|
PLATE FIBULA COMP 8H
|
Facility
|
OP
|
$2,021.51
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,940.65 |
| Rate for Payer: Aetna Commercial |
$1,556.56
|
| Rate for Payer: Anthem Medicaid |
$695.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,576.78
|
| Rate for Payer: Cash Price |
$1,010.76
|
| Rate for Payer: Cigna Commercial |
$1,677.85
|
| Rate for Payer: First Health Commercial |
$1,920.43
|
| Rate for Payer: Humana Commercial |
$1,718.28
|
| Rate for Payer: Humana KY Medicaid |
$695.20
|
| Rate for Payer: Kentucky WC Medicaid |
$702.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,657.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,491.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$606.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$709.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,778.93
|
| Rate for Payer: Ohio Health Group HMO |
$1,516.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$404.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$262.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$626.67
|
| Rate for Payer: PHCS Commercial |
$1,940.65
|
| Rate for Payer: United Healthcare All Payer |
$1,778.93
|
|
|
PLATE FIBULA COMP 9H
|
Facility
|
IP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
PLATE FIBULA COMP 9H
|
Facility
|
OP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Anthem Medicaid |
$723.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Humana KY Medicaid |
$723.05
|
| Rate for Payer: Kentucky WC Medicaid |
$730.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$737.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
PLATE FLAT T 4H
|
Facility
|
OP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem Medicaid |
$1,419.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Humana KY Medicaid |
$1,419.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,434.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,448.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 4H
|
Facility
|
IP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 5H
|
Facility
|
IP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 5H
|
Facility
|
OP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem Medicaid |
$1,419.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Humana KY Medicaid |
$1,419.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,434.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,448.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 6H
|
Facility
|
OP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem Medicaid |
$1,419.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Humana KY Medicaid |
$1,419.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,434.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,448.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 6H
|
Facility
|
IP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 7H
|
Facility
|
IP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FLAT T 7H
|
Facility
|
OP
|
$4,128.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$3,963.36 |
| Rate for Payer: Aetna Commercial |
$3,178.94
|
| Rate for Payer: Anthem Medicaid |
$1,419.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,220.23
|
| Rate for Payer: Cash Price |
$2,064.25
|
| Rate for Payer: Cigna Commercial |
$3,426.66
|
| Rate for Payer: First Health Commercial |
$3,922.08
|
| Rate for Payer: Humana Commercial |
$3,509.22
|
| Rate for Payer: Humana KY Medicaid |
$1,419.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,434.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,385.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,046.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,238.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,448.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,633.08
|
| Rate for Payer: Ohio Health Group HMO |
$3,096.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$825.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$536.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,279.84
|
| Rate for Payer: PHCS Commercial |
$3,963.36
|
| Rate for Payer: United Healthcare All Payer |
$3,633.08
|
|
|
PLATE FRACTURE 14H
|
Facility
|
IP
|
$4,559.66
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$592.76 |
| Max. Negotiated Rate |
$4,377.27 |
| Rate for Payer: Aetna Commercial |
$3,510.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,556.53
|
| Rate for Payer: Cash Price |
$2,279.83
|
| Rate for Payer: Cigna Commercial |
$3,784.52
|
| Rate for Payer: First Health Commercial |
$4,331.68
|
| Rate for Payer: Humana Commercial |
$3,875.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,738.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,365.03
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,367.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,012.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,419.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$911.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$592.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,413.49
|
| Rate for Payer: PHCS Commercial |
$4,377.27
|
| Rate for Payer: United Healthcare All Payer |
$4,012.50
|
|
|
PLATE FRACTURE 14H
|
Facility
|
OP
|
$4,559.66
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$592.76 |
| Max. Negotiated Rate |
$4,377.27 |
| Rate for Payer: Anthem Medicaid |
$1,568.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,556.53
|
| Rate for Payer: Cash Price |
$2,279.83
|
| Rate for Payer: Cigna Commercial |
$3,784.52
|
| Rate for Payer: First Health Commercial |
$4,331.68
|
| Rate for Payer: Humana Commercial |
$3,875.71
|
| Rate for Payer: Humana KY Medicaid |
$1,568.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,584.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,738.92
|
| Rate for Payer: Aetna Commercial |
$3,510.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,365.03
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,367.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,599.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,012.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,419.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$911.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$592.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,413.49
|
| Rate for Payer: PHCS Commercial |
$4,377.27
|
| Rate for Payer: United Healthcare All Payer |
$4,012.50
|
|
|
PLATE FRACTURE 4H
|
Facility
|
OP
|
$3,450.02
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$448.50 |
| Max. Negotiated Rate |
$3,312.02 |
| Rate for Payer: Aetna Commercial |
$2,656.52
|
| Rate for Payer: Anthem Medicaid |
$1,186.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,691.02
|
| Rate for Payer: Cash Price |
$1,725.01
|
| Rate for Payer: Cigna Commercial |
$2,863.52
|
| Rate for Payer: First Health Commercial |
$3,277.52
|
| Rate for Payer: Humana Commercial |
$2,932.52
|
| Rate for Payer: Humana KY Medicaid |
$1,186.46
|
| Rate for Payer: Kentucky WC Medicaid |
$1,198.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,829.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,546.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,035.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,210.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,036.02
|
| Rate for Payer: Ohio Health Group HMO |
$2,587.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$690.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$448.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,069.51
|
| Rate for Payer: PHCS Commercial |
$3,312.02
|
| Rate for Payer: United Healthcare All Payer |
$3,036.02
|
|
|
PLATE FRACTURE 4H
|
Facility
|
IP
|
$3,450.02
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$448.50 |
| Max. Negotiated Rate |
$3,312.02 |
| Rate for Payer: Aetna Commercial |
$2,656.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,691.02
|
| Rate for Payer: Cash Price |
$1,725.01
|
| Rate for Payer: Cigna Commercial |
$2,863.52
|
| Rate for Payer: First Health Commercial |
$3,277.52
|
| Rate for Payer: Humana Commercial |
$2,932.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,829.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,546.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,035.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,036.02
|
| Rate for Payer: Ohio Health Group HMO |
$2,587.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$690.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$448.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,069.51
|
| Rate for Payer: PHCS Commercial |
$3,312.02
|
| Rate for Payer: United Healthcare All Payer |
$3,036.02
|
|
|
PLATE FRACTURE 4H C SHAPE
|
Facility
|
OP
|
$3,539.06
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.08 |
| Max. Negotiated Rate |
$3,397.50 |
| Rate for Payer: Aetna Commercial |
$2,725.08
|
| Rate for Payer: Anthem Medicaid |
$1,217.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,760.47
|
| Rate for Payer: Cash Price |
$1,769.53
|
| Rate for Payer: Cigna Commercial |
$2,937.42
|
| Rate for Payer: First Health Commercial |
$3,362.11
|
| Rate for Payer: Humana Commercial |
$3,008.20
|
| Rate for Payer: Humana KY Medicaid |
$1,217.08
|
| Rate for Payer: Kentucky WC Medicaid |
$1,229.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,902.03
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,611.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,061.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,241.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,114.37
|
| Rate for Payer: Ohio Health Group HMO |
$2,654.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$707.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$460.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,097.11
|
| Rate for Payer: PHCS Commercial |
$3,397.50
|
| Rate for Payer: United Healthcare All Payer |
$3,114.37
|
|
|
PLATE FRACTURE 4H C SHAPE
|
Facility
|
IP
|
$3,539.06
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.08 |
| Max. Negotiated Rate |
$3,397.50 |
| Rate for Payer: Aetna Commercial |
$2,725.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,760.47
|
| Rate for Payer: Cash Price |
$1,769.53
|
| Rate for Payer: Cigna Commercial |
$2,937.42
|
| Rate for Payer: First Health Commercial |
$3,362.11
|
| Rate for Payer: Humana Commercial |
$3,008.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,902.03
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,611.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,061.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,114.37
|
| Rate for Payer: Ohio Health Group HMO |
$2,654.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$707.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$460.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,097.11
|
| Rate for Payer: PHCS Commercial |
$3,397.50
|
| Rate for Payer: United Healthcare All Payer |
$3,114.37
|
|
|
PLATE FRACTURE 4H WITH BAR
|
Facility
|
IP
|
$3,494.54
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$454.29 |
| Max. Negotiated Rate |
$3,354.76 |
| Rate for Payer: Aetna Commercial |
$2,690.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,725.74
|
| Rate for Payer: Cash Price |
$1,747.27
|
| Rate for Payer: Cigna Commercial |
$2,900.47
|
| Rate for Payer: First Health Commercial |
$3,319.81
|
| Rate for Payer: Humana Commercial |
$2,970.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,865.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,578.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,048.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,075.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,620.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$698.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$454.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,083.31
|
| Rate for Payer: PHCS Commercial |
$3,354.76
|
| Rate for Payer: United Healthcare All Payer |
$3,075.20
|
|
|
PLATE FRACTURE 4H WITH BAR
|
Facility
|
OP
|
$3,494.54
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$454.29 |
| Max. Negotiated Rate |
$3,354.76 |
| Rate for Payer: Aetna Commercial |
$2,690.80
|
| Rate for Payer: Anthem Medicaid |
$1,201.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,725.74
|
| Rate for Payer: Cash Price |
$1,747.27
|
| Rate for Payer: Cigna Commercial |
$2,900.47
|
| Rate for Payer: First Health Commercial |
$3,319.81
|
| Rate for Payer: Humana Commercial |
$2,970.36
|
| Rate for Payer: Humana KY Medicaid |
$1,201.77
|
| Rate for Payer: Kentucky WC Medicaid |
$1,214.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,865.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,578.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,048.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,225.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,075.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,620.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$698.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$454.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,083.31
|
| Rate for Payer: PHCS Commercial |
$3,354.76
|
| Rate for Payer: United Healthcare All Payer |
$3,075.20
|
|
|
PLATE FRACTURE 6H
|
Facility
|
OP
|
$3,717.18
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.23 |
| Max. Negotiated Rate |
$3,568.49 |
| Rate for Payer: Aetna Commercial |
$2,862.23
|
| Rate for Payer: Anthem Medicaid |
$1,278.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,899.40
|
| Rate for Payer: Cash Price |
$1,858.59
|
| Rate for Payer: Cigna Commercial |
$3,085.26
|
| Rate for Payer: First Health Commercial |
$3,531.32
|
| Rate for Payer: Humana Commercial |
$3,159.60
|
| Rate for Payer: Humana KY Medicaid |
$1,278.34
|
| Rate for Payer: Kentucky WC Medicaid |
$1,291.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,048.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,743.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,115.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,303.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,271.12
|
| Rate for Payer: Ohio Health Group HMO |
$2,787.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$743.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$483.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,152.33
|
| Rate for Payer: PHCS Commercial |
$3,568.49
|
| Rate for Payer: United Healthcare All Payer |
$3,271.12
|
|
|
PLATE FRACTURE 6H
|
Facility
|
IP
|
$3,717.18
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.23 |
| Max. Negotiated Rate |
$3,568.49 |
| Rate for Payer: Aetna Commercial |
$2,862.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,899.40
|
| Rate for Payer: Cash Price |
$1,858.59
|
| Rate for Payer: Cigna Commercial |
$3,085.26
|
| Rate for Payer: First Health Commercial |
$3,531.32
|
| Rate for Payer: Humana Commercial |
$3,159.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,048.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,743.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,115.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,271.12
|
| Rate for Payer: Ohio Health Group HMO |
$2,787.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$743.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$483.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,152.33
|
| Rate for Payer: PHCS Commercial |
$3,568.49
|
| Rate for Payer: United Healthcare All Payer |
$3,271.12
|
|
|
PLATE FRACTURE 6H 115 DEG
|
Facility
|
OP
|
$4,426.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.39 |
| Max. Negotiated Rate |
$4,249.06 |
| Rate for Payer: Anthem Medicaid |
$1,522.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,452.36
|
| Rate for Payer: Cash Price |
$2,213.05
|
| Rate for Payer: Cigna Commercial |
$3,673.66
|
| Rate for Payer: First Health Commercial |
$4,204.80
|
| Rate for Payer: Humana Commercial |
$3,762.18
|
| Rate for Payer: Humana KY Medicaid |
$1,522.14
|
| Rate for Payer: Kentucky WC Medicaid |
$1,537.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,629.40
|
| Rate for Payer: Aetna Commercial |
$3,408.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,266.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,327.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,552.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,894.97
|
| Rate for Payer: Ohio Health Group HMO |
$3,319.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$885.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$575.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,372.09
|
| Rate for Payer: PHCS Commercial |
$4,249.06
|
| Rate for Payer: United Healthcare All Payer |
$3,894.97
|
|
|
PLATE FRACTURE 6H 115 DEG
|
Facility
|
IP
|
$4,426.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.39 |
| Max. Negotiated Rate |
$4,249.06 |
| Rate for Payer: Aetna Commercial |
$3,408.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,452.36
|
| Rate for Payer: Cash Price |
$2,213.05
|
| Rate for Payer: Cigna Commercial |
$3,673.66
|
| Rate for Payer: First Health Commercial |
$4,204.80
|
| Rate for Payer: Humana Commercial |
$3,762.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,629.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,266.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,327.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,894.97
|
| Rate for Payer: Ohio Health Group HMO |
$3,319.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$885.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$575.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,372.09
|
| Rate for Payer: PHCS Commercial |
$4,249.06
|
| Rate for Payer: United Healthcare All Payer |
$3,894.97
|
|
|
PLATE FRACTURE 6H 140 DEG
|
Facility
|
OP
|
$4,470.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$581.18 |
| Max. Negotiated Rate |
$4,291.80 |
| Rate for Payer: Aetna Commercial |
$3,442.38
|
| Rate for Payer: Anthem Medicaid |
$1,537.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,487.08
|
| Rate for Payer: Cash Price |
$2,235.31
|
| Rate for Payer: Cigna Commercial |
$3,710.61
|
| Rate for Payer: First Health Commercial |
$4,247.09
|
| Rate for Payer: Humana Commercial |
$3,800.03
|
| Rate for Payer: Humana KY Medicaid |
$1,537.45
|
| Rate for Payer: Kentucky WC Medicaid |
$1,553.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,665.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,299.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,341.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,568.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,934.15
|
| Rate for Payer: Ohio Health Group HMO |
$3,352.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$894.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$581.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,385.89
|
| Rate for Payer: PHCS Commercial |
$4,291.80
|
| Rate for Payer: United Healthcare All Payer |
$3,934.15
|
|
|
PLATE FRACTURE 6H 140 DEG
|
Facility
|
IP
|
$4,470.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$581.18 |
| Max. Negotiated Rate |
$4,291.80 |
| Rate for Payer: Aetna Commercial |
$3,442.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,487.08
|
| Rate for Payer: Cash Price |
$2,235.31
|
| Rate for Payer: Cigna Commercial |
$3,710.61
|
| Rate for Payer: First Health Commercial |
$4,247.09
|
| Rate for Payer: Humana Commercial |
$3,800.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,665.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,299.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,341.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,934.15
|
| Rate for Payer: Ohio Health Group HMO |
$3,352.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$894.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$581.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,385.89
|
| Rate for Payer: PHCS Commercial |
$4,291.80
|
| Rate for Payer: United Healthcare All Payer |
$3,934.15
|
|
