|
PIN HAND DISLOCATION
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
HCPCS 26676
|
| Hospital Charge Code |
76100731
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.24 |
| Max. Negotiated Rate |
$3,918.70 |
| Rate for Payer: Aetna Commercial |
$729.96
|
| Rate for Payer: Anthem Medicaid |
$326.02
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,799.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$739.44
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,918.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,778.74
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cigna Commercial |
$786.84
|
| Rate for Payer: First Health Commercial |
$900.60
|
| Rate for Payer: Humana Commercial |
$805.80
|
| Rate for Payer: Humana KY Medicaid |
$326.02
|
| Rate for Payer: Humana Medicare Advantage |
$2,799.07
|
| Rate for Payer: Kentucky WC Medicaid |
$329.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$777.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$699.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,358.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$332.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$834.24
|
| Rate for Payer: Ohio Health Group HMO |
$711.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$189.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$123.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$293.88
|
| Rate for Payer: PHCS Commercial |
$910.08
|
| Rate for Payer: United Healthcare All Payer |
$834.24
|
|
|
PIN HAND DISLOCATION
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
HCPCS 26676
|
| Hospital Charge Code |
76100731
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.24 |
| Max. Negotiated Rate |
$910.08 |
| Rate for Payer: Aetna Commercial |
$729.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$739.44
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cigna Commercial |
$786.84
|
| Rate for Payer: First Health Commercial |
$900.60
|
| Rate for Payer: Humana Commercial |
$805.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$777.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$699.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$284.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$834.24
|
| Rate for Payer: Ohio Health Group HMO |
$711.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$189.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$123.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$293.88
|
| Rate for Payer: PHCS Commercial |
$910.08
|
| Rate for Payer: United Healthcare All Payer |
$834.24
|
|
|
PIN HAND DISLOCATION
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 26676
|
| Hospital Charge Code |
76100731
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$301.86 |
| Max. Negotiated Rate |
$948.00 |
| Rate for Payer: Aetna Commercial |
$704.90
|
| Rate for Payer: Anthem Medicaid |
$301.86
|
| Rate for Payer: Buckeye Medicare Advantage |
$948.00
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cigna Commercial |
$794.87
|
| Rate for Payer: Healthspan PPO |
$638.49
|
| Rate for Payer: Humana Medicaid |
$301.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$607.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$307.90
|
| Rate for Payer: Molina Healthcare Passport |
$301.86
|
| Rate for Payer: Multiplan PHCS |
$568.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$663.60
|
| Rate for Payer: UHCCP Medicaid |
$331.80
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$304.88
|
|
|
PIN HAND DISLOCATION(P
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 26676
|
| Hospital Charge Code |
761P0731
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$301.86 |
| Max. Negotiated Rate |
$948.00 |
| Rate for Payer: Aetna Commercial |
$704.90
|
| Rate for Payer: Anthem Medicaid |
$301.86
|
| Rate for Payer: Buckeye Medicare Advantage |
$948.00
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cash Price |
$474.00
|
| Rate for Payer: Cigna Commercial |
$794.87
|
| Rate for Payer: Healthspan PPO |
$638.49
|
| Rate for Payer: Humana Medicaid |
$301.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$607.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$307.90
|
| Rate for Payer: Molina Healthcare Passport |
$301.86
|
| Rate for Payer: Multiplan PHCS |
$568.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$663.60
|
| Rate for Payer: UHCCP Medicaid |
$331.80
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$304.88
|
|
|
PINNACLE ACET CUP 100*48MM
|
Facility
|
IP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*48MM
|
Facility
|
OP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem Medicaid |
$3,153.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Humana KY Medicaid |
$3,153.05
|
| Rate for Payer: Kentucky WC Medicaid |
$3,185.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,216.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*50MM
|
Facility
|
IP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*50MM
|
Facility
|
OP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem Medicaid |
$3,153.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Humana KY Medicaid |
$3,153.05
|
| Rate for Payer: Kentucky WC Medicaid |
$3,185.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,216.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*52MM
|
Facility
|
IP
|
$8,900.43
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,157.06 |
| Max. Negotiated Rate |
$8,544.41 |
| Rate for Payer: Aetna Commercial |
$6,853.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,942.34
|
| Rate for Payer: Cash Price |
$4,450.21
|
| Rate for Payer: Cigna Commercial |
$7,387.36
|
| Rate for Payer: First Health Commercial |
$8,455.41
|
| Rate for Payer: Humana Commercial |
$7,565.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,298.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,568.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,670.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,832.38
|
| Rate for Payer: Ohio Health Group HMO |
$6,675.32
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,780.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,157.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,759.13
|
| Rate for Payer: PHCS Commercial |
$8,544.41
|
| Rate for Payer: United Healthcare All Payer |
$7,832.38
|
|
|
PINNACLE ACET CUP 100*52MM
|
Facility
|
OP
|
$8,900.43
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,157.06 |
| Max. Negotiated Rate |
$8,544.41 |
| Rate for Payer: Aetna Commercial |
$6,853.33
|
| Rate for Payer: Anthem Medicaid |
$3,060.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,942.34
|
| Rate for Payer: Cash Price |
$4,450.21
|
| Rate for Payer: Cigna Commercial |
$7,387.36
|
| Rate for Payer: First Health Commercial |
$8,455.41
|
| Rate for Payer: Humana Commercial |
$7,565.37
|
| Rate for Payer: Humana KY Medicaid |
$3,060.86
|
| Rate for Payer: Kentucky WC Medicaid |
$3,092.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,298.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,568.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,670.13
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,122.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,832.38
|
| Rate for Payer: Ohio Health Group HMO |
$6,675.32
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,780.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,157.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,759.13
|
| Rate for Payer: PHCS Commercial |
$8,544.41
|
| Rate for Payer: United Healthcare All Payer |
$7,832.38
|
|
|
PINNACLE ACET CUP 100*54MM
|
Facility
|
IP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*54MM
|
Facility
|
OP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem Medicaid |
$3,153.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Humana KY Medicaid |
$3,153.05
|
| Rate for Payer: Kentucky WC Medicaid |
$3,185.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,216.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*56MM
|
Facility
|
OP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem Medicaid |
$3,153.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Humana KY Medicaid |
$3,153.05
|
| Rate for Payer: Kentucky WC Medicaid |
$3,185.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,216.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*56MM
|
Facility
|
IP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*58MM
|
Facility
|
IP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*58MM
|
Facility
|
OP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem Medicaid |
$3,153.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Humana KY Medicaid |
$3,153.05
|
| Rate for Payer: Kentucky WC Medicaid |
$3,185.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,216.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*60MM
|
Facility
|
OP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem Medicaid |
$3,153.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Humana KY Medicaid |
$3,153.05
|
| Rate for Payer: Kentucky WC Medicaid |
$3,185.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,216.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*60MM
|
Facility
|
IP
|
$9,168.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,191.91 |
| Max. Negotiated Rate |
$8,801.78 |
| Rate for Payer: Aetna Commercial |
$7,059.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,151.45
|
| Rate for Payer: Cash Price |
$4,584.26
|
| Rate for Payer: Cigna Commercial |
$7,609.87
|
| Rate for Payer: First Health Commercial |
$8,710.09
|
| Rate for Payer: Humana Commercial |
$7,793.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,518.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,766.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,750.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,068.30
|
| Rate for Payer: Ohio Health Group HMO |
$6,876.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,833.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,191.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,842.24
|
| Rate for Payer: PHCS Commercial |
$8,801.78
|
| Rate for Payer: United Healthcare All Payer |
$8,068.30
|
|
|
PINNACLE ACET CUP 100*64MM
|
Facility
|
IP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
|
PINNACLE ACET CUP 100*64MM
|
Facility
|
OP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem Medicaid |
$5,226.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Humana KY Medicaid |
$5,226.59
|
| Rate for Payer: Kentucky WC Medicaid |
$5,279.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,331.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
|
PINNACLE ACET CUP 100*66MM
|
Facility
|
OP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem Medicaid |
$5,226.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Humana KY Medicaid |
$5,226.59
|
| Rate for Payer: Kentucky WC Medicaid |
$5,279.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,331.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
|
PINNACLE ACET CUP 100*66MM
|
Facility
|
IP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
|
PINNACLE ACET CUP 300*48MM
|
Facility
|
IP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
|
PINNACLE ACET CUP 300*48MM
|
Facility
|
OP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem Medicaid |
$5,226.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Humana KY Medicaid |
$5,226.59
|
| Rate for Payer: Kentucky WC Medicaid |
$5,279.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,331.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
|
PINNACLE ACET CUP 300*50MM
|
Facility
|
IP
|
$15,198.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,975.74 |
| Max. Negotiated Rate |
$14,590.08 |
| Rate for Payer: Aetna Commercial |
$11,702.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,854.44
|
| Rate for Payer: Cash Price |
$7,599.00
|
| Rate for Payer: Cigna Commercial |
$12,614.34
|
| Rate for Payer: First Health Commercial |
$14,438.10
|
| Rate for Payer: Humana Commercial |
$12,918.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,462.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,216.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,559.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,374.24
|
| Rate for Payer: Ohio Health Group HMO |
$11,398.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,039.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,975.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,711.38
|
| Rate for Payer: PHCS Commercial |
$14,590.08
|
| Rate for Payer: United Healthcare All Payer |
$13,374.24
|
|
