|
PLATE FEMLK 4.5M 342M 16 R L-D
|
Facility
|
IP
|
$8,526.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,108.40 |
| Max. Negotiated Rate |
$8,185.08 |
| Rate for Payer: Aetna Commercial |
$6,565.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,650.37
|
| Rate for Payer: Cash Price |
$4,263.06
|
| Rate for Payer: Cigna Commercial |
$7,076.68
|
| Rate for Payer: First Health Commercial |
$8,099.81
|
| Rate for Payer: Humana Commercial |
$7,247.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,991.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,292.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,557.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,502.99
|
| Rate for Payer: Ohio Health Group HMO |
$6,394.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,705.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,108.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,643.10
|
| Rate for Payer: PHCS Commercial |
$8,185.08
|
| Rate for Payer: United Healthcare All Payer |
$7,502.99
|
|
|
PLATE FEMLK 4.5M 399M 19 L L-D
|
Facility
|
IP
|
$8,715.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,132.97 |
| Max. Negotiated Rate |
$8,366.58 |
| Rate for Payer: Aetna Commercial |
$6,710.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,797.85
|
| Rate for Payer: Cash Price |
$4,357.60
|
| Rate for Payer: Cigna Commercial |
$7,233.61
|
| Rate for Payer: First Health Commercial |
$8,279.43
|
| Rate for Payer: Humana Commercial |
$7,407.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,146.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,431.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,614.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,669.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,536.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,743.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,132.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,701.71
|
| Rate for Payer: PHCS Commercial |
$8,366.58
|
| Rate for Payer: United Healthcare All Payer |
$7,669.37
|
|
|
PLATE FEMLK 4.5M 399M 19 L L-D
|
Facility
|
OP
|
$8,715.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,132.97 |
| Max. Negotiated Rate |
$8,366.58 |
| Rate for Payer: Anthem Medicaid |
$2,997.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,797.85
|
| Rate for Payer: Cash Price |
$4,357.60
|
| Rate for Payer: Cigna Commercial |
$7,233.61
|
| Rate for Payer: First Health Commercial |
$8,279.43
|
| Rate for Payer: Humana Commercial |
$7,407.91
|
| Rate for Payer: Humana KY Medicaid |
$2,997.15
|
| Rate for Payer: Kentucky WC Medicaid |
$3,027.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,146.46
|
| Rate for Payer: Aetna Commercial |
$6,710.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,431.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,614.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,057.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,669.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,536.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,743.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,132.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,701.71
|
| Rate for Payer: PHCS Commercial |
$8,366.58
|
| Rate for Payer: United Healthcare All Payer |
$7,669.37
|
|
|
PLATE FEMLK 4.5M 399M 19 R L-D
|
Facility
|
IP
|
$8,715.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,132.97 |
| Max. Negotiated Rate |
$8,366.58 |
| Rate for Payer: Aetna Commercial |
$6,710.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,797.85
|
| Rate for Payer: Cash Price |
$4,357.60
|
| Rate for Payer: Cigna Commercial |
$7,233.61
|
| Rate for Payer: First Health Commercial |
$8,279.43
|
| Rate for Payer: Humana Commercial |
$7,407.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,146.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,431.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,614.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,669.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,536.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,743.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,132.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,701.71
|
| Rate for Payer: PHCS Commercial |
$8,366.58
|
| Rate for Payer: United Healthcare All Payer |
$7,669.37
|
|
|
PLATE FEMLK 4.5M 399M 19 R L-D
|
Facility
|
OP
|
$8,715.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,132.97 |
| Max. Negotiated Rate |
$8,366.58 |
| Rate for Payer: Aetna Commercial |
$6,710.70
|
| Rate for Payer: Anthem Medicaid |
$2,997.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,797.85
|
| Rate for Payer: Cash Price |
$4,357.60
|
| Rate for Payer: Cigna Commercial |
$7,233.61
|
| Rate for Payer: First Health Commercial |
$8,279.43
|
| Rate for Payer: Humana Commercial |
$7,407.91
|
| Rate for Payer: Humana KY Medicaid |
$2,997.15
|
| Rate for Payer: Kentucky WC Medicaid |
$3,027.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,146.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,431.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,614.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,057.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,669.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,536.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,743.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,132.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,701.71
|
| Rate for Payer: PHCS Commercial |
$8,366.58
|
| Rate for Payer: United Healthcare All Payer |
$7,669.37
|
|
|
PLATE FEM MID LCK 4.5 12H
|
Facility
|
OP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem Medicaid |
$1,950.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Humana KY Medicaid |
$1,950.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,969.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,989.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 12H
|
Facility
|
IP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 14H
|
Facility
|
IP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 14H
|
Facility
|
OP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem Medicaid |
$1,950.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Humana KY Medicaid |
$1,950.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,969.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,989.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 16H
|
Facility
|
OP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem Medicaid |
$1,950.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Humana KY Medicaid |
$1,950.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,969.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,989.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 16H
|
Facility
|
IP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 18H
|
Facility
|
OP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Anthem Medicaid |
$1,950.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Humana KY Medicaid |
$1,950.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,969.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,989.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FEM MID LCK 4.5 18H
|
Facility
|
IP
|
$5,670.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$737.18 |
| Max. Negotiated Rate |
$5,443.78 |
| Rate for Payer: Aetna Commercial |
$4,366.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,423.07
|
| Rate for Payer: Cash Price |
$2,835.30
|
| Rate for Payer: Cigna Commercial |
$4,706.60
|
| Rate for Payer: First Health Commercial |
$5,387.07
|
| Rate for Payer: Humana Commercial |
$4,820.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,649.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,184.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,701.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,990.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,252.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,134.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$737.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,757.89
|
| Rate for Payer: PHCS Commercial |
$5,443.78
|
| Rate for Payer: United Healthcare All Payer |
$4,990.13
|
|
|
PLATE FIB LK 3.5M L-D 3H 59M L
|
Facility
|
IP
|
$4,077.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$530.06 |
| Max. Negotiated Rate |
$3,914.30 |
| Rate for Payer: Aetna Commercial |
$3,139.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,180.37
|
| Rate for Payer: Cash Price |
$2,038.70
|
| Rate for Payer: Cigna Commercial |
$3,384.24
|
| Rate for Payer: First Health Commercial |
$3,873.53
|
| Rate for Payer: Humana Commercial |
$3,465.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,343.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,009.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,223.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,588.11
|
| Rate for Payer: Ohio Health Group HMO |
$3,058.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$815.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$530.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,263.99
|
| Rate for Payer: PHCS Commercial |
$3,914.30
|
| Rate for Payer: United Healthcare All Payer |
$3,588.11
|
|
|
PLATE FIB LK 3.5M L-D 3H 59M L
|
Facility
|
OP
|
$4,077.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$530.06 |
| Max. Negotiated Rate |
$3,914.30 |
| Rate for Payer: Aetna Commercial |
$3,139.60
|
| Rate for Payer: Anthem Medicaid |
$1,402.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,180.37
|
| Rate for Payer: Cash Price |
$2,038.70
|
| Rate for Payer: Cigna Commercial |
$3,384.24
|
| Rate for Payer: First Health Commercial |
$3,873.53
|
| Rate for Payer: Humana Commercial |
$3,465.79
|
| Rate for Payer: Humana KY Medicaid |
$1,402.22
|
| Rate for Payer: Kentucky WC Medicaid |
$1,416.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,343.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,009.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,223.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,430.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,588.11
|
| Rate for Payer: Ohio Health Group HMO |
$3,058.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$815.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$530.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,263.99
|
| Rate for Payer: PHCS Commercial |
$3,914.30
|
| Rate for Payer: United Healthcare All Payer |
$3,588.11
|
|
|
PLATE FIB LK 3.5M L-D 3H 59M R
|
Facility
|
IP
|
$4,052.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.79 |
| Max. Negotiated Rate |
$3,890.11 |
| Rate for Payer: Aetna Commercial |
$3,120.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,160.72
|
| Rate for Payer: Cash Price |
$2,026.10
|
| Rate for Payer: Cigna Commercial |
$3,363.33
|
| Rate for Payer: First Health Commercial |
$3,849.59
|
| Rate for Payer: Humana Commercial |
$3,444.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,322.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,990.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,215.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,565.94
|
| Rate for Payer: Ohio Health Group HMO |
$3,039.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$810.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$526.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,256.18
|
| Rate for Payer: PHCS Commercial |
$3,890.11
|
| Rate for Payer: United Healthcare All Payer |
$3,565.94
|
|
|
PLATE FIB LK 3.5M L-D 3H 59M R
|
Facility
|
OP
|
$4,052.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.79 |
| Max. Negotiated Rate |
$3,890.11 |
| Rate for Payer: Aetna Commercial |
$3,120.19
|
| Rate for Payer: Anthem Medicaid |
$1,393.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,160.72
|
| Rate for Payer: Cash Price |
$2,026.10
|
| Rate for Payer: Cigna Commercial |
$3,363.33
|
| Rate for Payer: First Health Commercial |
$3,849.59
|
| Rate for Payer: Humana Commercial |
$3,444.37
|
| Rate for Payer: Humana KY Medicaid |
$1,393.55
|
| Rate for Payer: Kentucky WC Medicaid |
$1,407.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,322.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,990.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,215.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,421.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,565.94
|
| Rate for Payer: Ohio Health Group HMO |
$3,039.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$810.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$526.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,256.18
|
| Rate for Payer: PHCS Commercial |
$3,890.11
|
| Rate for Payer: United Healthcare All Payer |
$3,565.94
|
|
|
PLATE FIB LK 3.5M L-D 4H 71M L
|
Facility
|
OP
|
$4,190.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$544.80 |
| Max. Negotiated Rate |
$4,023.17 |
| Rate for Payer: Aetna Commercial |
$3,226.92
|
| Rate for Payer: Anthem Medicaid |
$1,441.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,268.82
|
| Rate for Payer: Cash Price |
$2,095.40
|
| Rate for Payer: Cigna Commercial |
$3,478.36
|
| Rate for Payer: First Health Commercial |
$3,981.26
|
| Rate for Payer: Humana Commercial |
$3,562.18
|
| Rate for Payer: Humana KY Medicaid |
$1,441.22
|
| Rate for Payer: Kentucky WC Medicaid |
$1,455.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,436.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,092.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,257.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,470.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,687.90
|
| Rate for Payer: Ohio Health Group HMO |
$3,143.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$838.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$544.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,299.15
|
| Rate for Payer: PHCS Commercial |
$4,023.17
|
| Rate for Payer: United Healthcare All Payer |
$3,687.90
|
|
|
PLATE FIB LK 3.5M L-D 4H 71M L
|
Facility
|
IP
|
$4,190.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$544.80 |
| Max. Negotiated Rate |
$4,023.17 |
| Rate for Payer: Aetna Commercial |
$3,226.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,268.82
|
| Rate for Payer: Cash Price |
$2,095.40
|
| Rate for Payer: Cigna Commercial |
$3,478.36
|
| Rate for Payer: First Health Commercial |
$3,981.26
|
| Rate for Payer: Humana Commercial |
$3,562.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,436.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,092.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,257.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,687.90
|
| Rate for Payer: Ohio Health Group HMO |
$3,143.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$838.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$544.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,299.15
|
| Rate for Payer: PHCS Commercial |
$4,023.17
|
| Rate for Payer: United Healthcare All Payer |
$3,687.90
|
|
|
PLATE FIB LK 3.5M L-D 4H 71M R
|
Facility
|
OP
|
$4,178.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.17 |
| Max. Negotiated Rate |
$4,011.07 |
| Rate for Payer: Aetna Commercial |
$3,217.21
|
| Rate for Payer: Anthem Medicaid |
$1,436.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,259.00
|
| Rate for Payer: Cash Price |
$2,089.10
|
| Rate for Payer: Cigna Commercial |
$3,467.91
|
| Rate for Payer: First Health Commercial |
$3,969.29
|
| Rate for Payer: Humana Commercial |
$3,551.47
|
| Rate for Payer: Humana KY Medicaid |
$1,436.88
|
| Rate for Payer: Kentucky WC Medicaid |
$1,451.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,426.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,083.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,253.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,465.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,676.82
|
| Rate for Payer: Ohio Health Group HMO |
$3,133.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$835.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$543.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,295.24
|
| Rate for Payer: PHCS Commercial |
$4,011.07
|
| Rate for Payer: United Healthcare All Payer |
$3,676.82
|
|
|
PLATE FIB LK 3.5M L-D 4H 71M R
|
Facility
|
IP
|
$4,178.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.17 |
| Max. Negotiated Rate |
$4,011.07 |
| Rate for Payer: Aetna Commercial |
$3,217.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,259.00
|
| Rate for Payer: Cash Price |
$2,089.10
|
| Rate for Payer: Cigna Commercial |
$3,467.91
|
| Rate for Payer: First Health Commercial |
$3,969.29
|
| Rate for Payer: Humana Commercial |
$3,551.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,426.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,083.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,253.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,676.82
|
| Rate for Payer: Ohio Health Group HMO |
$3,133.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$835.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$543.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,295.24
|
| Rate for Payer: PHCS Commercial |
$4,011.07
|
| Rate for Payer: United Healthcare All Payer |
$3,676.82
|
|
|
PLATE FIB LK 3.5M L-D 5H 83M L
|
Facility
|
IP
|
$4,304.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.55 |
| Max. Negotiated Rate |
$4,132.03 |
| Rate for Payer: Aetna Commercial |
$3,314.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,357.28
|
| Rate for Payer: Cash Price |
$2,152.10
|
| Rate for Payer: Cigna Commercial |
$3,572.49
|
| Rate for Payer: First Health Commercial |
$4,088.99
|
| Rate for Payer: Humana Commercial |
$3,658.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,529.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,176.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,291.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,787.70
|
| Rate for Payer: Ohio Health Group HMO |
$3,228.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.30
|
| Rate for Payer: PHCS Commercial |
$4,132.03
|
| Rate for Payer: United Healthcare All Payer |
$3,787.70
|
|
|
PLATE FIB LK 3.5M L-D 5H 83M L
|
Facility
|
OP
|
$4,304.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.55 |
| Max. Negotiated Rate |
$4,132.03 |
| Rate for Payer: Anthem Medicaid |
$1,480.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,357.28
|
| Rate for Payer: Cash Price |
$2,152.10
|
| Rate for Payer: Cigna Commercial |
$3,572.49
|
| Rate for Payer: First Health Commercial |
$4,088.99
|
| Rate for Payer: Humana Commercial |
$3,658.57
|
| Rate for Payer: Humana KY Medicaid |
$1,480.21
|
| Rate for Payer: Kentucky WC Medicaid |
$1,495.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,529.44
|
| Rate for Payer: Aetna Commercial |
$3,314.23
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,176.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,291.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,509.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,787.70
|
| Rate for Payer: Ohio Health Group HMO |
$3,228.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.30
|
| Rate for Payer: PHCS Commercial |
$4,132.03
|
| Rate for Payer: United Healthcare All Payer |
$3,787.70
|
|
|
PLATE FIB LK 3.5M L-D 5H 83M R
|
Facility
|
OP
|
$4,291.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$557.91 |
| Max. Negotiated Rate |
$4,119.94 |
| Rate for Payer: Aetna Commercial |
$3,304.53
|
| Rate for Payer: Anthem Medicaid |
$1,475.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,347.45
|
| Rate for Payer: Cash Price |
$2,145.80
|
| Rate for Payer: Cigna Commercial |
$3,562.03
|
| Rate for Payer: First Health Commercial |
$4,077.02
|
| Rate for Payer: Humana Commercial |
$3,647.86
|
| Rate for Payer: Humana KY Medicaid |
$1,475.88
|
| Rate for Payer: Kentucky WC Medicaid |
$1,490.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,519.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,167.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,287.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,505.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,776.61
|
| Rate for Payer: Ohio Health Group HMO |
$3,218.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$858.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$557.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,330.40
|
| Rate for Payer: PHCS Commercial |
$4,119.94
|
| Rate for Payer: United Healthcare All Payer |
$3,776.61
|
|
|
PLATE FIB LK 3.5M L-D 5H 83M R
|
Facility
|
IP
|
$4,291.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$557.91 |
| Max. Negotiated Rate |
$4,119.94 |
| Rate for Payer: Aetna Commercial |
$3,304.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,347.45
|
| Rate for Payer: Cash Price |
$2,145.80
|
| Rate for Payer: Cigna Commercial |
$3,562.03
|
| Rate for Payer: First Health Commercial |
$4,077.02
|
| Rate for Payer: Humana Commercial |
$3,647.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,519.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,167.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,287.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,776.61
|
| Rate for Payer: Ohio Health Group HMO |
$3,218.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$858.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$557.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,330.40
|
| Rate for Payer: PHCS Commercial |
$4,119.94
|
| Rate for Payer: United Healthcare All Payer |
$3,776.61
|
|
