|
PLATE PROXIMAL LAT HUM 8H 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 PROX LAT HUM TS 3H L
|
Facility
|
IP
|
$9,078.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,180.14 |
| Max. Negotiated Rate |
$8,714.88 |
| Rate for Payer: Aetna Commercial |
$6,990.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,080.84
|
| Rate for Payer: Cash Price |
$4,539.00
|
| Rate for Payer: Cigna Commercial |
$7,534.74
|
| Rate for Payer: First Health Commercial |
$8,624.10
|
| Rate for Payer: Humana Commercial |
$7,716.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,443.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,699.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,723.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,988.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,808.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,815.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,180.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,814.18
|
| Rate for Payer: PHCS Commercial |
$8,714.88
|
| Rate for Payer: United Healthcare All Payer |
$7,988.64
|
|
|
PLATE PROX LAT HUM TS 3H L
|
Facility
|
OP
|
$9,078.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,180.14 |
| Max. Negotiated Rate |
$8,714.88 |
| Rate for Payer: Aetna Commercial |
$6,990.06
|
| Rate for Payer: Anthem Medicaid |
$3,121.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,080.84
|
| Rate for Payer: Cash Price |
$4,539.00
|
| Rate for Payer: Cigna Commercial |
$7,534.74
|
| Rate for Payer: First Health Commercial |
$8,624.10
|
| Rate for Payer: Humana Commercial |
$7,716.30
|
| Rate for Payer: Humana KY Medicaid |
$3,121.92
|
| Rate for Payer: Kentucky WC Medicaid |
$3,153.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,443.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,699.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,723.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,184.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,988.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,808.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,815.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,180.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,814.18
|
| Rate for Payer: PHCS Commercial |
$8,714.88
|
| Rate for Payer: United Healthcare All Payer |
$7,988.64
|
|
|
PLATE PROX LAT HUM TS 3H R
|
Facility
|
IP
|
$13,877.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,804.10 |
| Max. Negotiated Rate |
$13,322.59 |
| Rate for Payer: Aetna Commercial |
$10,685.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,824.61
|
| Rate for Payer: Cash Price |
$6,938.85
|
| Rate for Payer: Cigna Commercial |
$11,518.49
|
| Rate for Payer: First Health Commercial |
$13,183.82
|
| Rate for Payer: Humana Commercial |
$11,796.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,379.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,241.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,163.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,212.38
|
| Rate for Payer: Ohio Health Group HMO |
$10,408.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,775.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,804.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,302.09
|
| Rate for Payer: PHCS Commercial |
$13,322.59
|
| Rate for Payer: United Healthcare All Payer |
$12,212.38
|
|
|
PLATE PROX LAT HUM TS 3H R
|
Facility
|
OP
|
$13,877.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,804.10 |
| Max. Negotiated Rate |
$13,322.59 |
| Rate for Payer: Aetna Commercial |
$10,685.83
|
| Rate for Payer: Anthem Medicaid |
$4,772.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,824.61
|
| Rate for Payer: Cash Price |
$6,938.85
|
| Rate for Payer: Cigna Commercial |
$11,518.49
|
| Rate for Payer: First Health Commercial |
$13,183.82
|
| Rate for Payer: Humana Commercial |
$11,796.04
|
| Rate for Payer: Humana KY Medicaid |
$4,772.54
|
| Rate for Payer: Kentucky WC Medicaid |
$4,821.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,379.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,241.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,163.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,868.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,212.38
|
| Rate for Payer: Ohio Health Group HMO |
$10,408.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,775.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,804.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,302.09
|
| Rate for Payer: PHCS Commercial |
$13,322.59
|
| Rate for Payer: United Healthcare All Payer |
$12,212.38
|
|
|
PLATE PROX LAT HUM TS 5H L
|
Facility
|
IP
|
$13,881.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,804.58 |
| Max. Negotiated Rate |
$13,326.10 |
| Rate for Payer: Aetna Commercial |
$10,688.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,827.45
|
| Rate for Payer: Cash Price |
$6,940.68
|
| Rate for Payer: Cigna Commercial |
$11,521.52
|
| Rate for Payer: First Health Commercial |
$13,187.28
|
| Rate for Payer: Humana Commercial |
$11,799.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,382.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,244.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,164.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,215.59
|
| Rate for Payer: Ohio Health Group HMO |
$10,411.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,776.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,804.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,303.22
|
| Rate for Payer: PHCS Commercial |
$13,326.10
|
| Rate for Payer: United Healthcare All Payer |
$12,215.59
|
|
|
PLATE PROX LAT HUM TS 5H L
|
Facility
|
OP
|
$13,881.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,804.58 |
| Max. Negotiated Rate |
$13,326.10 |
| Rate for Payer: Aetna Commercial |
$10,688.64
|
| Rate for Payer: Anthem Medicaid |
$4,773.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,827.45
|
| Rate for Payer: Cash Price |
$6,940.68
|
| Rate for Payer: Cigna Commercial |
$11,521.52
|
| Rate for Payer: First Health Commercial |
$13,187.28
|
| Rate for Payer: Humana Commercial |
$11,799.15
|
| Rate for Payer: Humana KY Medicaid |
$4,773.80
|
| Rate for Payer: Kentucky WC Medicaid |
$4,822.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,382.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,244.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,164.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,869.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,215.59
|
| Rate for Payer: Ohio Health Group HMO |
$10,411.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,776.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,804.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,303.22
|
| Rate for Payer: PHCS Commercial |
$13,326.10
|
| Rate for Payer: United Healthcare All Payer |
$12,215.59
|
|
|
PLATE PROX LAT HUM TS 5H R
|
Facility
|
OP
|
$5,344.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$694.77 |
| Max. Negotiated Rate |
$5,130.62 |
| Rate for Payer: Aetna Commercial |
$4,115.19
|
| Rate for Payer: Anthem Medicaid |
$1,837.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,168.63
|
| Rate for Payer: Cash Price |
$2,672.20
|
| Rate for Payer: Cigna Commercial |
$4,435.85
|
| Rate for Payer: First Health Commercial |
$5,077.18
|
| Rate for Payer: Humana Commercial |
$4,542.74
|
| Rate for Payer: Humana KY Medicaid |
$1,837.94
|
| Rate for Payer: Kentucky WC Medicaid |
$1,856.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,382.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,944.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,603.32
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,874.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,703.07
|
| Rate for Payer: Ohio Health Group HMO |
$4,008.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,068.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$694.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,656.76
|
| Rate for Payer: PHCS Commercial |
$5,130.62
|
| Rate for Payer: United Healthcare All Payer |
$4,703.07
|
|
|
PLATE PROX LAT HUM TS 5H R
|
Facility
|
IP
|
$5,344.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$694.77 |
| Max. Negotiated Rate |
$5,130.62 |
| Rate for Payer: Aetna Commercial |
$4,115.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,168.63
|
| Rate for Payer: Cash Price |
$2,672.20
|
| Rate for Payer: Cigna Commercial |
$4,435.85
|
| Rate for Payer: First Health Commercial |
$5,077.18
|
| Rate for Payer: Humana Commercial |
$4,542.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,382.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,944.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,603.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,703.07
|
| Rate for Payer: Ohio Health Group HMO |
$4,008.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,068.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$694.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,656.76
|
| Rate for Payer: PHCS Commercial |
$5,130.62
|
| Rate for Payer: United Healthcare All Payer |
$4,703.07
|
|
|
PLATE PROX LAT HUM TS 8H L
|
Facility
|
OP
|
$13,881.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,804.58 |
| Max. Negotiated Rate |
$13,326.10 |
| Rate for Payer: Humana Commercial |
$11,799.15
|
| Rate for Payer: Humana KY Medicaid |
$4,773.80
|
| Rate for Payer: Kentucky WC Medicaid |
$4,822.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,382.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,244.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,164.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,869.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,215.59
|
| Rate for Payer: Ohio Health Group HMO |
$10,411.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,776.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,804.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,303.22
|
| Rate for Payer: PHCS Commercial |
$13,326.10
|
| Rate for Payer: United Healthcare All Payer |
$12,215.59
|
| Rate for Payer: Aetna Commercial |
$10,688.64
|
| Rate for Payer: Anthem Medicaid |
$4,773.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,827.45
|
| Rate for Payer: Cash Price |
$6,940.68
|
| Rate for Payer: Cigna Commercial |
$11,521.52
|
| Rate for Payer: First Health Commercial |
$13,187.28
|
|
|
PLATE PROX LAT HUM TS 8H L
|
Facility
|
IP
|
$13,881.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,804.58 |
| Max. Negotiated Rate |
$13,326.10 |
| Rate for Payer: Aetna Commercial |
$10,688.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,827.45
|
| Rate for Payer: Cash Price |
$6,940.68
|
| Rate for Payer: Cigna Commercial |
$11,521.52
|
| Rate for Payer: First Health Commercial |
$13,187.28
|
| Rate for Payer: Humana Commercial |
$11,799.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,382.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,244.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,164.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,215.59
|
| Rate for Payer: Ohio Health Group HMO |
$10,411.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,776.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,804.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,303.22
|
| Rate for Payer: PHCS Commercial |
$13,326.10
|
| Rate for Payer: United Healthcare All Payer |
$12,215.59
|
|
|
PLATE PROX LAT HUM TS 8H R
|
Facility
|
IP
|
$11,765.08
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,529.46 |
| Max. Negotiated Rate |
$11,294.48 |
| Rate for Payer: Aetna Commercial |
$9,059.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,176.76
|
| Rate for Payer: Cash Price |
$5,882.54
|
| Rate for Payer: Cigna Commercial |
$9,765.02
|
| Rate for Payer: First Health Commercial |
$11,176.83
|
| Rate for Payer: Humana Commercial |
$10,000.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,647.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,682.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,529.52
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,353.27
|
| Rate for Payer: Ohio Health Group HMO |
$8,823.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,353.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,529.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,647.17
|
| Rate for Payer: PHCS Commercial |
$11,294.48
|
| Rate for Payer: United Healthcare All Payer |
$10,353.27
|
|
|
PLATE PROX LAT HUM TS 8H R
|
Facility
|
OP
|
$11,765.08
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,529.46 |
| Max. Negotiated Rate |
$11,294.48 |
| Rate for Payer: Aetna Commercial |
$9,059.11
|
| Rate for Payer: Anthem Medicaid |
$4,046.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,176.76
|
| Rate for Payer: Cash Price |
$5,882.54
|
| Rate for Payer: Cigna Commercial |
$9,765.02
|
| Rate for Payer: First Health Commercial |
$11,176.83
|
| Rate for Payer: Humana Commercial |
$10,000.32
|
| Rate for Payer: Humana KY Medicaid |
$4,046.01
|
| Rate for Payer: Kentucky WC Medicaid |
$4,087.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,647.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,682.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,529.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,127.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,353.27
|
| Rate for Payer: Ohio Health Group HMO |
$8,823.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,353.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,529.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,647.17
|
| Rate for Payer: PHCS Commercial |
$11,294.48
|
| Rate for Payer: United Healthcare All Payer |
$10,353.27
|
|
|
PLATE PROX LAT TIBIA 10H L
|
Facility
|
IP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 10H L
|
Facility
|
OP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem Medicaid |
$4,778.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Humana KY Medicaid |
$4,778.82
|
| Rate for Payer: Kentucky WC Medicaid |
$4,827.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,874.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 10H R
|
Facility
|
OP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem Medicaid |
$4,778.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Humana KY Medicaid |
$4,778.82
|
| Rate for Payer: Kentucky WC Medicaid |
$4,827.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,874.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 10H R
|
Facility
|
IP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 12H L
|
Facility
|
IP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 12H L
|
Facility
|
OP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem Medicaid |
$4,778.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Humana KY Medicaid |
$4,778.82
|
| Rate for Payer: Kentucky WC Medicaid |
$4,827.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,874.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 12H R
|
Facility
|
OP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem Medicaid |
$4,778.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Humana KY Medicaid |
$4,778.82
|
| Rate for Payer: Kentucky WC Medicaid |
$4,827.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,874.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 12H R
|
Facility
|
IP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 14H L
|
Facility
|
IP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 14H L
|
Facility
|
OP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem Medicaid |
$4,778.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Humana KY Medicaid |
$4,778.82
|
| Rate for Payer: Kentucky WC Medicaid |
$4,827.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,874.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 14H R
|
Facility
|
IP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
|
PLATE PROX LAT TIBIA 14H R
|
Facility
|
OP
|
$13,895.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,806.47 |
| Max. Negotiated Rate |
$13,340.11 |
| Rate for Payer: Aetna Commercial |
$10,699.88
|
| Rate for Payer: Anthem Medicaid |
$4,778.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,838.84
|
| Rate for Payer: Cash Price |
$6,947.98
|
| Rate for Payer: Cigna Commercial |
$11,533.64
|
| Rate for Payer: First Health Commercial |
$13,201.15
|
| Rate for Payer: Humana Commercial |
$11,811.56
|
| Rate for Payer: Humana KY Medicaid |
$4,778.82
|
| Rate for Payer: Kentucky WC Medicaid |
$4,827.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,394.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,255.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,168.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,874.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,228.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,421.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,779.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,806.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,307.74
|
| Rate for Payer: PHCS Commercial |
$13,340.11
|
| Rate for Payer: United Healthcare All Payer |
$12,228.44
|
|
