|
REUNION HUMERAL HEAD SZ40*20MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 44*16M
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 44*16M
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 44*19M
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 44*19M
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ44*22MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ44*22MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ48*15MM
|
Facility
|
OP
|
$9,215.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,198.02 |
| Max. Negotiated Rate |
$8,846.88 |
| Rate for Payer: Aetna Commercial |
$7,095.94
|
| Rate for Payer: Anthem Medicaid |
$3,169.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,188.09
|
| Rate for Payer: Cash Price |
$4,607.75
|
| Rate for Payer: Cigna Commercial |
$7,648.86
|
| Rate for Payer: First Health Commercial |
$8,754.72
|
| Rate for Payer: Humana Commercial |
$7,833.18
|
| Rate for Payer: Humana KY Medicaid |
$3,169.21
|
| Rate for Payer: Kentucky WC Medicaid |
$3,201.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,556.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,801.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,764.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,232.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,109.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,911.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,843.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,198.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,856.80
|
| Rate for Payer: PHCS Commercial |
$8,846.88
|
| Rate for Payer: United Healthcare All Payer |
$8,109.64
|
|
|
REUNION HUMERAL HEAD SZ48*15MM
|
Facility
|
IP
|
$9,215.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,198.02 |
| Max. Negotiated Rate |
$8,846.88 |
| Rate for Payer: Aetna Commercial |
$7,095.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,188.09
|
| Rate for Payer: Cash Price |
$4,607.75
|
| Rate for Payer: Cigna Commercial |
$7,648.86
|
| Rate for Payer: First Health Commercial |
$8,754.72
|
| Rate for Payer: Humana Commercial |
$7,833.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,556.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,801.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,764.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,109.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,911.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,843.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,198.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,856.80
|
| Rate for Payer: PHCS Commercial |
$8,846.88
|
| Rate for Payer: United Healthcare All Payer |
$8,109.64
|
|
|
REUNION HUMERAL HEAD SZ 48*18M
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 48*18M
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ48*21MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ48*21MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 48*24M
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ 48*24M
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*17MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*17MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*20MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*20MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*23MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*23MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*26MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ52*26MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ56*19MM
|
Facility
|
IP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
|
REUNION HUMERAL HEAD SZ56*19MM
|
Facility
|
OP
|
$12,574.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,634.70 |
| Max. Negotiated Rate |
$12,071.66 |
| Rate for Payer: Aetna Commercial |
$9,682.48
|
| Rate for Payer: Anthem Medicaid |
$4,324.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,808.23
|
| Rate for Payer: Cash Price |
$6,287.32
|
| Rate for Payer: Cigna Commercial |
$10,436.96
|
| Rate for Payer: First Health Commercial |
$11,945.92
|
| Rate for Payer: Humana Commercial |
$10,688.45
|
| Rate for Payer: Humana KY Medicaid |
$4,324.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,368.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,311.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,280.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,772.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,411.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,065.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,430.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,514.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,634.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,898.14
|
| Rate for Payer: PHCS Commercial |
$12,071.66
|
| Rate for Payer: United Healthcare All Payer |
$11,065.69
|
|
