|
HII CARBON CONNCTN ROD 8*100MM
|
Facility
|
IP
|
$1,759.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.71 |
| Max. Negotiated Rate |
$1,688.68 |
| Rate for Payer: Aetna Commercial |
$1,354.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.05
|
| Rate for Payer: Cash Price |
$879.52
|
| Rate for Payer: Cigna Commercial |
$1,460.00
|
| Rate for Payer: First Health Commercial |
$1,671.09
|
| Rate for Payer: Humana Commercial |
$1,495.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,547.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,213.74
|
| Rate for Payer: PHCS Commercial |
$1,688.68
|
| Rate for Payer: United Healthcare All Payer |
$1,547.96
|
|
|
HII CARBON CONNCTN ROD 8*100MM
|
Facility
|
OP
|
$1,759.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.71 |
| Max. Negotiated Rate |
$1,688.68 |
| Rate for Payer: Aetna Commercial |
$1,354.46
|
| Rate for Payer: Anthem Medicaid |
$604.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.05
|
| Rate for Payer: Cash Price |
$879.52
|
| Rate for Payer: Cigna Commercial |
$1,460.00
|
| Rate for Payer: First Health Commercial |
$1,671.09
|
| Rate for Payer: Humana Commercial |
$1,495.18
|
| Rate for Payer: Humana KY Medicaid |
$604.93
|
| Rate for Payer: Kentucky WC Medicaid |
$611.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$617.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,547.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,213.74
|
| Rate for Payer: PHCS Commercial |
$1,688.68
|
| Rate for Payer: United Healthcare All Payer |
$1,547.96
|
|
|
HII CARBON CONNCTN ROD 8*150MM
|
Facility
|
IP
|
$1,759.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.71 |
| Max. Negotiated Rate |
$1,688.68 |
| Rate for Payer: Aetna Commercial |
$1,354.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.05
|
| Rate for Payer: Cash Price |
$879.52
|
| Rate for Payer: Cigna Commercial |
$1,460.00
|
| Rate for Payer: First Health Commercial |
$1,671.09
|
| Rate for Payer: Humana Commercial |
$1,495.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,547.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,213.74
|
| Rate for Payer: PHCS Commercial |
$1,688.68
|
| Rate for Payer: United Healthcare All Payer |
$1,547.96
|
|
|
HII CARBON CONNCTN ROD 8*150MM
|
Facility
|
OP
|
$1,759.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.71 |
| Max. Negotiated Rate |
$1,688.68 |
| Rate for Payer: Aetna Commercial |
$1,354.46
|
| Rate for Payer: Anthem Medicaid |
$604.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.05
|
| Rate for Payer: Cash Price |
$879.52
|
| Rate for Payer: Cigna Commercial |
$1,460.00
|
| Rate for Payer: First Health Commercial |
$1,671.09
|
| Rate for Payer: Humana Commercial |
$1,495.18
|
| Rate for Payer: Humana KY Medicaid |
$604.93
|
| Rate for Payer: Kentucky WC Medicaid |
$611.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$617.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,547.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,213.74
|
| Rate for Payer: PHCS Commercial |
$1,688.68
|
| Rate for Payer: United Healthcare All Payer |
$1,547.96
|
|
|
HII CARBON CONNCTN ROD 8*200MM
|
Facility
|
IP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*200MM
|
Facility
|
OP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem Medicaid |
$618.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Humana KY Medicaid |
$618.52
|
| Rate for Payer: Kentucky WC Medicaid |
$624.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*250MM
|
Facility
|
OP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem Medicaid |
$618.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Humana KY Medicaid |
$618.52
|
| Rate for Payer: Kentucky WC Medicaid |
$624.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*250MM
|
Facility
|
IP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*300MM
|
Facility
|
IP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*300MM
|
Facility
|
OP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem Medicaid |
$618.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Humana KY Medicaid |
$618.52
|
| Rate for Payer: Kentucky WC Medicaid |
$624.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*350MM
|
Facility
|
IP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*350MM
|
Facility
|
OP
|
$1,798.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.57 |
| Max. Negotiated Rate |
$1,726.62 |
| Rate for Payer: Aetna Commercial |
$1,384.89
|
| Rate for Payer: Anthem Medicaid |
$618.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.88
|
| Rate for Payer: Cash Price |
$899.28
|
| Rate for Payer: Cigna Commercial |
$1,492.80
|
| Rate for Payer: First Health Commercial |
$1,708.63
|
| Rate for Payer: Humana Commercial |
$1,528.78
|
| Rate for Payer: Humana KY Medicaid |
$618.52
|
| Rate for Payer: Kentucky WC Medicaid |
$624.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,327.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.73
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.85
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,241.01
|
| Rate for Payer: PHCS Commercial |
$1,726.62
|
| Rate for Payer: United Healthcare All Payer |
$1,582.73
|
|
|
HII CARBON CONNCTN ROD 8*400MM
|
Facility
|
OP
|
$1,835.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.51 |
| Max. Negotiated Rate |
$1,761.64 |
| Rate for Payer: Aetna Commercial |
$1,412.98
|
| Rate for Payer: Anthem Medicaid |
$631.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,431.33
|
| Rate for Payer: Cash Price |
$917.52
|
| Rate for Payer: Cigna Commercial |
$1,523.08
|
| Rate for Payer: First Health Commercial |
$1,743.29
|
| Rate for Payer: Humana Commercial |
$1,559.78
|
| Rate for Payer: Humana KY Medicaid |
$631.07
|
| Rate for Payer: Kentucky WC Medicaid |
$637.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,504.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,354.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$550.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$643.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,614.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,376.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,468.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,596.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,266.18
|
| Rate for Payer: PHCS Commercial |
$1,761.64
|
| Rate for Payer: United Healthcare All Payer |
$1,614.84
|
|
|
HII CARBON CONNCTN ROD 8*400MM
|
Facility
|
IP
|
$1,835.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.51 |
| Max. Negotiated Rate |
$1,761.64 |
| Rate for Payer: Aetna Commercial |
$1,412.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,431.33
|
| Rate for Payer: Cash Price |
$917.52
|
| Rate for Payer: Cigna Commercial |
$1,523.08
|
| Rate for Payer: First Health Commercial |
$1,743.29
|
| Rate for Payer: Humana Commercial |
$1,559.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,504.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,354.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$550.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,614.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,376.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,468.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,596.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,266.18
|
| Rate for Payer: PHCS Commercial |
$1,761.64
|
| Rate for Payer: United Healthcare All Payer |
$1,614.84
|
|
|
HII CARBON CONNCTN ROD 8*450MM
|
Facility
|
IP
|
$1,917.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.14 |
| Max. Negotiated Rate |
$1,840.44 |
| Rate for Payer: Aetna Commercial |
$1,476.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,495.35
|
| Rate for Payer: Cash Price |
$958.56
|
| Rate for Payer: Cigna Commercial |
$1,591.21
|
| Rate for Payer: First Health Commercial |
$1,821.26
|
| Rate for Payer: Humana Commercial |
$1,629.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,572.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,414.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,687.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,437.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,533.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,667.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,322.81
|
| Rate for Payer: PHCS Commercial |
$1,840.44
|
| Rate for Payer: United Healthcare All Payer |
$1,687.07
|
|
|
HII CARBON CONNCTN ROD 8*450MM
|
Facility
|
OP
|
$1,917.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.14 |
| Max. Negotiated Rate |
$1,840.44 |
| Rate for Payer: Aetna Commercial |
$1,476.18
|
| Rate for Payer: Anthem Medicaid |
$659.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,495.35
|
| Rate for Payer: Cash Price |
$958.56
|
| Rate for Payer: Cigna Commercial |
$1,591.21
|
| Rate for Payer: First Health Commercial |
$1,821.26
|
| Rate for Payer: Humana Commercial |
$1,629.55
|
| Rate for Payer: Humana KY Medicaid |
$659.30
|
| Rate for Payer: Kentucky WC Medicaid |
$666.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,572.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,414.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$672.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,687.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,437.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,533.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,667.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,322.81
|
| Rate for Payer: PHCS Commercial |
$1,840.44
|
| Rate for Payer: United Healthcare All Payer |
$1,687.07
|
|
|
HII CARBON CONNCTN ROD 8*500MM
|
Facility
|
OP
|
$1,917.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.14 |
| Max. Negotiated Rate |
$1,840.44 |
| Rate for Payer: Aetna Commercial |
$1,476.18
|
| Rate for Payer: Anthem Medicaid |
$659.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,495.35
|
| Rate for Payer: Cash Price |
$958.56
|
| Rate for Payer: Cigna Commercial |
$1,591.21
|
| Rate for Payer: First Health Commercial |
$1,821.26
|
| Rate for Payer: Humana Commercial |
$1,629.55
|
| Rate for Payer: Humana KY Medicaid |
$659.30
|
| Rate for Payer: Kentucky WC Medicaid |
$666.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,572.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,414.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$672.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,687.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,437.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,533.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,667.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,322.81
|
| Rate for Payer: PHCS Commercial |
$1,840.44
|
| Rate for Payer: United Healthcare All Payer |
$1,687.07
|
|
|
HII CARBON CONNCTN ROD 8*500MM
|
Facility
|
IP
|
$1,917.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.14 |
| Max. Negotiated Rate |
$1,840.44 |
| Rate for Payer: Aetna Commercial |
$1,476.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,495.35
|
| Rate for Payer: Cash Price |
$958.56
|
| Rate for Payer: Cigna Commercial |
$1,591.21
|
| Rate for Payer: First Health Commercial |
$1,821.26
|
| Rate for Payer: Humana Commercial |
$1,629.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,572.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,414.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,687.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,437.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,533.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,667.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,322.81
|
| Rate for Payer: PHCS Commercial |
$1,840.44
|
| Rate for Payer: United Healthcare All Payer |
$1,687.07
|
|
|
HII CARBON CONNECTN ROD 8*65MM
|
Facility
|
IP
|
$1,759.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.71 |
| Max. Negotiated Rate |
$1,688.68 |
| Rate for Payer: Aetna Commercial |
$1,354.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.05
|
| Rate for Payer: Cash Price |
$879.52
|
| Rate for Payer: Cigna Commercial |
$1,460.00
|
| Rate for Payer: First Health Commercial |
$1,671.09
|
| Rate for Payer: Humana Commercial |
$1,495.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,547.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,213.74
|
| Rate for Payer: PHCS Commercial |
$1,688.68
|
| Rate for Payer: United Healthcare All Payer |
$1,547.96
|
|
|
HII CARBON CONNECTN ROD 8*65MM
|
Facility
|
OP
|
$1,759.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.71 |
| Max. Negotiated Rate |
$1,688.68 |
| Rate for Payer: Aetna Commercial |
$1,354.46
|
| Rate for Payer: Anthem Medicaid |
$604.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.05
|
| Rate for Payer: Cash Price |
$879.52
|
| Rate for Payer: Cigna Commercial |
$1,460.00
|
| Rate for Payer: First Health Commercial |
$1,671.09
|
| Rate for Payer: Humana Commercial |
$1,495.18
|
| Rate for Payer: Humana KY Medicaid |
$604.93
|
| Rate for Payer: Kentucky WC Medicaid |
$611.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,442.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$617.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,547.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,530.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,213.74
|
| Rate for Payer: PHCS Commercial |
$1,688.68
|
| Rate for Payer: United Healthcare All Payer |
$1,547.96
|
|
|
HII COMP MOD WRIST KIT STER
|
Facility
|
IP
|
$18,948.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,684.52 |
| Max. Negotiated Rate |
$18,190.46 |
| Rate for Payer: Aetna Commercial |
$14,590.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,779.75
|
| Rate for Payer: Cash Price |
$9,474.20
|
| Rate for Payer: Cigna Commercial |
$15,727.17
|
| Rate for Payer: First Health Commercial |
$18,000.98
|
| Rate for Payer: Humana Commercial |
$16,106.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,537.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,983.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,684.52
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,674.59
|
| Rate for Payer: Ohio Health Group HMO |
$14,211.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,158.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,485.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,074.40
|
| Rate for Payer: PHCS Commercial |
$18,190.46
|
| Rate for Payer: United Healthcare All Payer |
$16,674.59
|
|
|
HII COMP MOD WRIST KIT STER
|
Facility
|
OP
|
$18,948.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,684.52 |
| Max. Negotiated Rate |
$18,190.46 |
| Rate for Payer: Aetna Commercial |
$14,590.27
|
| Rate for Payer: Anthem Medicaid |
$6,516.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,779.75
|
| Rate for Payer: Cash Price |
$9,474.20
|
| Rate for Payer: Cigna Commercial |
$15,727.17
|
| Rate for Payer: First Health Commercial |
$18,000.98
|
| Rate for Payer: Humana Commercial |
$16,106.14
|
| Rate for Payer: Humana KY Medicaid |
$6,516.35
|
| Rate for Payer: Kentucky WC Medicaid |
$6,582.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,537.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,983.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,684.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,647.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,674.59
|
| Rate for Payer: Ohio Health Group HMO |
$14,211.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,158.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,485.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,074.40
|
| Rate for Payer: PHCS Commercial |
$18,190.46
|
| Rate for Payer: United Healthcare All Payer |
$16,674.59
|
|
|
HII COMPR/DISTA ROD
|
Facility
|
OP
|
$3,878.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,163.40 |
| Max. Negotiated Rate |
$3,722.88 |
| Rate for Payer: Aetna Commercial |
$2,986.06
|
| Rate for Payer: Anthem Medicaid |
$1,333.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,024.84
|
| Rate for Payer: Cash Price |
$1,939.00
|
| Rate for Payer: Cigna Commercial |
$3,218.74
|
| Rate for Payer: First Health Commercial |
$3,684.10
|
| Rate for Payer: Humana Commercial |
$3,296.30
|
| Rate for Payer: Humana KY Medicaid |
$1,333.64
|
| Rate for Payer: Kentucky WC Medicaid |
$1,347.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,179.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,861.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,163.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,360.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,412.64
|
| Rate for Payer: Ohio Health Group HMO |
$2,908.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,102.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,373.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,675.82
|
| Rate for Payer: PHCS Commercial |
$3,722.88
|
| Rate for Payer: United Healthcare All Payer |
$3,412.64
|
|
|
HII COMPR/DISTA ROD
|
Facility
|
IP
|
$3,878.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,163.40 |
| Max. Negotiated Rate |
$3,722.88 |
| Rate for Payer: Aetna Commercial |
$2,986.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,024.84
|
| Rate for Payer: Cash Price |
$1,939.00
|
| Rate for Payer: Cigna Commercial |
$3,218.74
|
| Rate for Payer: First Health Commercial |
$3,684.10
|
| Rate for Payer: Humana Commercial |
$3,296.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,179.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,861.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,163.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,412.64
|
| Rate for Payer: Ohio Health Group HMO |
$2,908.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,102.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,373.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,675.82
|
| Rate for Payer: PHCS Commercial |
$3,722.88
|
| Rate for Payer: United Healthcare All Payer |
$3,412.64
|
|
|
HII CURVED ALUM ROD 134MM WIDT
|
Facility
|
IP
|
$1,728.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$518.59 |
| Max. Negotiated Rate |
$1,659.49 |
| Rate for Payer: Aetna Commercial |
$1,331.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,348.34
|
| Rate for Payer: Cash Price |
$864.32
|
| Rate for Payer: Cigna Commercial |
$1,434.77
|
| Rate for Payer: First Health Commercial |
$1,642.21
|
| Rate for Payer: Humana Commercial |
$1,469.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,417.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,521.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.48
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,382.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,503.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,192.76
|
| Rate for Payer: PHCS Commercial |
$1,659.49
|
| Rate for Payer: United Healthcare All Payer |
$1,521.20
|
|
