|
PLATE COLUMN FUSION 3.5MM
|
Facility
|
IP
|
$8,107.08
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,432.12 |
| Max. Negotiated Rate |
$7,782.80 |
| Rate for Payer: Aetna Commercial |
$6,242.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,323.52
|
| Rate for Payer: Cash Price |
$4,053.54
|
| Rate for Payer: Cigna Commercial |
$6,728.88
|
| Rate for Payer: First Health Commercial |
$7,701.73
|
| Rate for Payer: Humana Commercial |
$6,891.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,647.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,983.03
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,432.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,134.23
|
| Rate for Payer: Ohio Health Group HMO |
$6,080.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,485.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,053.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,593.89
|
| Rate for Payer: PHCS Commercial |
$7,782.80
|
| Rate for Payer: United Healthcare All Payer |
$7,134.23
|
|
|
PLATE COM LK 3.5MM 4H 67MM
|
Facility
|
IP
|
$3,040.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$912.19 |
| Max. Negotiated Rate |
$2,919.00 |
| Rate for Payer: Aetna Commercial |
$2,341.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,371.68
|
| Rate for Payer: Cash Price |
$1,520.31
|
| Rate for Payer: Cigna Commercial |
$2,523.71
|
| Rate for Payer: First Health Commercial |
$2,888.59
|
| Rate for Payer: Humana Commercial |
$2,584.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,493.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,243.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$912.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,675.75
|
| Rate for Payer: Ohio Health Group HMO |
$2,280.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,432.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,645.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,098.03
|
| Rate for Payer: PHCS Commercial |
$2,919.00
|
| Rate for Payer: United Healthcare All Payer |
$2,675.75
|
|
|
PLATE COM LK 3.5MM 4H 67MM
|
Facility
|
OP
|
$3,040.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$912.19 |
| Max. Negotiated Rate |
$2,919.00 |
| Rate for Payer: Aetna Commercial |
$2,341.28
|
| Rate for Payer: Anthem Medicaid |
$1,045.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,371.68
|
| Rate for Payer: Cash Price |
$1,520.31
|
| Rate for Payer: Cigna Commercial |
$2,523.71
|
| Rate for Payer: First Health Commercial |
$2,888.59
|
| Rate for Payer: Humana Commercial |
$2,584.53
|
| Rate for Payer: Humana KY Medicaid |
$1,045.67
|
| Rate for Payer: Kentucky WC Medicaid |
$1,056.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,493.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,243.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$912.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,066.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,675.75
|
| Rate for Payer: Ohio Health Group HMO |
$2,280.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,432.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,645.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,098.03
|
| Rate for Payer: PHCS Commercial |
$2,919.00
|
| Rate for Payer: United Healthcare All Payer |
$2,675.75
|
|
|
PLATE COMP 10H 3.5*145
|
Facility
|
OP
|
$1,942.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.66 |
| Max. Negotiated Rate |
$1,864.51 |
| Rate for Payer: Aetna Commercial |
$1,495.49
|
| Rate for Payer: Anthem Medicaid |
$667.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,514.92
|
| Rate for Payer: Cash Price |
$971.10
|
| Rate for Payer: Cigna Commercial |
$1,612.03
|
| Rate for Payer: First Health Commercial |
$1,845.09
|
| Rate for Payer: Humana Commercial |
$1,650.87
|
| Rate for Payer: Humana KY Medicaid |
$667.92
|
| Rate for Payer: Kentucky WC Medicaid |
$674.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,592.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,433.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$582.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$681.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,709.14
|
| Rate for Payer: Ohio Health Group HMO |
$1,456.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,553.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,689.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,340.12
|
| Rate for Payer: PHCS Commercial |
$1,864.51
|
| Rate for Payer: United Healthcare All Payer |
$1,709.14
|
|
|
PLATE COMP 10H 3.5*145
|
Facility
|
IP
|
$1,942.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$582.66 |
| Max. Negotiated Rate |
$1,864.51 |
| Rate for Payer: Aetna Commercial |
$1,495.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,514.92
|
| Rate for Payer: Cash Price |
$971.10
|
| Rate for Payer: Cigna Commercial |
$1,612.03
|
| Rate for Payer: First Health Commercial |
$1,845.09
|
| Rate for Payer: Humana Commercial |
$1,650.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,592.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,433.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$582.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,709.14
|
| Rate for Payer: Ohio Health Group HMO |
$1,456.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,553.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,689.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,340.12
|
| Rate for Payer: PHCS Commercial |
$1,864.51
|
| Rate for Payer: United Healthcare All Payer |
$1,709.14
|
|
|
PLATE COMP 1/3 TUB 3 H 3.5MM
|
Facility
|
IP
|
$4,663.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,398.97 |
| Max. Negotiated Rate |
$4,476.72 |
| Rate for Payer: Aetna Commercial |
$3,590.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,637.34
|
| Rate for Payer: Cash Price |
$2,331.62
|
| Rate for Payer: Cigna Commercial |
$3,870.50
|
| Rate for Payer: First Health Commercial |
$4,430.09
|
| Rate for Payer: Humana Commercial |
$3,963.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,823.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,441.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,398.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,103.66
|
| Rate for Payer: Ohio Health Group HMO |
$3,497.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,730.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,057.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,217.64
|
| Rate for Payer: PHCS Commercial |
$4,476.72
|
| Rate for Payer: United Healthcare All Payer |
$4,103.66
|
|
|
PLATE COMP 1/3 TUB 3 H 3.5MM
|
Facility
|
OP
|
$4,663.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,398.97 |
| Max. Negotiated Rate |
$4,476.72 |
| Rate for Payer: Aetna Commercial |
$3,590.70
|
| Rate for Payer: Anthem Medicaid |
$1,603.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,637.34
|
| Rate for Payer: Cash Price |
$2,331.62
|
| Rate for Payer: Cigna Commercial |
$3,870.50
|
| Rate for Payer: First Health Commercial |
$4,430.09
|
| Rate for Payer: Humana Commercial |
$3,963.76
|
| Rate for Payer: Humana KY Medicaid |
$1,603.69
|
| Rate for Payer: Kentucky WC Medicaid |
$1,620.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,823.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,441.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,398.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,635.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,103.66
|
| Rate for Payer: Ohio Health Group HMO |
$3,497.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,730.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,057.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,217.64
|
| Rate for Payer: PHCS Commercial |
$4,476.72
|
| Rate for Payer: United Healthcare All Payer |
$4,103.66
|
|
|
PLATE COMP 1/3 TUB 5 H 3.5MM
|
Facility
|
OP
|
$4,961.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,488.41 |
| Max. Negotiated Rate |
$4,762.92 |
| Rate for Payer: Aetna Commercial |
$3,820.26
|
| Rate for Payer: Anthem Medicaid |
$1,706.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,869.88
|
| Rate for Payer: Cash Price |
$2,480.69
|
| Rate for Payer: Cigna Commercial |
$4,117.95
|
| Rate for Payer: First Health Commercial |
$4,713.31
|
| Rate for Payer: Humana Commercial |
$4,217.17
|
| Rate for Payer: Humana KY Medicaid |
$1,706.22
|
| Rate for Payer: Kentucky WC Medicaid |
$1,723.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,068.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,661.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,488.41
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,740.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,366.01
|
| Rate for Payer: Ohio Health Group HMO |
$3,721.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,969.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,316.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,423.35
|
| Rate for Payer: PHCS Commercial |
$4,762.92
|
| Rate for Payer: United Healthcare All Payer |
$4,366.01
|
|
|
PLATE COMP 1/3 TUB 5 H 3.5MM
|
Facility
|
IP
|
$4,961.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,488.41 |
| Max. Negotiated Rate |
$4,762.92 |
| Rate for Payer: Aetna Commercial |
$3,820.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,869.88
|
| Rate for Payer: Cash Price |
$2,480.69
|
| Rate for Payer: Cigna Commercial |
$4,117.95
|
| Rate for Payer: First Health Commercial |
$4,713.31
|
| Rate for Payer: Humana Commercial |
$4,217.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,068.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,661.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,488.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,366.01
|
| Rate for Payer: Ohio Health Group HMO |
$3,721.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,969.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,316.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,423.35
|
| Rate for Payer: PHCS Commercial |
$4,762.92
|
| Rate for Payer: United Healthcare All Payer |
$4,366.01
|
|
|
PLATE COMP 1/3 TUB 7 H 3.5MM
|
Facility
|
OP
|
$5,110.44
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,533.13 |
| Max. Negotiated Rate |
$4,906.02 |
| Rate for Payer: Aetna Commercial |
$3,935.04
|
| Rate for Payer: Anthem Medicaid |
$1,757.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,986.14
|
| Rate for Payer: Cash Price |
$2,555.22
|
| Rate for Payer: Cigna Commercial |
$4,241.67
|
| Rate for Payer: First Health Commercial |
$4,854.92
|
| Rate for Payer: Humana Commercial |
$4,343.87
|
| Rate for Payer: Humana KY Medicaid |
$1,757.48
|
| Rate for Payer: Kentucky WC Medicaid |
$1,775.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,190.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,771.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,533.13
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,792.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,497.19
|
| Rate for Payer: Ohio Health Group HMO |
$3,832.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,088.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,446.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,526.20
|
| Rate for Payer: PHCS Commercial |
$4,906.02
|
| Rate for Payer: United Healthcare All Payer |
$4,497.19
|
|
|
PLATE COMP 1/3 TUB 7 H 3.5MM
|
Facility
|
IP
|
$5,110.44
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,533.13 |
| Max. Negotiated Rate |
$4,906.02 |
| Rate for Payer: Aetna Commercial |
$3,935.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,986.14
|
| Rate for Payer: Cash Price |
$2,555.22
|
| Rate for Payer: Cigna Commercial |
$4,241.67
|
| Rate for Payer: First Health Commercial |
$4,854.92
|
| Rate for Payer: Humana Commercial |
$4,343.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,190.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,771.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,533.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,497.19
|
| Rate for Payer: Ohio Health Group HMO |
$3,832.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,088.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,446.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,526.20
|
| Rate for Payer: PHCS Commercial |
$4,906.02
|
| Rate for Payer: United Healthcare All Payer |
$4,497.19
|
|
|
PLATE COMP 3.5*106 7H
|
Facility
|
IP
|
$1,897.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$569.26 |
| Max. Negotiated Rate |
$1,821.65 |
| Rate for Payer: Aetna Commercial |
$1,461.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,480.09
|
| Rate for Payer: Cash Price |
$948.78
|
| Rate for Payer: Cigna Commercial |
$1,574.97
|
| Rate for Payer: First Health Commercial |
$1,802.67
|
| Rate for Payer: Humana Commercial |
$1,612.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,555.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,400.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$569.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,669.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,423.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,518.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,650.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,309.31
|
| Rate for Payer: PHCS Commercial |
$1,821.65
|
| Rate for Payer: United Healthcare All Payer |
$1,669.84
|
|
|
PLATE COMP 3.5*106 7H
|
Facility
|
OP
|
$1,897.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$569.26 |
| Max. Negotiated Rate |
$1,821.65 |
| Rate for Payer: Aetna Commercial |
$1,461.11
|
| Rate for Payer: Anthem Medicaid |
$652.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,480.09
|
| Rate for Payer: Cash Price |
$948.78
|
| Rate for Payer: Cigna Commercial |
$1,574.97
|
| Rate for Payer: First Health Commercial |
$1,802.67
|
| Rate for Payer: Humana Commercial |
$1,612.92
|
| Rate for Payer: Humana KY Medicaid |
$652.57
|
| Rate for Payer: Kentucky WC Medicaid |
$659.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,555.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,400.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$569.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$665.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,669.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,423.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,518.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,650.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,309.31
|
| Rate for Payer: PHCS Commercial |
$1,821.65
|
| Rate for Payer: United Healthcare All Payer |
$1,669.84
|
|
|
PLATE COMP 3.5*119 8H
|
Facility
|
IP
|
$1,925.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$577.70 |
| Max. Negotiated Rate |
$1,848.64 |
| Rate for Payer: Aetna Commercial |
$1,482.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,502.02
|
| Rate for Payer: Cash Price |
$962.84
|
| Rate for Payer: Cigna Commercial |
$1,598.31
|
| Rate for Payer: First Health Commercial |
$1,829.39
|
| Rate for Payer: Humana Commercial |
$1,636.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,579.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,421.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$577.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,694.59
|
| Rate for Payer: Ohio Health Group HMO |
$1,444.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,540.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,675.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,328.71
|
| Rate for Payer: PHCS Commercial |
$1,848.64
|
| Rate for Payer: United Healthcare All Payer |
$1,694.59
|
|
|
PLATE COMP 3.5*119 8H
|
Facility
|
OP
|
$1,925.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$577.70 |
| Max. Negotiated Rate |
$1,848.64 |
| Rate for Payer: Aetna Commercial |
$1,482.77
|
| Rate for Payer: Anthem Medicaid |
$662.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,502.02
|
| Rate for Payer: Cash Price |
$962.84
|
| Rate for Payer: Cigna Commercial |
$1,598.31
|
| Rate for Payer: First Health Commercial |
$1,829.39
|
| Rate for Payer: Humana Commercial |
$1,636.82
|
| Rate for Payer: Humana KY Medicaid |
$662.24
|
| Rate for Payer: Kentucky WC Medicaid |
$668.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,579.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,421.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$577.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$675.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,694.59
|
| Rate for Payer: Ohio Health Group HMO |
$1,444.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,540.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,675.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,328.71
|
| Rate for Payer: PHCS Commercial |
$1,848.64
|
| Rate for Payer: United Healthcare All Payer |
$1,694.59
|
|
|
PLATE COMP 3.5*132 9H
|
Facility
|
OP
|
$1,932.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$579.81 |
| Max. Negotiated Rate |
$1,855.39 |
| Rate for Payer: Aetna Commercial |
$1,488.18
|
| Rate for Payer: Anthem Medicaid |
$664.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,507.51
|
| Rate for Payer: Cash Price |
$966.35
|
| Rate for Payer: Cigna Commercial |
$1,604.14
|
| Rate for Payer: First Health Commercial |
$1,836.07
|
| Rate for Payer: Humana Commercial |
$1,642.80
|
| Rate for Payer: Humana KY Medicaid |
$664.66
|
| Rate for Payer: Kentucky WC Medicaid |
$671.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,584.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,426.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$579.81
|
| Rate for Payer: Molina Healthcare Medicaid |
$677.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,700.78
|
| Rate for Payer: Ohio Health Group HMO |
$1,449.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,546.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,681.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.56
|
| Rate for Payer: PHCS Commercial |
$1,855.39
|
| Rate for Payer: United Healthcare All Payer |
$1,700.78
|
|
|
PLATE COMP 3.5*132 9H
|
Facility
|
IP
|
$1,932.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$579.81 |
| Max. Negotiated Rate |
$1,855.39 |
| Rate for Payer: Aetna Commercial |
$1,488.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,507.51
|
| Rate for Payer: Cash Price |
$966.35
|
| Rate for Payer: Cigna Commercial |
$1,604.14
|
| Rate for Payer: First Health Commercial |
$1,836.07
|
| Rate for Payer: Humana Commercial |
$1,642.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,584.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,426.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$579.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,700.78
|
| Rate for Payer: Ohio Health Group HMO |
$1,449.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,546.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,681.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.56
|
| Rate for Payer: PHCS Commercial |
$1,855.39
|
| Rate for Payer: United Healthcare All Payer |
$1,700.78
|
|
|
PLATE COMP 3.5*145 10H
|
Facility
|
OP
|
$1,946.76
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$584.03 |
| Max. Negotiated Rate |
$1,868.89 |
| Rate for Payer: Aetna Commercial |
$1,499.01
|
| Rate for Payer: Anthem Medicaid |
$669.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,518.47
|
| Rate for Payer: Cash Price |
$973.38
|
| Rate for Payer: Cigna Commercial |
$1,615.81
|
| Rate for Payer: First Health Commercial |
$1,849.42
|
| Rate for Payer: Humana Commercial |
$1,654.75
|
| Rate for Payer: Humana KY Medicaid |
$669.49
|
| Rate for Payer: Kentucky WC Medicaid |
$676.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,596.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$584.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,713.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,460.07
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,557.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,343.26
|
| Rate for Payer: PHCS Commercial |
$1,868.89
|
| Rate for Payer: United Healthcare All Payer |
$1,713.15
|
|
|
PLATE COMP 3.5*145 10H
|
Facility
|
IP
|
$1,946.76
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$584.03 |
| Max. Negotiated Rate |
$1,868.89 |
| Rate for Payer: Aetna Commercial |
$1,499.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,518.47
|
| Rate for Payer: Cash Price |
$973.38
|
| Rate for Payer: Cigna Commercial |
$1,615.81
|
| Rate for Payer: First Health Commercial |
$1,849.42
|
| Rate for Payer: Humana Commercial |
$1,654.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,596.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$584.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,713.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,460.07
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,557.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,343.26
|
| Rate for Payer: PHCS Commercial |
$1,868.89
|
| Rate for Payer: United Healthcare All Payer |
$1,713.15
|
|
|
PLATE COMP 3.5*158 11H
|
Facility
|
IP
|
$1,974.88
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$592.46 |
| Max. Negotiated Rate |
$1,895.88 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,540.41
|
| Rate for Payer: Cash Price |
$987.44
|
| Rate for Payer: Cigna Commercial |
$1,639.15
|
| Rate for Payer: First Health Commercial |
$1,876.14
|
| Rate for Payer: Humana Commercial |
$1,678.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,619.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,457.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$592.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,737.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,481.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,579.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,718.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,362.67
|
| Rate for Payer: PHCS Commercial |
$1,895.88
|
| Rate for Payer: United Healthcare All Payer |
$1,737.89
|
|
|
PLATE COMP 3.5*158 11H
|
Facility
|
OP
|
$1,974.88
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$592.46 |
| Max. Negotiated Rate |
$1,895.88 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Anthem Medicaid |
$679.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,540.41
|
| Rate for Payer: Cash Price |
$987.44
|
| Rate for Payer: Cigna Commercial |
$1,639.15
|
| Rate for Payer: First Health Commercial |
$1,876.14
|
| Rate for Payer: Humana Commercial |
$1,678.65
|
| Rate for Payer: Humana KY Medicaid |
$679.16
|
| Rate for Payer: Kentucky WC Medicaid |
$686.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,619.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,457.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$592.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$692.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,737.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,481.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,579.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,718.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,362.67
|
| Rate for Payer: PHCS Commercial |
$1,895.88
|
| Rate for Payer: United Healthcare All Payer |
$1,737.89
|
|
|
PLATE COMP 3.5*171 12H
|
Facility
|
IP
|
$1,974.88
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$592.46 |
| Max. Negotiated Rate |
$1,895.88 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,540.41
|
| Rate for Payer: Cash Price |
$987.44
|
| Rate for Payer: Cigna Commercial |
$1,639.15
|
| Rate for Payer: First Health Commercial |
$1,876.14
|
| Rate for Payer: Humana Commercial |
$1,678.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,619.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,457.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$592.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,737.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,481.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,579.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,718.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,362.67
|
| Rate for Payer: PHCS Commercial |
$1,895.88
|
| Rate for Payer: United Healthcare All Payer |
$1,737.89
|
|
|
PLATE COMP 3.5*171 12H
|
Facility
|
OP
|
$1,974.88
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$592.46 |
| Max. Negotiated Rate |
$1,895.88 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Anthem Medicaid |
$679.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,540.41
|
| Rate for Payer: Cash Price |
$987.44
|
| Rate for Payer: Cigna Commercial |
$1,639.15
|
| Rate for Payer: First Health Commercial |
$1,876.14
|
| Rate for Payer: Humana Commercial |
$1,678.65
|
| Rate for Payer: Humana KY Medicaid |
$679.16
|
| Rate for Payer: Kentucky WC Medicaid |
$686.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,619.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,457.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$592.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$692.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,737.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,481.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,579.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,718.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,362.67
|
| Rate for Payer: PHCS Commercial |
$1,895.88
|
| Rate for Payer: United Healthcare All Payer |
$1,737.89
|
|
|
PLATE COMP 3.5*197 14H
|
Facility
|
IP
|
$3,352.81
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.84 |
| Max. Negotiated Rate |
$3,218.70 |
| Rate for Payer: Aetna Commercial |
$2,581.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,615.19
|
| Rate for Payer: Cash Price |
$1,676.41
|
| Rate for Payer: Cigna Commercial |
$2,782.83
|
| Rate for Payer: First Health Commercial |
$3,185.17
|
| Rate for Payer: Humana Commercial |
$2,849.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,749.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,474.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,005.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,950.47
|
| Rate for Payer: Ohio Health Group HMO |
$2,514.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,682.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,916.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,313.44
|
| Rate for Payer: PHCS Commercial |
$3,218.70
|
| Rate for Payer: United Healthcare All Payer |
$2,950.47
|
|
|
PLATE COMP 3.5*197 14H
|
Facility
|
OP
|
$3,352.81
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.84 |
| Max. Negotiated Rate |
$3,218.70 |
| Rate for Payer: Aetna Commercial |
$2,581.66
|
| Rate for Payer: Anthem Medicaid |
$1,153.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,615.19
|
| Rate for Payer: Cash Price |
$1,676.41
|
| Rate for Payer: Cigna Commercial |
$2,782.83
|
| Rate for Payer: First Health Commercial |
$3,185.17
|
| Rate for Payer: Humana Commercial |
$2,849.89
|
| Rate for Payer: Humana KY Medicaid |
$1,153.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,164.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,749.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,474.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,005.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,176.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,950.47
|
| Rate for Payer: Ohio Health Group HMO |
$2,514.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,682.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,916.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,313.44
|
| Rate for Payer: PHCS Commercial |
$3,218.70
|
| Rate for Payer: United Healthcare All Payer |
$2,950.47
|
|
