.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,022.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423051
|
Facility
|
IP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423055
|
Facility
|
IP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423055
|
Facility
|
OP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem Medicaid |
$2,962.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Humana KY Medicaid |
$2,962.88
|
| Rate for Payer: Kentucky WC Medicaid |
$2,993.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,022.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423059
|
Facility
|
IP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423059
|
Facility
|
OP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem Medicaid |
$2,962.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Humana KY Medicaid |
$2,962.88
|
| Rate for Payer: Kentucky WC Medicaid |
$2,993.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,022.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423063
|
Facility
|
OP
|
$8,834.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,650.36 |
| Max. Negotiated Rate |
$8,481.14 |
| Rate for Payer: Aetna Commercial |
$6,802.58
|
| Rate for Payer: Anthem Medicaid |
$3,038.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,890.93
|
| Rate for Payer: Cash Price |
$4,417.26
|
| Rate for Payer: Cigna Commercial |
$7,332.65
|
| Rate for Payer: First Health Commercial |
$8,392.79
|
| Rate for Payer: Humana Commercial |
$7,509.34
|
| Rate for Payer: Humana KY Medicaid |
$3,038.19
|
| Rate for Payer: Kentucky WC Medicaid |
$3,069.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,244.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,519.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,650.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,099.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,774.38
|
| Rate for Payer: Ohio Health Group HMO |
$6,625.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,067.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,686.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,095.82
|
| Rate for Payer: PHCS Commercial |
$8,481.14
|
| Rate for Payer: United Healthcare All Payer |
$7,774.38
|
|
|
G2 TIBIAL WDGE SZ 5-6 71423063
|
Facility
|
IP
|
$8,834.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,650.36 |
| Max. Negotiated Rate |
$8,481.14 |
| Rate for Payer: Aetna Commercial |
$6,802.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,890.93
|
| Rate for Payer: Cash Price |
$4,417.26
|
| Rate for Payer: Cigna Commercial |
$7,332.65
|
| Rate for Payer: First Health Commercial |
$8,392.79
|
| Rate for Payer: Humana Commercial |
$7,509.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,244.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,519.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,650.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,774.38
|
| Rate for Payer: Ohio Health Group HMO |
$6,625.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,067.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,686.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,095.82
|
| Rate for Payer: PHCS Commercial |
$8,481.14
|
| Rate for Payer: United Healthcare All Payer |
$7,774.38
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423020
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423020
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423024
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423024
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423028
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423028
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423032
|
Facility
|
IP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423032
|
Facility
|
OP
|
$7,110.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,133.24 |
| Max. Negotiated Rate |
$6,826.38 |
| Rate for Payer: Aetna Commercial |
$5,475.32
|
| Rate for Payer: Anthem Medicaid |
$2,445.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,546.43
|
| Rate for Payer: Cash Price |
$3,555.41
|
| Rate for Payer: Cigna Commercial |
$5,901.97
|
| Rate for Payer: First Health Commercial |
$6,755.27
|
| Rate for Payer: Humana Commercial |
$6,044.19
|
| Rate for Payer: Humana KY Medicaid |
$2,445.41
|
| Rate for Payer: Kentucky WC Medicaid |
$2,470.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,830.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,247.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,133.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,494.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,257.51
|
| Rate for Payer: Ohio Health Group HMO |
$5,333.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,688.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,186.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,906.46
|
| Rate for Payer: PHCS Commercial |
$6,826.38
|
| Rate for Payer: United Healthcare All Payer |
$6,257.51
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423052
|
Facility
|
OP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem Medicaid |
$2,962.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Humana KY Medicaid |
$2,962.88
|
| Rate for Payer: Kentucky WC Medicaid |
$2,993.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,022.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423052
|
Facility
|
IP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
|
G2 TIBIAL WDGE SZ 7-8 71423056
|
Facility
|
OP
|
$8,615.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,584.66 |
| Max. Negotiated Rate |
$8,270.90 |
| Rate for Payer: Aetna Commercial |
$6,633.95
|
| Rate for Payer: Anthem Medicaid |
$2,962.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,720.11
|
| Rate for Payer: Cash Price |
$4,307.76
|
| Rate for Payer: Cigna Commercial |
$7,150.88
|
| Rate for Payer: First Health Commercial |
$8,184.74
|
| Rate for Payer: Humana Commercial |
$7,323.19
|
| Rate for Payer: Humana KY Medicaid |
$2,962.88
|
| Rate for Payer: Kentucky WC Medicaid |
$2,993.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,064.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,358.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,584.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,022.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,581.66
|
| Rate for Payer: Ohio Health Group HMO |
$6,461.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,892.42
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,495.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,944.71
|
| Rate for Payer: PHCS Commercial |
$8,270.90
|
| Rate for Payer: United Healthcare All Payer |
$7,581.66
|
|
