|
PLATE FEM LK 4.5M 155M 6 R L-D
|
Facility
|
IP
|
$7,990.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,397.03 |
| Max. Negotiated Rate |
$7,670.50 |
| Rate for Payer: Aetna Commercial |
$6,152.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,232.28
|
| Rate for Payer: Cash Price |
$3,995.05
|
| Rate for Payer: Cigna Commercial |
$6,631.78
|
| Rate for Payer: First Health Commercial |
$7,590.60
|
| Rate for Payer: Humana Commercial |
$6,791.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,551.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,896.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,397.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,031.29
|
| Rate for Payer: Ohio Health Group HMO |
$5,992.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,392.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,951.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,513.17
|
| Rate for Payer: PHCS Commercial |
$7,670.50
|
| Rate for Payer: United Healthcare All Payer |
$7,031.29
|
|
|
PLATE FEM LK 4.5M 155M 6 R L-D
|
Facility
|
OP
|
$7,990.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,397.03 |
| Max. Negotiated Rate |
$7,670.50 |
| Rate for Payer: Aetna Commercial |
$6,152.38
|
| Rate for Payer: Anthem Medicaid |
$2,747.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,232.28
|
| Rate for Payer: Cash Price |
$3,995.05
|
| Rate for Payer: Cigna Commercial |
$6,631.78
|
| Rate for Payer: First Health Commercial |
$7,590.60
|
| Rate for Payer: Humana Commercial |
$6,791.59
|
| Rate for Payer: Humana KY Medicaid |
$2,747.80
|
| Rate for Payer: Kentucky WC Medicaid |
$2,775.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,551.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,896.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,397.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,802.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,031.29
|
| Rate for Payer: Ohio Health Group HMO |
$5,992.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,392.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,951.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,513.17
|
| Rate for Payer: PHCS Commercial |
$7,670.50
|
| Rate for Payer: United Healthcare All Payer |
$7,031.29
|
|
|
PLATE FEM LK 4.5M 193M 8 L L-D
|
Facility
|
IP
|
$8,280.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,484.14 |
| Max. Negotiated Rate |
$7,949.24 |
| Rate for Payer: Aetna Commercial |
$6,375.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,458.76
|
| Rate for Payer: Cash Price |
$4,140.23
|
| Rate for Payer: Cigna Commercial |
$6,872.78
|
| Rate for Payer: First Health Commercial |
$7,866.44
|
| Rate for Payer: Humana Commercial |
$7,038.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,789.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,110.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,484.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,286.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,210.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,624.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,204.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,713.52
|
| Rate for Payer: PHCS Commercial |
$7,949.24
|
| Rate for Payer: United Healthcare All Payer |
$7,286.80
|
|
|
PLATE FEM LK 4.5M 193M 8 L L-D
|
Facility
|
OP
|
$8,280.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,484.14 |
| Max. Negotiated Rate |
$7,949.24 |
| Rate for Payer: Aetna Commercial |
$6,375.95
|
| Rate for Payer: Anthem Medicaid |
$2,847.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,458.76
|
| Rate for Payer: Cash Price |
$4,140.23
|
| Rate for Payer: Cigna Commercial |
$6,872.78
|
| Rate for Payer: First Health Commercial |
$7,866.44
|
| Rate for Payer: Humana Commercial |
$7,038.39
|
| Rate for Payer: Humana KY Medicaid |
$2,847.65
|
| Rate for Payer: Kentucky WC Medicaid |
$2,876.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,789.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,110.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,484.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,904.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,286.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,210.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,624.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,204.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,713.52
|
| Rate for Payer: PHCS Commercial |
$7,949.24
|
| Rate for Payer: United Healthcare All Payer |
$7,286.80
|
|
|
PLATE FEM LK 4.5M 193M 8 R L-D
|
Facility
|
OP
|
$8,280.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,484.14 |
| Max. Negotiated Rate |
$7,949.24 |
| Rate for Payer: Aetna Commercial |
$6,375.95
|
| Rate for Payer: Anthem Medicaid |
$2,847.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,458.76
|
| Rate for Payer: Cash Price |
$4,140.23
|
| Rate for Payer: Cigna Commercial |
$6,872.78
|
| Rate for Payer: First Health Commercial |
$7,866.44
|
| Rate for Payer: Humana Commercial |
$7,038.39
|
| Rate for Payer: Humana KY Medicaid |
$2,847.65
|
| Rate for Payer: Kentucky WC Medicaid |
$2,876.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,789.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,110.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,484.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,904.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,286.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,210.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,624.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,204.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,713.52
|
| Rate for Payer: PHCS Commercial |
$7,949.24
|
| Rate for Payer: United Healthcare All Payer |
$7,286.80
|
|
|
PLATE FEM LK 4.5M 193M 8 R L-D
|
Facility
|
IP
|
$8,280.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,484.14 |
| Max. Negotiated Rate |
$7,949.24 |
| Rate for Payer: Aetna Commercial |
$6,375.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,458.76
|
| Rate for Payer: Cash Price |
$4,140.23
|
| Rate for Payer: Cigna Commercial |
$6,872.78
|
| Rate for Payer: First Health Commercial |
$7,866.44
|
| Rate for Payer: Humana Commercial |
$7,038.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,789.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,110.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,484.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,286.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,210.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,624.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,204.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,713.52
|
| Rate for Payer: PHCS Commercial |
$7,949.24
|
| Rate for Payer: United Healthcare All Payer |
$7,286.80
|
|
|
PLATE FEMLK 4.5M 230M 10 L L-D
|
Facility
|
IP
|
$8,368.24
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,510.47 |
| Max. Negotiated Rate |
$8,033.51 |
| Rate for Payer: Aetna Commercial |
$6,443.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,527.23
|
| Rate for Payer: Cash Price |
$4,184.12
|
| Rate for Payer: Cigna Commercial |
$6,945.64
|
| Rate for Payer: First Health Commercial |
$7,949.83
|
| Rate for Payer: Humana Commercial |
$7,113.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,861.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,175.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,510.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,364.05
|
| Rate for Payer: Ohio Health Group HMO |
$6,276.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,694.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,280.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,774.09
|
| Rate for Payer: PHCS Commercial |
$8,033.51
|
| Rate for Payer: United Healthcare All Payer |
$7,364.05
|
|
|
PLATE FEMLK 4.5M 230M 10 L L-D
|
Facility
|
OP
|
$8,368.24
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,510.47 |
| Max. Negotiated Rate |
$8,033.51 |
| Rate for Payer: Aetna Commercial |
$6,443.54
|
| Rate for Payer: Anthem Medicaid |
$2,877.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,527.23
|
| Rate for Payer: Cash Price |
$4,184.12
|
| Rate for Payer: Cigna Commercial |
$6,945.64
|
| Rate for Payer: First Health Commercial |
$7,949.83
|
| Rate for Payer: Humana Commercial |
$7,113.00
|
| Rate for Payer: Humana KY Medicaid |
$2,877.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,907.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,861.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,175.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,510.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,935.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,364.05
|
| Rate for Payer: Ohio Health Group HMO |
$6,276.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,694.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,280.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,774.09
|
| Rate for Payer: PHCS Commercial |
$8,033.51
|
| Rate for Payer: United Healthcare All Payer |
$7,364.05
|
|
|
PLATE FEMLK 4.5M 230M 10 R L-D
|
Facility
|
OP
|
$8,368.24
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,510.47 |
| Max. Negotiated Rate |
$8,033.51 |
| Rate for Payer: Aetna Commercial |
$6,443.54
|
| Rate for Payer: Anthem Medicaid |
$2,877.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,527.23
|
| Rate for Payer: Cash Price |
$4,184.12
|
| Rate for Payer: Cigna Commercial |
$6,945.64
|
| Rate for Payer: First Health Commercial |
$7,949.83
|
| Rate for Payer: Humana Commercial |
$7,113.00
|
| Rate for Payer: Humana KY Medicaid |
$2,877.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,907.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,861.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,175.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,510.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,935.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,364.05
|
| Rate for Payer: Ohio Health Group HMO |
$6,276.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,694.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,280.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,774.09
|
| Rate for Payer: PHCS Commercial |
$8,033.51
|
| Rate for Payer: United Healthcare All Payer |
$7,364.05
|
|
|
PLATE FEMLK 4.5M 230M 10 R L-D
|
Facility
|
IP
|
$8,368.24
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,510.47 |
| Max. Negotiated Rate |
$8,033.51 |
| Rate for Payer: Aetna Commercial |
$6,443.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,527.23
|
| Rate for Payer: Cash Price |
$4,184.12
|
| Rate for Payer: Cigna Commercial |
$6,945.64
|
| Rate for Payer: First Health Commercial |
$7,949.83
|
| Rate for Payer: Humana Commercial |
$7,113.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,861.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,175.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,510.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,364.05
|
| Rate for Payer: Ohio Health Group HMO |
$6,276.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,694.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,280.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,774.09
|
| Rate for Payer: PHCS Commercial |
$8,033.51
|
| Rate for Payer: United Healthcare All Payer |
$7,364.05
|
|
|
PLATE FEMLK 4.5M 230M 13 R L-D
|
Facility
|
OP
|
$8,624.83
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,587.45 |
| Max. Negotiated Rate |
$8,279.84 |
| Rate for Payer: Aetna Commercial |
$6,641.12
|
| Rate for Payer: Anthem Medicaid |
$2,966.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,727.37
|
| Rate for Payer: Cash Price |
$4,312.42
|
| Rate for Payer: Cigna Commercial |
$7,158.61
|
| Rate for Payer: First Health Commercial |
$8,193.59
|
| Rate for Payer: Humana Commercial |
$7,331.11
|
| Rate for Payer: Humana KY Medicaid |
$2,966.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,996.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,072.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,365.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,587.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,025.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,589.85
|
| Rate for Payer: Ohio Health Group HMO |
$6,468.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,899.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,503.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,951.13
|
| Rate for Payer: PHCS Commercial |
$8,279.84
|
| Rate for Payer: United Healthcare All Payer |
$7,589.85
|
|
|
PLATE FEMLK 4.5M 230M 13 R L-D
|
Facility
|
IP
|
$8,624.83
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,587.45 |
| Max. Negotiated Rate |
$8,279.84 |
| Rate for Payer: Aetna Commercial |
$6,641.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,727.37
|
| Rate for Payer: Cash Price |
$4,312.42
|
| Rate for Payer: Cigna Commercial |
$7,158.61
|
| Rate for Payer: First Health Commercial |
$8,193.59
|
| Rate for Payer: Humana Commercial |
$7,331.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,072.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,365.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,587.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,589.85
|
| Rate for Payer: Ohio Health Group HMO |
$6,468.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,899.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,503.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,951.13
|
| Rate for Payer: PHCS Commercial |
$8,279.84
|
| Rate for Payer: United Healthcare All Payer |
$7,589.85
|
|
|
PLATE FEMLK 4.5M 286M 13 L L-D
|
Facility
|
IP
|
$8,368.24
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,510.47 |
| Max. Negotiated Rate |
$8,033.51 |
| Rate for Payer: Aetna Commercial |
$6,443.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,527.23
|
| Rate for Payer: Cash Price |
$4,184.12
|
| Rate for Payer: Cigna Commercial |
$6,945.64
|
| Rate for Payer: First Health Commercial |
$7,949.83
|
| Rate for Payer: Humana Commercial |
$7,113.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,861.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,175.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,510.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,364.05
|
| Rate for Payer: Ohio Health Group HMO |
$6,276.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,694.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,280.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,774.09
|
| Rate for Payer: PHCS Commercial |
$8,033.51
|
| Rate for Payer: United Healthcare All Payer |
$7,364.05
|
|
|
PLATE FEMLK 4.5M 286M 13 L L-D
|
Facility
|
OP
|
$8,368.24
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,510.47 |
| Max. Negotiated Rate |
$8,033.51 |
| Rate for Payer: Aetna Commercial |
$6,443.54
|
| Rate for Payer: Anthem Medicaid |
$2,877.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,527.23
|
| Rate for Payer: Cash Price |
$4,184.12
|
| Rate for Payer: Cigna Commercial |
$6,945.64
|
| Rate for Payer: First Health Commercial |
$7,949.83
|
| Rate for Payer: Humana Commercial |
$7,113.00
|
| Rate for Payer: Humana KY Medicaid |
$2,877.84
|
| Rate for Payer: Kentucky WC Medicaid |
$2,907.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,861.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,175.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,510.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,935.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,364.05
|
| Rate for Payer: Ohio Health Group HMO |
$6,276.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,694.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,280.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,774.09
|
| Rate for Payer: PHCS Commercial |
$8,033.51
|
| Rate for Payer: United Healthcare All Payer |
$7,364.05
|
|
|
PLATE FEMLK 4.5M 342M 16 L L-D
|
Facility
|
OP
|
$8,726.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,617.84 |
| Max. Negotiated Rate |
$8,377.08 |
| Rate for Payer: Aetna Commercial |
$6,719.11
|
| Rate for Payer: Anthem Medicaid |
$3,000.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,806.37
|
| Rate for Payer: Cash Price |
$4,363.06
|
| Rate for Payer: Cigna Commercial |
$7,242.68
|
| Rate for Payer: First Health Commercial |
$8,289.81
|
| Rate for Payer: Humana Commercial |
$7,417.20
|
| Rate for Payer: Humana KY Medicaid |
$3,000.91
|
| Rate for Payer: Kentucky WC Medicaid |
$3,031.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,155.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,439.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,617.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,061.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,678.99
|
| Rate for Payer: Ohio Health Group HMO |
$6,544.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,980.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,591.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,021.02
|
| Rate for Payer: PHCS Commercial |
$8,377.08
|
| Rate for Payer: United Healthcare All Payer |
$7,678.99
|
|
|
PLATE FEMLK 4.5M 342M 16 L L-D
|
Facility
|
IP
|
$8,726.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,617.84 |
| Max. Negotiated Rate |
$8,377.08 |
| Rate for Payer: Aetna Commercial |
$6,719.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,806.37
|
| Rate for Payer: Cash Price |
$4,363.06
|
| Rate for Payer: Cigna Commercial |
$7,242.68
|
| Rate for Payer: First Health Commercial |
$8,289.81
|
| Rate for Payer: Humana Commercial |
$7,417.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,155.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,439.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,617.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,678.99
|
| Rate for Payer: Ohio Health Group HMO |
$6,544.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,980.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,591.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,021.02
|
| Rate for Payer: PHCS Commercial |
$8,377.08
|
| Rate for Payer: United Healthcare All Payer |
$7,678.99
|
|
|
PLATE FEMLK 4.5M 342M 16 R L-D
|
Facility
|
OP
|
$8,726.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,617.84 |
| Max. Negotiated Rate |
$8,377.08 |
| Rate for Payer: Aetna Commercial |
$6,719.11
|
| Rate for Payer: Anthem Medicaid |
$3,000.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,806.37
|
| Rate for Payer: Cash Price |
$4,363.06
|
| Rate for Payer: Cigna Commercial |
$7,242.68
|
| Rate for Payer: First Health Commercial |
$8,289.81
|
| Rate for Payer: Humana Commercial |
$7,417.20
|
| Rate for Payer: Humana KY Medicaid |
$3,000.91
|
| Rate for Payer: Kentucky WC Medicaid |
$3,031.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,155.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,439.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,617.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,061.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,678.99
|
| Rate for Payer: Ohio Health Group HMO |
$6,544.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,980.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,591.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,021.02
|
| Rate for Payer: PHCS Commercial |
$8,377.08
|
| Rate for Payer: United Healthcare All Payer |
$7,678.99
|
|
|
PLATE FEMLK 4.5M 342M 16 R L-D
|
Facility
|
IP
|
$8,726.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,617.84 |
| Max. Negotiated Rate |
$8,377.08 |
| Rate for Payer: Aetna Commercial |
$6,719.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,806.37
|
| Rate for Payer: Cash Price |
$4,363.06
|
| Rate for Payer: Cigna Commercial |
$7,242.68
|
| Rate for Payer: First Health Commercial |
$8,289.81
|
| Rate for Payer: Humana Commercial |
$7,417.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,155.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,439.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,617.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,678.99
|
| Rate for Payer: Ohio Health Group HMO |
$6,544.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,980.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,591.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,021.02
|
| Rate for Payer: PHCS Commercial |
$8,377.08
|
| Rate for Payer: United Healthcare All Payer |
$7,678.99
|
|
|
PLATE FEMLK 4.5M 399M 19 L L-D
|
Facility
|
OP
|
$8,915.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,674.56 |
| Max. Negotiated Rate |
$8,558.58 |
| Rate for Payer: Aetna Commercial |
$6,864.70
|
| Rate for Payer: Anthem Medicaid |
$3,065.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,953.85
|
| Rate for Payer: Cash Price |
$4,457.60
|
| Rate for Payer: Cigna Commercial |
$7,399.61
|
| Rate for Payer: First Health Commercial |
$8,469.43
|
| Rate for Payer: Humana Commercial |
$7,577.91
|
| Rate for Payer: Humana KY Medicaid |
$3,065.93
|
| Rate for Payer: Kentucky WC Medicaid |
$3,097.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,310.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,579.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,674.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,127.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,845.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,686.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,132.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,756.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,151.48
|
| Rate for Payer: PHCS Commercial |
$8,558.58
|
| Rate for Payer: United Healthcare All Payer |
$7,845.37
|
|
|
PLATE FEMLK 4.5M 399M 19 L L-D
|
Facility
|
IP
|
$8,915.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,674.56 |
| Max. Negotiated Rate |
$8,558.58 |
| Rate for Payer: Aetna Commercial |
$6,864.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,953.85
|
| Rate for Payer: Cash Price |
$4,457.60
|
| Rate for Payer: Cigna Commercial |
$7,399.61
|
| Rate for Payer: First Health Commercial |
$8,469.43
|
| Rate for Payer: Humana Commercial |
$7,577.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,310.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,579.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,674.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,845.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,686.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,132.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,756.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,151.48
|
| Rate for Payer: PHCS Commercial |
$8,558.58
|
| Rate for Payer: United Healthcare All Payer |
$7,845.37
|
|
|
PLATE FEMLK 4.5M 399M 19 R L-D
|
Facility
|
IP
|
$8,915.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,674.56 |
| Max. Negotiated Rate |
$8,558.58 |
| Rate for Payer: Aetna Commercial |
$6,864.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,953.85
|
| Rate for Payer: Cash Price |
$4,457.60
|
| Rate for Payer: Cigna Commercial |
$7,399.61
|
| Rate for Payer: First Health Commercial |
$8,469.43
|
| Rate for Payer: Humana Commercial |
$7,577.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,310.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,579.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,674.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,845.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,686.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,132.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,756.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,151.48
|
| Rate for Payer: PHCS Commercial |
$8,558.58
|
| Rate for Payer: United Healthcare All Payer |
$7,845.37
|
|
|
PLATE FEMLK 4.5M 399M 19 R L-D
|
Facility
|
OP
|
$8,915.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,674.56 |
| Max. Negotiated Rate |
$8,558.58 |
| Rate for Payer: Aetna Commercial |
$6,864.70
|
| Rate for Payer: Anthem Medicaid |
$3,065.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,953.85
|
| Rate for Payer: Cash Price |
$4,457.60
|
| Rate for Payer: Cigna Commercial |
$7,399.61
|
| Rate for Payer: First Health Commercial |
$8,469.43
|
| Rate for Payer: Humana Commercial |
$7,577.91
|
| Rate for Payer: Humana KY Medicaid |
$3,065.93
|
| Rate for Payer: Kentucky WC Medicaid |
$3,097.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,310.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,579.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,674.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,127.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,845.37
|
| Rate for Payer: Ohio Health Group HMO |
$6,686.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,132.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,756.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,151.48
|
| Rate for Payer: PHCS Commercial |
$8,558.58
|
| Rate for Payer: United Healthcare All Payer |
$7,845.37
|
|
|
PLATE FEM MID LCK 4.5 12H
|
Facility
|
OP
|
$5,718.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,715.55 |
| Max. Negotiated Rate |
$5,489.76 |
| Rate for Payer: Aetna Commercial |
$4,403.24
|
| Rate for Payer: Anthem Medicaid |
$1,966.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,460.43
|
| Rate for Payer: Cash Price |
$2,859.25
|
| Rate for Payer: Cigna Commercial |
$4,746.35
|
| Rate for Payer: First Health Commercial |
$5,432.57
|
| Rate for Payer: Humana Commercial |
$4,860.73
|
| Rate for Payer: Humana KY Medicaid |
$1,966.59
|
| Rate for Payer: Kentucky WC Medicaid |
$1,986.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,689.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,220.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,715.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,006.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,032.28
|
| Rate for Payer: Ohio Health Group HMO |
$4,288.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,574.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,975.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,945.76
|
| Rate for Payer: PHCS Commercial |
$5,489.76
|
| Rate for Payer: United Healthcare All Payer |
$5,032.28
|
|
|
PLATE FEM MID LCK 4.5 12H
|
Facility
|
IP
|
$5,718.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,715.55 |
| Max. Negotiated Rate |
$5,489.76 |
| Rate for Payer: Aetna Commercial |
$4,403.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,460.43
|
| Rate for Payer: Cash Price |
$2,859.25
|
| Rate for Payer: Cigna Commercial |
$4,746.35
|
| Rate for Payer: First Health Commercial |
$5,432.57
|
| Rate for Payer: Humana Commercial |
$4,860.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,689.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,220.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,715.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,032.28
|
| Rate for Payer: Ohio Health Group HMO |
$4,288.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,574.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,975.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,945.76
|
| Rate for Payer: PHCS Commercial |
$5,489.76
|
| Rate for Payer: United Healthcare All Payer |
$5,032.28
|
|
|
PLATE FEM MID LCK 4.5 14H
|
Facility
|
IP
|
$5,718.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,715.55 |
| Max. Negotiated Rate |
$5,489.76 |
| Rate for Payer: Aetna Commercial |
$4,403.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,460.43
|
| Rate for Payer: Cash Price |
$2,859.25
|
| Rate for Payer: Cigna Commercial |
$4,746.35
|
| Rate for Payer: First Health Commercial |
$5,432.57
|
| Rate for Payer: Humana Commercial |
$4,860.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,689.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,220.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,715.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,032.28
|
| Rate for Payer: Ohio Health Group HMO |
$4,288.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,574.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,975.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,945.76
|
| Rate for Payer: PHCS Commercial |
$5,489.76
|
| Rate for Payer: United Healthcare All Payer |
$5,032.28
|
|
