|
RCS COCR CABLE/SWAGE 1.6
|
Facility
|
IP
|
$3,265.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$979.63 |
| Max. Negotiated Rate |
$3,134.82 |
| Rate for Payer: Aetna Commercial |
$2,514.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,547.04
|
| Rate for Payer: Cash Price |
$1,632.72
|
| Rate for Payer: Cigna Commercial |
$2,710.32
|
| Rate for Payer: First Health Commercial |
$3,102.17
|
| Rate for Payer: Humana Commercial |
$2,775.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,677.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,409.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$979.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,873.59
|
| Rate for Payer: Ohio Health Group HMO |
$2,449.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,612.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,840.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,253.15
|
| Rate for Payer: PHCS Commercial |
$3,134.82
|
| Rate for Payer: United Healthcare All Payer |
$2,873.59
|
|
|
READI-CAT 2 450ML
|
Facility
|
OP
|
$12.04
|
|
|
Service Code
|
NDC 32909071103
|
| Hospital Charge Code |
25003925
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$11.56 |
| Rate for Payer: Aetna Commercial |
$9.27
|
| Rate for Payer: Anthem Medicaid |
$4.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9.39
|
| Rate for Payer: Cash Price |
$6.02
|
| Rate for Payer: Cigna Commercial |
$9.99
|
| Rate for Payer: First Health Commercial |
$11.44
|
| Rate for Payer: Humana Commercial |
$10.23
|
| Rate for Payer: Humana KY Medicaid |
$4.14
|
| Rate for Payer: Kentucky WC Medicaid |
$4.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$4.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$10.60
|
| Rate for Payer: Ohio Health Group HMO |
$9.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8.31
|
| Rate for Payer: PHCS Commercial |
$11.56
|
| Rate for Payer: United Healthcare All Payer |
$10.60
|
|
|
READI-CAT 2 450ML
|
Facility
|
IP
|
$12.04
|
|
|
Service Code
|
NDC 32909071103
|
| Hospital Charge Code |
25003925
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$11.56 |
| Rate for Payer: Aetna Commercial |
$9.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9.39
|
| Rate for Payer: Cash Price |
$6.02
|
| Rate for Payer: Cigna Commercial |
$9.99
|
| Rate for Payer: First Health Commercial |
$11.44
|
| Rate for Payer: Humana Commercial |
$10.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$10.60
|
| Rate for Payer: Ohio Health Group HMO |
$9.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8.31
|
| Rate for Payer: PHCS Commercial |
$11.56
|
| Rate for Payer: United Healthcare All Payer |
$10.60
|
|
|
REALIGNMENT OF LOWER LEG
|
Facility
|
OP
|
$2,500.00
|
|
|
Service Code
|
HCPCS 27712
|
| Hospital Charge Code |
76100919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$1,925.00
|
| Rate for Payer: Anthem Medicaid |
$859.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,950.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,075.00
|
| Rate for Payer: First Health Commercial |
$2,375.00
|
| Rate for Payer: Humana Commercial |
$2,125.00
|
| Rate for Payer: Humana KY Medicaid |
$859.75
|
| Rate for Payer: Kentucky WC Medicaid |
$868.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,050.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,845.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$750.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$877.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,875.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,175.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,725.00
|
| Rate for Payer: PHCS Commercial |
$2,400.00
|
| Rate for Payer: United Healthcare All Payer |
$2,200.00
|
|
|
REALIGNMENT OF LOWER LEG
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 27712
|
| Hospital Charge Code |
76100919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$680.93 |
| Max. Negotiated Rate |
$1,745.06 |
| Rate for Payer: Aetna Commercial |
$1,628.11
|
| Rate for Payer: Ambetter Exchange |
$1,048.25
|
| Rate for Payer: Anthem Medicaid |
$680.93
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,048.25
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,048.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,257.90
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$1,745.06
|
| Rate for Payer: Healthspan PPO |
$1,474.72
|
| Rate for Payer: Humana Medicaid |
$680.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,378.55
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,048.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,048.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$694.55
|
| Rate for Payer: Molina Healthcare Passport |
$680.93
|
| Rate for Payer: Multiplan PHCS |
$1,500.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,362.72
|
| Rate for Payer: UHCCP Medicaid |
$875.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$687.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,048.25
|
|
|
REALIGNMENT OF LOWER LEG
|
Facility
|
IP
|
$2,500.00
|
|
|
Service Code
|
HCPCS 27712
|
| Hospital Charge Code |
76100919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$1,925.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,950.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,075.00
|
| Rate for Payer: First Health Commercial |
$2,375.00
|
| Rate for Payer: Humana Commercial |
$2,125.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,050.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,845.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$750.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,875.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,175.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,725.00
|
| Rate for Payer: PHCS Commercial |
$2,400.00
|
| Rate for Payer: United Healthcare All Payer |
$2,200.00
|
|
|
REALIGNMENT OF LOWER LEG(P
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 27712
|
| Hospital Charge Code |
761P0919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$680.93 |
| Max. Negotiated Rate |
$1,745.06 |
| Rate for Payer: Aetna Commercial |
$1,628.11
|
| Rate for Payer: Ambetter Exchange |
$1,048.25
|
| Rate for Payer: Anthem Medicaid |
$680.93
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,048.25
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,048.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,257.90
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$1,745.06
|
| Rate for Payer: Healthspan PPO |
$1,474.72
|
| Rate for Payer: Humana Medicaid |
$680.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,378.55
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,048.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,048.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$694.55
|
| Rate for Payer: Molina Healthcare Passport |
$680.93
|
| Rate for Payer: Multiplan PHCS |
$1,500.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,362.72
|
| Rate for Payer: UHCCP Medicaid |
$875.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$687.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,048.25
|
|
|
REALIGNMENT OF TENDONS
|
Facility
|
OP
|
$1,190.00
|
|
|
Service Code
|
HCPCS 26437
|
| Hospital Charge Code |
76100699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$409.24 |
| Max. Negotiated Rate |
$4,197.13 |
| Rate for Payer: Aetna Commercial |
$916.30
|
| Rate for Payer: Anthem Medicaid |
$409.24
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,997.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$928.20
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,197.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,047.23
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cigna Commercial |
$987.70
|
| Rate for Payer: First Health Commercial |
$1,130.50
|
| Rate for Payer: Humana Commercial |
$1,011.50
|
| Rate for Payer: Humana KY Medicaid |
$409.24
|
| Rate for Payer: Humana Medicare Advantage |
$2,997.95
|
| Rate for Payer: Kentucky WC Medicaid |
$413.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$975.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$878.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,597.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$417.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,047.20
|
| Rate for Payer: Ohio Health Group HMO |
$892.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$952.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,035.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$821.10
|
| Rate for Payer: PHCS Commercial |
$1,142.40
|
| Rate for Payer: United Healthcare All Payer |
$1,047.20
|
|
|
REALIGNMENT OF TENDONS
|
Facility
|
IP
|
$1,190.00
|
|
|
Service Code
|
HCPCS 26437
|
| Hospital Charge Code |
76100699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$1,142.40 |
| Rate for Payer: Aetna Commercial |
$916.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$928.20
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cigna Commercial |
$987.70
|
| Rate for Payer: First Health Commercial |
$1,130.50
|
| Rate for Payer: Humana Commercial |
$1,011.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$975.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$878.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$357.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,047.20
|
| Rate for Payer: Ohio Health Group HMO |
$892.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$952.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,035.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$821.10
|
| Rate for Payer: PHCS Commercial |
$1,142.40
|
| Rate for Payer: United Healthcare All Payer |
$1,047.20
|
|
|
REALIGNMENT OF TENDONS
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 26437
|
| Hospital Charge Code |
76100699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$287.42 |
| Max. Negotiated Rate |
$1,071.46 |
| Rate for Payer: Aetna Commercial |
$871.10
|
| Rate for Payer: Ambetter Exchange |
$617.83
|
| Rate for Payer: Anthem Medicaid |
$287.42
|
| Rate for Payer: Buckeye Individual/Medicaid |
$617.83
|
| Rate for Payer: Buckeye Medicare Advantage |
$617.83
|
| Rate for Payer: CareSource Just4Me Medicare |
$741.40
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cigna Commercial |
$1,071.46
|
| Rate for Payer: Healthspan PPO |
$789.03
|
| Rate for Payer: Humana Medicaid |
$287.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$748.14
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$617.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$617.83
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$293.17
|
| Rate for Payer: Molina Healthcare Passport |
$287.42
|
| Rate for Payer: Multiplan PHCS |
$714.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$803.18
|
| Rate for Payer: UHCCP Medicaid |
$416.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$290.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$617.83
|
|
|
REALIGNMENT OF TENDONS(P
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 26437
|
| Hospital Charge Code |
761P0699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$287.42 |
| Max. Negotiated Rate |
$1,071.46 |
| Rate for Payer: Aetna Commercial |
$871.10
|
| Rate for Payer: Ambetter Exchange |
$617.83
|
| Rate for Payer: Anthem Medicaid |
$287.42
|
| Rate for Payer: Buckeye Individual/Medicaid |
$617.83
|
| Rate for Payer: Buckeye Medicare Advantage |
$617.83
|
| Rate for Payer: CareSource Just4Me Medicare |
$741.40
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cash Price |
$595.00
|
| Rate for Payer: Cigna Commercial |
$1,071.46
|
| Rate for Payer: Healthspan PPO |
$789.03
|
| Rate for Payer: Humana Medicaid |
$287.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$748.14
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$617.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$617.83
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$293.17
|
| Rate for Payer: Molina Healthcare Passport |
$287.42
|
| Rate for Payer: Multiplan PHCS |
$714.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$803.18
|
| Rate for Payer: UHCCP Medicaid |
$416.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$290.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$617.83
|
|
|
REAMER FOR CROSS-PLATES
|
Facility
|
IP
|
$4,798.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,439.50 |
| Max. Negotiated Rate |
$4,606.39 |
| Rate for Payer: Aetna Commercial |
$3,694.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,742.69
|
| Rate for Payer: Cash Price |
$2,399.16
|
| Rate for Payer: Cigna Commercial |
$3,982.61
|
| Rate for Payer: First Health Commercial |
$4,558.40
|
| Rate for Payer: Humana Commercial |
$4,078.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,934.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,541.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,439.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,222.52
|
| Rate for Payer: Ohio Health Group HMO |
$3,598.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,838.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,174.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,310.84
|
| Rate for Payer: PHCS Commercial |
$4,606.39
|
| Rate for Payer: United Healthcare All Payer |
$4,222.52
|
|
|
REAMER FOR CROSS-PLATES
|
Facility
|
OP
|
$4,798.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,439.50 |
| Max. Negotiated Rate |
$4,606.39 |
| Rate for Payer: Aetna Commercial |
$3,694.71
|
| Rate for Payer: Anthem Medicaid |
$1,650.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,742.69
|
| Rate for Payer: Cash Price |
$2,399.16
|
| Rate for Payer: Cigna Commercial |
$3,982.61
|
| Rate for Payer: First Health Commercial |
$4,558.40
|
| Rate for Payer: Humana Commercial |
$4,078.57
|
| Rate for Payer: Humana KY Medicaid |
$1,650.14
|
| Rate for Payer: Kentucky WC Medicaid |
$1,666.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,934.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,541.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,439.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,683.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,222.52
|
| Rate for Payer: Ohio Health Group HMO |
$3,598.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,838.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,174.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,310.84
|
| Rate for Payer: PHCS Commercial |
$4,606.39
|
| Rate for Payer: United Healthcare All Payer |
$4,222.52
|
|
|
REAMER LOW PROFILE 10.5MM
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 10.5MM
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 10MM
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 10MM
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 11.5MM
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 11.5MM
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 11MM
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 11MM
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 8.5MM
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 8.5MM
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 9.5MM
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
REAMER LOW PROFILE 9.5MM
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
