PLATE PROXIMAL LAT HUM 10H R
|
Facility
|
OP
|
$11,542.94
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,500.58 |
Max. Negotiated Rate |
$11,081.22 |
Rate for Payer: Aetna Commercial |
$8,888.06
|
Rate for Payer: Anthem Medicaid |
$3,969.62
|
Rate for Payer: Anthem POS/PPO/Traditional |
$9,003.49
|
Rate for Payer: Cash Price |
$5,771.47
|
Rate for Payer: Cigna Commercial |
$9,580.64
|
Rate for Payer: First Health Commercial |
$10,965.79
|
Rate for Payer: Humana Commercial |
$9,811.50
|
Rate for Payer: Humana KY Medicaid |
$3,969.62
|
Rate for Payer: Kentucky WC Medicaid |
$4,010.02
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$9,465.21
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,518.69
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$3,462.88
|
Rate for Payer: Molina Healthcare Medicaid |
$4,049.26
|
Rate for Payer: Ohio Health Choice Commercial |
$10,157.79
|
Rate for Payer: Ohio Health Group HMO |
$8,657.20
|
Rate for Payer: Ohio Health Group PPO Differential |
$2,308.59
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,500.58
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,578.31
|
Rate for Payer: PHCS Commercial |
$11,081.22
|
Rate for Payer: United Healthcare All Payer |
$10,157.79
|
|
PLATE PROXIMAL LAT HUM 10H R
|
Facility
|
IP
|
$11,542.94
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,500.58 |
Max. Negotiated Rate |
$11,081.22 |
Rate for Payer: Aetna Commercial |
$8,888.06
|
Rate for Payer: Anthem POS/PPO/Traditional |
$9,003.49
|
Rate for Payer: Cash Price |
$5,771.47
|
Rate for Payer: Cigna Commercial |
$9,580.64
|
Rate for Payer: First Health Commercial |
$10,965.79
|
Rate for Payer: Humana Commercial |
$9,811.50
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$9,465.21
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,518.69
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$3,462.88
|
Rate for Payer: Ohio Health Choice Commercial |
$10,157.79
|
Rate for Payer: Ohio Health Group HMO |
$8,657.20
|
Rate for Payer: Ohio Health Group PPO Differential |
$2,308.59
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,500.58
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,578.31
|
Rate for Payer: PHCS Commercial |
$11,081.22
|
Rate for Payer: United Healthcare All Payer |
$10,157.79
|
|
PLATE PROXIMAL LAT HUM 12H L
|
Facility
|
OP
|
$11,907.80
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,548.01 |
Max. Negotiated Rate |
$11,431.49 |
Rate for Payer: Aetna Commercial |
$9,169.01
|
Rate for Payer: Anthem Medicaid |
$4,095.09
|
Rate for Payer: Anthem POS/PPO/Traditional |
$9,288.08
|
Rate for Payer: Cash Price |
$5,953.90
|
Rate for Payer: Cigna Commercial |
$9,883.47
|
Rate for Payer: First Health Commercial |
$11,312.41
|
Rate for Payer: Humana Commercial |
$10,121.63
|
Rate for Payer: Humana KY Medicaid |
$4,095.09
|
Rate for Payer: Kentucky WC Medicaid |
$4,136.77
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$9,764.40
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,787.96
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$3,572.34
|
Rate for Payer: Molina Healthcare Medicaid |
$4,177.26
|
Rate for Payer: Ohio Health Choice Commercial |
$10,478.86
|
Rate for Payer: Ohio Health Group HMO |
$8,930.85
|
Rate for Payer: Ohio Health Group PPO Differential |
$2,381.56
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,548.01
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,691.42
|
Rate for Payer: PHCS Commercial |
$11,431.49
|
Rate for Payer: United Healthcare All Payer |
$10,478.86
|
|
PLATE PROXIMAL LAT HUM 12H L
|
Facility
|
IP
|
$11,907.80
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,548.01 |
Max. Negotiated Rate |
$11,431.49 |
Rate for Payer: Aetna Commercial |
$9,169.01
|
Rate for Payer: Anthem POS/PPO/Traditional |
$9,288.08
|
Rate for Payer: Cash Price |
$5,953.90
|
Rate for Payer: Cigna Commercial |
$9,883.47
|
Rate for Payer: First Health Commercial |
$11,312.41
|
Rate for Payer: Humana Commercial |
$10,121.63
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$9,764.40
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,787.96
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$3,572.34
|
Rate for Payer: Ohio Health Choice Commercial |
$10,478.86
|
Rate for Payer: Ohio Health Group HMO |
$8,930.85
|
Rate for Payer: Ohio Health Group PPO Differential |
$2,381.56
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,548.01
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,691.42
|
Rate for Payer: PHCS Commercial |
$11,431.49
|
Rate for Payer: United Healthcare All Payer |
$10,478.86
|
|
PLATE PROXIMAL LAT HUM 12H R
|
Facility
|
IP
|
$9,364.09
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,217.33 |
Max. Negotiated Rate |
$8,989.53 |
Rate for Payer: Aetna Commercial |
$7,210.35
|
Rate for Payer: Anthem POS/PPO/Traditional |
$7,303.99
|
Rate for Payer: Cash Price |
$4,682.04
|
Rate for Payer: Cigna Commercial |
$7,772.19
|
Rate for Payer: First Health Commercial |
$8,895.89
|
Rate for Payer: Humana Commercial |
$7,959.48
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$7,678.55
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,910.70
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,809.23
|
Rate for Payer: Ohio Health Choice Commercial |
$8,240.40
|
Rate for Payer: Ohio Health Group HMO |
$7,023.07
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,872.82
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,217.33
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,902.87
|
Rate for Payer: PHCS Commercial |
$8,989.53
|
Rate for Payer: United Healthcare All Payer |
$8,240.40
|
|
PLATE PROXIMAL LAT HUM 12H R
|
Facility
|
OP
|
$9,364.09
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,217.33 |
Max. Negotiated Rate |
$8,989.53 |
Rate for Payer: Aetna Commercial |
$7,210.35
|
Rate for Payer: Anthem Medicaid |
$3,220.31
|
Rate for Payer: Anthem POS/PPO/Traditional |
$7,303.99
|
Rate for Payer: Cash Price |
$4,682.04
|
Rate for Payer: Cigna Commercial |
$7,772.19
|
Rate for Payer: First Health Commercial |
$8,895.89
|
Rate for Payer: Humana Commercial |
$7,959.48
|
Rate for Payer: Humana KY Medicaid |
$3,220.31
|
Rate for Payer: Kentucky WC Medicaid |
$3,253.08
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$7,678.55
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,910.70
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,809.23
|
Rate for Payer: Molina Healthcare Medicaid |
$3,284.92
|
Rate for Payer: Ohio Health Choice Commercial |
$8,240.40
|
Rate for Payer: Ohio Health Group HMO |
$7,023.07
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,872.82
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,217.33
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,902.87
|
Rate for Payer: PHCS Commercial |
$8,989.53
|
Rate for Payer: United Healthcare All Payer |
$8,240.40
|
|
PLATE PROXIMAL LAT HUM 3H L
|
Facility
|
OP
|
$8,248.83
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,072.35 |
Max. Negotiated Rate |
$7,918.88 |
Rate for Payer: Aetna Commercial |
$6,351.60
|
Rate for Payer: Anthem Medicaid |
$2,836.77
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6,434.09
|
Rate for Payer: Cash Price |
$4,124.41
|
Rate for Payer: Cigna Commercial |
$6,846.53
|
Rate for Payer: First Health Commercial |
$7,836.39
|
Rate for Payer: Humana Commercial |
$7,011.51
|
Rate for Payer: Humana KY Medicaid |
$2,836.77
|
Rate for Payer: Kentucky WC Medicaid |
$2,865.64
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6,764.04
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,087.64
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,474.65
|
Rate for Payer: Molina Healthcare Medicaid |
$2,893.69
|
Rate for Payer: Ohio Health Choice Commercial |
$7,258.97
|
Rate for Payer: Ohio Health Group HMO |
$6,186.62
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,649.77
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.35
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,557.14
|
Rate for Payer: PHCS Commercial |
$7,918.88
|
Rate for Payer: United Healthcare All Payer |
$7,258.97
|
|
PLATE PROXIMAL LAT HUM 3H L
|
Facility
|
IP
|
$8,248.83
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,072.35 |
Max. Negotiated Rate |
$7,918.88 |
Rate for Payer: Aetna Commercial |
$6,351.60
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6,434.09
|
Rate for Payer: Cash Price |
$4,124.41
|
Rate for Payer: Cigna Commercial |
$6,846.53
|
Rate for Payer: First Health Commercial |
$7,836.39
|
Rate for Payer: Humana Commercial |
$7,011.51
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6,764.04
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,087.64
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,474.65
|
Rate for Payer: Ohio Health Choice Commercial |
$7,258.97
|
Rate for Payer: Ohio Health Group HMO |
$6,186.62
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,649.77
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.35
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,557.14
|
Rate for Payer: PHCS Commercial |
$7,918.88
|
Rate for Payer: United Healthcare All Payer |
$7,258.97
|
|
PLATE PROXIMAL LAT HUM 3H R
|
Facility
|
OP
|
$8,248.83
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,072.35 |
Max. Negotiated Rate |
$7,918.88 |
Rate for Payer: Anthem Medicaid |
$2,836.77
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6,434.09
|
Rate for Payer: Cash Price |
$4,124.41
|
Rate for Payer: Cigna Commercial |
$6,846.53
|
Rate for Payer: First Health Commercial |
$7,836.39
|
Rate for Payer: Humana Commercial |
$7,011.51
|
Rate for Payer: Humana KY Medicaid |
$2,836.77
|
Rate for Payer: Kentucky WC Medicaid |
$2,865.64
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6,764.04
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,087.64
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,474.65
|
Rate for Payer: Molina Healthcare Medicaid |
$2,893.69
|
Rate for Payer: Ohio Health Choice Commercial |
$7,258.97
|
Rate for Payer: Ohio Health Group HMO |
$6,186.62
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,649.77
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.35
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,557.14
|
Rate for Payer: PHCS Commercial |
$7,918.88
|
Rate for Payer: United Healthcare All Payer |
$7,258.97
|
Rate for Payer: Aetna Commercial |
$6,351.60
|
|
PLATE PROXIMAL LAT HUM 3H R
|
Facility
|
IP
|
$8,248.83
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,072.35 |
Max. Negotiated Rate |
$7,918.88 |
Rate for Payer: Aetna Commercial |
$6,351.60
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6,434.09
|
Rate for Payer: Cash Price |
$4,124.41
|
Rate for Payer: Cigna Commercial |
$6,846.53
|
Rate for Payer: First Health Commercial |
$7,836.39
|
Rate for Payer: Humana Commercial |
$7,011.51
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6,764.04
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,087.64
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,474.65
|
Rate for Payer: Ohio Health Choice Commercial |
$7,258.97
|
Rate for Payer: Ohio Health Group HMO |
$6,186.62
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,649.77
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.35
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,557.14
|
Rate for Payer: PHCS Commercial |
$7,918.88
|
Rate for Payer: United Healthcare All Payer |
$7,258.97
|
|
PLATE PROXIMAL LAT HUM 4H L
|
Facility
|
OP
|
$8,248.83
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,072.35 |
Max. Negotiated Rate |
$7,918.88 |
Rate for Payer: Aetna Commercial |
$6,351.60
|
Rate for Payer: Anthem Medicaid |
$2,836.77
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6,434.09
|
Rate for Payer: Cash Price |
$4,124.41
|
Rate for Payer: Cigna Commercial |
$6,846.53
|
Rate for Payer: First Health Commercial |
$7,836.39
|
Rate for Payer: Humana Commercial |
$7,011.51
|
Rate for Payer: Humana KY Medicaid |
$2,836.77
|
Rate for Payer: Kentucky WC Medicaid |
$2,865.64
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6,764.04
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,087.64
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,474.65
|
Rate for Payer: Molina Healthcare Medicaid |
$2,893.69
|
Rate for Payer: Ohio Health Choice Commercial |
$7,258.97
|
Rate for Payer: Ohio Health Group HMO |
$6,186.62
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,649.77
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.35
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,557.14
|
Rate for Payer: PHCS Commercial |
$7,918.88
|
Rate for Payer: United Healthcare All Payer |
$7,258.97
|
|
PLATE PROXIMAL LAT HUM 4H L
|
Facility
|
IP
|
$8,248.83
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,072.35 |
Max. Negotiated Rate |
$7,918.88 |
Rate for Payer: Aetna Commercial |
$6,351.60
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6,434.09
|
Rate for Payer: Cash Price |
$4,124.41
|
Rate for Payer: Cigna Commercial |
$6,846.53
|
Rate for Payer: First Health Commercial |
$7,836.39
|
Rate for Payer: Humana Commercial |
$7,011.51
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6,764.04
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,087.64
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,474.65
|
Rate for Payer: Ohio Health Choice Commercial |
$7,258.97
|
Rate for Payer: Ohio Health Group HMO |
$6,186.62
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,649.77
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.35
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,557.14
|
Rate for Payer: PHCS Commercial |
$7,918.88
|
Rate for Payer: United Healthcare All Payer |
$7,258.97
|
|
PLATE PROXIMAL LAT HUM 4H R
|
Facility
|
IP
|
$9,943.56
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,292.66 |
Max. Negotiated Rate |
$9,545.82 |
Rate for Payer: Aetna Commercial |
$7,656.54
|
Rate for Payer: Anthem POS/PPO/Traditional |
$7,755.98
|
Rate for Payer: Cash Price |
$4,971.78
|
Rate for Payer: Cigna Commercial |
$8,253.15
|
Rate for Payer: First Health Commercial |
$9,446.38
|
Rate for Payer: Humana Commercial |
$8,452.03
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$8,153.72
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,338.35
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,983.07
|
Rate for Payer: Ohio Health Choice Commercial |
$8,750.33
|
Rate for Payer: Ohio Health Group HMO |
$7,457.67
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,988.71
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,292.66
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,082.50
|
Rate for Payer: PHCS Commercial |
$9,545.82
|
Rate for Payer: United Healthcare All Payer |
$8,750.33
|
|
PLATE PROXIMAL LAT HUM 4H R
|
Facility
|
OP
|
$9,943.56
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,292.66 |
Max. Negotiated Rate |
$9,545.82 |
Rate for Payer: Aetna Commercial |
$7,656.54
|
Rate for Payer: Anthem Medicaid |
$3,419.59
|
Rate for Payer: Anthem POS/PPO/Traditional |
$7,755.98
|
Rate for Payer: Cash Price |
$4,971.78
|
Rate for Payer: Cigna Commercial |
$8,253.15
|
Rate for Payer: First Health Commercial |
$9,446.38
|
Rate for Payer: Humana Commercial |
$8,452.03
|
Rate for Payer: Humana KY Medicaid |
$3,419.59
|
Rate for Payer: Kentucky WC Medicaid |
$3,454.39
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$8,153.72
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,338.35
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,983.07
|
Rate for Payer: Molina Healthcare Medicaid |
$3,488.20
|
Rate for Payer: Ohio Health Choice Commercial |
$8,750.33
|
Rate for Payer: Ohio Health Group HMO |
$7,457.67
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,988.71
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,292.66
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,082.50
|
Rate for Payer: PHCS Commercial |
$9,545.82
|
Rate for Payer: United Healthcare All Payer |
$8,750.33
|
|
PLATE PROXIMAL LAT HUM 5H L
|
Facility
|
OP
|
$15,054.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,957.02 |
Max. Negotiated Rate |
$14,451.84 |
Rate for Payer: Aetna Commercial |
$11,591.58
|
Rate for Payer: Anthem Medicaid |
$5,177.07
|
Rate for Payer: Anthem POS/PPO/Traditional |
$11,742.12
|
Rate for Payer: Cash Price |
$7,527.00
|
Rate for Payer: Cigna Commercial |
$12,494.82
|
Rate for Payer: First Health Commercial |
$14,301.30
|
Rate for Payer: Humana Commercial |
$12,795.90
|
Rate for Payer: Humana KY Medicaid |
$5,177.07
|
Rate for Payer: Kentucky WC Medicaid |
$5,229.76
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$12,344.28
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,109.85
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,516.20
|
Rate for Payer: Molina Healthcare Medicaid |
$5,280.94
|
Rate for Payer: Ohio Health Choice Commercial |
$13,247.52
|
Rate for Payer: Ohio Health Group HMO |
$11,290.50
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,010.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,957.02
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,666.74
|
Rate for Payer: PHCS Commercial |
$14,451.84
|
Rate for Payer: United Healthcare All Payer |
$13,247.52
|
|
PLATE PROXIMAL LAT HUM 5H L
|
Facility
|
IP
|
$15,054.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,957.02 |
Max. Negotiated Rate |
$14,451.84 |
Rate for Payer: Aetna Commercial |
$11,591.58
|
Rate for Payer: Anthem POS/PPO/Traditional |
$11,742.12
|
Rate for Payer: Cash Price |
$7,527.00
|
Rate for Payer: Cigna Commercial |
$12,494.82
|
Rate for Payer: First Health Commercial |
$14,301.30
|
Rate for Payer: Humana Commercial |
$12,795.90
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$12,344.28
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,109.85
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,516.20
|
Rate for Payer: Ohio Health Choice Commercial |
$13,247.52
|
Rate for Payer: Ohio Health Group HMO |
$11,290.50
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,010.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,957.02
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,666.74
|
Rate for Payer: PHCS Commercial |
$14,451.84
|
Rate for Payer: United Healthcare All Payer |
$13,247.52
|
|
PLATE PROXIMAL LAT HUM 5H R
|
Facility
|
IP
|
$9,943.56
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,292.66 |
Max. Negotiated Rate |
$9,545.82 |
Rate for Payer: Aetna Commercial |
$7,656.54
|
Rate for Payer: Anthem POS/PPO/Traditional |
$7,755.98
|
Rate for Payer: Cash Price |
$4,971.78
|
Rate for Payer: Cigna Commercial |
$8,253.15
|
Rate for Payer: First Health Commercial |
$9,446.38
|
Rate for Payer: Humana Commercial |
$8,452.03
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$8,153.72
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,338.35
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,983.07
|
Rate for Payer: Ohio Health Choice Commercial |
$8,750.33
|
Rate for Payer: Ohio Health Group HMO |
$7,457.67
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,988.71
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,292.66
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,082.50
|
Rate for Payer: PHCS Commercial |
$9,545.82
|
Rate for Payer: United Healthcare All Payer |
$8,750.33
|
|
PLATE PROXIMAL LAT HUM 5H R
|
Facility
|
OP
|
$9,943.56
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,292.66 |
Max. Negotiated Rate |
$9,545.82 |
Rate for Payer: Aetna Commercial |
$7,656.54
|
Rate for Payer: Anthem Medicaid |
$3,419.59
|
Rate for Payer: Anthem POS/PPO/Traditional |
$7,755.98
|
Rate for Payer: Cash Price |
$4,971.78
|
Rate for Payer: Cigna Commercial |
$8,253.15
|
Rate for Payer: First Health Commercial |
$9,446.38
|
Rate for Payer: Humana Commercial |
$8,452.03
|
Rate for Payer: Humana KY Medicaid |
$3,419.59
|
Rate for Payer: Kentucky WC Medicaid |
$3,454.39
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$8,153.72
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,338.35
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2,983.07
|
Rate for Payer: Molina Healthcare Medicaid |
$3,488.20
|
Rate for Payer: Ohio Health Choice Commercial |
$8,750.33
|
Rate for Payer: Ohio Health Group HMO |
$7,457.67
|
Rate for Payer: Ohio Health Group PPO Differential |
$1,988.71
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,292.66
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,082.50
|
Rate for Payer: PHCS Commercial |
$9,545.82
|
Rate for Payer: United Healthcare All Payer |
$8,750.33
|
|
PLATE PROXIMAL LAT HUM 6H L
|
Facility
|
IP
|
$16,724.40
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,174.17 |
Max. Negotiated Rate |
$16,055.42 |
Rate for Payer: Aetna Commercial |
$12,877.79
|
Rate for Payer: Anthem POS/PPO/Traditional |
$13,045.03
|
Rate for Payer: Cash Price |
$8,362.20
|
Rate for Payer: Cigna Commercial |
$13,881.25
|
Rate for Payer: First Health Commercial |
$15,888.18
|
Rate for Payer: Humana Commercial |
$14,215.74
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$13,714.01
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,342.61
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$5,017.32
|
Rate for Payer: Ohio Health Choice Commercial |
$14,717.47
|
Rate for Payer: Ohio Health Group HMO |
$12,543.30
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,344.88
|
Rate for Payer: Ohio Health Group PPO No Differential |
$2,174.17
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,184.56
|
Rate for Payer: PHCS Commercial |
$16,055.42
|
Rate for Payer: United Healthcare All Payer |
$14,717.47
|
|
PLATE PROXIMAL LAT HUM 6H L
|
Facility
|
OP
|
$16,724.40
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,174.17 |
Max. Negotiated Rate |
$16,055.42 |
Rate for Payer: Aetna Commercial |
$12,877.79
|
Rate for Payer: Anthem Medicaid |
$5,751.52
|
Rate for Payer: Anthem POS/PPO/Traditional |
$13,045.03
|
Rate for Payer: Cash Price |
$8,362.20
|
Rate for Payer: Cigna Commercial |
$13,881.25
|
Rate for Payer: First Health Commercial |
$15,888.18
|
Rate for Payer: Humana Commercial |
$14,215.74
|
Rate for Payer: Humana KY Medicaid |
$5,751.52
|
Rate for Payer: Kentucky WC Medicaid |
$5,810.06
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$13,714.01
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,342.61
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$5,017.32
|
Rate for Payer: Molina Healthcare Medicaid |
$5,866.92
|
Rate for Payer: Ohio Health Choice Commercial |
$14,717.47
|
Rate for Payer: Ohio Health Group HMO |
$12,543.30
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,344.88
|
Rate for Payer: Ohio Health Group PPO No Differential |
$2,174.17
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,184.56
|
Rate for Payer: PHCS Commercial |
$16,055.42
|
Rate for Payer: United Healthcare All Payer |
$14,717.47
|
|
PLATE PROXIMAL LAT HUM 6H R
|
Facility
|
OP
|
$15,054.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,957.02 |
Max. Negotiated Rate |
$14,451.84 |
Rate for Payer: Aetna Commercial |
$11,591.58
|
Rate for Payer: Anthem Medicaid |
$5,177.07
|
Rate for Payer: Anthem POS/PPO/Traditional |
$11,742.12
|
Rate for Payer: Cash Price |
$7,527.00
|
Rate for Payer: Cigna Commercial |
$12,494.82
|
Rate for Payer: First Health Commercial |
$14,301.30
|
Rate for Payer: Humana Commercial |
$12,795.90
|
Rate for Payer: Humana KY Medicaid |
$5,177.07
|
Rate for Payer: Kentucky WC Medicaid |
$5,229.76
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$12,344.28
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,109.85
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,516.20
|
Rate for Payer: Molina Healthcare Medicaid |
$5,280.94
|
Rate for Payer: Ohio Health Choice Commercial |
$13,247.52
|
Rate for Payer: Ohio Health Group HMO |
$11,290.50
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,010.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,957.02
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,666.74
|
Rate for Payer: PHCS Commercial |
$14,451.84
|
Rate for Payer: United Healthcare All Payer |
$13,247.52
|
|
PLATE PROXIMAL LAT HUM 6H R
|
Facility
|
IP
|
$15,054.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,957.02 |
Max. Negotiated Rate |
$14,451.84 |
Rate for Payer: Aetna Commercial |
$11,591.58
|
Rate for Payer: Anthem POS/PPO/Traditional |
$11,742.12
|
Rate for Payer: Cash Price |
$7,527.00
|
Rate for Payer: Cigna Commercial |
$12,494.82
|
Rate for Payer: First Health Commercial |
$14,301.30
|
Rate for Payer: Humana Commercial |
$12,795.90
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$12,344.28
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,109.85
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,516.20
|
Rate for Payer: Ohio Health Choice Commercial |
$13,247.52
|
Rate for Payer: Ohio Health Group HMO |
$11,290.50
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,010.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,957.02
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,666.74
|
Rate for Payer: PHCS Commercial |
$14,451.84
|
Rate for Payer: United Healthcare All Payer |
$13,247.52
|
|
PLATE PROXIMAL LAT HUM 8H L
|
Facility
|
IP
|
$13,680.60
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,778.48 |
Max. Negotiated Rate |
$13,133.38 |
Rate for Payer: Aetna Commercial |
$10,534.06
|
Rate for Payer: Anthem POS/PPO/Traditional |
$10,670.87
|
Rate for Payer: Cash Price |
$6,840.30
|
Rate for Payer: Cigna Commercial |
$11,354.90
|
Rate for Payer: First Health Commercial |
$12,996.57
|
Rate for Payer: Humana Commercial |
$11,628.51
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$11,218.09
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,096.28
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,104.18
|
Rate for Payer: Ohio Health Choice Commercial |
$12,038.93
|
Rate for Payer: Ohio Health Group HMO |
$10,260.45
|
Rate for Payer: Ohio Health Group PPO Differential |
$2,736.12
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,778.48
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,240.99
|
Rate for Payer: PHCS Commercial |
$13,133.38
|
Rate for Payer: United Healthcare All Payer |
$12,038.93
|
|
PLATE PROXIMAL LAT HUM 8H L
|
Facility
|
OP
|
$13,680.60
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,778.48 |
Max. Negotiated Rate |
$13,133.38 |
Rate for Payer: Aetna Commercial |
$10,534.06
|
Rate for Payer: Anthem Medicaid |
$4,704.76
|
Rate for Payer: Anthem POS/PPO/Traditional |
$10,670.87
|
Rate for Payer: Cash Price |
$6,840.30
|
Rate for Payer: Cigna Commercial |
$11,354.90
|
Rate for Payer: First Health Commercial |
$12,996.57
|
Rate for Payer: Humana Commercial |
$11,628.51
|
Rate for Payer: Humana KY Medicaid |
$4,704.76
|
Rate for Payer: Kentucky WC Medicaid |
$4,752.64
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$11,218.09
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,096.28
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,104.18
|
Rate for Payer: Molina Healthcare Medicaid |
$4,799.15
|
Rate for Payer: Ohio Health Choice Commercial |
$12,038.93
|
Rate for Payer: Ohio Health Group HMO |
$10,260.45
|
Rate for Payer: Ohio Health Group PPO Differential |
$2,736.12
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,778.48
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,240.99
|
Rate for Payer: PHCS Commercial |
$13,133.38
|
Rate for Payer: United Healthcare All Payer |
$12,038.93
|
|
PLATE PROXIMAL LAT HUM 8H R
|
Facility
|
OP
|
$15,054.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000005
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,957.02 |
Max. Negotiated Rate |
$14,451.84 |
Rate for Payer: Aetna Commercial |
$11,591.58
|
Rate for Payer: Anthem Medicaid |
$5,177.07
|
Rate for Payer: Anthem POS/PPO/Traditional |
$11,742.12
|
Rate for Payer: Cash Price |
$7,527.00
|
Rate for Payer: Cigna Commercial |
$12,494.82
|
Rate for Payer: First Health Commercial |
$14,301.30
|
Rate for Payer: Humana Commercial |
$12,795.90
|
Rate for Payer: Humana KY Medicaid |
$5,177.07
|
Rate for Payer: Kentucky WC Medicaid |
$5,229.76
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$12,344.28
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,109.85
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$4,516.20
|
Rate for Payer: Molina Healthcare Medicaid |
$5,280.94
|
Rate for Payer: Ohio Health Choice Commercial |
$13,247.52
|
Rate for Payer: Ohio Health Group HMO |
$11,290.50
|
Rate for Payer: Ohio Health Group PPO Differential |
$3,010.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1,957.02
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,666.74
|
Rate for Payer: PHCS Commercial |
$14,451.84
|
Rate for Payer: United Healthcare All Payer |
$13,247.52
|
|