|
HII ALUM CONNECTNG ROD 8*200MM
|
Facility
|
OP
|
$1,142.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.51 |
| Max. Negotiated Rate |
$1,096.70 |
| Rate for Payer: Aetna Commercial |
$879.65
|
| Rate for Payer: Anthem Medicaid |
$392.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$891.07
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$948.19
|
| Rate for Payer: First Health Commercial |
$1,085.28
|
| Rate for Payer: Humana Commercial |
$971.04
|
| Rate for Payer: Humana KY Medicaid |
$392.87
|
| Rate for Payer: Kentucky WC Medicaid |
$396.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$936.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$843.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$342.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$400.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,005.31
|
| Rate for Payer: Ohio Health Group HMO |
$856.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$228.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$148.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$354.14
|
| Rate for Payer: PHCS Commercial |
$1,096.70
|
| Rate for Payer: United Healthcare All Payer |
$1,005.31
|
|
|
HII ALUM CONNECTNG ROD 8*300MM
|
Facility
|
IP
|
$1,142.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.51 |
| Max. Negotiated Rate |
$1,096.70 |
| Rate for Payer: Aetna Commercial |
$879.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$891.07
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$948.19
|
| Rate for Payer: First Health Commercial |
$1,085.28
|
| Rate for Payer: Humana Commercial |
$971.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$936.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$843.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$342.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,005.31
|
| Rate for Payer: Ohio Health Group HMO |
$856.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$228.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$148.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$354.14
|
| Rate for Payer: PHCS Commercial |
$1,096.70
|
| Rate for Payer: United Healthcare All Payer |
$1,005.31
|
|
|
HII ALUM CONNECTNG ROD 8*300MM
|
Facility
|
OP
|
$1,142.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.51 |
| Max. Negotiated Rate |
$1,096.70 |
| Rate for Payer: Aetna Commercial |
$879.65
|
| Rate for Payer: Anthem Medicaid |
$392.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$891.07
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cigna Commercial |
$948.19
|
| Rate for Payer: First Health Commercial |
$1,085.28
|
| Rate for Payer: Humana Commercial |
$971.04
|
| Rate for Payer: Humana KY Medicaid |
$392.87
|
| Rate for Payer: Kentucky WC Medicaid |
$396.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$936.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$843.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$342.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$400.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,005.31
|
| Rate for Payer: Ohio Health Group HMO |
$856.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$228.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$148.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$354.14
|
| Rate for Payer: PHCS Commercial |
$1,096.70
|
| Rate for Payer: United Healthcare All Payer |
$1,005.31
|
|
|
HII CARBON CONNCTN ROD 8*100MM
|
Facility
|
OP
|
$1,772.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$1,701.89 |
| Rate for Payer: Aetna Commercial |
$1,365.06
|
| Rate for Payer: Anthem Medicaid |
$609.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,382.78
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cigna Commercial |
$1,471.42
|
| Rate for Payer: First Health Commercial |
$1,684.16
|
| Rate for Payer: Humana Commercial |
$1,506.88
|
| Rate for Payer: Humana KY Medicaid |
$609.67
|
| Rate for Payer: Kentucky WC Medicaid |
$615.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,453.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,308.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$621.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,560.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,329.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$354.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$230.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.57
|
| Rate for Payer: PHCS Commercial |
$1,701.89
|
| Rate for Payer: United Healthcare All Payer |
$1,560.06
|
|
|
HII CARBON CONNCTN ROD 8*100MM
|
Facility
|
IP
|
$1,772.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$1,701.89 |
| Rate for Payer: Aetna Commercial |
$1,365.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,382.78
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cigna Commercial |
$1,471.42
|
| Rate for Payer: First Health Commercial |
$1,684.16
|
| Rate for Payer: Humana Commercial |
$1,506.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,453.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,308.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,560.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,329.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$354.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$230.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.57
|
| Rate for Payer: PHCS Commercial |
$1,701.89
|
| Rate for Payer: United Healthcare All Payer |
$1,560.06
|
|
|
HII CARBON CONNCTN ROD 8*150MM
|
Facility
|
IP
|
$1,772.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$1,701.89 |
| Rate for Payer: Aetna Commercial |
$1,365.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,382.78
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cigna Commercial |
$1,471.42
|
| Rate for Payer: First Health Commercial |
$1,684.16
|
| Rate for Payer: Humana Commercial |
$1,506.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,453.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,308.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,560.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,329.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$354.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$230.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.57
|
| Rate for Payer: PHCS Commercial |
$1,701.89
|
| Rate for Payer: United Healthcare All Payer |
$1,560.06
|
|
|
HII CARBON CONNCTN ROD 8*150MM
|
Facility
|
OP
|
$1,772.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$1,701.89 |
| Rate for Payer: Aetna Commercial |
$1,365.06
|
| Rate for Payer: Anthem Medicaid |
$609.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,382.78
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cigna Commercial |
$1,471.42
|
| Rate for Payer: First Health Commercial |
$1,684.16
|
| Rate for Payer: Humana Commercial |
$1,506.88
|
| Rate for Payer: Humana KY Medicaid |
$609.67
|
| Rate for Payer: Kentucky WC Medicaid |
$615.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,453.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,308.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$621.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,560.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,329.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$354.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$230.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.57
|
| Rate for Payer: PHCS Commercial |
$1,701.89
|
| Rate for Payer: United Healthcare All Payer |
$1,560.06
|
|
|
HII CARBON CONNCTN ROD 8*200MM
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*200MM
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem Medicaid |
$622.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Humana KY Medicaid |
$622.18
|
| Rate for Payer: Kentucky WC Medicaid |
$628.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$634.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*250MM
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem Medicaid |
$622.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Humana KY Medicaid |
$622.18
|
| Rate for Payer: Kentucky WC Medicaid |
$628.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$634.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*250MM
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*300MM
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem Medicaid |
$622.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Humana KY Medicaid |
$622.18
|
| Rate for Payer: Kentucky WC Medicaid |
$628.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$634.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*300MM
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*350MM
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*350MM
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,736.83 |
| Rate for Payer: Aetna Commercial |
$1,393.08
|
| Rate for Payer: Anthem Medicaid |
$622.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,411.18
|
| Rate for Payer: Cash Price |
$904.60
|
| Rate for Payer: Cigna Commercial |
$1,501.64
|
| Rate for Payer: First Health Commercial |
$1,718.74
|
| Rate for Payer: Humana Commercial |
$1,537.82
|
| Rate for Payer: Humana KY Medicaid |
$622.18
|
| Rate for Payer: Kentucky WC Medicaid |
$628.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,483.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,335.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$542.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$634.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,592.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,356.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$560.85
|
| Rate for Payer: PHCS Commercial |
$1,736.83
|
| Rate for Payer: United Healthcare All Payer |
$1,592.10
|
|
|
HII CARBON CONNCTN ROD 8*400MM
|
Facility
|
OP
|
$1,842.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.56 |
| Max. Negotiated Rate |
$1,769.09 |
| Rate for Payer: Aetna Commercial |
$1,418.96
|
| Rate for Payer: Anthem Medicaid |
$633.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,437.38
|
| Rate for Payer: Cash Price |
$921.40
|
| Rate for Payer: Cigna Commercial |
$1,529.52
|
| Rate for Payer: First Health Commercial |
$1,750.66
|
| Rate for Payer: Humana Commercial |
$1,566.38
|
| Rate for Payer: Humana KY Medicaid |
$633.74
|
| Rate for Payer: Kentucky WC Medicaid |
$640.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,511.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,359.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$552.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$646.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,621.66
|
| Rate for Payer: Ohio Health Group HMO |
$1,382.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$368.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$571.27
|
| Rate for Payer: PHCS Commercial |
$1,769.09
|
| Rate for Payer: United Healthcare All Payer |
$1,621.66
|
|
|
HII CARBON CONNCTN ROD 8*400MM
|
Facility
|
IP
|
$1,842.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.56 |
| Max. Negotiated Rate |
$1,769.09 |
| Rate for Payer: Aetna Commercial |
$1,418.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,437.38
|
| Rate for Payer: Cash Price |
$921.40
|
| Rate for Payer: Cigna Commercial |
$1,529.52
|
| Rate for Payer: First Health Commercial |
$1,750.66
|
| Rate for Payer: Humana Commercial |
$1,566.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,511.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,359.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$552.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,621.66
|
| Rate for Payer: Ohio Health Group HMO |
$1,382.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$368.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$571.27
|
| Rate for Payer: PHCS Commercial |
$1,769.09
|
| Rate for Payer: United Healthcare All Payer |
$1,621.66
|
|
|
HII CARBON CONNCTN ROD 8*450MM
|
Facility
|
OP
|
$1,918.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.39 |
| Max. Negotiated Rate |
$1,841.66 |
| Rate for Payer: Aetna Commercial |
$1,477.17
|
| Rate for Payer: Anthem Medicaid |
$659.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,496.35
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cigna Commercial |
$1,592.27
|
| Rate for Payer: First Health Commercial |
$1,822.48
|
| Rate for Payer: Humana Commercial |
$1,630.64
|
| Rate for Payer: Humana KY Medicaid |
$659.74
|
| Rate for Payer: Kentucky WC Medicaid |
$666.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,573.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,415.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$672.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,688.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,438.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$383.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$249.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$594.70
|
| Rate for Payer: PHCS Commercial |
$1,841.66
|
| Rate for Payer: United Healthcare All Payer |
$1,688.19
|
|
|
HII CARBON CONNCTN ROD 8*450MM
|
Facility
|
IP
|
$1,918.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.39 |
| Max. Negotiated Rate |
$1,841.66 |
| Rate for Payer: Aetna Commercial |
$1,477.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,496.35
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cigna Commercial |
$1,592.27
|
| Rate for Payer: First Health Commercial |
$1,822.48
|
| Rate for Payer: Humana Commercial |
$1,630.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,573.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,415.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.52
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,688.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,438.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$383.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$249.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$594.70
|
| Rate for Payer: PHCS Commercial |
$1,841.66
|
| Rate for Payer: United Healthcare All Payer |
$1,688.19
|
|
|
HII CARBON CONNCTN ROD 8*500MM
|
Facility
|
IP
|
$1,918.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.39 |
| Max. Negotiated Rate |
$1,841.66 |
| Rate for Payer: Aetna Commercial |
$1,477.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,496.35
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cigna Commercial |
$1,592.27
|
| Rate for Payer: First Health Commercial |
$1,822.48
|
| Rate for Payer: Humana Commercial |
$1,630.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,573.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,415.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.52
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,688.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,438.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$383.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$249.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$594.70
|
| Rate for Payer: PHCS Commercial |
$1,841.66
|
| Rate for Payer: United Healthcare All Payer |
$1,688.19
|
|
|
HII CARBON CONNCTN ROD 8*500MM
|
Facility
|
OP
|
$1,918.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.39 |
| Max. Negotiated Rate |
$1,841.66 |
| Rate for Payer: Aetna Commercial |
$1,477.17
|
| Rate for Payer: Anthem Medicaid |
$659.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,496.35
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cigna Commercial |
$1,592.27
|
| Rate for Payer: First Health Commercial |
$1,822.48
|
| Rate for Payer: Humana Commercial |
$1,630.64
|
| Rate for Payer: Humana KY Medicaid |
$659.74
|
| Rate for Payer: Kentucky WC Medicaid |
$666.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,573.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,415.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$672.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,688.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,438.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$383.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$249.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$594.70
|
| Rate for Payer: PHCS Commercial |
$1,841.66
|
| Rate for Payer: United Healthcare All Payer |
$1,688.19
|
|
|
HII CARBON CONNECTN ROD 8*65MM
|
Facility
|
OP
|
$1,772.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$1,701.89 |
| Rate for Payer: Aetna Commercial |
$1,365.06
|
| Rate for Payer: Anthem Medicaid |
$609.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,382.78
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cigna Commercial |
$1,471.42
|
| Rate for Payer: First Health Commercial |
$1,684.16
|
| Rate for Payer: Humana Commercial |
$1,506.88
|
| Rate for Payer: Humana KY Medicaid |
$609.67
|
| Rate for Payer: Kentucky WC Medicaid |
$615.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,453.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,308.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$621.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,560.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,329.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$354.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$230.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.57
|
| Rate for Payer: PHCS Commercial |
$1,701.89
|
| Rate for Payer: United Healthcare All Payer |
$1,560.06
|
|
|
HII CARBON CONNECTN ROD 8*65MM
|
Facility
|
IP
|
$1,772.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$1,701.89 |
| Rate for Payer: Aetna Commercial |
$1,365.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,382.78
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cigna Commercial |
$1,471.42
|
| Rate for Payer: First Health Commercial |
$1,684.16
|
| Rate for Payer: Humana Commercial |
$1,506.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,453.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,308.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,560.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,329.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$354.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$230.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.57
|
| Rate for Payer: PHCS Commercial |
$1,701.89
|
| Rate for Payer: United Healthcare All Payer |
$1,560.06
|
|
|
HII COMP MOD WRIST KIT STER
|
Facility
|
OP
|
$18,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,386.18 |
| Max. Negotiated Rate |
$17,620.99 |
| Rate for Payer: Aetna Commercial |
$14,133.50
|
| Rate for Payer: Anthem Medicaid |
$6,312.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,317.06
|
| Rate for Payer: Cash Price |
$9,177.60
|
| Rate for Payer: Cigna Commercial |
$15,234.82
|
| Rate for Payer: First Health Commercial |
$17,437.44
|
| Rate for Payer: Humana Commercial |
$15,601.92
|
| Rate for Payer: Humana KY Medicaid |
$6,312.35
|
| Rate for Payer: Kentucky WC Medicaid |
$6,376.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,051.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,546.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,506.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,439.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,152.58
|
| Rate for Payer: Ohio Health Group HMO |
$13,766.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,671.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,386.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,690.11
|
| Rate for Payer: PHCS Commercial |
$17,620.99
|
| Rate for Payer: United Healthcare All Payer |
$16,152.58
|
|
|
HII COMP MOD WRIST KIT STER
|
Facility
|
IP
|
$18,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,386.18 |
| Max. Negotiated Rate |
$17,620.99 |
| Rate for Payer: Aetna Commercial |
$14,133.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,317.06
|
| Rate for Payer: Cash Price |
$9,177.60
|
| Rate for Payer: Cigna Commercial |
$15,234.82
|
| Rate for Payer: First Health Commercial |
$17,437.44
|
| Rate for Payer: Humana Commercial |
$15,601.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,051.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,546.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,506.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,152.58
|
| Rate for Payer: Ohio Health Group HMO |
$13,766.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,671.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,386.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,690.11
|
| Rate for Payer: PHCS Commercial |
$17,620.99
|
| Rate for Payer: United Healthcare All Payer |
$16,152.58
|
|
