|
HII CURVED ALUM ROD 134MM WIDT
|
Facility
|
OP
|
$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 Medicaid |
$594.48
|
| 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: Humana KY Medicaid |
$594.48
|
| Rate for Payer: Kentucky WC Medicaid |
$600.53
|
| 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: Molina Healthcare Medicaid |
$606.41
|
| 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
|
|
|
HII CURVED ALUM ROD 174MM WIDT
|
Facility
|
IP
|
$1,746.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.06 |
| Max. Negotiated Rate |
$1,677.00 |
| Rate for Payer: Aetna Commercial |
$1,345.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,362.57
|
| Rate for Payer: Cash Price |
$873.44
|
| Rate for Payer: Cigna Commercial |
$1,449.91
|
| Rate for Payer: First Health Commercial |
$1,659.54
|
| Rate for Payer: Humana Commercial |
$1,484.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,432.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,289.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$524.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,537.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,310.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,397.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,519.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,205.35
|
| Rate for Payer: PHCS Commercial |
$1,677.00
|
| Rate for Payer: United Healthcare All Payer |
$1,537.25
|
|
|
HII CURVED ALUM ROD 174MM WIDT
|
Facility
|
OP
|
$1,746.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.06 |
| Max. Negotiated Rate |
$1,677.00 |
| Rate for Payer: Aetna Commercial |
$1,345.10
|
| Rate for Payer: Anthem Medicaid |
$600.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,362.57
|
| Rate for Payer: Cash Price |
$873.44
|
| Rate for Payer: Cigna Commercial |
$1,449.91
|
| Rate for Payer: First Health Commercial |
$1,659.54
|
| Rate for Payer: Humana Commercial |
$1,484.85
|
| Rate for Payer: Humana KY Medicaid |
$600.75
|
| Rate for Payer: Kentucky WC Medicaid |
$606.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,432.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,289.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$524.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$612.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,537.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,310.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,397.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,519.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,205.35
|
| Rate for Payer: PHCS Commercial |
$1,677.00
|
| Rate for Payer: United Healthcare All Payer |
$1,537.25
|
|
|
HII CURVED ALUM ROD 214MM WIDT
|
Facility
|
IP
|
$1,765.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$529.54 |
| Max. Negotiated Rate |
$1,694.52 |
| Rate for Payer: Aetna Commercial |
$1,359.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,376.79
|
| Rate for Payer: Cash Price |
$882.56
|
| Rate for Payer: Cigna Commercial |
$1,465.05
|
| Rate for Payer: First Health Commercial |
$1,676.86
|
| Rate for Payer: Humana Commercial |
$1,500.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,447.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,302.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,553.31
|
| Rate for Payer: Ohio Health Group HMO |
$1,323.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,412.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,217.93
|
| Rate for Payer: PHCS Commercial |
$1,694.52
|
| Rate for Payer: United Healthcare All Payer |
$1,553.31
|
|
|
HII CURVED ALUM ROD 214MM WIDT
|
Facility
|
OP
|
$1,765.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$529.54 |
| Max. Negotiated Rate |
$1,694.52 |
| Rate for Payer: Aetna Commercial |
$1,359.14
|
| Rate for Payer: Anthem Medicaid |
$607.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,376.79
|
| Rate for Payer: Cash Price |
$882.56
|
| Rate for Payer: Cigna Commercial |
$1,465.05
|
| Rate for Payer: First Health Commercial |
$1,676.86
|
| Rate for Payer: Humana Commercial |
$1,500.35
|
| Rate for Payer: Humana KY Medicaid |
$607.02
|
| Rate for Payer: Kentucky WC Medicaid |
$613.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,447.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,302.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,553.31
|
| Rate for Payer: Ohio Health Group HMO |
$1,323.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,412.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,217.93
|
| Rate for Payer: PHCS Commercial |
$1,694.52
|
| Rate for Payer: United Healthcare All Payer |
$1,553.31
|
|
|
HII DYNAMIZATION ROD
|
Facility
|
OP
|
$10,081.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,024.30 |
| Max. Negotiated Rate |
$9,677.76 |
| Rate for Payer: Aetna Commercial |
$7,762.37
|
| Rate for Payer: Anthem Medicaid |
$3,466.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,863.18
|
| Rate for Payer: Cash Price |
$5,040.50
|
| Rate for Payer: Cigna Commercial |
$8,367.23
|
| Rate for Payer: First Health Commercial |
$9,576.95
|
| Rate for Payer: Humana Commercial |
$8,568.85
|
| Rate for Payer: Humana KY Medicaid |
$3,466.86
|
| Rate for Payer: Kentucky WC Medicaid |
$3,502.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,266.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,439.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,024.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,536.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,871.28
|
| Rate for Payer: Ohio Health Group HMO |
$7,560.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,064.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,770.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,955.89
|
| Rate for Payer: PHCS Commercial |
$9,677.76
|
| Rate for Payer: United Healthcare All Payer |
$8,871.28
|
|
|
HII DYNAMIZATION ROD
|
Facility
|
IP
|
$10,081.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,024.30 |
| Max. Negotiated Rate |
$9,677.76 |
| Rate for Payer: Aetna Commercial |
$7,762.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,863.18
|
| Rate for Payer: Cash Price |
$5,040.50
|
| Rate for Payer: Cigna Commercial |
$8,367.23
|
| Rate for Payer: First Health Commercial |
$9,576.95
|
| Rate for Payer: Humana Commercial |
$8,568.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,266.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,439.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,024.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,871.28
|
| Rate for Payer: Ohio Health Group HMO |
$7,560.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,064.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,770.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,955.89
|
| Rate for Payer: PHCS Commercial |
$9,677.76
|
| Rate for Payer: United Healthcare All Payer |
$8,871.28
|
|
|
HII INVERT COUPLING 8/4 +5M
|
Facility
|
OP
|
$3,725.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,117.50 |
| Max. Negotiated Rate |
$3,576.00 |
| Rate for Payer: Aetna Commercial |
$2,868.25
|
| Rate for Payer: Anthem Medicaid |
$1,281.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,905.50
|
| Rate for Payer: Cash Price |
$1,862.50
|
| Rate for Payer: Cigna Commercial |
$3,091.75
|
| Rate for Payer: First Health Commercial |
$3,538.75
|
| Rate for Payer: Humana Commercial |
$3,166.25
|
| Rate for Payer: Humana KY Medicaid |
$1,281.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,294.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,054.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,749.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,117.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,306.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,278.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,793.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,980.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,240.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,570.25
|
| Rate for Payer: PHCS Commercial |
$3,576.00
|
| Rate for Payer: United Healthcare All Payer |
$3,278.00
|
|
|
HII INVERT COUPLING 8/4 +5M
|
Facility
|
IP
|
$3,725.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,117.50 |
| Max. Negotiated Rate |
$3,576.00 |
| Rate for Payer: Aetna Commercial |
$2,868.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,905.50
|
| Rate for Payer: Cash Price |
$1,862.50
|
| Rate for Payer: Cigna Commercial |
$3,091.75
|
| Rate for Payer: First Health Commercial |
$3,538.75
|
| Rate for Payer: Humana Commercial |
$3,166.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,054.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,749.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,117.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,278.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,793.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,980.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,240.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,570.25
|
| Rate for Payer: PHCS Commercial |
$3,576.00
|
| Rate for Payer: United Healthcare All Payer |
$3,278.00
|
|
|
HII MED MONO ROD COUPLING
|
Facility
|
OP
|
$3,914.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,174.20 |
| Max. Negotiated Rate |
$3,757.44 |
| Rate for Payer: Aetna Commercial |
$3,013.78
|
| Rate for Payer: Anthem Medicaid |
$1,346.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,052.92
|
| Rate for Payer: Cash Price |
$1,957.00
|
| Rate for Payer: Cigna Commercial |
$3,248.62
|
| Rate for Payer: First Health Commercial |
$3,718.30
|
| Rate for Payer: Humana Commercial |
$3,326.90
|
| Rate for Payer: Humana KY Medicaid |
$1,346.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,359.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,209.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,888.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,174.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,373.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,444.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,935.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,131.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,405.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,700.66
|
| Rate for Payer: PHCS Commercial |
$3,757.44
|
| Rate for Payer: United Healthcare All Payer |
$3,444.32
|
|
|
HII MED MONO ROD COUPLING
|
Facility
|
IP
|
$3,914.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,174.20 |
| Max. Negotiated Rate |
$3,757.44 |
| Rate for Payer: Aetna Commercial |
$3,013.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,052.92
|
| Rate for Payer: Cash Price |
$1,957.00
|
| Rate for Payer: Cigna Commercial |
$3,248.62
|
| Rate for Payer: First Health Commercial |
$3,718.30
|
| Rate for Payer: Humana Commercial |
$3,326.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,209.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,888.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,174.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,444.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,935.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,131.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,405.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,700.66
|
| Rate for Payer: PHCS Commercial |
$3,757.44
|
| Rate for Payer: United Healthcare All Payer |
$3,444.32
|
|
|
HII MICRO ROD TO ROD CLAMP3/3
|
Facility
|
IP
|
$4,002.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,200.75 |
| Max. Negotiated Rate |
$3,842.40 |
| Rate for Payer: Aetna Commercial |
$3,081.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,121.95
|
| Rate for Payer: Cash Price |
$2,001.25
|
| Rate for Payer: Cigna Commercial |
$3,322.07
|
| Rate for Payer: First Health Commercial |
$3,802.38
|
| Rate for Payer: Humana Commercial |
$3,402.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,282.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,953.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,200.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,522.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,001.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,202.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,482.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,761.72
|
| Rate for Payer: PHCS Commercial |
$3,842.40
|
| Rate for Payer: United Healthcare All Payer |
$3,522.20
|
|
|
HII MICRO ROD TO ROD CLAMP3/3
|
Facility
|
OP
|
$4,002.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,200.75 |
| Max. Negotiated Rate |
$3,842.40 |
| Rate for Payer: Aetna Commercial |
$3,081.93
|
| Rate for Payer: Anthem Medicaid |
$1,376.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,121.95
|
| Rate for Payer: Cash Price |
$2,001.25
|
| Rate for Payer: Cigna Commercial |
$3,322.07
|
| Rate for Payer: First Health Commercial |
$3,802.38
|
| Rate for Payer: Humana Commercial |
$3,402.12
|
| Rate for Payer: Humana KY Medicaid |
$1,376.46
|
| Rate for Payer: Kentucky WC Medicaid |
$1,390.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,282.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,953.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,200.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,404.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,522.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,001.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,202.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,482.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,761.72
|
| Rate for Payer: PHCS Commercial |
$3,842.40
|
| Rate for Payer: United Healthcare All Payer |
$3,522.20
|
|
|
HII PIN CLAMP ASSY W/O POST
|
Facility
|
OP
|
$3,818.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,145.40 |
| Max. Negotiated Rate |
$3,665.28 |
| Rate for Payer: Aetna Commercial |
$2,939.86
|
| Rate for Payer: Anthem Medicaid |
$1,313.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,978.04
|
| Rate for Payer: Cash Price |
$1,909.00
|
| Rate for Payer: Cigna Commercial |
$3,168.94
|
| Rate for Payer: First Health Commercial |
$3,627.10
|
| Rate for Payer: Humana Commercial |
$3,245.30
|
| Rate for Payer: Humana KY Medicaid |
$1,313.01
|
| Rate for Payer: Kentucky WC Medicaid |
$1,326.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,130.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,817.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,145.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,339.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,359.84
|
| Rate for Payer: Ohio Health Group HMO |
$2,863.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,054.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,321.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,634.42
|
| Rate for Payer: PHCS Commercial |
$3,665.28
|
| Rate for Payer: United Healthcare All Payer |
$3,359.84
|
|
|
HII PIN CLAMP ASSY W/O POST
|
Facility
|
IP
|
$3,818.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,145.40 |
| Max. Negotiated Rate |
$3,665.28 |
| Rate for Payer: Aetna Commercial |
$2,939.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,978.04
|
| Rate for Payer: Cash Price |
$1,909.00
|
| Rate for Payer: Cigna Commercial |
$3,168.94
|
| Rate for Payer: First Health Commercial |
$3,627.10
|
| Rate for Payer: Humana Commercial |
$3,245.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,130.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,817.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,145.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,359.84
|
| Rate for Payer: Ohio Health Group HMO |
$2,863.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,054.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,321.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,634.42
|
| Rate for Payer: PHCS Commercial |
$3,665.28
|
| Rate for Payer: United Healthcare All Payer |
$3,359.84
|
|
|
HII SS CONNECTING ROD 8*100MM
|
Facility
|
IP
|
$832.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$798.72 |
| Rate for Payer: Aetna Commercial |
$640.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$648.96
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$690.56
|
| Rate for Payer: First Health Commercial |
$790.40
|
| Rate for Payer: Humana Commercial |
$707.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$682.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$614.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$732.16
|
| Rate for Payer: Ohio Health Group HMO |
$624.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$665.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$723.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$574.08
|
| Rate for Payer: PHCS Commercial |
$798.72
|
| Rate for Payer: United Healthcare All Payer |
$732.16
|
|
|
HII SS CONNECTING ROD 8*100MM
|
Facility
|
OP
|
$832.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$798.72 |
| Rate for Payer: Aetna Commercial |
$640.64
|
| Rate for Payer: Anthem Medicaid |
$286.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$648.96
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$690.56
|
| Rate for Payer: First Health Commercial |
$790.40
|
| Rate for Payer: Humana Commercial |
$707.20
|
| Rate for Payer: Humana KY Medicaid |
$286.12
|
| Rate for Payer: Kentucky WC Medicaid |
$289.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$682.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$614.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$291.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$732.16
|
| Rate for Payer: Ohio Health Group HMO |
$624.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$665.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$723.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$574.08
|
| Rate for Payer: PHCS Commercial |
$798.72
|
| Rate for Payer: United Healthcare All Payer |
$732.16
|
|
|
HII SS CONNECTING ROD 8*150MM
|
Facility
|
OP
|
$832.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$798.72 |
| Rate for Payer: Aetna Commercial |
$640.64
|
| Rate for Payer: Anthem Medicaid |
$286.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$648.96
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$690.56
|
| Rate for Payer: First Health Commercial |
$790.40
|
| Rate for Payer: Humana Commercial |
$707.20
|
| Rate for Payer: Humana KY Medicaid |
$286.12
|
| Rate for Payer: Kentucky WC Medicaid |
$289.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$682.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$614.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$291.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$732.16
|
| Rate for Payer: Ohio Health Group HMO |
$624.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$665.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$723.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$574.08
|
| Rate for Payer: PHCS Commercial |
$798.72
|
| Rate for Payer: United Healthcare All Payer |
$732.16
|
|
|
HII SS CONNECTING ROD 8*150MM
|
Facility
|
IP
|
$832.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$798.72 |
| Rate for Payer: Aetna Commercial |
$640.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$648.96
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$690.56
|
| Rate for Payer: First Health Commercial |
$790.40
|
| Rate for Payer: Humana Commercial |
$707.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$682.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$614.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$732.16
|
| Rate for Payer: Ohio Health Group HMO |
$624.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$665.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$723.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$574.08
|
| Rate for Payer: PHCS Commercial |
$798.72
|
| Rate for Payer: United Healthcare All Payer |
$732.16
|
|
|
HII SS CONNECTING ROD 8*200MM
|
Facility
|
OP
|
$1,106.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem Medicaid |
$380.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Humana KY Medicaid |
$380.35
|
| Rate for Payer: Kentucky WC Medicaid |
$384.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$387.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
HII SS CONNECTING ROD 8*200MM
|
Facility
|
IP
|
$1,106.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
HII SS CONNECTING ROD 8*250MM
|
Facility
|
OP
|
$1,106.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem Medicaid |
$380.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Humana KY Medicaid |
$380.35
|
| Rate for Payer: Kentucky WC Medicaid |
$384.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$387.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
HII SS CONNECTING ROD 8*250MM
|
Facility
|
IP
|
$1,106.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
HII SS CONNECTING ROD 8*300MM
|
Facility
|
IP
|
$1,106.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
HII SS CONNECTING ROD 8*300MM
|
Facility
|
OP
|
$1,106.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem Medicaid |
$380.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Humana KY Medicaid |
$380.35
|
| Rate for Payer: Kentucky WC Medicaid |
$384.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$387.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
