|
PLATE TW 4H 85MM
|
Facility
|
IP
|
$1,839.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$551.88 |
| Max. Negotiated Rate |
$1,766.02 |
| Rate for Payer: Aetna Commercial |
$1,416.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,434.89
|
| Rate for Payer: Cash Price |
$919.80
|
| Rate for Payer: Cigna Commercial |
$1,526.87
|
| Rate for Payer: First Health Commercial |
$1,747.62
|
| Rate for Payer: Humana Commercial |
$1,563.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,508.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,357.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$551.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,618.85
|
| Rate for Payer: Ohio Health Group HMO |
$1,379.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,600.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,269.32
|
| Rate for Payer: PHCS Commercial |
$1,766.02
|
| Rate for Payer: United Healthcare All Payer |
$1,618.85
|
|
|
PLATE T W/PF HOLES 4H
|
Facility
|
OP
|
$1,853.09
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.93 |
| Max. Negotiated Rate |
$1,778.97 |
| Rate for Payer: Aetna Commercial |
$1,426.88
|
| Rate for Payer: Anthem Medicaid |
$637.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,445.41
|
| Rate for Payer: Cash Price |
$926.54
|
| Rate for Payer: Cigna Commercial |
$1,538.06
|
| Rate for Payer: First Health Commercial |
$1,760.44
|
| Rate for Payer: Humana Commercial |
$1,575.13
|
| Rate for Payer: Humana KY Medicaid |
$637.28
|
| Rate for Payer: Kentucky WC Medicaid |
$643.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,519.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,367.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$650.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,630.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,389.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,482.47
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,612.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,278.63
|
| Rate for Payer: PHCS Commercial |
$1,778.97
|
| Rate for Payer: United Healthcare All Payer |
$1,630.72
|
|
|
PLATE T W/PF HOLES 4H
|
Facility
|
IP
|
$1,853.09
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.93 |
| Max. Negotiated Rate |
$1,778.97 |
| Rate for Payer: Aetna Commercial |
$1,426.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,445.41
|
| Rate for Payer: Cash Price |
$926.54
|
| Rate for Payer: Cigna Commercial |
$1,538.06
|
| Rate for Payer: First Health Commercial |
$1,760.44
|
| Rate for Payer: Humana Commercial |
$1,575.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,519.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,367.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,630.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,389.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,482.47
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,612.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,278.63
|
| Rate for Payer: PHCS Commercial |
$1,778.97
|
| Rate for Payer: United Healthcare All Payer |
$1,630.72
|
|
|
PLATE T W/PF HOLES 6H
|
Facility
|
IP
|
$1,915.41
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$574.62 |
| Max. Negotiated Rate |
$1,838.79 |
| Rate for Payer: Aetna Commercial |
$1,474.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,494.02
|
| Rate for Payer: Cash Price |
$957.70
|
| Rate for Payer: Cigna Commercial |
$1,589.79
|
| Rate for Payer: First Health Commercial |
$1,819.64
|
| Rate for Payer: Humana Commercial |
$1,628.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,570.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,413.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$574.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,685.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,436.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,532.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,666.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,321.63
|
| Rate for Payer: PHCS Commercial |
$1,838.79
|
| Rate for Payer: United Healthcare All Payer |
$1,685.56
|
|
|
PLATE T W/PF HOLES 6H
|
Facility
|
OP
|
$1,915.41
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$574.62 |
| Max. Negotiated Rate |
$1,838.79 |
| Rate for Payer: Aetna Commercial |
$1,474.87
|
| Rate for Payer: Anthem Medicaid |
$658.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,494.02
|
| Rate for Payer: Cash Price |
$957.70
|
| Rate for Payer: Cigna Commercial |
$1,589.79
|
| Rate for Payer: First Health Commercial |
$1,819.64
|
| Rate for Payer: Humana Commercial |
$1,628.10
|
| Rate for Payer: Humana KY Medicaid |
$658.71
|
| Rate for Payer: Kentucky WC Medicaid |
$665.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,570.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,413.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$574.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$671.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,685.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,436.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,532.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,666.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,321.63
|
| Rate for Payer: PHCS Commercial |
$1,838.79
|
| Rate for Payer: United Healthcare All Payer |
$1,685.56
|
|
|
PLATE T W/PF HOLES 8H
|
Facility
|
OP
|
$3,806.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,141.97 |
| Max. Negotiated Rate |
$3,654.30 |
| Rate for Payer: Aetna Commercial |
$2,931.05
|
| Rate for Payer: Anthem Medicaid |
$1,309.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,969.12
|
| Rate for Payer: Cash Price |
$1,903.28
|
| Rate for Payer: Cigna Commercial |
$3,159.44
|
| Rate for Payer: First Health Commercial |
$3,616.23
|
| Rate for Payer: Humana Commercial |
$3,235.58
|
| Rate for Payer: Humana KY Medicaid |
$1,309.08
|
| Rate for Payer: Kentucky WC Medicaid |
$1,322.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,121.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,809.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,141.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,335.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,349.77
|
| Rate for Payer: Ohio Health Group HMO |
$2,854.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,045.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,311.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,626.53
|
| Rate for Payer: PHCS Commercial |
$3,654.30
|
| Rate for Payer: United Healthcare All Payer |
$3,349.77
|
|
|
PLATE T W/PF HOLES 8H
|
Facility
|
IP
|
$3,806.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,141.97 |
| Max. Negotiated Rate |
$3,654.30 |
| Rate for Payer: Aetna Commercial |
$2,931.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,969.12
|
| Rate for Payer: Cash Price |
$1,903.28
|
| Rate for Payer: Cigna Commercial |
$3,159.44
|
| Rate for Payer: First Health Commercial |
$3,616.23
|
| Rate for Payer: Humana Commercial |
$3,235.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,121.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,809.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,141.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,349.77
|
| Rate for Payer: Ohio Health Group HMO |
$2,854.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,045.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,311.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,626.53
|
| Rate for Payer: PHCS Commercial |
$3,654.30
|
| Rate for Payer: United Healthcare All Payer |
$3,349.77
|
|
|
PLATE ULNA MIDSAFT 14H
|
Facility
|
OP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem Medicaid |
$1,604.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Humana KY Medicaid |
$1,604.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,621.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,636.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSAFT 14H
|
Facility
|
IP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSAFT 16H
|
Facility
|
OP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem Medicaid |
$1,604.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Humana KY Medicaid |
$1,604.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,621.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,636.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSAFT 16H
|
Facility
|
IP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 10H
|
Facility
|
OP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem Medicaid |
$1,604.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Humana KY Medicaid |
$1,604.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,621.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,636.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 10H
|
Facility
|
IP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 12H
|
Facility
|
IP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 12H
|
Facility
|
OP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem Medicaid |
$1,604.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Humana KY Medicaid |
$1,604.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,621.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,636.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 6H
|
Facility
|
OP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem Medicaid |
$1,604.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Humana KY Medicaid |
$1,604.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,621.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,636.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 6H
|
Facility
|
IP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 8H
|
Facility
|
IP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNA MIDSHAFT 8H
|
Facility
|
OP
|
$4,666.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,399.88 |
| Max. Negotiated Rate |
$4,479.60 |
| Rate for Payer: Aetna Commercial |
$3,593.01
|
| Rate for Payer: Anthem Medicaid |
$1,604.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,639.68
|
| Rate for Payer: Cash Price |
$2,333.12
|
| Rate for Payer: Cigna Commercial |
$3,872.99
|
| Rate for Payer: First Health Commercial |
$4,432.94
|
| Rate for Payer: Humana Commercial |
$3,966.31
|
| Rate for Payer: Humana KY Medicaid |
$1,604.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,621.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,826.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,443.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,399.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,636.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,106.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,499.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,733.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,059.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,219.71
|
| Rate for Payer: PHCS Commercial |
$4,479.60
|
| Rate for Payer: United Healthcare All Payer |
$4,106.30
|
|
|
PLATE ULNAR COL SMARTLCK SHT L
|
Facility
|
IP
|
$3,935.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,180.55 |
| Max. Negotiated Rate |
$3,777.74 |
| Rate for Payer: Aetna Commercial |
$3,030.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,069.42
|
| Rate for Payer: Cash Price |
$1,967.58
|
| Rate for Payer: Cigna Commercial |
$3,266.17
|
| Rate for Payer: First Health Commercial |
$3,738.39
|
| Rate for Payer: Humana Commercial |
$3,344.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,226.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,904.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,180.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,462.93
|
| Rate for Payer: Ohio Health Group HMO |
$2,951.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,148.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,423.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,715.25
|
| Rate for Payer: PHCS Commercial |
$3,777.74
|
| Rate for Payer: United Healthcare All Payer |
$3,462.93
|
|
|
PLATE ULNAR COL SMARTLCK SHT L
|
Facility
|
OP
|
$3,935.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,180.55 |
| Max. Negotiated Rate |
$3,777.74 |
| Rate for Payer: Aetna Commercial |
$3,030.07
|
| Rate for Payer: Anthem Medicaid |
$1,353.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,069.42
|
| Rate for Payer: Cash Price |
$1,967.58
|
| Rate for Payer: Cigna Commercial |
$3,266.17
|
| Rate for Payer: First Health Commercial |
$3,738.39
|
| Rate for Payer: Humana Commercial |
$3,344.88
|
| Rate for Payer: Humana KY Medicaid |
$1,353.30
|
| Rate for Payer: Kentucky WC Medicaid |
$1,367.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,226.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,904.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,180.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,380.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,462.93
|
| Rate for Payer: Ohio Health Group HMO |
$2,951.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,148.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,423.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,715.25
|
| Rate for Payer: PHCS Commercial |
$3,777.74
|
| Rate for Payer: United Healthcare All Payer |
$3,462.93
|
|
|
PLATE ULNAR COL SMARTLCK SHT R
|
Facility
|
OP
|
$4,141.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,242.38 |
| Max. Negotiated Rate |
$3,975.60 |
| Rate for Payer: Aetna Commercial |
$3,188.76
|
| Rate for Payer: Anthem Medicaid |
$1,424.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,230.18
|
| Rate for Payer: Cash Price |
$2,070.62
|
| Rate for Payer: Cigna Commercial |
$3,437.24
|
| Rate for Payer: First Health Commercial |
$3,934.19
|
| Rate for Payer: Humana Commercial |
$3,520.06
|
| Rate for Payer: Humana KY Medicaid |
$1,424.18
|
| Rate for Payer: Kentucky WC Medicaid |
$1,438.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,395.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,056.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,242.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,452.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,644.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,105.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,313.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,602.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,857.46
|
| Rate for Payer: PHCS Commercial |
$3,975.60
|
| Rate for Payer: United Healthcare All Payer |
$3,644.30
|
|
|
PLATE ULNAR COL SMARTLCK SHT R
|
Facility
|
IP
|
$4,141.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,242.38 |
| Max. Negotiated Rate |
$3,975.60 |
| Rate for Payer: Aetna Commercial |
$3,188.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,230.18
|
| Rate for Payer: Cash Price |
$2,070.62
|
| Rate for Payer: Cigna Commercial |
$3,437.24
|
| Rate for Payer: First Health Commercial |
$3,934.19
|
| Rate for Payer: Humana Commercial |
$3,520.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,395.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,056.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,242.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,644.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,105.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,313.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,602.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,857.46
|
| Rate for Payer: PHCS Commercial |
$3,975.60
|
| Rate for Payer: United Healthcare All Payer |
$3,644.30
|
|
|
PLATE UNIV 5TH METARSAL HOOK
|
Facility
|
IP
|
$5,468.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,640.62 |
| Max. Negotiated Rate |
$5,250.00 |
| Rate for Payer: Aetna Commercial |
$4,210.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,265.62
|
| Rate for Payer: Cash Price |
$2,734.38
|
| Rate for Payer: Cigna Commercial |
$4,539.06
|
| Rate for Payer: First Health Commercial |
$5,195.31
|
| Rate for Payer: Humana Commercial |
$4,648.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,484.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,035.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,640.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,812.50
|
| Rate for Payer: Ohio Health Group HMO |
$4,101.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,375.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,757.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,773.44
|
| Rate for Payer: PHCS Commercial |
$5,250.00
|
| Rate for Payer: United Healthcare All Payer |
$4,812.50
|
|
|
PLATE UNIV 5TH METARSAL HOOK
|
Facility
|
OP
|
$5,468.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,640.62 |
| Max. Negotiated Rate |
$5,250.00 |
| Rate for Payer: Aetna Commercial |
$4,210.94
|
| Rate for Payer: Anthem Medicaid |
$1,880.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,265.62
|
| Rate for Payer: Cash Price |
$2,734.38
|
| Rate for Payer: Cigna Commercial |
$4,539.06
|
| Rate for Payer: First Health Commercial |
$5,195.31
|
| Rate for Payer: Humana Commercial |
$4,648.44
|
| Rate for Payer: Humana KY Medicaid |
$1,880.70
|
| Rate for Payer: Kentucky WC Medicaid |
$1,899.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,484.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,035.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,640.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,918.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,812.50
|
| Rate for Payer: Ohio Health Group HMO |
$4,101.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,375.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,757.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,773.44
|
| Rate for Payer: PHCS Commercial |
$5,250.00
|
| Rate for Payer: United Healthcare All Payer |
$4,812.50
|
|
