|
NEXGEN FEM-POST AUG 10MM SZE/F
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN FEM-POST AUG 10MM SZE/F
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN FEM-POST AUG 10MM SZ G
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN FEM-POST AUG 10MM SZ G
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN KNEE FEM CUT GUDE C LT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE C LT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE C RT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE C RT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE D LT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE D LT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE D RT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE D RT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE E LT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE E LT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE E RT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE E RT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE F LT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE F LT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE F RT
|
Facility
|
OP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem Medicaid |
$3,401.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Humana KY Medicaid |
$3,401.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,436.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,469.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN KNEE FEM CUT GUDE F RT
|
Facility
|
IP
|
$9,891.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,967.36 |
| Max. Negotiated Rate |
$9,495.55 |
| Rate for Payer: Aetna Commercial |
$7,616.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,715.14
|
| Rate for Payer: Cash Price |
$4,945.60
|
| Rate for Payer: Cigna Commercial |
$8,209.70
|
| Rate for Payer: First Health Commercial |
$9,396.64
|
| Rate for Payer: Humana Commercial |
$8,407.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,110.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,299.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,967.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,704.26
|
| Rate for Payer: Ohio Health Group HMO |
$7,418.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,912.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,605.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,824.93
|
| Rate for Payer: PHCS Commercial |
$9,495.55
|
| Rate for Payer: United Healthcare All Payer |
$8,704.26
|
|
|
NEXGEN LPS AP TIB SZ3 YEL 10MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN LPS AP TIB SZ3 YEL 10MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN LPS AP TIB SZ3 YEL 12MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN LPS AP TIB SZ3 YEL 12MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NEXGEN LPS AP TIB SZ3 YEL 14MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
