|
REUNION HUMERAL HEAD SZ 56*22M
|
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 56*22M
|
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*25MM
|
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 SZ56*25MM
|
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*28MM
|
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 SZ56*28MM
|
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 HUM HEAD STD SZ40*14MM
|
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 HUM HEAD STD SZ40*14MM
|
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 HUM HEAD STD SZ40*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 HUM HEAD STD SZ40*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 HUM HEAD STD SZ40*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 HUM HEAD STD 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 HUM HEAD STD SZ44*16MM
|
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 HUM HEAD STD SZ44*16MM
|
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 HUM HEAD STD SZ44*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 HUM HEAD STD SZ44*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
|
|
|
REUNION HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD SZ48*15MM
|
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 HUM HEAD STD SZ48*15MM
|
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 HUM HEAD STD SZ48*18MM
|
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 HUM HEAD STD SZ48*18MM
|
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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD SZ48*24MM
|
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
|
|
