|
PLATE OLECRANON EXT LOCK 13H
|
Facility
|
IP
|
$5,225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,567.50 |
| Max. Negotiated Rate |
$5,016.00 |
| Rate for Payer: Aetna Commercial |
$4,023.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,075.50
|
| Rate for Payer: Cash Price |
$2,612.50
|
| Rate for Payer: Cigna Commercial |
$4,336.75
|
| Rate for Payer: First Health Commercial |
$4,963.75
|
| Rate for Payer: Humana Commercial |
$4,441.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,284.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,856.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,567.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,598.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,918.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,180.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,545.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,605.25
|
| Rate for Payer: PHCS Commercial |
$5,016.00
|
| Rate for Payer: United Healthcare All Payer |
$4,598.00
|
|
|
PLATE OLECRANON LARGE
|
Facility
|
OP
|
$5,352.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,605.75 |
| Max. Negotiated Rate |
$5,138.40 |
| Rate for Payer: Aetna Commercial |
$4,121.43
|
| Rate for Payer: Anthem Medicaid |
$1,840.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,174.95
|
| Rate for Payer: Cash Price |
$2,676.25
|
| Rate for Payer: Cigna Commercial |
$4,442.57
|
| Rate for Payer: First Health Commercial |
$5,084.88
|
| Rate for Payer: Humana Commercial |
$4,549.62
|
| Rate for Payer: Humana KY Medicaid |
$1,840.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,859.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,389.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,950.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,605.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,877.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,710.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,014.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,282.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,656.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,693.22
|
| Rate for Payer: PHCS Commercial |
$5,138.40
|
| Rate for Payer: United Healthcare All Payer |
$4,710.20
|
|
|
PLATE OLECRANON LARGE
|
Facility
|
IP
|
$5,352.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,605.75 |
| Max. Negotiated Rate |
$5,138.40 |
| Rate for Payer: Aetna Commercial |
$4,121.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,174.95
|
| Rate for Payer: Cash Price |
$2,676.25
|
| Rate for Payer: Cigna Commercial |
$4,442.57
|
| Rate for Payer: First Health Commercial |
$5,084.88
|
| Rate for Payer: Humana Commercial |
$4,549.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,389.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,950.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,605.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,710.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,014.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,282.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,656.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,693.22
|
| Rate for Payer: PHCS Commercial |
$5,138.40
|
| Rate for Payer: United Healthcare All Payer |
$4,710.20
|
|
|
PLATE OLECRANON LCK 12H 157M L
|
Facility
|
IP
|
$7,434.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,230.43 |
| Max. Negotiated Rate |
$7,137.36 |
| Rate for Payer: Aetna Commercial |
$5,724.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,799.10
|
| Rate for Payer: Cash Price |
$3,717.38
|
| Rate for Payer: Cigna Commercial |
$6,170.84
|
| Rate for Payer: First Health Commercial |
$7,063.01
|
| Rate for Payer: Humana Commercial |
$6,319.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,096.49
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,486.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,230.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,542.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,576.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,947.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,468.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,129.98
|
| Rate for Payer: PHCS Commercial |
$7,137.36
|
| Rate for Payer: United Healthcare All Payer |
$6,542.58
|
|
|
PLATE OLECRANON LCK 12H 157M L
|
Facility
|
OP
|
$7,434.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,230.43 |
| Max. Negotiated Rate |
$7,137.36 |
| Rate for Payer: Aetna Commercial |
$5,724.76
|
| Rate for Payer: Anthem Medicaid |
$2,556.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,799.10
|
| Rate for Payer: Cash Price |
$3,717.38
|
| Rate for Payer: Cigna Commercial |
$6,170.84
|
| Rate for Payer: First Health Commercial |
$7,063.01
|
| Rate for Payer: Humana Commercial |
$6,319.54
|
| Rate for Payer: Humana KY Medicaid |
$2,556.81
|
| Rate for Payer: Kentucky WC Medicaid |
$2,582.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,096.49
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,486.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,230.43
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,608.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,542.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,576.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,947.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,468.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,129.98
|
| Rate for Payer: PHCS Commercial |
$7,137.36
|
| Rate for Payer: United Healthcare All Payer |
$6,542.58
|
|
|
PLATE OLECRANON LCK 4 56M R
|
Facility
|
IP
|
$7,301.34
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,190.40 |
| Max. Negotiated Rate |
$7,009.29 |
| Rate for Payer: Aetna Commercial |
$5,622.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,695.05
|
| Rate for Payer: Cash Price |
$3,650.67
|
| Rate for Payer: Cigna Commercial |
$6,060.11
|
| Rate for Payer: First Health Commercial |
$6,936.27
|
| Rate for Payer: Humana Commercial |
$6,206.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,987.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,388.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,190.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,425.18
|
| Rate for Payer: Ohio Health Group HMO |
$5,476.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,841.07
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,352.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,037.92
|
| Rate for Payer: PHCS Commercial |
$7,009.29
|
| Rate for Payer: United Healthcare All Payer |
$6,425.18
|
|
|
PLATE OLECRANON LCK 4 56M R
|
Facility
|
OP
|
$7,301.34
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,190.40 |
| Max. Negotiated Rate |
$7,009.29 |
| Rate for Payer: Aetna Commercial |
$5,622.03
|
| Rate for Payer: Anthem Medicaid |
$2,510.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,695.05
|
| Rate for Payer: Cash Price |
$3,650.67
|
| Rate for Payer: Cigna Commercial |
$6,060.11
|
| Rate for Payer: First Health Commercial |
$6,936.27
|
| Rate for Payer: Humana Commercial |
$6,206.14
|
| Rate for Payer: Humana KY Medicaid |
$2,510.93
|
| Rate for Payer: Kentucky WC Medicaid |
$2,536.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,987.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,388.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,190.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,561.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,425.18
|
| Rate for Payer: Ohio Health Group HMO |
$5,476.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,841.07
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,352.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,037.92
|
| Rate for Payer: PHCS Commercial |
$7,009.29
|
| Rate for Payer: United Healthcare All Payer |
$6,425.18
|
|
|
PLATE OLECRANON LCK 8H 107M L
|
Facility
|
IP
|
$8,057.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,417.29 |
| Max. Negotiated Rate |
$7,735.32 |
| Rate for Payer: Aetna Commercial |
$6,204.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,284.94
|
| Rate for Payer: Cash Price |
$4,028.81
|
| Rate for Payer: Cigna Commercial |
$6,687.82
|
| Rate for Payer: First Health Commercial |
$7,654.74
|
| Rate for Payer: Humana Commercial |
$6,848.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,607.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,946.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,417.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,090.71
|
| Rate for Payer: Ohio Health Group HMO |
$6,043.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,446.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,010.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,559.76
|
| Rate for Payer: PHCS Commercial |
$7,735.32
|
| Rate for Payer: United Healthcare All Payer |
$7,090.71
|
|
|
PLATE OLECRANON LCK 8H 107M L
|
Facility
|
OP
|
$8,057.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,417.29 |
| Max. Negotiated Rate |
$7,735.32 |
| Rate for Payer: Aetna Commercial |
$6,204.37
|
| Rate for Payer: Anthem Medicaid |
$2,771.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,284.94
|
| Rate for Payer: Cash Price |
$4,028.81
|
| Rate for Payer: Cigna Commercial |
$6,687.82
|
| Rate for Payer: First Health Commercial |
$7,654.74
|
| Rate for Payer: Humana Commercial |
$6,848.98
|
| Rate for Payer: Humana KY Medicaid |
$2,771.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,799.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,607.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,946.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,417.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,826.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,090.71
|
| Rate for Payer: Ohio Health Group HMO |
$6,043.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,446.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,010.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,559.76
|
| Rate for Payer: PHCS Commercial |
$7,735.32
|
| Rate for Payer: United Healthcare All Payer |
$7,090.71
|
|
|
PLATE OLECRANON LK 10 132MM L
|
Facility
|
OP
|
$8,233.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,469.96 |
| Max. Negotiated Rate |
$7,903.86 |
| Rate for Payer: Aetna Commercial |
$6,339.56
|
| Rate for Payer: Anthem Medicaid |
$2,831.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,421.89
|
| Rate for Payer: Cash Price |
$4,116.59
|
| Rate for Payer: Cigna Commercial |
$6,833.55
|
| Rate for Payer: First Health Commercial |
$7,821.53
|
| Rate for Payer: Humana Commercial |
$6,998.21
|
| Rate for Payer: Humana KY Medicaid |
$2,831.39
|
| Rate for Payer: Kentucky WC Medicaid |
$2,860.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,751.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,076.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,469.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,888.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,245.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,174.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,586.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,162.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,680.90
|
| Rate for Payer: PHCS Commercial |
$7,903.86
|
| Rate for Payer: United Healthcare All Payer |
$7,245.21
|
|
|
PLATE OLECRANON LK 10 132MM L
|
Facility
|
IP
|
$8,233.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,469.96 |
| Max. Negotiated Rate |
$7,903.86 |
| Rate for Payer: Aetna Commercial |
$6,339.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,421.89
|
| Rate for Payer: Cash Price |
$4,116.59
|
| Rate for Payer: Cigna Commercial |
$6,833.55
|
| Rate for Payer: First Health Commercial |
$7,821.53
|
| Rate for Payer: Humana Commercial |
$6,998.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,751.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,076.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,469.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,245.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,174.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,586.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,162.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,680.90
|
| Rate for Payer: PHCS Commercial |
$7,903.86
|
| Rate for Payer: United Healthcare All Payer |
$7,245.21
|
|
|
PLATE OLECRANON LK 10 132MM R
|
Facility
|
IP
|
$8,233.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,469.96 |
| Max. Negotiated Rate |
$7,903.86 |
| Rate for Payer: Aetna Commercial |
$6,339.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,421.89
|
| Rate for Payer: Cash Price |
$4,116.59
|
| Rate for Payer: Cigna Commercial |
$6,833.55
|
| Rate for Payer: First Health Commercial |
$7,821.53
|
| Rate for Payer: Humana Commercial |
$6,998.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,751.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,076.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,469.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,245.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,174.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,586.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,162.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,680.90
|
| Rate for Payer: PHCS Commercial |
$7,903.86
|
| Rate for Payer: United Healthcare All Payer |
$7,245.21
|
|
|
PLATE OLECRANON LK 10 132MM R
|
Facility
|
OP
|
$8,233.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,469.96 |
| Max. Negotiated Rate |
$7,903.86 |
| Rate for Payer: Aetna Commercial |
$6,339.56
|
| Rate for Payer: Anthem Medicaid |
$2,831.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,421.89
|
| Rate for Payer: Cash Price |
$4,116.59
|
| Rate for Payer: Cigna Commercial |
$6,833.55
|
| Rate for Payer: First Health Commercial |
$7,821.53
|
| Rate for Payer: Humana Commercial |
$6,998.21
|
| Rate for Payer: Humana KY Medicaid |
$2,831.39
|
| Rate for Payer: Kentucky WC Medicaid |
$2,860.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,751.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,076.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,469.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,888.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,245.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,174.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,586.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,162.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,680.90
|
| Rate for Payer: PHCS Commercial |
$7,903.86
|
| Rate for Payer: United Healthcare All Payer |
$7,245.21
|
|
|
PLATE OLECRANON LK 12 157MM L
|
Facility
|
IP
|
$8,300.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,490.21 |
| Max. Negotiated Rate |
$7,968.68 |
| Rate for Payer: Aetna Commercial |
$6,391.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,474.55
|
| Rate for Payer: Cash Price |
$4,150.36
|
| Rate for Payer: Cigna Commercial |
$6,889.59
|
| Rate for Payer: First Health Commercial |
$7,885.67
|
| Rate for Payer: Humana Commercial |
$7,055.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,806.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,125.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,490.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,304.62
|
| Rate for Payer: Ohio Health Group HMO |
$6,225.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,640.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,221.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,727.49
|
| Rate for Payer: PHCS Commercial |
$7,968.68
|
| Rate for Payer: United Healthcare All Payer |
$7,304.62
|
|
|
PLATE OLECRANON LK 12 157MM L
|
Facility
|
OP
|
$8,300.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,490.21 |
| Max. Negotiated Rate |
$7,968.68 |
| Rate for Payer: Aetna Commercial |
$6,391.55
|
| Rate for Payer: Anthem Medicaid |
$2,854.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,474.55
|
| Rate for Payer: Cash Price |
$4,150.36
|
| Rate for Payer: Cigna Commercial |
$6,889.59
|
| Rate for Payer: First Health Commercial |
$7,885.67
|
| Rate for Payer: Humana Commercial |
$7,055.60
|
| Rate for Payer: Humana KY Medicaid |
$2,854.61
|
| Rate for Payer: Kentucky WC Medicaid |
$2,883.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,806.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,125.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,490.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,911.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,304.62
|
| Rate for Payer: Ohio Health Group HMO |
$6,225.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,640.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,221.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,727.49
|
| Rate for Payer: PHCS Commercial |
$7,968.68
|
| Rate for Payer: United Healthcare All Payer |
$7,304.62
|
|
|
PLATE OLECRANON LK 12 157MM R
|
Facility
|
OP
|
$8,300.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,490.21 |
| Max. Negotiated Rate |
$7,968.68 |
| Rate for Payer: Aetna Commercial |
$6,391.55
|
| Rate for Payer: Anthem Medicaid |
$2,854.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,474.55
|
| Rate for Payer: Cash Price |
$4,150.36
|
| Rate for Payer: Cigna Commercial |
$6,889.59
|
| Rate for Payer: First Health Commercial |
$7,885.67
|
| Rate for Payer: Humana Commercial |
$7,055.60
|
| Rate for Payer: Humana KY Medicaid |
$2,854.61
|
| Rate for Payer: Kentucky WC Medicaid |
$2,883.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,806.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,125.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,490.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,911.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,304.62
|
| Rate for Payer: Ohio Health Group HMO |
$6,225.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,640.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,221.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,727.49
|
| Rate for Payer: PHCS Commercial |
$7,968.68
|
| Rate for Payer: United Healthcare All Payer |
$7,304.62
|
|
|
PLATE OLECRANON LK 12 157MM R
|
Facility
|
IP
|
$8,300.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,490.21 |
| Max. Negotiated Rate |
$7,968.68 |
| Rate for Payer: Aetna Commercial |
$6,391.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,474.55
|
| Rate for Payer: Cash Price |
$4,150.36
|
| Rate for Payer: Cigna Commercial |
$6,889.59
|
| Rate for Payer: First Health Commercial |
$7,885.67
|
| Rate for Payer: Humana Commercial |
$7,055.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,806.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,125.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,490.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,304.62
|
| Rate for Payer: Ohio Health Group HMO |
$6,225.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,640.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,221.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,727.49
|
| Rate for Payer: PHCS Commercial |
$7,968.68
|
| Rate for Payer: United Healthcare All Payer |
$7,304.62
|
|
|
PLATE OLECRANON LK 12H 157MM L
|
Facility
|
IP
|
$8,300.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,490.21 |
| Max. Negotiated Rate |
$7,968.68 |
| Rate for Payer: Aetna Commercial |
$6,391.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,474.55
|
| Rate for Payer: Cash Price |
$4,150.36
|
| Rate for Payer: Cigna Commercial |
$6,889.59
|
| Rate for Payer: First Health Commercial |
$7,885.67
|
| Rate for Payer: Humana Commercial |
$7,055.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,806.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,125.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,490.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,304.62
|
| Rate for Payer: Ohio Health Group HMO |
$6,225.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,640.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,221.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,727.49
|
| Rate for Payer: PHCS Commercial |
$7,968.68
|
| Rate for Payer: United Healthcare All Payer |
$7,304.62
|
|
|
PLATE OLECRANON LK 12H 157MM L
|
Facility
|
OP
|
$8,300.71
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,490.21 |
| Max. Negotiated Rate |
$7,968.68 |
| Rate for Payer: Aetna Commercial |
$6,391.55
|
| Rate for Payer: Anthem Medicaid |
$2,854.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,474.55
|
| Rate for Payer: Cash Price |
$4,150.36
|
| Rate for Payer: Cigna Commercial |
$6,889.59
|
| Rate for Payer: First Health Commercial |
$7,885.67
|
| Rate for Payer: Humana Commercial |
$7,055.60
|
| Rate for Payer: Humana KY Medicaid |
$2,854.61
|
| Rate for Payer: Kentucky WC Medicaid |
$2,883.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,806.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,125.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,490.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,911.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,304.62
|
| Rate for Payer: Ohio Health Group HMO |
$6,225.53
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,640.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,221.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,727.49
|
| Rate for Payer: PHCS Commercial |
$7,968.68
|
| Rate for Payer: United Healthcare All Payer |
$7,304.62
|
|
|
PLATE OLECRANON LK 4 56MM L
|
Facility
|
IP
|
$7,301.34
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,190.40 |
| Max. Negotiated Rate |
$7,009.29 |
| Rate for Payer: Aetna Commercial |
$5,622.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,695.05
|
| Rate for Payer: Cash Price |
$3,650.67
|
| Rate for Payer: Cigna Commercial |
$6,060.11
|
| Rate for Payer: First Health Commercial |
$6,936.27
|
| Rate for Payer: Humana Commercial |
$6,206.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,987.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,388.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,190.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,425.18
|
| Rate for Payer: Ohio Health Group HMO |
$5,476.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,841.07
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,352.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,037.92
|
| Rate for Payer: PHCS Commercial |
$7,009.29
|
| Rate for Payer: United Healthcare All Payer |
$6,425.18
|
|
|
PLATE OLECRANON LK 4 56MM L
|
Facility
|
OP
|
$7,301.34
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,190.40 |
| Max. Negotiated Rate |
$7,009.29 |
| Rate for Payer: Aetna Commercial |
$5,622.03
|
| Rate for Payer: Anthem Medicaid |
$2,510.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,695.05
|
| Rate for Payer: Cash Price |
$3,650.67
|
| Rate for Payer: Cigna Commercial |
$6,060.11
|
| Rate for Payer: First Health Commercial |
$6,936.27
|
| Rate for Payer: Humana Commercial |
$6,206.14
|
| Rate for Payer: Humana KY Medicaid |
$2,510.93
|
| Rate for Payer: Kentucky WC Medicaid |
$2,536.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,987.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,388.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,190.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,561.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,425.18
|
| Rate for Payer: Ohio Health Group HMO |
$5,476.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,841.07
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,352.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,037.92
|
| Rate for Payer: PHCS Commercial |
$7,009.29
|
| Rate for Payer: United Healthcare All Payer |
$6,425.18
|
|
|
PLATE OLECRANON LK 4H 56MM L
|
Facility
|
OP
|
$7,301.34
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,190.40 |
| Max. Negotiated Rate |
$7,009.29 |
| Rate for Payer: Aetna Commercial |
$5,622.03
|
| Rate for Payer: Anthem Medicaid |
$2,510.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,695.05
|
| Rate for Payer: Cash Price |
$3,650.67
|
| Rate for Payer: Cigna Commercial |
$6,060.11
|
| Rate for Payer: First Health Commercial |
$6,936.27
|
| Rate for Payer: Humana Commercial |
$6,206.14
|
| Rate for Payer: Humana KY Medicaid |
$2,510.93
|
| Rate for Payer: Kentucky WC Medicaid |
$2,536.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,987.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,388.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,190.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,561.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,425.18
|
| Rate for Payer: Ohio Health Group HMO |
$5,476.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,841.07
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,352.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,037.92
|
| Rate for Payer: PHCS Commercial |
$7,009.29
|
| Rate for Payer: United Healthcare All Payer |
$6,425.18
|
|
|
PLATE OLECRANON LK 4H 56MM L
|
Facility
|
IP
|
$7,301.34
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,190.40 |
| Max. Negotiated Rate |
$7,009.29 |
| Rate for Payer: Aetna Commercial |
$5,622.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,695.05
|
| Rate for Payer: Cash Price |
$3,650.67
|
| Rate for Payer: Cigna Commercial |
$6,060.11
|
| Rate for Payer: First Health Commercial |
$6,936.27
|
| Rate for Payer: Humana Commercial |
$6,206.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,987.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,388.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,190.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,425.18
|
| Rate for Payer: Ohio Health Group HMO |
$5,476.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,841.07
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,352.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,037.92
|
| Rate for Payer: PHCS Commercial |
$7,009.29
|
| Rate for Payer: United Healthcare All Payer |
$6,425.18
|
|
|
PLATE OLECRANON LK 6 81MM L
|
Facility
|
IP
|
$8,057.99
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,417.40 |
| Max. Negotiated Rate |
$7,735.67 |
| Rate for Payer: Aetna Commercial |
$6,204.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,285.23
|
| Rate for Payer: Cash Price |
$4,028.99
|
| Rate for Payer: Cigna Commercial |
$6,688.13
|
| Rate for Payer: First Health Commercial |
$7,655.09
|
| Rate for Payer: Humana Commercial |
$6,849.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,607.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,946.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,417.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,091.03
|
| Rate for Payer: Ohio Health Group HMO |
$6,043.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,446.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,010.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,560.01
|
| Rate for Payer: PHCS Commercial |
$7,735.67
|
| Rate for Payer: United Healthcare All Payer |
$7,091.03
|
|
|
PLATE OLECRANON LK 6 81MM L
|
Facility
|
OP
|
$8,057.99
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,417.40 |
| Max. Negotiated Rate |
$7,735.67 |
| Rate for Payer: Aetna Commercial |
$6,204.65
|
| Rate for Payer: Anthem Medicaid |
$2,771.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,285.23
|
| Rate for Payer: Cash Price |
$4,028.99
|
| Rate for Payer: Cigna Commercial |
$6,688.13
|
| Rate for Payer: First Health Commercial |
$7,655.09
|
| Rate for Payer: Humana Commercial |
$6,849.29
|
| Rate for Payer: Humana KY Medicaid |
$2,771.14
|
| Rate for Payer: Kentucky WC Medicaid |
$2,799.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,607.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,946.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,417.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,826.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,091.03
|
| Rate for Payer: Ohio Health Group HMO |
$6,043.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,446.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,010.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,560.01
|
| Rate for Payer: PHCS Commercial |
$7,735.67
|
| Rate for Payer: United Healthcare All Payer |
$7,091.03
|
|
