|
GUIDEWIRE THREADED 2.0M*250M
|
Facility
|
IP
|
$1,794.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$538.20 |
| Max. Negotiated Rate |
$1,722.24 |
| Rate for Payer: Aetna Commercial |
$1,381.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,399.32
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,489.02
|
| Rate for Payer: First Health Commercial |
$1,704.30
|
| Rate for Payer: Humana Commercial |
$1,524.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,471.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,323.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$538.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,578.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,345.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,435.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,560.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,237.86
|
| Rate for Payer: PHCS Commercial |
$1,722.24
|
| Rate for Payer: United Healthcare All Payer |
$1,578.72
|
|
|
GUIDEWIRE THREADED 3.2*300MM
|
Facility
|
IP
|
$795.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$238.50 |
| Max. Negotiated Rate |
$763.20 |
| Rate for Payer: Aetna Commercial |
$612.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$620.10
|
| Rate for Payer: Cash Price |
$397.50
|
| Rate for Payer: Cigna Commercial |
$659.85
|
| Rate for Payer: First Health Commercial |
$755.25
|
| Rate for Payer: Humana Commercial |
$675.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$651.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$586.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$238.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$699.60
|
| Rate for Payer: Ohio Health Group HMO |
$596.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$636.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$691.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$548.55
|
| Rate for Payer: PHCS Commercial |
$763.20
|
| Rate for Payer: United Healthcare All Payer |
$699.60
|
|
|
GUIDEWIRE THREADED 3.2*300MM
|
Facility
|
OP
|
$795.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$238.50 |
| Max. Negotiated Rate |
$763.20 |
| Rate for Payer: Aetna Commercial |
$612.15
|
| Rate for Payer: Anthem Medicaid |
$273.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$620.10
|
| Rate for Payer: Cash Price |
$397.50
|
| Rate for Payer: Cigna Commercial |
$659.85
|
| Rate for Payer: First Health Commercial |
$755.25
|
| Rate for Payer: Humana Commercial |
$675.75
|
| Rate for Payer: Humana KY Medicaid |
$273.40
|
| Rate for Payer: Kentucky WC Medicaid |
$276.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$651.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$586.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$238.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$278.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$699.60
|
| Rate for Payer: Ohio Health Group HMO |
$596.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$636.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$691.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$548.55
|
| Rate for Payer: PHCS Commercial |
$763.20
|
| Rate for Payer: United Healthcare All Payer |
$699.60
|
|
|
GUIDEWIRE THREADED 3.2*300MM S
|
Facility
|
OP
|
$1,568.60
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$470.58 |
| Max. Negotiated Rate |
$1,505.86 |
| Rate for Payer: Aetna Commercial |
$1,207.82
|
| Rate for Payer: Anthem Medicaid |
$539.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,223.51
|
| Rate for Payer: Cash Price |
$784.30
|
| Rate for Payer: Cigna Commercial |
$1,301.94
|
| Rate for Payer: First Health Commercial |
$1,490.17
|
| Rate for Payer: Humana Commercial |
$1,333.31
|
| Rate for Payer: Humana KY Medicaid |
$539.44
|
| Rate for Payer: Kentucky WC Medicaid |
$544.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,286.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,157.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$470.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$550.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,380.37
|
| Rate for Payer: Ohio Health Group HMO |
$1,176.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,254.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,364.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,082.33
|
| Rate for Payer: PHCS Commercial |
$1,505.86
|
| Rate for Payer: United Healthcare All Payer |
$1,380.37
|
|
|
GUIDEWIRE THREADED 3.2*300MM S
|
Facility
|
IP
|
$1,568.60
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$470.58 |
| Max. Negotiated Rate |
$1,505.86 |
| Rate for Payer: Aetna Commercial |
$1,207.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,223.51
|
| Rate for Payer: Cash Price |
$784.30
|
| Rate for Payer: Cigna Commercial |
$1,301.94
|
| Rate for Payer: First Health Commercial |
$1,490.17
|
| Rate for Payer: Humana Commercial |
$1,333.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,286.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,157.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$470.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,380.37
|
| Rate for Payer: Ohio Health Group HMO |
$1,176.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,254.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,364.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,082.33
|
| Rate for Payer: PHCS Commercial |
$1,505.86
|
| Rate for Payer: United Healthcare All Payer |
$1,380.37
|
|
|
GUIDEWIRE THRUWAY JTIP .014*13
|
Facility
|
IP
|
$1,497.92
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$449.38 |
| Max. Negotiated Rate |
$1,438.00 |
| Rate for Payer: Aetna Commercial |
$1,153.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,168.38
|
| Rate for Payer: Cash Price |
$748.96
|
| Rate for Payer: Cigna Commercial |
$1,243.27
|
| Rate for Payer: First Health Commercial |
$1,423.02
|
| Rate for Payer: Humana Commercial |
$1,273.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,228.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,105.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$449.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,318.17
|
| Rate for Payer: Ohio Health Group HMO |
$1,123.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,198.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,303.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,033.56
|
| Rate for Payer: PHCS Commercial |
$1,438.00
|
| Rate for Payer: United Healthcare All Payer |
$1,318.17
|
|
|
GUIDEWIRE THRUWAY JTIP .014*13
|
Facility
|
OP
|
$1,497.92
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$449.38 |
| Max. Negotiated Rate |
$1,438.00 |
| Rate for Payer: Aetna Commercial |
$1,153.40
|
| Rate for Payer: Anthem Medicaid |
$515.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,168.38
|
| Rate for Payer: Cash Price |
$748.96
|
| Rate for Payer: Cigna Commercial |
$1,243.27
|
| Rate for Payer: First Health Commercial |
$1,423.02
|
| Rate for Payer: Humana Commercial |
$1,273.23
|
| Rate for Payer: Humana KY Medicaid |
$515.13
|
| Rate for Payer: Kentucky WC Medicaid |
$520.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,228.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,105.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$449.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$525.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,318.17
|
| Rate for Payer: Ohio Health Group HMO |
$1,123.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,198.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,303.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,033.56
|
| Rate for Payer: PHCS Commercial |
$1,438.00
|
| Rate for Payer: United Healthcare All Payer |
$1,318.17
|
|
|
GUIDEWIRE THRUWAY STR 0.14*300
|
Facility
|
OP
|
$1,759.42
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$527.83 |
| Max. Negotiated Rate |
$1,689.04 |
| Rate for Payer: Aetna Commercial |
$1,354.75
|
| Rate for Payer: Anthem Medicaid |
$605.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.35
|
| Rate for Payer: Cash Price |
$879.71
|
| Rate for Payer: Cigna Commercial |
$1,460.32
|
| Rate for Payer: First Health Commercial |
$1,671.45
|
| Rate for Payer: Humana Commercial |
$1,495.51
|
| Rate for Payer: Humana KY Medicaid |
$605.06
|
| Rate for Payer: Kentucky WC Medicaid |
$611.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$617.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,548.29
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,214.00
|
| Rate for Payer: PHCS Commercial |
$1,689.04
|
| Rate for Payer: United Healthcare All Payer |
$1,548.29
|
|
|
GUIDEWIRE THRUWAY STR 0.14*300
|
Facility
|
IP
|
$1,759.42
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$527.83 |
| Max. Negotiated Rate |
$1,689.04 |
| Rate for Payer: Aetna Commercial |
$1,354.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.35
|
| Rate for Payer: Cash Price |
$879.71
|
| Rate for Payer: Cigna Commercial |
$1,460.32
|
| Rate for Payer: First Health Commercial |
$1,671.45
|
| Rate for Payer: Humana Commercial |
$1,495.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,548.29
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,214.00
|
| Rate for Payer: PHCS Commercial |
$1,689.04
|
| Rate for Payer: United Healthcare All Payer |
$1,548.29
|
|
|
GUIDEWIRE THRUWAY STR .018*130
|
Facility
|
IP
|
$1,504.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.20 |
| Max. Negotiated Rate |
$1,443.84 |
| Rate for Payer: Aetna Commercial |
$1,158.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,173.12
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cigna Commercial |
$1,248.32
|
| Rate for Payer: First Health Commercial |
$1,428.80
|
| Rate for Payer: Humana Commercial |
$1,278.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,233.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,109.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$451.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,323.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,128.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,203.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,308.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,037.76
|
| Rate for Payer: PHCS Commercial |
$1,443.84
|
| Rate for Payer: United Healthcare All Payer |
$1,323.52
|
|
|
GUIDEWIRE THRUWAY STR .018*130
|
Facility
|
OP
|
$1,504.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.20 |
| Max. Negotiated Rate |
$1,443.84 |
| Rate for Payer: Aetna Commercial |
$1,158.08
|
| Rate for Payer: Anthem Medicaid |
$517.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,173.12
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cigna Commercial |
$1,248.32
|
| Rate for Payer: First Health Commercial |
$1,428.80
|
| Rate for Payer: Humana Commercial |
$1,278.40
|
| Rate for Payer: Humana KY Medicaid |
$517.23
|
| Rate for Payer: Kentucky WC Medicaid |
$522.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,233.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,109.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$451.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$527.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,323.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,128.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,203.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,308.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,037.76
|
| Rate for Payer: PHCS Commercial |
$1,443.84
|
| Rate for Payer: United Healthcare All Payer |
$1,323.52
|
|
|
GUIDEWIRE TOURGUID 8.5F 90*17M
|
Facility
|
IP
|
$4,385.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,315.50 |
| Max. Negotiated Rate |
$4,209.60 |
| Rate for Payer: Aetna Commercial |
$3,376.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,420.30
|
| Rate for Payer: Cash Price |
$2,192.50
|
| Rate for Payer: Cigna Commercial |
$3,639.55
|
| Rate for Payer: First Health Commercial |
$4,165.75
|
| Rate for Payer: Humana Commercial |
$3,727.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,595.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,236.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,858.80
|
| Rate for Payer: Ohio Health Group HMO |
$3,288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,508.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,814.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,025.65
|
| Rate for Payer: PHCS Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Payer |
$3,858.80
|
|
|
GUIDEWIRE TOURGUID 8.5F 90*17M
|
Facility
|
OP
|
$4,385.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,315.50 |
| Max. Negotiated Rate |
$4,209.60 |
| Rate for Payer: Aetna Commercial |
$3,376.45
|
| Rate for Payer: Anthem Medicaid |
$1,508.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,420.30
|
| Rate for Payer: Cash Price |
$2,192.50
|
| Rate for Payer: Cigna Commercial |
$3,639.55
|
| Rate for Payer: First Health Commercial |
$4,165.75
|
| Rate for Payer: Humana Commercial |
$3,727.25
|
| Rate for Payer: Humana KY Medicaid |
$1,508.00
|
| Rate for Payer: Kentucky WC Medicaid |
$1,523.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,595.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,236.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,538.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,858.80
|
| Rate for Payer: Ohio Health Group HMO |
$3,288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,508.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,814.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,025.65
|
| Rate for Payer: PHCS Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Payer |
$3,858.80
|
|
|
GUIDEWIRE TOURGUIDE 6.5F 90*9M
|
Facility
|
OP
|
$4,385.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,315.50 |
| Max. Negotiated Rate |
$4,209.60 |
| Rate for Payer: Aetna Commercial |
$3,376.45
|
| Rate for Payer: Anthem Medicaid |
$1,508.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,420.30
|
| Rate for Payer: Cash Price |
$2,192.50
|
| Rate for Payer: Cigna Commercial |
$3,639.55
|
| Rate for Payer: First Health Commercial |
$4,165.75
|
| Rate for Payer: Humana Commercial |
$3,727.25
|
| Rate for Payer: Humana KY Medicaid |
$1,508.00
|
| Rate for Payer: Kentucky WC Medicaid |
$1,523.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,595.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,236.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,538.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,858.80
|
| Rate for Payer: Ohio Health Group HMO |
$3,288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,508.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,814.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,025.65
|
| Rate for Payer: PHCS Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Payer |
$3,858.80
|
|
|
GUIDEWIRE TOURGUIDE 6.5F 90*9M
|
Facility
|
IP
|
$4,385.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,315.50 |
| Max. Negotiated Rate |
$4,209.60 |
| Rate for Payer: Aetna Commercial |
$3,376.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,420.30
|
| Rate for Payer: Cash Price |
$2,192.50
|
| Rate for Payer: Cigna Commercial |
$3,639.55
|
| Rate for Payer: First Health Commercial |
$4,165.75
|
| Rate for Payer: Humana Commercial |
$3,727.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,595.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,236.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,858.80
|
| Rate for Payer: Ohio Health Group HMO |
$3,288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,508.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,814.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,025.65
|
| Rate for Payer: PHCS Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Payer |
$3,858.80
|
|
|
GUIDEWIRE TOURGUIDE 7F 90*9MM
|
Facility
|
IP
|
$4,385.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,315.50 |
| Max. Negotiated Rate |
$4,209.60 |
| Rate for Payer: Aetna Commercial |
$3,376.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,420.30
|
| Rate for Payer: Cash Price |
$2,192.50
|
| Rate for Payer: Cigna Commercial |
$3,639.55
|
| Rate for Payer: First Health Commercial |
$4,165.75
|
| Rate for Payer: Humana Commercial |
$3,727.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,595.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,236.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,858.80
|
| Rate for Payer: Ohio Health Group HMO |
$3,288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,508.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,814.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,025.65
|
| Rate for Payer: PHCS Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Payer |
$3,858.80
|
|
|
GUIDEWIRE TOURGUIDE 7F 90*9MM
|
Facility
|
OP
|
$4,385.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,315.50 |
| Max. Negotiated Rate |
$4,209.60 |
| Rate for Payer: Aetna Commercial |
$3,376.45
|
| Rate for Payer: Anthem Medicaid |
$1,508.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,420.30
|
| Rate for Payer: Cash Price |
$2,192.50
|
| Rate for Payer: Cigna Commercial |
$3,639.55
|
| Rate for Payer: First Health Commercial |
$4,165.75
|
| Rate for Payer: Humana Commercial |
$3,727.25
|
| Rate for Payer: Humana KY Medicaid |
$1,508.00
|
| Rate for Payer: Kentucky WC Medicaid |
$1,523.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,595.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,236.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,538.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,858.80
|
| Rate for Payer: Ohio Health Group HMO |
$3,288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,508.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,814.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,025.65
|
| Rate for Payer: PHCS Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Payer |
$3,858.80
|
|
|
GUIDEWIRE TOURGUIDE 7FR 45*17
|
Facility
|
IP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 45*17
|
Facility
|
OP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem Medicaid |
$1,474.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Humana KY Medicaid |
$1,474.47
|
| Rate for Payer: Kentucky WC Medicaid |
$1,489.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,504.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 45*9
|
Facility
|
IP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 45*9
|
Facility
|
OP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem Medicaid |
$1,474.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Humana KY Medicaid |
$1,474.47
|
| Rate for Payer: Kentucky WC Medicaid |
$1,489.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,504.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 55*17
|
Facility
|
OP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem Medicaid |
$1,474.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Humana KY Medicaid |
$1,474.47
|
| Rate for Payer: Kentucky WC Medicaid |
$1,489.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,504.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 55*17
|
Facility
|
IP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 55*9
|
Facility
|
OP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem Medicaid |
$1,474.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Humana KY Medicaid |
$1,474.47
|
| Rate for Payer: Kentucky WC Medicaid |
$1,489.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,504.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
|
GUIDEWIRE TOURGUIDE 7FR 55*9
|
Facility
|
IP
|
$4,287.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$4,116.00 |
| Rate for Payer: Aetna Commercial |
$3,301.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,344.25
|
| Rate for Payer: Cash Price |
$2,143.75
|
| Rate for Payer: Cigna Commercial |
$3,558.62
|
| Rate for Payer: First Health Commercial |
$4,073.12
|
| Rate for Payer: Humana Commercial |
$3,644.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,515.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,164.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,286.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,773.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,215.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,430.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,730.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,958.38
|
| Rate for Payer: PHCS Commercial |
$4,116.00
|
| Rate for Payer: United Healthcare All Payer |
$3,773.00
|
|
