|
HII COMPR/DISTA ROD
|
Facility
|
IP
|
$3,952.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.86 |
| Max. Negotiated Rate |
$3,794.69 |
| Rate for Payer: Aetna Commercial |
$3,043.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,083.18
|
| Rate for Payer: Cash Price |
$1,976.40
|
| Rate for Payer: Cigna Commercial |
$3,280.82
|
| Rate for Payer: First Health Commercial |
$3,755.16
|
| Rate for Payer: Humana Commercial |
$3,359.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,241.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,917.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,185.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,478.46
|
| Rate for Payer: Ohio Health Group HMO |
$2,964.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$790.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$513.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,225.37
|
| Rate for Payer: PHCS Commercial |
$3,794.69
|
| Rate for Payer: United Healthcare All Payer |
$3,478.46
|
|
|
HII COMPR/DISTA ROD
|
Facility
|
OP
|
$3,952.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.86 |
| Max. Negotiated Rate |
$3,794.69 |
| Rate for Payer: Aetna Commercial |
$3,043.66
|
| Rate for Payer: Anthem Medicaid |
$1,359.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,083.18
|
| Rate for Payer: Cash Price |
$1,976.40
|
| Rate for Payer: Cigna Commercial |
$3,280.82
|
| Rate for Payer: First Health Commercial |
$3,755.16
|
| Rate for Payer: Humana Commercial |
$3,359.88
|
| Rate for Payer: Humana KY Medicaid |
$1,359.37
|
| Rate for Payer: Kentucky WC Medicaid |
$1,373.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,241.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,917.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,185.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,386.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,478.46
|
| Rate for Payer: Ohio Health Group HMO |
$2,964.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$790.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$513.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,225.37
|
| Rate for Payer: PHCS Commercial |
$3,794.69
|
| Rate for Payer: United Healthcare All Payer |
$3,478.46
|
|
|
HII CURVED ALUM ROD 134MM WIDT
|
Facility
|
OP
|
$1,744.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$226.82 |
| Max. Negotiated Rate |
$1,675.01 |
| Rate for Payer: Aetna Commercial |
$1,343.50
|
| Rate for Payer: Anthem Medicaid |
$600.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,360.94
|
| Rate for Payer: Cash Price |
$872.40
|
| Rate for Payer: Cigna Commercial |
$1,448.18
|
| Rate for Payer: First Health Commercial |
$1,657.56
|
| Rate for Payer: Humana Commercial |
$1,483.08
|
| Rate for Payer: Humana KY Medicaid |
$600.04
|
| Rate for Payer: Kentucky WC Medicaid |
$606.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,430.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,287.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$523.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$612.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,535.42
|
| Rate for Payer: Ohio Health Group HMO |
$1,308.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$348.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$226.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.89
|
| Rate for Payer: PHCS Commercial |
$1,675.01
|
| Rate for Payer: United Healthcare All Payer |
$1,535.42
|
|
|
HII CURVED ALUM ROD 134MM WIDT
|
Facility
|
IP
|
$1,744.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$226.82 |
| Max. Negotiated Rate |
$1,675.01 |
| Rate for Payer: Aetna Commercial |
$1,343.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,360.94
|
| Rate for Payer: Cash Price |
$872.40
|
| Rate for Payer: Cigna Commercial |
$1,448.18
|
| Rate for Payer: First Health Commercial |
$1,657.56
|
| Rate for Payer: Humana Commercial |
$1,483.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,430.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,287.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$523.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,535.42
|
| Rate for Payer: Ohio Health Group HMO |
$1,308.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$348.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$226.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.89
|
| Rate for Payer: PHCS Commercial |
$1,675.01
|
| Rate for Payer: United Healthcare All Payer |
$1,535.42
|
|
|
HII CURVED ALUM ROD 174MM WIDT
|
Facility
|
OP
|
$1,761.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.01 |
| Max. Negotiated Rate |
$1,691.14 |
| Rate for Payer: Aetna Commercial |
$1,356.43
|
| Rate for Payer: Anthem Medicaid |
$605.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,374.05
|
| Rate for Payer: Cash Price |
$880.80
|
| Rate for Payer: Cigna Commercial |
$1,462.13
|
| Rate for Payer: First Health Commercial |
$1,673.52
|
| Rate for Payer: Humana Commercial |
$1,497.36
|
| Rate for Payer: Humana KY Medicaid |
$605.81
|
| Rate for Payer: Kentucky WC Medicaid |
$611.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,444.51
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,300.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$528.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$617.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,550.21
|
| Rate for Payer: Ohio Health Group HMO |
$1,321.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$352.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$546.10
|
| Rate for Payer: PHCS Commercial |
$1,691.14
|
| Rate for Payer: United Healthcare All Payer |
$1,550.21
|
|
|
HII CURVED ALUM ROD 174MM WIDT
|
Facility
|
IP
|
$1,761.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.01 |
| Max. Negotiated Rate |
$1,691.14 |
| Rate for Payer: Aetna Commercial |
$1,356.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,374.05
|
| Rate for Payer: Cash Price |
$880.80
|
| Rate for Payer: Cigna Commercial |
$1,462.13
|
| Rate for Payer: First Health Commercial |
$1,673.52
|
| Rate for Payer: Humana Commercial |
$1,497.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,444.51
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,300.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$528.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,550.21
|
| Rate for Payer: Ohio Health Group HMO |
$1,321.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$352.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$546.10
|
| Rate for Payer: PHCS Commercial |
$1,691.14
|
| Rate for Payer: United Healthcare All Payer |
$1,550.21
|
|
|
HII CURVED ALUM ROD 214MM WIDT
|
Facility
|
OP
|
$1,778.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$231.19 |
| Max. Negotiated Rate |
$1,707.26 |
| Rate for Payer: Aetna Commercial |
$1,369.37
|
| Rate for Payer: Anthem Medicaid |
$611.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,387.15
|
| Rate for Payer: Cash Price |
$889.20
|
| Rate for Payer: Cigna Commercial |
$1,476.07
|
| Rate for Payer: First Health Commercial |
$1,689.48
|
| Rate for Payer: Humana Commercial |
$1,511.64
|
| Rate for Payer: Humana KY Medicaid |
$611.59
|
| Rate for Payer: Kentucky WC Medicaid |
$617.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,458.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,312.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$533.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$623.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,564.99
|
| Rate for Payer: Ohio Health Group HMO |
$1,333.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$355.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$231.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$551.30
|
| Rate for Payer: PHCS Commercial |
$1,707.26
|
| Rate for Payer: United Healthcare All Payer |
$1,564.99
|
|
|
HII CURVED ALUM ROD 214MM WIDT
|
Facility
|
IP
|
$1,778.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$231.19 |
| Max. Negotiated Rate |
$1,707.26 |
| Rate for Payer: Aetna Commercial |
$1,369.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,387.15
|
| Rate for Payer: Cash Price |
$889.20
|
| Rate for Payer: Cigna Commercial |
$1,476.07
|
| Rate for Payer: First Health Commercial |
$1,689.48
|
| Rate for Payer: Humana Commercial |
$1,511.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,458.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,312.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$533.52
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,564.99
|
| Rate for Payer: Ohio Health Group HMO |
$1,333.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$355.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$231.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$551.30
|
| Rate for Payer: PHCS Commercial |
$1,707.26
|
| Rate for Payer: United Healthcare All Payer |
$1,564.99
|
|
|
HII DYNAMIZATION ROD
|
Facility
|
OP
|
$9,881.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,284.53 |
| Max. Negotiated Rate |
$9,485.76 |
| Rate for Payer: Aetna Commercial |
$7,608.37
|
| Rate for Payer: Anthem Medicaid |
$3,398.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,707.18
|
| Rate for Payer: Cash Price |
$4,940.50
|
| Rate for Payer: Cigna Commercial |
$8,201.23
|
| Rate for Payer: First Health Commercial |
$9,386.95
|
| Rate for Payer: Humana Commercial |
$8,398.85
|
| Rate for Payer: Humana KY Medicaid |
$3,398.08
|
| Rate for Payer: Kentucky WC Medicaid |
$3,432.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,102.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,292.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,964.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,466.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,695.28
|
| Rate for Payer: Ohio Health Group HMO |
$7,410.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,976.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,284.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,063.11
|
| Rate for Payer: PHCS Commercial |
$9,485.76
|
| Rate for Payer: United Healthcare All Payer |
$8,695.28
|
|
|
HII DYNAMIZATION ROD
|
Facility
|
IP
|
$9,881.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,284.53 |
| Max. Negotiated Rate |
$9,485.76 |
| Rate for Payer: Aetna Commercial |
$7,608.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,707.18
|
| Rate for Payer: Cash Price |
$4,940.50
|
| Rate for Payer: Cigna Commercial |
$8,201.23
|
| Rate for Payer: First Health Commercial |
$9,386.95
|
| Rate for Payer: Humana Commercial |
$8,398.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,102.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,292.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,964.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,695.28
|
| Rate for Payer: Ohio Health Group HMO |
$7,410.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,976.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,284.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,063.11
|
| Rate for Payer: PHCS Commercial |
$9,485.76
|
| Rate for Payer: United Healthcare All Payer |
$8,695.28
|
|
|
HII INVERT COUPLING 8/4 +5M
|
Facility
|
IP
|
$3,810.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$495.30 |
| Max. Negotiated Rate |
$3,657.60 |
| Rate for Payer: Aetna Commercial |
$2,933.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,971.80
|
| Rate for Payer: Cash Price |
$1,905.00
|
| Rate for Payer: Cigna Commercial |
$3,162.30
|
| Rate for Payer: First Health Commercial |
$3,619.50
|
| Rate for Payer: Humana Commercial |
$3,238.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,124.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,811.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,143.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,352.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,857.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$762.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$495.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,181.10
|
| Rate for Payer: PHCS Commercial |
$3,657.60
|
| Rate for Payer: United Healthcare All Payer |
$3,352.80
|
|
|
HII INVERT COUPLING 8/4 +5M
|
Facility
|
OP
|
$3,810.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$495.30 |
| Max. Negotiated Rate |
$3,657.60 |
| Rate for Payer: Aetna Commercial |
$2,933.70
|
| Rate for Payer: Anthem Medicaid |
$1,310.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,971.80
|
| Rate for Payer: Cash Price |
$1,905.00
|
| Rate for Payer: Cigna Commercial |
$3,162.30
|
| Rate for Payer: First Health Commercial |
$3,619.50
|
| Rate for Payer: Humana Commercial |
$3,238.50
|
| Rate for Payer: Humana KY Medicaid |
$1,310.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,323.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,124.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,811.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,143.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,336.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,352.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,857.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$762.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$495.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,181.10
|
| Rate for Payer: PHCS Commercial |
$3,657.60
|
| Rate for Payer: United Healthcare All Payer |
$3,352.80
|
|
|
HII MED MONO ROD COUPLING
|
Facility
|
IP
|
$3,986.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$518.23 |
| Max. Negotiated Rate |
$3,826.94 |
| Rate for Payer: Aetna Commercial |
$3,069.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,109.39
|
| Rate for Payer: Cash Price |
$1,993.20
|
| Rate for Payer: Cigna Commercial |
$3,308.71
|
| Rate for Payer: First Health Commercial |
$3,787.08
|
| Rate for Payer: Humana Commercial |
$3,388.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,268.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,941.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,195.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,508.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,989.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$797.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$518.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.78
|
| Rate for Payer: PHCS Commercial |
$3,826.94
|
| Rate for Payer: United Healthcare All Payer |
$3,508.03
|
|
|
HII MED MONO ROD COUPLING
|
Facility
|
OP
|
$3,986.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$518.23 |
| Max. Negotiated Rate |
$3,826.94 |
| Rate for Payer: Aetna Commercial |
$3,069.53
|
| Rate for Payer: Anthem Medicaid |
$1,370.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,109.39
|
| Rate for Payer: Cash Price |
$1,993.20
|
| Rate for Payer: Cigna Commercial |
$3,308.71
|
| Rate for Payer: First Health Commercial |
$3,787.08
|
| Rate for Payer: Humana Commercial |
$3,388.44
|
| Rate for Payer: Humana KY Medicaid |
$1,370.92
|
| Rate for Payer: Kentucky WC Medicaid |
$1,384.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,268.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,941.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,195.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,398.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,508.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,989.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$797.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$518.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.78
|
| Rate for Payer: PHCS Commercial |
$3,826.94
|
| Rate for Payer: United Healthcare All Payer |
$3,508.03
|
|
|
HII MICRO ROD TO ROD CLAMP3/3
|
Facility
|
OP
|
$4,069.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.97 |
| Max. Negotiated Rate |
$3,906.24 |
| Rate for Payer: Aetna Commercial |
$3,133.13
|
| Rate for Payer: Anthem Medicaid |
$1,399.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,173.82
|
| Rate for Payer: Cash Price |
$2,034.50
|
| Rate for Payer: Cigna Commercial |
$3,377.27
|
| Rate for Payer: First Health Commercial |
$3,865.55
|
| Rate for Payer: Humana Commercial |
$3,458.65
|
| Rate for Payer: Humana KY Medicaid |
$1,399.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,413.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,336.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,002.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,220.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,427.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,580.72
|
| Rate for Payer: Ohio Health Group HMO |
$3,051.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$813.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$528.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,261.39
|
| Rate for Payer: PHCS Commercial |
$3,906.24
|
| Rate for Payer: United Healthcare All Payer |
$3,580.72
|
|
|
HII MICRO ROD TO ROD CLAMP3/3
|
Facility
|
IP
|
$4,069.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$528.97 |
| Max. Negotiated Rate |
$3,906.24 |
| Rate for Payer: Aetna Commercial |
$3,133.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,173.82
|
| Rate for Payer: Cash Price |
$2,034.50
|
| Rate for Payer: Cigna Commercial |
$3,377.27
|
| Rate for Payer: First Health Commercial |
$3,865.55
|
| Rate for Payer: Humana Commercial |
$3,458.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,336.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,002.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,220.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,580.72
|
| Rate for Payer: Ohio Health Group HMO |
$3,051.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$813.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$528.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,261.39
|
| Rate for Payer: PHCS Commercial |
$3,906.24
|
| Rate for Payer: United Healthcare All Payer |
$3,580.72
|
|
|
HII PIN CLAMP ASSY W/O POST
|
Facility
|
IP
|
$3,896.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$506.58 |
| Max. Negotiated Rate |
$3,740.93 |
| Rate for Payer: Aetna Commercial |
$3,000.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,039.50
|
| Rate for Payer: Cash Price |
$1,948.40
|
| Rate for Payer: Cigna Commercial |
$3,234.34
|
| Rate for Payer: First Health Commercial |
$3,701.96
|
| Rate for Payer: Humana Commercial |
$3,312.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,195.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,875.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,169.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,429.18
|
| Rate for Payer: Ohio Health Group HMO |
$2,922.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$779.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$506.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,208.01
|
| Rate for Payer: PHCS Commercial |
$3,740.93
|
| Rate for Payer: United Healthcare All Payer |
$3,429.18
|
|
|
HII PIN CLAMP ASSY W/O POST
|
Facility
|
OP
|
$3,896.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$506.58 |
| Max. Negotiated Rate |
$3,740.93 |
| Rate for Payer: Aetna Commercial |
$3,000.54
|
| Rate for Payer: Anthem Medicaid |
$1,340.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,039.50
|
| Rate for Payer: Cash Price |
$1,948.40
|
| Rate for Payer: Cigna Commercial |
$3,234.34
|
| Rate for Payer: First Health Commercial |
$3,701.96
|
| Rate for Payer: Humana Commercial |
$3,312.28
|
| Rate for Payer: Humana KY Medicaid |
$1,340.11
|
| Rate for Payer: Kentucky WC Medicaid |
$1,353.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,195.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,875.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,169.04
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,367.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,429.18
|
| Rate for Payer: Ohio Health Group HMO |
$2,922.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$779.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$506.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,208.01
|
| Rate for Payer: PHCS Commercial |
$3,740.93
|
| Rate for Payer: United Healthcare All Payer |
$3,429.18
|
|
|
HII SS CONNECTING ROD 8*100MM
|
Facility
|
OP
|
$808.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.14 |
| Max. Negotiated Rate |
$776.45 |
| Rate for Payer: Aetna Commercial |
$622.78
|
| Rate for Payer: Anthem Medicaid |
$278.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$630.86
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$671.30
|
| Rate for Payer: First Health Commercial |
$768.36
|
| Rate for Payer: Humana Commercial |
$687.48
|
| Rate for Payer: Humana KY Medicaid |
$278.15
|
| Rate for Payer: Kentucky WC Medicaid |
$280.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$663.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$596.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$242.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$283.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$711.74
|
| Rate for Payer: Ohio Health Group HMO |
$606.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$161.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$250.73
|
| Rate for Payer: PHCS Commercial |
$776.45
|
| Rate for Payer: United Healthcare All Payer |
$711.74
|
|
|
HII SS CONNECTING ROD 8*100MM
|
Facility
|
IP
|
$808.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.14 |
| Max. Negotiated Rate |
$776.45 |
| Rate for Payer: Aetna Commercial |
$622.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$630.86
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$671.30
|
| Rate for Payer: First Health Commercial |
$768.36
|
| Rate for Payer: Humana Commercial |
$687.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$663.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$596.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$242.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$711.74
|
| Rate for Payer: Ohio Health Group HMO |
$606.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$161.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$250.73
|
| Rate for Payer: PHCS Commercial |
$776.45
|
| Rate for Payer: United Healthcare All Payer |
$711.74
|
|
|
HII SS CONNECTING ROD 8*150MM
|
Facility
|
OP
|
$808.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.14 |
| Max. Negotiated Rate |
$776.45 |
| Rate for Payer: Aetna Commercial |
$622.78
|
| Rate for Payer: Anthem Medicaid |
$278.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$630.86
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$671.30
|
| Rate for Payer: First Health Commercial |
$768.36
|
| Rate for Payer: Humana Commercial |
$687.48
|
| Rate for Payer: Humana KY Medicaid |
$278.15
|
| Rate for Payer: Kentucky WC Medicaid |
$280.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$663.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$596.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$242.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$283.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$711.74
|
| Rate for Payer: Ohio Health Group HMO |
$606.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$161.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$250.73
|
| Rate for Payer: PHCS Commercial |
$776.45
|
| Rate for Payer: United Healthcare All Payer |
$711.74
|
|
|
HII SS CONNECTING ROD 8*150MM
|
Facility
|
IP
|
$808.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.14 |
| Max. Negotiated Rate |
$776.45 |
| Rate for Payer: Aetna Commercial |
$622.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$630.86
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cigna Commercial |
$671.30
|
| Rate for Payer: First Health Commercial |
$768.36
|
| Rate for Payer: Humana Commercial |
$687.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$663.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$596.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$242.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$711.74
|
| Rate for Payer: Ohio Health Group HMO |
$606.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$161.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$250.73
|
| Rate for Payer: PHCS Commercial |
$776.45
|
| Rate for Payer: United Healthcare All Payer |
$711.74
|
|
|
HII SS CONNECTING ROD 8*200MM
|
Facility
|
IP
|
$1,070.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.12 |
| Max. Negotiated Rate |
$1,027.35 |
| Rate for Payer: Aetna Commercial |
$824.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$834.72
|
| Rate for Payer: Cash Price |
$535.08
|
| Rate for Payer: Cigna Commercial |
$888.23
|
| Rate for Payer: First Health Commercial |
$1,016.65
|
| Rate for Payer: Humana Commercial |
$909.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$877.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$789.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$321.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$941.74
|
| Rate for Payer: Ohio Health Group HMO |
$802.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$214.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$331.75
|
| Rate for Payer: PHCS Commercial |
$1,027.35
|
| Rate for Payer: United Healthcare All Payer |
$941.74
|
|
|
HII SS CONNECTING ROD 8*200MM
|
Facility
|
OP
|
$1,070.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.12 |
| Max. Negotiated Rate |
$1,027.35 |
| Rate for Payer: Aetna Commercial |
$824.02
|
| Rate for Payer: Anthem Medicaid |
$368.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$834.72
|
| Rate for Payer: Cash Price |
$535.08
|
| Rate for Payer: Cigna Commercial |
$888.23
|
| Rate for Payer: First Health Commercial |
$1,016.65
|
| Rate for Payer: Humana Commercial |
$909.64
|
| Rate for Payer: Humana KY Medicaid |
$368.03
|
| Rate for Payer: Kentucky WC Medicaid |
$371.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$877.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$789.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$321.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$375.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$941.74
|
| Rate for Payer: Ohio Health Group HMO |
$802.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$214.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$331.75
|
| Rate for Payer: PHCS Commercial |
$1,027.35
|
| Rate for Payer: United Healthcare All Payer |
$941.74
|
|
|
HII SS CONNECTING ROD 8*250MM
|
Facility
|
IP
|
$1,070.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.12 |
| Max. Negotiated Rate |
$1,027.35 |
| Rate for Payer: Aetna Commercial |
$824.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$834.72
|
| Rate for Payer: Cash Price |
$535.08
|
| Rate for Payer: Cigna Commercial |
$888.23
|
| Rate for Payer: First Health Commercial |
$1,016.65
|
| Rate for Payer: Humana Commercial |
$909.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$877.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$789.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$321.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$941.74
|
| Rate for Payer: Ohio Health Group HMO |
$802.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$214.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$331.75
|
| Rate for Payer: PHCS Commercial |
$1,027.35
|
| Rate for Payer: United Healthcare All Payer |
$941.74
|
|
