|
PLATE 6 HOLE TUBULAR STRAIGHT
|
Facility
|
OP
|
$1,103.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.02 |
| Max. Negotiated Rate |
$1,059.26 |
| Rate for Payer: Aetna Commercial |
$849.62
|
| Rate for Payer: Anthem Medicaid |
$379.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$860.65
|
| Rate for Payer: Cash Price |
$551.70
|
| Rate for Payer: Cigna Commercial |
$915.82
|
| Rate for Payer: First Health Commercial |
$1,048.23
|
| Rate for Payer: Humana Commercial |
$937.89
|
| Rate for Payer: Humana KY Medicaid |
$379.46
|
| Rate for Payer: Kentucky WC Medicaid |
$383.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$904.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$814.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$387.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$970.99
|
| Rate for Payer: Ohio Health Group HMO |
$827.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$882.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$959.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$761.35
|
| Rate for Payer: PHCS Commercial |
$1,059.26
|
| Rate for Payer: United Healthcare All Payer |
$970.99
|
|
|
PLATE 6 HOLE TUBULAR STRAIGHT
|
Facility
|
IP
|
$1,103.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.02 |
| Max. Negotiated Rate |
$1,059.26 |
| Rate for Payer: Aetna Commercial |
$849.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$860.65
|
| Rate for Payer: Cash Price |
$551.70
|
| Rate for Payer: Cigna Commercial |
$915.82
|
| Rate for Payer: First Health Commercial |
$1,048.23
|
| Rate for Payer: Humana Commercial |
$937.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$904.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$814.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$970.99
|
| Rate for Payer: Ohio Health Group HMO |
$827.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$882.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$959.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$761.35
|
| Rate for Payer: PHCS Commercial |
$1,059.26
|
| Rate for Payer: United Healthcare All Payer |
$970.99
|
|
|
PLATE 6H RECON 3.5*84MM
|
Facility
|
OP
|
$4,089.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,226.84 |
| Max. Negotiated Rate |
$3,925.88 |
| Rate for Payer: Aetna Commercial |
$3,148.88
|
| Rate for Payer: Anthem Medicaid |
$1,406.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,189.78
|
| Rate for Payer: Cash Price |
$2,044.73
|
| Rate for Payer: Cigna Commercial |
$3,394.25
|
| Rate for Payer: First Health Commercial |
$3,884.99
|
| Rate for Payer: Humana Commercial |
$3,476.04
|
| Rate for Payer: Humana KY Medicaid |
$1,406.37
|
| Rate for Payer: Kentucky WC Medicaid |
$1,420.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,353.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,018.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,226.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,434.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,598.72
|
| Rate for Payer: Ohio Health Group HMO |
$3,067.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,271.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,557.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,821.73
|
| Rate for Payer: PHCS Commercial |
$3,925.88
|
| Rate for Payer: United Healthcare All Payer |
$3,598.72
|
|
|
PLATE 6H RECON 3.5*84MM
|
Facility
|
IP
|
$4,089.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,226.84 |
| Max. Negotiated Rate |
$3,925.88 |
| Rate for Payer: Aetna Commercial |
$3,148.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,189.78
|
| Rate for Payer: Cash Price |
$2,044.73
|
| Rate for Payer: Cigna Commercial |
$3,394.25
|
| Rate for Payer: First Health Commercial |
$3,884.99
|
| Rate for Payer: Humana Commercial |
$3,476.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,353.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,018.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,226.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,598.72
|
| Rate for Payer: Ohio Health Group HMO |
$3,067.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,271.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,557.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,821.73
|
| Rate for Payer: PHCS Commercial |
$3,925.88
|
| Rate for Payer: United Healthcare All Payer |
$3,598.72
|
|
|
PLATE 6H STR
|
Facility
|
OP
|
$5,375.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,612.50 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$4,138.75
|
| Rate for Payer: Anthem Medicaid |
$1,848.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,192.50
|
| Rate for Payer: Cash Price |
$2,687.50
|
| Rate for Payer: Cigna Commercial |
$4,461.25
|
| Rate for Payer: First Health Commercial |
$5,106.25
|
| Rate for Payer: Humana Commercial |
$4,568.75
|
| Rate for Payer: Humana KY Medicaid |
$1,848.46
|
| Rate for Payer: Kentucky WC Medicaid |
$1,867.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,407.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,966.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,612.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,885.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,730.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,031.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,300.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,676.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,708.75
|
| Rate for Payer: PHCS Commercial |
$5,160.00
|
| Rate for Payer: United Healthcare All Payer |
$4,730.00
|
|
|
PLATE 6H STR
|
Facility
|
IP
|
$5,375.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,612.50 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$4,138.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,192.50
|
| Rate for Payer: Cash Price |
$2,687.50
|
| Rate for Payer: Cigna Commercial |
$4,461.25
|
| Rate for Payer: First Health Commercial |
$5,106.25
|
| Rate for Payer: Humana Commercial |
$4,568.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,407.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,966.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,612.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,730.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,031.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,300.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,676.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,708.75
|
| Rate for Payer: PHCS Commercial |
$5,160.00
|
| Rate for Payer: United Healthcare All Payer |
$4,730.00
|
|
|
PLATE 6H STR W/BAR MAND LOCK
|
Facility
|
IP
|
$5,266.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,579.88 |
| Max. Negotiated Rate |
$5,055.60 |
| Rate for Payer: Aetna Commercial |
$4,055.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,107.68
|
| Rate for Payer: Cash Price |
$2,633.12
|
| Rate for Payer: Cigna Commercial |
$4,370.99
|
| Rate for Payer: First Health Commercial |
$5,002.94
|
| Rate for Payer: Humana Commercial |
$4,476.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,318.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,886.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,579.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,634.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,949.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,213.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,581.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,633.71
|
| Rate for Payer: PHCS Commercial |
$5,055.60
|
| Rate for Payer: United Healthcare All Payer |
$4,634.30
|
|
|
PLATE 6H STR W/BAR MAND LOCK
|
Facility
|
OP
|
$5,266.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,579.88 |
| Max. Negotiated Rate |
$5,055.60 |
| Rate for Payer: Aetna Commercial |
$4,055.01
|
| Rate for Payer: Anthem Medicaid |
$1,811.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,107.68
|
| Rate for Payer: Cash Price |
$2,633.12
|
| Rate for Payer: Cigna Commercial |
$4,370.99
|
| Rate for Payer: First Health Commercial |
$5,002.94
|
| Rate for Payer: Humana Commercial |
$4,476.31
|
| Rate for Payer: Humana KY Medicaid |
$1,811.06
|
| Rate for Payer: Kentucky WC Medicaid |
$1,829.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,318.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,886.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,579.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,847.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,634.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,949.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,213.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,581.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,633.71
|
| Rate for Payer: PHCS Commercial |
$5,055.60
|
| Rate for Payer: United Healthcare All Payer |
$4,634.30
|
|
|
PLATE 7H 1/3 TUB W/COLLAR 81MM
|
Facility
|
IP
|
$2,061.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$618.48 |
| Max. Negotiated Rate |
$1,979.14 |
| Rate for Payer: Aetna Commercial |
$1,587.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,608.05
|
| Rate for Payer: Cash Price |
$1,030.80
|
| Rate for Payer: Cigna Commercial |
$1,711.13
|
| Rate for Payer: First Health Commercial |
$1,958.52
|
| Rate for Payer: Humana Commercial |
$1,752.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,690.51
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,521.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$618.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,814.21
|
| Rate for Payer: Ohio Health Group HMO |
$1,546.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,649.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,793.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,422.50
|
| Rate for Payer: PHCS Commercial |
$1,979.14
|
| Rate for Payer: United Healthcare All Payer |
$1,814.21
|
|
|
PLATE 7H 1/3 TUB W/COLLAR 81MM
|
Facility
|
OP
|
$2,061.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$618.48 |
| Max. Negotiated Rate |
$1,979.14 |
| Rate for Payer: Aetna Commercial |
$1,587.43
|
| Rate for Payer: Anthem Medicaid |
$708.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,608.05
|
| Rate for Payer: Cash Price |
$1,030.80
|
| Rate for Payer: Cigna Commercial |
$1,711.13
|
| Rate for Payer: First Health Commercial |
$1,958.52
|
| Rate for Payer: Humana Commercial |
$1,752.36
|
| Rate for Payer: Humana KY Medicaid |
$708.98
|
| Rate for Payer: Kentucky WC Medicaid |
$716.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,690.51
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,521.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$618.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$723.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,814.21
|
| Rate for Payer: Ohio Health Group HMO |
$1,546.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,649.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,793.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,422.50
|
| Rate for Payer: PHCS Commercial |
$1,979.14
|
| Rate for Payer: United Healthcare All Payer |
$1,814.21
|
|
|
PLATE 7H 210MM 350817
|
Facility
|
OP
|
$5,052.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,515.75 |
| Max. Negotiated Rate |
$4,850.40 |
| Rate for Payer: Aetna Commercial |
$3,890.43
|
| Rate for Payer: Anthem Medicaid |
$1,737.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,940.95
|
| Rate for Payer: Cash Price |
$2,526.25
|
| Rate for Payer: Cigna Commercial |
$4,193.57
|
| Rate for Payer: First Health Commercial |
$4,799.88
|
| Rate for Payer: Humana Commercial |
$4,294.62
|
| Rate for Payer: Humana KY Medicaid |
$1,737.55
|
| Rate for Payer: Kentucky WC Medicaid |
$1,755.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,143.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,728.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,515.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,772.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,446.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,789.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,042.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,395.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,486.22
|
| Rate for Payer: PHCS Commercial |
$4,850.40
|
| Rate for Payer: United Healthcare All Payer |
$4,446.20
|
|
|
PLATE 7H 210MM 350817
|
Facility
|
IP
|
$5,052.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,515.75 |
| Max. Negotiated Rate |
$4,850.40 |
| Rate for Payer: Aetna Commercial |
$3,890.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,940.95
|
| Rate for Payer: Cash Price |
$2,526.25
|
| Rate for Payer: Cigna Commercial |
$4,193.57
|
| Rate for Payer: First Health Commercial |
$4,799.88
|
| Rate for Payer: Humana Commercial |
$4,294.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,143.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,728.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,515.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,446.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,789.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,042.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,395.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,486.22
|
| Rate for Payer: PHCS Commercial |
$4,850.40
|
| Rate for Payer: United Healthcare All Payer |
$4,446.20
|
|
|
PLATE 7H LATERAL MALLEOLAR
|
Facility
|
OP
|
$5,600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,680.00 |
| Max. Negotiated Rate |
$5,376.00 |
| Rate for Payer: Aetna Commercial |
$4,312.00
|
| Rate for Payer: Anthem Medicaid |
$1,925.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,368.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cigna Commercial |
$4,648.00
|
| Rate for Payer: First Health Commercial |
$5,320.00
|
| Rate for Payer: Humana Commercial |
$4,760.00
|
| Rate for Payer: Humana KY Medicaid |
$1,925.84
|
| Rate for Payer: Kentucky WC Medicaid |
$1,945.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,592.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,132.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,680.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,964.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,928.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,200.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,872.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,864.00
|
| Rate for Payer: PHCS Commercial |
$5,376.00
|
| Rate for Payer: United Healthcare All Payer |
$4,928.00
|
|
|
PLATE 7H LATERAL MALLEOLAR
|
Facility
|
IP
|
$5,600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,680.00 |
| Max. Negotiated Rate |
$5,376.00 |
| Rate for Payer: Aetna Commercial |
$4,312.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,368.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cigna Commercial |
$4,648.00
|
| Rate for Payer: First Health Commercial |
$5,320.00
|
| Rate for Payer: Humana Commercial |
$4,760.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,592.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,132.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,680.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,928.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,200.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,872.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,864.00
|
| Rate for Payer: PHCS Commercial |
$5,376.00
|
| Rate for Payer: United Healthcare All Payer |
$4,928.00
|
|
|
PLATE 7H RECON 3.5*98MM
|
Facility
|
IP
|
$4,195.48
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,258.64 |
| Max. Negotiated Rate |
$4,027.66 |
| Rate for Payer: Aetna Commercial |
$3,230.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,272.47
|
| Rate for Payer: Cash Price |
$2,097.74
|
| Rate for Payer: Cigna Commercial |
$3,482.25
|
| Rate for Payer: First Health Commercial |
$3,985.71
|
| Rate for Payer: Humana Commercial |
$3,566.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,440.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,096.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,258.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,692.02
|
| Rate for Payer: Ohio Health Group HMO |
$3,146.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,356.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,650.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,894.88
|
| Rate for Payer: PHCS Commercial |
$4,027.66
|
| Rate for Payer: United Healthcare All Payer |
$3,692.02
|
|
|
PLATE 7H RECON 3.5*98MM
|
Facility
|
OP
|
$4,195.48
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,258.64 |
| Max. Negotiated Rate |
$4,027.66 |
| Rate for Payer: Aetna Commercial |
$3,230.52
|
| Rate for Payer: Anthem Medicaid |
$1,442.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,272.47
|
| Rate for Payer: Cash Price |
$2,097.74
|
| Rate for Payer: Cigna Commercial |
$3,482.25
|
| Rate for Payer: First Health Commercial |
$3,985.71
|
| Rate for Payer: Humana Commercial |
$3,566.16
|
| Rate for Payer: Humana KY Medicaid |
$1,442.83
|
| Rate for Payer: Kentucky WC Medicaid |
$1,457.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,440.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,096.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,258.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,471.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,692.02
|
| Rate for Payer: Ohio Health Group HMO |
$3,146.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,356.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,650.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,894.88
|
| Rate for Payer: PHCS Commercial |
$4,027.66
|
| Rate for Payer: United Healthcare All Payer |
$3,692.02
|
|
|
PLATE 8H 1/3 TUB W/COLLAR 93MM
|
Facility
|
IP
|
$2,097.66
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.30 |
| Max. Negotiated Rate |
$2,013.75 |
| Rate for Payer: Aetna Commercial |
$1,615.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,636.17
|
| Rate for Payer: Cash Price |
$1,048.83
|
| Rate for Payer: Cigna Commercial |
$1,741.06
|
| Rate for Payer: First Health Commercial |
$1,992.78
|
| Rate for Payer: Humana Commercial |
$1,783.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,720.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,548.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$629.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,845.94
|
| Rate for Payer: Ohio Health Group HMO |
$1,573.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,678.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,824.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,447.39
|
| Rate for Payer: PHCS Commercial |
$2,013.75
|
| Rate for Payer: United Healthcare All Payer |
$1,845.94
|
|
|
PLATE 8H 1/3 TUB W/COLLAR 93MM
|
Facility
|
OP
|
$2,097.66
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.30 |
| Max. Negotiated Rate |
$2,013.75 |
| Rate for Payer: Aetna Commercial |
$1,615.20
|
| Rate for Payer: Anthem Medicaid |
$721.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,636.17
|
| Rate for Payer: Cash Price |
$1,048.83
|
| Rate for Payer: Cigna Commercial |
$1,741.06
|
| Rate for Payer: First Health Commercial |
$1,992.78
|
| Rate for Payer: Humana Commercial |
$1,783.01
|
| Rate for Payer: Humana KY Medicaid |
$721.39
|
| Rate for Payer: Kentucky WC Medicaid |
$728.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,720.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,548.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$629.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$735.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,845.94
|
| Rate for Payer: Ohio Health Group HMO |
$1,573.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,678.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,824.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,447.39
|
| Rate for Payer: PHCS Commercial |
$2,013.75
|
| Rate for Payer: United Healthcare All Payer |
$1,845.94
|
|
|
PLATE 8H 3.5*111MM SM FRAG
|
Facility
|
OP
|
$3,434.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,030.38 |
| Max. Negotiated Rate |
$3,297.22 |
| Rate for Payer: Aetna Commercial |
$2,644.64
|
| Rate for Payer: Anthem Medicaid |
$1,181.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,678.99
|
| Rate for Payer: Cash Price |
$1,717.30
|
| Rate for Payer: Cigna Commercial |
$2,850.72
|
| Rate for Payer: First Health Commercial |
$3,262.87
|
| Rate for Payer: Humana Commercial |
$2,919.41
|
| Rate for Payer: Humana KY Medicaid |
$1,181.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,193.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,816.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,534.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,030.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,204.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,022.45
|
| Rate for Payer: Ohio Health Group HMO |
$2,575.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,747.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,988.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,369.87
|
| Rate for Payer: PHCS Commercial |
$3,297.22
|
| Rate for Payer: United Healthcare All Payer |
$3,022.45
|
|
|
PLATE 8H 3.5*111MM SM FRAG
|
Facility
|
IP
|
$3,434.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,030.38 |
| Max. Negotiated Rate |
$3,297.22 |
| Rate for Payer: Aetna Commercial |
$2,644.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,678.99
|
| Rate for Payer: Cash Price |
$1,717.30
|
| Rate for Payer: Cigna Commercial |
$2,850.72
|
| Rate for Payer: First Health Commercial |
$3,262.87
|
| Rate for Payer: Humana Commercial |
$2,919.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,816.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,534.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,030.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,022.45
|
| Rate for Payer: Ohio Health Group HMO |
$2,575.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,747.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,988.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,369.87
|
| Rate for Payer: PHCS Commercial |
$3,297.22
|
| Rate for Payer: United Healthcare All Payer |
$3,022.45
|
|
|
PLATE 8H LOCKING FIB
|
Facility
|
OP
|
$3,106.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$931.88 |
| Max. Negotiated Rate |
$2,982.00 |
| Rate for Payer: Aetna Commercial |
$2,391.81
|
| Rate for Payer: Anthem Medicaid |
$1,068.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,422.88
|
| Rate for Payer: Cash Price |
$1,553.12
|
| Rate for Payer: Cigna Commercial |
$2,578.19
|
| Rate for Payer: First Health Commercial |
$2,950.94
|
| Rate for Payer: Humana Commercial |
$2,640.31
|
| Rate for Payer: Humana KY Medicaid |
$1,068.24
|
| Rate for Payer: Kentucky WC Medicaid |
$1,079.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,547.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,292.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$931.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,089.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,733.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,329.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,485.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,702.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,143.31
|
| Rate for Payer: PHCS Commercial |
$2,982.00
|
| Rate for Payer: United Healthcare All Payer |
$2,733.50
|
|
|
PLATE 8H LOCKING FIB
|
Facility
|
IP
|
$3,106.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$931.88 |
| Max. Negotiated Rate |
$2,982.00 |
| Rate for Payer: Aetna Commercial |
$2,391.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,422.88
|
| Rate for Payer: Cash Price |
$1,553.12
|
| Rate for Payer: Cigna Commercial |
$2,578.19
|
| Rate for Payer: First Health Commercial |
$2,950.94
|
| Rate for Payer: Humana Commercial |
$2,640.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,547.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,292.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$931.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,733.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,329.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,485.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,702.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,143.31
|
| Rate for Payer: PHCS Commercial |
$2,982.00
|
| Rate for Payer: United Healthcare All Payer |
$2,733.50
|
|
|
PLATE 8 HOLE L
|
Facility
|
IP
|
$4,793.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,438.12 |
| Max. Negotiated Rate |
$4,602.00 |
| Rate for Payer: Aetna Commercial |
$3,691.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,739.12
|
| Rate for Payer: Cash Price |
$2,396.88
|
| Rate for Payer: Cigna Commercial |
$3,978.81
|
| Rate for Payer: First Health Commercial |
$4,554.06
|
| Rate for Payer: Humana Commercial |
$4,074.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,930.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,537.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,438.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,218.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,595.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,835.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,170.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,307.69
|
| Rate for Payer: PHCS Commercial |
$4,602.00
|
| Rate for Payer: United Healthcare All Payer |
$4,218.50
|
|
|
PLATE 8 HOLE L
|
Facility
|
OP
|
$4,793.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,438.12 |
| Max. Negotiated Rate |
$4,602.00 |
| Rate for Payer: Aetna Commercial |
$3,691.19
|
| Rate for Payer: Anthem Medicaid |
$1,648.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,739.12
|
| Rate for Payer: Cash Price |
$2,396.88
|
| Rate for Payer: Cigna Commercial |
$3,978.81
|
| Rate for Payer: First Health Commercial |
$4,554.06
|
| Rate for Payer: Humana Commercial |
$4,074.69
|
| Rate for Payer: Humana KY Medicaid |
$1,648.57
|
| Rate for Payer: Kentucky WC Medicaid |
$1,665.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,930.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,537.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,438.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,681.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,218.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,595.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,835.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,170.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,307.69
|
| Rate for Payer: PHCS Commercial |
$4,602.00
|
| Rate for Payer: United Healthcare All Payer |
$4,218.50
|
|
|
PLATE 8H RECON 3.5*112MM
|
Facility
|
OP
|
$4,290.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,287.02 |
| Max. Negotiated Rate |
$4,118.45 |
| Rate for Payer: Aetna Commercial |
$3,303.34
|
| Rate for Payer: Anthem Medicaid |
$1,475.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,346.24
|
| Rate for Payer: Cash Price |
$2,145.02
|
| Rate for Payer: Cigna Commercial |
$3,560.74
|
| Rate for Payer: First Health Commercial |
$4,075.55
|
| Rate for Payer: Humana Commercial |
$3,646.54
|
| Rate for Payer: Humana KY Medicaid |
$1,475.35
|
| Rate for Payer: Kentucky WC Medicaid |
$1,490.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,517.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,166.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,287.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,504.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,775.24
|
| Rate for Payer: Ohio Health Group HMO |
$3,217.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,432.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,732.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,960.13
|
| Rate for Payer: PHCS Commercial |
$4,118.45
|
| Rate for Payer: United Healthcare All Payer |
$3,775.24
|
|
