|
ANCHORAGE CP LAP PLATE 1MM L
|
Facility
|
IP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE CP LAP PLATE 1MM L
|
Facility
|
OP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem Medicaid |
$3,341.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Humana KY Medicaid |
$3,341.59
|
| Rate for Payer: Kentucky WC Medicaid |
$3,375.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,408.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE CP LAP PLATE 1MM R
|
Facility
|
OP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Humana KY Medicaid |
$3,341.59
|
| Rate for Payer: Kentucky WC Medicaid |
$3,375.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem Medicaid |
$3,341.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,408.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE CP LAP PLATE 1MM R
|
Facility
|
IP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE CP LAP PLATE 2MM L
|
Facility
|
OP
|
$8,333.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,083.34 |
| Max. Negotiated Rate |
$8,000.06 |
| Rate for Payer: Aetna Commercial |
$6,416.72
|
| Rate for Payer: Anthem Medicaid |
$2,865.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,500.05
|
| Rate for Payer: Cash Price |
$4,166.70
|
| Rate for Payer: Cigna Commercial |
$6,916.72
|
| Rate for Payer: First Health Commercial |
$7,916.73
|
| Rate for Payer: Humana Commercial |
$7,083.39
|
| Rate for Payer: Humana KY Medicaid |
$2,865.86
|
| Rate for Payer: Kentucky WC Medicaid |
$2,895.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,833.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,150.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,500.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,923.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,333.39
|
| Rate for Payer: Ohio Health Group HMO |
$6,250.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,666.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,083.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,583.35
|
| Rate for Payer: PHCS Commercial |
$8,000.06
|
| Rate for Payer: United Healthcare All Payer |
$7,333.39
|
|
|
ANCHORAGE CP LAP PLATE 2MM L
|
Facility
|
IP
|
$8,333.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,083.34 |
| Max. Negotiated Rate |
$8,000.06 |
| Rate for Payer: Aetna Commercial |
$6,416.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,500.05
|
| Rate for Payer: Cash Price |
$4,166.70
|
| Rate for Payer: Cigna Commercial |
$6,916.72
|
| Rate for Payer: First Health Commercial |
$7,916.73
|
| Rate for Payer: Humana Commercial |
$7,083.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,833.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,150.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,500.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,333.39
|
| Rate for Payer: Ohio Health Group HMO |
$6,250.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,666.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,083.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,583.35
|
| Rate for Payer: PHCS Commercial |
$8,000.06
|
| Rate for Payer: United Healthcare All Payer |
$7,333.39
|
|
|
ANCHORAGE CP LAP PLATE 2MM R
|
Facility
|
IP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE CP LAP PLATE 2MM R
|
Facility
|
OP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem Medicaid |
$3,341.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Humana KY Medicaid |
$3,341.59
|
| Rate for Payer: Kentucky WC Medicaid |
$3,375.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,408.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE GUIDEWIRE 0.9*70MM
|
Facility
|
OP
|
$528.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.76 |
| Max. Negotiated Rate |
$507.77 |
| Rate for Payer: Aetna Commercial |
$407.28
|
| Rate for Payer: Anthem Medicaid |
$181.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$412.57
|
| Rate for Payer: Cash Price |
$264.46
|
| Rate for Payer: Cigna Commercial |
$439.01
|
| Rate for Payer: First Health Commercial |
$502.48
|
| Rate for Payer: Humana Commercial |
$449.59
|
| Rate for Payer: Humana KY Medicaid |
$181.90
|
| Rate for Payer: Kentucky WC Medicaid |
$183.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$433.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$390.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$158.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$185.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$465.46
|
| Rate for Payer: Ohio Health Group HMO |
$396.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$105.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$68.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$163.97
|
| Rate for Payer: PHCS Commercial |
$507.77
|
| Rate for Payer: United Healthcare All Payer |
$465.46
|
|
|
ANCHORAGE GUIDEWIRE 0.9*70MM
|
Facility
|
IP
|
$528.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.76 |
| Max. Negotiated Rate |
$507.77 |
| Rate for Payer: Aetna Commercial |
$407.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$412.57
|
| Rate for Payer: Cash Price |
$264.46
|
| Rate for Payer: Cigna Commercial |
$439.01
|
| Rate for Payer: First Health Commercial |
$502.48
|
| Rate for Payer: Humana Commercial |
$449.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$433.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$390.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$158.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$465.46
|
| Rate for Payer: Ohio Health Group HMO |
$396.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$105.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$68.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$163.97
|
| Rate for Payer: PHCS Commercial |
$507.77
|
| Rate for Payer: United Healthcare All Payer |
$465.46
|
|
|
ANCHORAGE GUIDEWIRE 1.0*100MM
|
Facility
|
IP
|
$811.50
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$779.04 |
| Rate for Payer: Aetna Commercial |
$624.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$632.97
|
| Rate for Payer: Cash Price |
$405.75
|
| Rate for Payer: Cigna Commercial |
$673.54
|
| Rate for Payer: First Health Commercial |
$770.92
|
| Rate for Payer: Humana Commercial |
$689.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$665.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$598.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$243.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$714.12
|
| Rate for Payer: Ohio Health Group HMO |
$608.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$162.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$251.56
|
| Rate for Payer: PHCS Commercial |
$779.04
|
| Rate for Payer: United Healthcare All Payer |
$714.12
|
|
|
ANCHORAGE GUIDEWIRE 1.0*100MM
|
Facility
|
OP
|
$811.50
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$779.04 |
| Rate for Payer: Aetna Commercial |
$624.86
|
| Rate for Payer: Anthem Medicaid |
$279.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$632.97
|
| Rate for Payer: Cash Price |
$405.75
|
| Rate for Payer: Cigna Commercial |
$673.54
|
| Rate for Payer: First Health Commercial |
$770.92
|
| Rate for Payer: Humana Commercial |
$689.78
|
| Rate for Payer: Humana KY Medicaid |
$279.07
|
| Rate for Payer: Kentucky WC Medicaid |
$281.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$665.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$598.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$243.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$284.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$714.12
|
| Rate for Payer: Ohio Health Group HMO |
$608.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$162.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$251.56
|
| Rate for Payer: PHCS Commercial |
$779.04
|
| Rate for Payer: United Healthcare All Payer |
$714.12
|
|
|
ANCHORAGE GUIDEWIRE 1.0*70MM
|
Facility
|
OP
|
$780.14
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.42 |
| Max. Negotiated Rate |
$748.93 |
| Rate for Payer: Aetna Commercial |
$600.71
|
| Rate for Payer: Anthem Medicaid |
$268.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$608.51
|
| Rate for Payer: Cash Price |
$390.07
|
| Rate for Payer: Cigna Commercial |
$647.52
|
| Rate for Payer: First Health Commercial |
$741.13
|
| Rate for Payer: Humana Commercial |
$663.12
|
| Rate for Payer: Humana KY Medicaid |
$268.29
|
| Rate for Payer: Kentucky WC Medicaid |
$271.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$639.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$575.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$234.04
|
| Rate for Payer: Molina Healthcare Medicaid |
$273.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$686.52
|
| Rate for Payer: Ohio Health Group HMO |
$585.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$156.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$101.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$241.84
|
| Rate for Payer: PHCS Commercial |
$748.93
|
| Rate for Payer: United Healthcare All Payer |
$686.52
|
|
|
ANCHORAGE GUIDEWIRE 1.0*70MM
|
Facility
|
IP
|
$780.14
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.42 |
| Max. Negotiated Rate |
$748.93 |
| Rate for Payer: Aetna Commercial |
$600.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$608.51
|
| Rate for Payer: Cash Price |
$390.07
|
| Rate for Payer: Cigna Commercial |
$647.52
|
| Rate for Payer: First Health Commercial |
$741.13
|
| Rate for Payer: Humana Commercial |
$663.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$639.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$575.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$234.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$686.52
|
| Rate for Payer: Ohio Health Group HMO |
$585.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$156.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$101.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$241.84
|
| Rate for Payer: PHCS Commercial |
$748.93
|
| Rate for Payer: United Healthcare All Payer |
$686.52
|
|
|
ANCHORAGE GUIDEWIRE 1.2*70MM
|
Facility
|
IP
|
$816.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$783.36 |
| Rate for Payer: Aetna Commercial |
$628.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$636.48
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cigna Commercial |
$677.28
|
| Rate for Payer: First Health Commercial |
$775.20
|
| Rate for Payer: Humana Commercial |
$693.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$669.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$602.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$718.08
|
| Rate for Payer: Ohio Health Group HMO |
$612.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$163.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$106.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$252.96
|
| Rate for Payer: PHCS Commercial |
$783.36
|
| Rate for Payer: United Healthcare All Payer |
$718.08
|
|
|
ANCHORAGE GUIDEWIRE 1.2*70MM
|
Facility
|
OP
|
$816.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$783.36 |
| Rate for Payer: Aetna Commercial |
$628.32
|
| Rate for Payer: Anthem Medicaid |
$280.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$636.48
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cigna Commercial |
$677.28
|
| Rate for Payer: First Health Commercial |
$775.20
|
| Rate for Payer: Humana Commercial |
$693.60
|
| Rate for Payer: Humana KY Medicaid |
$280.62
|
| Rate for Payer: Kentucky WC Medicaid |
$283.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$669.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$602.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$286.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$718.08
|
| Rate for Payer: Ohio Health Group HMO |
$612.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$163.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$106.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$252.96
|
| Rate for Payer: PHCS Commercial |
$783.36
|
| Rate for Payer: United Healthcare All Payer |
$718.08
|
|
|
ANCHORAGE LAP PLATE 1MM L
|
Facility
|
OP
|
$9,680.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,258.43 |
| Max. Negotiated Rate |
$9,293.04 |
| Rate for Payer: Aetna Commercial |
$7,453.79
|
| Rate for Payer: Anthem Medicaid |
$3,329.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,550.60
|
| Rate for Payer: Cash Price |
$4,840.12
|
| Rate for Payer: Cigna Commercial |
$8,034.61
|
| Rate for Payer: First Health Commercial |
$9,196.24
|
| Rate for Payer: Humana Commercial |
$8,228.21
|
| Rate for Payer: Humana KY Medicaid |
$3,329.04
|
| Rate for Payer: Kentucky WC Medicaid |
$3,362.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,937.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,144.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,904.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,395.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,518.62
|
| Rate for Payer: Ohio Health Group HMO |
$7,260.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,936.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,258.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,000.88
|
| Rate for Payer: PHCS Commercial |
$9,293.04
|
| Rate for Payer: United Healthcare All Payer |
$8,518.62
|
|
|
ANCHORAGE LAP PLATE 1MM L
|
Facility
|
IP
|
$9,680.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,258.43 |
| Max. Negotiated Rate |
$9,293.04 |
| Rate for Payer: Aetna Commercial |
$7,453.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,550.60
|
| Rate for Payer: Cash Price |
$4,840.12
|
| Rate for Payer: Cigna Commercial |
$8,034.61
|
| Rate for Payer: First Health Commercial |
$9,196.24
|
| Rate for Payer: Humana Commercial |
$8,228.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,937.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,144.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,904.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,518.62
|
| Rate for Payer: Ohio Health Group HMO |
$7,260.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,936.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,258.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,000.88
|
| Rate for Payer: PHCS Commercial |
$9,293.04
|
| Rate for Payer: United Healthcare All Payer |
$8,518.62
|
|
|
ANCHORAGE MTP CP PLATE L
|
Facility
|
IP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE MTP CP PLATE L
|
Facility
|
OP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem Medicaid |
$3,341.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Humana KY Medicaid |
$3,341.59
|
| Rate for Payer: Kentucky WC Medicaid |
$3,375.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,408.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE MTP CP PLATE R
|
Facility
|
IP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHORAGE MTP CP PLATE R
|
Facility
|
OP
|
$9,716.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,263.18 |
| Max. Negotiated Rate |
$9,328.08 |
| Rate for Payer: Aetna Commercial |
$7,481.90
|
| Rate for Payer: Anthem Medicaid |
$3,341.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,579.06
|
| Rate for Payer: Cash Price |
$4,858.38
|
| Rate for Payer: Cigna Commercial |
$8,064.90
|
| Rate for Payer: First Health Commercial |
$9,230.91
|
| Rate for Payer: Humana Commercial |
$8,259.24
|
| Rate for Payer: Humana KY Medicaid |
$3,341.59
|
| Rate for Payer: Kentucky WC Medicaid |
$3,375.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,967.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,170.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,915.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,408.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,550.74
|
| Rate for Payer: Ohio Health Group HMO |
$7,287.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,943.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,263.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,012.19
|
| Rate for Payer: PHCS Commercial |
$9,328.08
|
| Rate for Payer: United Healthcare All Payer |
$8,550.74
|
|
|
ANCHOR FASTAK CORKSCREW 3.5MM
|
Facility
|
IP
|
$1,980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$257.40 |
| Max. Negotiated Rate |
$1,900.80 |
| Rate for Payer: Aetna Commercial |
$1,524.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,544.40
|
| Rate for Payer: Cash Price |
$990.00
|
| Rate for Payer: Cigna Commercial |
$1,643.40
|
| Rate for Payer: First Health Commercial |
$1,881.00
|
| Rate for Payer: Humana Commercial |
$1,683.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,623.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,461.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$594.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,742.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,485.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$396.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$257.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$613.80
|
| Rate for Payer: PHCS Commercial |
$1,900.80
|
| Rate for Payer: United Healthcare All Payer |
$1,742.40
|
|
|
ANCHOR FASTAK CORKSCREW 3.5MM
|
Facility
|
OP
|
$1,980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$257.40 |
| Max. Negotiated Rate |
$1,900.80 |
| Rate for Payer: Aetna Commercial |
$1,524.60
|
| Rate for Payer: Anthem Medicaid |
$680.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,544.40
|
| Rate for Payer: Cash Price |
$990.00
|
| Rate for Payer: Cigna Commercial |
$1,643.40
|
| Rate for Payer: First Health Commercial |
$1,881.00
|
| Rate for Payer: Humana Commercial |
$1,683.00
|
| Rate for Payer: Humana KY Medicaid |
$680.92
|
| Rate for Payer: Kentucky WC Medicaid |
$687.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,623.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,461.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$594.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$694.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,742.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,485.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$396.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$257.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$613.80
|
| Rate for Payer: PHCS Commercial |
$1,900.80
|
| Rate for Payer: United Healthcare All Payer |
$1,742.40
|
|
|
ANCHOR FASTAK CORKSCREW 6.5MM
|
Facility
|
IP
|
$2,032.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$264.22 |
| Max. Negotiated Rate |
$1,951.20 |
| Rate for Payer: Aetna Commercial |
$1,565.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,585.35
|
| Rate for Payer: Cash Price |
$1,016.25
|
| Rate for Payer: Cigna Commercial |
$1,686.98
|
| Rate for Payer: First Health Commercial |
$1,930.88
|
| Rate for Payer: Humana Commercial |
$1,727.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,666.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,499.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$609.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,788.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,524.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$406.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$264.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$630.08
|
| Rate for Payer: PHCS Commercial |
$1,951.20
|
| Rate for Payer: United Healthcare All Payer |
$1,788.60
|
|
