|
KREULCK COMP SCREW SS 2.7*12MM
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULCK COMP SCREW SS 2.7*18MM
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULCK COMP SCREW SS 2.7*18MM
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULCK COMP SCREW SS 2.7*20MM
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULCK COMP SCREW SS 2.7*20MM
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULOCK COMP SCREW 3.5*12
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULOCK COMP SCREW 3.5*12
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULOCK COMP SCREW 3.5*14
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULOCK COMP SCREW 3.5*14
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULOCK COMP SCREW 3.5*16
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KREULOCK COMP SCREW 3.5*16
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
KWIRE .062*9 2 PT DM
|
Facility
|
IP
|
$486.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.95 |
| Max. Negotiated Rate |
$467.04 |
| Rate for Payer: Aetna Commercial |
$374.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$379.47
|
| Rate for Payer: Cash Price |
$243.25
|
| Rate for Payer: Cigna Commercial |
$403.80
|
| Rate for Payer: First Health Commercial |
$462.18
|
| Rate for Payer: Humana Commercial |
$413.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$398.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$359.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$145.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$428.12
|
| Rate for Payer: Ohio Health Group HMO |
$364.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$423.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$335.69
|
| Rate for Payer: PHCS Commercial |
$467.04
|
| Rate for Payer: United Healthcare All Payer |
$428.12
|
|
|
KWIRE .062*9 2 PT DM
|
Facility
|
OP
|
$486.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.95 |
| Max. Negotiated Rate |
$467.04 |
| Rate for Payer: Aetna Commercial |
$374.61
|
| Rate for Payer: Anthem Medicaid |
$167.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$379.47
|
| Rate for Payer: Cash Price |
$243.25
|
| Rate for Payer: Cigna Commercial |
$403.80
|
| Rate for Payer: First Health Commercial |
$462.18
|
| Rate for Payer: Humana Commercial |
$413.52
|
| Rate for Payer: Humana KY Medicaid |
$167.31
|
| Rate for Payer: Kentucky WC Medicaid |
$169.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$398.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$359.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$145.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$170.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$428.12
|
| Rate for Payer: Ohio Health Group HMO |
$364.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$423.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$335.69
|
| Rate for Payer: PHCS Commercial |
$467.04
|
| Rate for Payer: United Healthcare All Payer |
$428.12
|
|
|
KWIRE 1.1
|
Facility
|
IP
|
$2,039.86
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.96 |
| Max. Negotiated Rate |
$1,958.27 |
| Rate for Payer: Aetna Commercial |
$1,570.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.09
|
| Rate for Payer: Cash Price |
$1,019.93
|
| Rate for Payer: Cigna Commercial |
$1,693.08
|
| Rate for Payer: First Health Commercial |
$1,937.87
|
| Rate for Payer: Humana Commercial |
$1,733.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,672.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,505.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$611.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,795.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,529.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,631.89
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,774.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,407.50
|
| Rate for Payer: PHCS Commercial |
$1,958.27
|
| Rate for Payer: United Healthcare All Payer |
$1,795.08
|
|
|
KWIRE 1.1
|
Facility
|
OP
|
$2,039.86
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.96 |
| Max. Negotiated Rate |
$1,958.27 |
| Rate for Payer: Aetna Commercial |
$1,570.69
|
| Rate for Payer: Anthem Medicaid |
$701.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.09
|
| Rate for Payer: Cash Price |
$1,019.93
|
| Rate for Payer: Cigna Commercial |
$1,693.08
|
| Rate for Payer: First Health Commercial |
$1,937.87
|
| Rate for Payer: Humana Commercial |
$1,733.88
|
| Rate for Payer: Humana KY Medicaid |
$701.51
|
| Rate for Payer: Kentucky WC Medicaid |
$708.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,672.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,505.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$611.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,795.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,529.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,631.89
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,774.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,407.50
|
| Rate for Payer: PHCS Commercial |
$1,958.27
|
| Rate for Payer: United Healthcare All Payer |
$1,795.08
|
|
|
K-WIRE 1.1*150MM BLUNT/TROCAR
|
Facility
|
OP
|
$466.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.88 |
| Max. Negotiated Rate |
$447.60 |
| Rate for Payer: Aetna Commercial |
$359.01
|
| Rate for Payer: Anthem Medicaid |
$160.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$363.68
|
| Rate for Payer: Cash Price |
$233.12
|
| Rate for Payer: Cigna Commercial |
$386.99
|
| Rate for Payer: First Health Commercial |
$442.94
|
| Rate for Payer: Humana Commercial |
$396.31
|
| Rate for Payer: Humana KY Medicaid |
$160.34
|
| Rate for Payer: Kentucky WC Medicaid |
$161.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$382.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$344.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$139.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$163.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$410.30
|
| Rate for Payer: Ohio Health Group HMO |
$349.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$373.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$321.71
|
| Rate for Payer: PHCS Commercial |
$447.60
|
| Rate for Payer: United Healthcare All Payer |
$410.30
|
|
|
K-WIRE 1.1*150MM BLUNT/TROCAR
|
Facility
|
IP
|
$466.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.88 |
| Max. Negotiated Rate |
$447.60 |
| Rate for Payer: Aetna Commercial |
$359.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$363.68
|
| Rate for Payer: Cash Price |
$233.12
|
| Rate for Payer: Cigna Commercial |
$386.99
|
| Rate for Payer: First Health Commercial |
$442.94
|
| Rate for Payer: Humana Commercial |
$396.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$382.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$344.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$139.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$410.30
|
| Rate for Payer: Ohio Health Group HMO |
$349.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$373.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$321.71
|
| Rate for Payer: PHCS Commercial |
$447.60
|
| Rate for Payer: United Healthcare All Payer |
$410.30
|
|
|
K-WIRE 1.1MM
|
Facility
|
IP
|
$1,738.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.67 |
| Max. Negotiated Rate |
$1,669.34 |
| Rate for Payer: Aetna Commercial |
$1,338.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,356.34
|
| Rate for Payer: Cash Price |
$869.45
|
| Rate for Payer: Cigna Commercial |
$1,443.29
|
| Rate for Payer: First Health Commercial |
$1,651.95
|
| Rate for Payer: Humana Commercial |
$1,478.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,425.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,283.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,530.23
|
| Rate for Payer: Ohio Health Group HMO |
$1,304.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,391.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,512.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,199.84
|
| Rate for Payer: PHCS Commercial |
$1,669.34
|
| Rate for Payer: United Healthcare All Payer |
$1,530.23
|
|
|
K-WIRE 1.1MM
|
Facility
|
OP
|
$1,738.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.67 |
| Max. Negotiated Rate |
$1,669.34 |
| Rate for Payer: Aetna Commercial |
$1,338.95
|
| Rate for Payer: Anthem Medicaid |
$598.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,356.34
|
| Rate for Payer: Cash Price |
$869.45
|
| Rate for Payer: Cigna Commercial |
$1,443.29
|
| Rate for Payer: First Health Commercial |
$1,651.95
|
| Rate for Payer: Humana Commercial |
$1,478.07
|
| Rate for Payer: Humana KY Medicaid |
$598.01
|
| Rate for Payer: Kentucky WC Medicaid |
$604.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,425.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,283.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.67
|
| Rate for Payer: Molina Healthcare Medicaid |
$610.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,530.23
|
| Rate for Payer: Ohio Health Group HMO |
$1,304.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,391.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,512.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,199.84
|
| Rate for Payer: PHCS Commercial |
$1,669.34
|
| Rate for Payer: United Healthcare All Payer |
$1,530.23
|
|
|
K-WIRE 2.3*150
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$385.00
|
| Rate for Payer: Anthem Medicaid |
$171.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$390.00
|
| Rate for Payer: Cash Price |
$250.00
|
| Rate for Payer: Cigna Commercial |
$415.00
|
| Rate for Payer: First Health Commercial |
$475.00
|
| Rate for Payer: Humana Commercial |
$425.00
|
| Rate for Payer: Humana KY Medicaid |
$171.95
|
| Rate for Payer: Kentucky WC Medicaid |
$173.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$410.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$369.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$150.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$175.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$440.00
|
| Rate for Payer: Ohio Health Group HMO |
$375.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$345.00
|
| Rate for Payer: PHCS Commercial |
$480.00
|
| Rate for Payer: United Healthcare All Payer |
$440.00
|
|
|
K-WIRE 2.3*150
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$385.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$390.00
|
| Rate for Payer: Cash Price |
$250.00
|
| Rate for Payer: Cigna Commercial |
$415.00
|
| Rate for Payer: First Health Commercial |
$475.00
|
| Rate for Payer: Humana Commercial |
$425.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$410.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$369.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$150.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$440.00
|
| Rate for Payer: Ohio Health Group HMO |
$375.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$345.00
|
| Rate for Payer: PHCS Commercial |
$480.00
|
| Rate for Payer: United Healthcare All Payer |
$440.00
|
|
|
KWIRE ASNIS MICRO 1.2*100MM
|
Facility
|
IP
|
$535.24
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$513.83 |
| Rate for Payer: Aetna Commercial |
$412.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$417.49
|
| Rate for Payer: Cash Price |
$267.62
|
| Rate for Payer: Cigna Commercial |
$444.25
|
| Rate for Payer: First Health Commercial |
$508.48
|
| Rate for Payer: Humana Commercial |
$454.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$438.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$395.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$160.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$471.01
|
| Rate for Payer: Ohio Health Group HMO |
$401.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$428.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$465.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$369.32
|
| Rate for Payer: PHCS Commercial |
$513.83
|
| Rate for Payer: United Healthcare All Payer |
$471.01
|
|
|
KWIRE ASNIS MICRO 1.2*100MM
|
Facility
|
OP
|
$535.24
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$513.83 |
| Rate for Payer: Aetna Commercial |
$412.13
|
| Rate for Payer: Anthem Medicaid |
$184.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$417.49
|
| Rate for Payer: Cash Price |
$267.62
|
| Rate for Payer: Cigna Commercial |
$444.25
|
| Rate for Payer: First Health Commercial |
$508.48
|
| Rate for Payer: Humana Commercial |
$454.95
|
| Rate for Payer: Humana KY Medicaid |
$184.07
|
| Rate for Payer: Kentucky WC Medicaid |
$185.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$438.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$395.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$160.57
|
| Rate for Payer: Molina Healthcare Medicaid |
$187.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$471.01
|
| Rate for Payer: Ohio Health Group HMO |
$401.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$428.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$465.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$369.32
|
| Rate for Payer: PHCS Commercial |
$513.83
|
| Rate for Payer: United Healthcare All Payer |
$471.01
|
|
|
K-WIRE DBL ENDED 09*150
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$385.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$390.00
|
| Rate for Payer: Cash Price |
$250.00
|
| Rate for Payer: Cigna Commercial |
$415.00
|
| Rate for Payer: First Health Commercial |
$475.00
|
| Rate for Payer: Humana Commercial |
$425.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$410.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$369.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$150.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$440.00
|
| Rate for Payer: Ohio Health Group HMO |
$375.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$345.00
|
| Rate for Payer: PHCS Commercial |
$480.00
|
| Rate for Payer: United Healthcare All Payer |
$440.00
|
|
|
K-WIRE DBL ENDED 09*150
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$385.00
|
| Rate for Payer: Anthem Medicaid |
$171.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$390.00
|
| Rate for Payer: Cash Price |
$250.00
|
| Rate for Payer: Cigna Commercial |
$415.00
|
| Rate for Payer: First Health Commercial |
$475.00
|
| Rate for Payer: Humana Commercial |
$425.00
|
| Rate for Payer: Humana KY Medicaid |
$171.95
|
| Rate for Payer: Kentucky WC Medicaid |
$173.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$410.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$369.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$150.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$175.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$440.00
|
| Rate for Payer: Ohio Health Group HMO |
$375.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$345.00
|
| Rate for Payer: PHCS Commercial |
$480.00
|
| Rate for Payer: United Healthcare All Payer |
$440.00
|
|
