|
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
|
|
|
ANCHOR FASTAK SUTURE S BNE 0
|
Facility
|
OP
|
$1,822.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.92 |
| Max. Negotiated Rate |
$1,749.60 |
| Rate for Payer: Aetna Commercial |
$1,403.32
|
| Rate for Payer: Anthem Medicaid |
$626.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,421.55
|
| Rate for Payer: Cash Price |
$911.25
|
| Rate for Payer: Cigna Commercial |
$1,512.68
|
| Rate for Payer: First Health Commercial |
$1,731.38
|
| Rate for Payer: Humana Commercial |
$1,549.12
|
| Rate for Payer: Humana KY Medicaid |
$626.76
|
| Rate for Payer: Kentucky WC Medicaid |
$633.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,494.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,345.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$546.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$639.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,603.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,366.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$364.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$236.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$564.98
|
| Rate for Payer: PHCS Commercial |
$1,749.60
|
| Rate for Payer: United Healthcare All Payer |
$1,603.80
|
|
|
ANCHOR FASTAK SUTURE S BNE 0
|
Facility
|
IP
|
$1,822.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.92 |
| Max. Negotiated Rate |
$1,749.60 |
| Rate for Payer: Aetna Commercial |
$1,403.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,421.55
|
| Rate for Payer: Cash Price |
$911.25
|
| Rate for Payer: Cigna Commercial |
$1,512.68
|
| Rate for Payer: First Health Commercial |
$1,731.38
|
| Rate for Payer: Humana Commercial |
$1,549.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,494.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,345.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$546.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,603.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,366.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$364.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$236.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$564.98
|
| Rate for Payer: PHCS Commercial |
$1,749.60
|
| Rate for Payer: United Healthcare All Payer |
$1,603.80
|
|
|
ANCHOR FASTAK SUTURE S BNE 2-0
|
Facility
|
IP
|
$1,997.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.68 |
| Max. Negotiated Rate |
$1,917.60 |
| Rate for Payer: Aetna Commercial |
$1,538.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,558.05
|
| Rate for Payer: Cash Price |
$998.75
|
| Rate for Payer: Cigna Commercial |
$1,657.92
|
| Rate for Payer: First Health Commercial |
$1,897.62
|
| Rate for Payer: Humana Commercial |
$1,697.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,637.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,474.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$599.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,757.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,498.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$399.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$259.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$619.22
|
| Rate for Payer: PHCS Commercial |
$1,917.60
|
| Rate for Payer: United Healthcare All Payer |
$1,757.80
|
|
|
ANCHOR FASTAK SUTURE S BNE 2-0
|
Facility
|
OP
|
$1,997.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.68 |
| Max. Negotiated Rate |
$1,917.60 |
| Rate for Payer: Aetna Commercial |
$1,538.08
|
| Rate for Payer: Anthem Medicaid |
$686.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,558.05
|
| Rate for Payer: Cash Price |
$998.75
|
| Rate for Payer: Cigna Commercial |
$1,657.92
|
| Rate for Payer: First Health Commercial |
$1,897.62
|
| Rate for Payer: Humana Commercial |
$1,697.88
|
| Rate for Payer: Humana KY Medicaid |
$686.94
|
| Rate for Payer: Kentucky WC Medicaid |
$693.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,637.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,474.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$599.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$700.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,757.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,498.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$399.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$259.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$619.22
|
| Rate for Payer: PHCS Commercial |
$1,917.60
|
| Rate for Payer: United Healthcare All Payer |
$1,757.80
|
|
|
ANCHOR FIBERTAK 1.8 KNOTLSS
|
Facility
|
IP
|
$3,670.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$477.10 |
| Max. Negotiated Rate |
$3,523.20 |
| Rate for Payer: Aetna Commercial |
$2,825.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,862.60
|
| Rate for Payer: Cash Price |
$1,835.00
|
| Rate for Payer: Cigna Commercial |
$3,046.10
|
| Rate for Payer: First Health Commercial |
$3,486.50
|
| Rate for Payer: Humana Commercial |
$3,119.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,009.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,708.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,101.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,229.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,752.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$734.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$477.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,137.70
|
| Rate for Payer: PHCS Commercial |
$3,523.20
|
| Rate for Payer: United Healthcare All Payer |
$3,229.60
|
|
|
ANCHOR FIBERTAK 1.8 KNOTLSS
|
Facility
|
OP
|
$3,670.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$477.10 |
| Max. Negotiated Rate |
$3,523.20 |
| Rate for Payer: Aetna Commercial |
$2,825.90
|
| Rate for Payer: Anthem Medicaid |
$1,262.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,862.60
|
| Rate for Payer: Cash Price |
$1,835.00
|
| Rate for Payer: Cigna Commercial |
$3,046.10
|
| Rate for Payer: First Health Commercial |
$3,486.50
|
| Rate for Payer: Humana Commercial |
$3,119.50
|
| Rate for Payer: Humana KY Medicaid |
$1,262.11
|
| Rate for Payer: Kentucky WC Medicaid |
$1,274.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,009.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,708.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,101.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,287.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,229.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,752.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$734.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$477.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,137.70
|
| Rate for Payer: PHCS Commercial |
$3,523.20
|
| Rate for Payer: United Healthcare All Payer |
$3,229.60
|
|
|
ANCHOR FIBER TAK KNOTLSS 2.6MM
|
Facility
|
IP
|
$1,565.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.45 |
| Max. Negotiated Rate |
$1,502.40 |
| Rate for Payer: Aetna Commercial |
$1,205.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,220.70
|
| Rate for Payer: Cash Price |
$782.50
|
| Rate for Payer: Cigna Commercial |
$1,298.95
|
| Rate for Payer: First Health Commercial |
$1,486.75
|
| Rate for Payer: Humana Commercial |
$1,330.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,283.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,154.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$469.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,377.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,173.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$313.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$485.15
|
| Rate for Payer: PHCS Commercial |
$1,502.40
|
| Rate for Payer: United Healthcare All Payer |
$1,377.20
|
|
|
ANCHOR FIBER TAK KNOTLSS 2.6MM
|
Facility
|
OP
|
$1,565.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.45 |
| Max. Negotiated Rate |
$1,502.40 |
| Rate for Payer: Aetna Commercial |
$1,205.05
|
| Rate for Payer: Anthem Medicaid |
$538.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,220.70
|
| Rate for Payer: Cash Price |
$782.50
|
| Rate for Payer: Cigna Commercial |
$1,298.95
|
| Rate for Payer: First Health Commercial |
$1,486.75
|
| Rate for Payer: Humana Commercial |
$1,330.25
|
| Rate for Payer: Humana KY Medicaid |
$538.20
|
| Rate for Payer: Kentucky WC Medicaid |
$543.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,283.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,154.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$469.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$549.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,377.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,173.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$313.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$485.15
|
| Rate for Payer: PHCS Commercial |
$1,502.40
|
| Rate for Payer: United Healthcare All Payer |
$1,377.20
|
|
|
ANCHOR FIBERTAK SING LOAD
|
Facility
|
OP
|
$1,591.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.93 |
| Max. Negotiated Rate |
$1,528.11 |
| Rate for Payer: Aetna Commercial |
$1,225.67
|
| Rate for Payer: Anthem Medicaid |
$547.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,241.59
|
| Rate for Payer: Cash Price |
$795.89
|
| Rate for Payer: Cigna Commercial |
$1,321.18
|
| Rate for Payer: First Health Commercial |
$1,512.19
|
| Rate for Payer: Humana Commercial |
$1,353.01
|
| Rate for Payer: Humana KY Medicaid |
$547.41
|
| Rate for Payer: Kentucky WC Medicaid |
$552.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,305.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,174.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$477.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$558.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,400.77
|
| Rate for Payer: Ohio Health Group HMO |
$1,193.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$318.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$206.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$493.45
|
| Rate for Payer: PHCS Commercial |
$1,528.11
|
| Rate for Payer: United Healthcare All Payer |
$1,400.77
|
|
|
ANCHOR FIBERTAK SING LOAD
|
Facility
|
IP
|
$1,591.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.93 |
| Max. Negotiated Rate |
$1,528.11 |
| Rate for Payer: Aetna Commercial |
$1,225.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,241.59
|
| Rate for Payer: Cash Price |
$795.89
|
| Rate for Payer: Cigna Commercial |
$1,321.18
|
| Rate for Payer: First Health Commercial |
$1,512.19
|
| Rate for Payer: Humana Commercial |
$1,353.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,305.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,174.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$477.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,400.77
|
| Rate for Payer: Ohio Health Group HMO |
$1,193.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$318.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$206.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$493.45
|
| Rate for Payer: PHCS Commercial |
$1,528.11
|
| Rate for Payer: United Healthcare All Payer |
$1,400.77
|
|
|
ANCHOR FIBERTK RC DBL LD BL TP
|
Facility
|
OP
|
$3,559.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.77 |
| Max. Negotiated Rate |
$3,417.36 |
| Rate for Payer: Aetna Commercial |
$2,741.01
|
| Rate for Payer: Anthem Medicaid |
$1,224.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,776.60
|
| Rate for Payer: Cash Price |
$1,779.88
|
| Rate for Payer: Cigna Commercial |
$2,954.59
|
| Rate for Payer: First Health Commercial |
$3,381.76
|
| Rate for Payer: Humana Commercial |
$3,025.79
|
| Rate for Payer: Humana KY Medicaid |
$1,224.20
|
| Rate for Payer: Kentucky WC Medicaid |
$1,236.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,919.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,627.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,067.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,248.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,132.58
|
| Rate for Payer: Ohio Health Group HMO |
$2,669.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$711.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$462.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,103.52
|
| Rate for Payer: PHCS Commercial |
$3,417.36
|
| Rate for Payer: United Healthcare All Payer |
$3,132.58
|
|
|
ANCHOR FIBERTK RC DBL LD BL TP
|
Facility
|
IP
|
$3,559.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.77 |
| Max. Negotiated Rate |
$3,417.36 |
| Rate for Payer: Aetna Commercial |
$2,741.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,776.60
|
| Rate for Payer: Cash Price |
$1,779.88
|
| Rate for Payer: Cigna Commercial |
$2,954.59
|
| Rate for Payer: First Health Commercial |
$3,381.76
|
| Rate for Payer: Humana Commercial |
$3,025.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,919.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,627.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,067.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,132.58
|
| Rate for Payer: Ohio Health Group HMO |
$2,669.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$711.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$462.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,103.52
|
| Rate for Payer: PHCS Commercial |
$3,417.36
|
| Rate for Payer: United Healthcare All Payer |
$3,132.58
|
|
|
ANCHOR QUICK SUPER
|
Facility
|
IP
|
$3,176.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$412.94 |
| Max. Negotiated Rate |
$3,049.44 |
| Rate for Payer: Humana Commercial |
$2,700.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,604.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,344.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$952.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,795.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,382.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$635.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$412.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$984.72
|
| Rate for Payer: PHCS Commercial |
$3,049.44
|
| Rate for Payer: United Healthcare All Payer |
$2,795.32
|
| Rate for Payer: Aetna Commercial |
$2,445.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,477.67
|
| Rate for Payer: Cash Price |
$1,588.25
|
| Rate for Payer: Cigna Commercial |
$2,636.50
|
| Rate for Payer: First Health Commercial |
$3,017.68
|
|
|
ANCHOR QUICK SUPER
|
Facility
|
OP
|
$3,176.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$412.94 |
| Max. Negotiated Rate |
$3,049.44 |
| Rate for Payer: Aetna Commercial |
$2,445.90
|
| Rate for Payer: Anthem Medicaid |
$1,092.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,477.67
|
| Rate for Payer: Cash Price |
$1,588.25
|
| Rate for Payer: Cigna Commercial |
$2,636.50
|
| Rate for Payer: First Health Commercial |
$3,017.68
|
| Rate for Payer: Humana Commercial |
$2,700.02
|
| Rate for Payer: Humana KY Medicaid |
$1,092.40
|
| Rate for Payer: Kentucky WC Medicaid |
$1,103.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,604.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,344.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$952.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,114.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,795.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,382.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$635.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$412.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$984.72
|
| Rate for Payer: PHCS Commercial |
$3,049.44
|
| Rate for Payer: United Healthcare All Payer |
$2,795.32
|
|
|
ANCHOR REELX STT 4.5MM
|
Facility
|
OP
|
$4,028.64
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$523.72 |
| Max. Negotiated Rate |
$3,867.49 |
| Rate for Payer: Aetna Commercial |
$3,102.05
|
| Rate for Payer: Anthem Medicaid |
$1,385.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,142.34
|
| Rate for Payer: Cash Price |
$2,014.32
|
| Rate for Payer: Cigna Commercial |
$3,343.77
|
| Rate for Payer: First Health Commercial |
$3,827.21
|
| Rate for Payer: Humana Commercial |
$3,424.34
|
| Rate for Payer: Humana KY Medicaid |
$1,385.45
|
| Rate for Payer: Kentucky WC Medicaid |
$1,399.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,303.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,973.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,208.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,413.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,545.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,021.48
|
| Rate for Payer: Ohio Health Group PPO Differential |
$805.73
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$523.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,248.88
|
| Rate for Payer: PHCS Commercial |
$3,867.49
|
| Rate for Payer: United Healthcare All Payer |
$3,545.20
|
|
|
ANCHOR REELX STT 4.5MM
|
Facility
|
IP
|
$4,028.64
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$523.72 |
| Max. Negotiated Rate |
$3,867.49 |
| Rate for Payer: Aetna Commercial |
$3,102.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,142.34
|
| Rate for Payer: Cash Price |
$2,014.32
|
| Rate for Payer: Cigna Commercial |
$3,343.77
|
| Rate for Payer: First Health Commercial |
$3,827.21
|
| Rate for Payer: Humana Commercial |
$3,424.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,303.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,973.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,208.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,545.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,021.48
|
| Rate for Payer: Ohio Health Group PPO Differential |
$805.73
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$523.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,248.88
|
| Rate for Payer: PHCS Commercial |
$3,867.49
|
| Rate for Payer: United Healthcare All Payer |
$3,545.20
|
|
|
ANCHOR SUT BIOCOMP TAK #1 FIBE
|
Facility
|
OP
|
$3,687.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$479.38 |
| Max. Negotiated Rate |
$3,540.00 |
| Rate for Payer: Aetna Commercial |
$2,839.38
|
| Rate for Payer: Anthem Medicaid |
$1,268.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,876.25
|
| Rate for Payer: Cash Price |
$1,843.75
|
| Rate for Payer: Cigna Commercial |
$3,060.62
|
| Rate for Payer: First Health Commercial |
$3,503.12
|
| Rate for Payer: Humana Commercial |
$3,134.38
|
| Rate for Payer: Humana KY Medicaid |
$1,268.13
|
| Rate for Payer: Kentucky WC Medicaid |
$1,281.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,023.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,721.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,106.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,293.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,245.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,765.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$737.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$479.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,143.12
|
| Rate for Payer: PHCS Commercial |
$3,540.00
|
| Rate for Payer: United Healthcare All Payer |
$3,245.00
|
|
|
ANCHOR SUT BIOCOMP TAK #1 FIBE
|
Facility
|
IP
|
$3,687.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$479.38 |
| Max. Negotiated Rate |
$3,540.00 |
| Rate for Payer: Aetna Commercial |
$2,839.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,876.25
|
| Rate for Payer: Cash Price |
$1,843.75
|
| Rate for Payer: Cigna Commercial |
$3,060.62
|
| Rate for Payer: First Health Commercial |
$3,503.12
|
| Rate for Payer: Humana Commercial |
$3,134.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,023.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,721.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,106.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,245.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,765.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$737.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$479.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,143.12
|
| Rate for Payer: PHCS Commercial |
$3,540.00
|
| Rate for Payer: United Healthcare All Payer |
$3,245.00
|
|
|
ANCHOR SUT BIO-CO S-TAK KNTLS
|
Facility
|
IP
|
$3,687.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$479.38 |
| Max. Negotiated Rate |
$3,540.00 |
| Rate for Payer: Aetna Commercial |
$2,839.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,876.25
|
| Rate for Payer: Cash Price |
$1,843.75
|
| Rate for Payer: Cigna Commercial |
$3,060.62
|
| Rate for Payer: First Health Commercial |
$3,503.12
|
| Rate for Payer: Humana Commercial |
$3,134.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,023.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,721.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,106.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,245.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,765.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$737.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$479.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,143.12
|
| Rate for Payer: PHCS Commercial |
$3,540.00
|
| Rate for Payer: United Healthcare All Payer |
$3,245.00
|
|
|
ANCHOR SUT BIO-CO S-TAK KNTLS
|
Facility
|
OP
|
$3,687.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$479.38 |
| Max. Negotiated Rate |
$3,540.00 |
| Rate for Payer: Aetna Commercial |
$2,839.38
|
| Rate for Payer: Anthem Medicaid |
$1,268.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,876.25
|
| Rate for Payer: Cash Price |
$1,843.75
|
| Rate for Payer: Cigna Commercial |
$3,060.62
|
| Rate for Payer: First Health Commercial |
$3,503.12
|
| Rate for Payer: Humana Commercial |
$3,134.38
|
| Rate for Payer: Humana KY Medicaid |
$1,268.13
|
| Rate for Payer: Kentucky WC Medicaid |
$1,281.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,023.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,721.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,106.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,293.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,245.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,765.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$737.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$479.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,143.12
|
| Rate for Payer: PHCS Commercial |
$3,540.00
|
| Rate for Payer: United Healthcare All Payer |
$3,245.00
|
|
|
ANCHOR SUT PEEK S-TAK 3-12.7MM
|
Facility
|
IP
|
$9,826.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,277.41 |
| Max. Negotiated Rate |
$9,433.20 |
| Rate for Payer: Aetna Commercial |
$7,566.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,664.48
|
| Rate for Payer: Cash Price |
$4,913.12
|
| Rate for Payer: Cigna Commercial |
$8,155.79
|
| Rate for Payer: First Health Commercial |
$9,334.94
|
| Rate for Payer: Humana Commercial |
$8,352.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,057.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,251.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,947.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,647.10
|
| Rate for Payer: Ohio Health Group HMO |
$7,369.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,965.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,277.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,046.14
|
| Rate for Payer: PHCS Commercial |
$9,433.20
|
| Rate for Payer: United Healthcare All Payer |
$8,647.10
|
|
|
ANCHOR SUT PEEK S-TAK 3-12.7MM
|
Facility
|
OP
|
$9,826.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,277.41 |
| Max. Negotiated Rate |
$9,433.20 |
| Rate for Payer: Humana Commercial |
$8,352.31
|
| Rate for Payer: Humana KY Medicaid |
$3,379.25
|
| Rate for Payer: Kentucky WC Medicaid |
$3,413.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,057.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,251.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,947.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,447.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,647.10
|
| Rate for Payer: Ohio Health Group HMO |
$7,369.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,965.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,277.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,046.14
|
| Rate for Payer: PHCS Commercial |
$9,433.20
|
| Rate for Payer: United Healthcare All Payer |
$8,647.10
|
| Rate for Payer: Aetna Commercial |
$7,566.21
|
| Rate for Payer: Anthem Medicaid |
$3,379.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,664.48
|
| Rate for Payer: Cash Price |
$4,913.12
|
| Rate for Payer: Cigna Commercial |
$8,155.79
|
| Rate for Payer: First Health Commercial |
$9,334.94
|
|
|
ANCHOR SUTURE MINI BC SUT TAK
|
Facility
|
IP
|
$3,337.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$433.88 |
| Max. Negotiated Rate |
$3,204.00 |
| Rate for Payer: Aetna Commercial |
$2,569.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,603.25
|
| Rate for Payer: Cash Price |
$1,668.75
|
| Rate for Payer: Cigna Commercial |
$2,770.12
|
| Rate for Payer: First Health Commercial |
$3,170.62
|
| Rate for Payer: Humana Commercial |
$2,836.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,736.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,463.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,001.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,937.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,503.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$667.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$433.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,034.62
|
| Rate for Payer: PHCS Commercial |
$3,204.00
|
| Rate for Payer: United Healthcare All Payer |
$2,937.00
|
|
|
ANCHOR SUTURE MINI BC SUT TAK
|
Facility
|
OP
|
$3,337.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$433.88 |
| Max. Negotiated Rate |
$3,204.00 |
| Rate for Payer: Aetna Commercial |
$2,569.88
|
| Rate for Payer: Anthem Medicaid |
$1,147.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,603.25
|
| Rate for Payer: Cash Price |
$1,668.75
|
| Rate for Payer: Cigna Commercial |
$2,770.12
|
| Rate for Payer: First Health Commercial |
$3,170.62
|
| Rate for Payer: Humana Commercial |
$2,836.88
|
| Rate for Payer: Humana KY Medicaid |
$1,147.77
|
| Rate for Payer: Kentucky WC Medicaid |
$1,159.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,736.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,463.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,001.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,170.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,937.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,503.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$667.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$433.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,034.62
|
| Rate for Payer: PHCS Commercial |
$3,204.00
|
| Rate for Payer: United Healthcare All Payer |
$2,937.00
|
|
