|
REUNION HUM HEAD STD SZ48*24MM
|
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 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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
|
|
|
REUNION HUM HEAD STD SZ56*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 SZ56*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 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 HUM HEAD STD 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 HUM HEAD STD 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 HUM HEAD STD 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 MOD HUM STEM LNG SZ6 1
|
Facility
|
IP
|
$26,132.79
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,397.26 |
| Max. Negotiated Rate |
$25,087.48 |
| Rate for Payer: Aetna Commercial |
$20,122.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,383.58
|
| Rate for Payer: Cash Price |
$13,066.40
|
| Rate for Payer: Cigna Commercial |
$21,690.22
|
| Rate for Payer: First Health Commercial |
$24,826.15
|
| Rate for Payer: Humana Commercial |
$22,212.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,428.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,286.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,839.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,996.86
|
| Rate for Payer: Ohio Health Group HMO |
$19,599.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,226.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,397.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,101.16
|
| Rate for Payer: PHCS Commercial |
$25,087.48
|
| Rate for Payer: United Healthcare All Payer |
$22,996.86
|
|
|
REUNION MOD HUM STEM LNG SZ6 1
|
Facility
|
OP
|
$26,132.79
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,397.26 |
| Max. Negotiated Rate |
$25,087.48 |
| Rate for Payer: Aetna Commercial |
$20,122.25
|
| Rate for Payer: Anthem Medicaid |
$8,987.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,383.58
|
| Rate for Payer: Cash Price |
$13,066.40
|
| Rate for Payer: Cigna Commercial |
$21,690.22
|
| Rate for Payer: First Health Commercial |
$24,826.15
|
| Rate for Payer: Humana Commercial |
$22,212.87
|
| Rate for Payer: Humana KY Medicaid |
$8,987.07
|
| Rate for Payer: Kentucky WC Medicaid |
$9,078.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,428.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,286.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,839.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,167.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,996.86
|
| Rate for Payer: Ohio Health Group HMO |
$19,599.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,226.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,397.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,101.16
|
| Rate for Payer: PHCS Commercial |
$25,087.48
|
| Rate for Payer: United Healthcare All Payer |
$22,996.86
|
|
|
REUNION MOD HUM STEM LNG SZ8 2
|
Facility
|
IP
|
$26,132.79
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,397.26 |
| Max. Negotiated Rate |
$25,087.48 |
| Rate for Payer: Aetna Commercial |
$20,122.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,383.58
|
| Rate for Payer: Cash Price |
$13,066.40
|
| Rate for Payer: Cigna Commercial |
$21,690.22
|
| Rate for Payer: First Health Commercial |
$24,826.15
|
| Rate for Payer: Humana Commercial |
$22,212.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,428.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,286.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,839.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,996.86
|
| Rate for Payer: Ohio Health Group HMO |
$19,599.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,226.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,397.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,101.16
|
| Rate for Payer: PHCS Commercial |
$25,087.48
|
| Rate for Payer: United Healthcare All Payer |
$22,996.86
|
|
|
REUNION MOD HUM STEM LNG SZ8 2
|
Facility
|
OP
|
$26,132.79
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,397.26 |
| Max. Negotiated Rate |
$25,087.48 |
| Rate for Payer: Aetna Commercial |
$20,122.25
|
| Rate for Payer: Anthem Medicaid |
$8,987.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,383.58
|
| Rate for Payer: Cash Price |
$13,066.40
|
| Rate for Payer: Cigna Commercial |
$21,690.22
|
| Rate for Payer: First Health Commercial |
$24,826.15
|
| Rate for Payer: Humana Commercial |
$22,212.87
|
| Rate for Payer: Humana KY Medicaid |
$8,987.07
|
| Rate for Payer: Kentucky WC Medicaid |
$9,078.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,428.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,286.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,839.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,167.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,996.86
|
| Rate for Payer: Ohio Health Group HMO |
$19,599.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,226.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,397.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,101.16
|
| Rate for Payer: PHCS Commercial |
$25,087.48
|
| Rate for Payer: United Healthcare All Payer |
$22,996.86
|
|
|
REUNION NITINOL PILOT WIRE
|
Facility
|
OP
|
$776.40
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.93 |
| Max. Negotiated Rate |
$745.34 |
| Rate for Payer: Aetna Commercial |
$597.83
|
| Rate for Payer: Anthem Medicaid |
$267.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$605.59
|
| Rate for Payer: Cash Price |
$388.20
|
| Rate for Payer: Cigna Commercial |
$644.41
|
| Rate for Payer: First Health Commercial |
$737.58
|
| Rate for Payer: Humana Commercial |
$659.94
|
| Rate for Payer: Humana KY Medicaid |
$267.00
|
| Rate for Payer: Kentucky WC Medicaid |
$269.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$636.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$572.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$232.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$272.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$683.23
|
| Rate for Payer: Ohio Health Group HMO |
$582.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$155.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$100.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$240.68
|
| Rate for Payer: PHCS Commercial |
$745.34
|
| Rate for Payer: United Healthcare All Payer |
$683.23
|
|
|
REUNION NITINOL PILOT WIRE
|
Facility
|
IP
|
$776.40
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.93 |
| Max. Negotiated Rate |
$745.34 |
| Rate for Payer: Aetna Commercial |
$597.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$605.59
|
| Rate for Payer: Cash Price |
$388.20
|
| Rate for Payer: Cigna Commercial |
$644.41
|
| Rate for Payer: First Health Commercial |
$737.58
|
| Rate for Payer: Humana Commercial |
$659.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$636.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$572.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$232.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$683.23
|
| Rate for Payer: Ohio Health Group HMO |
$582.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$155.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$100.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$240.68
|
| Rate for Payer: PHCS Commercial |
$745.34
|
| Rate for Payer: United Healthcare All Payer |
$683.23
|
|
|
REUNION PRESFIT HUM STEM 7*L91
|
Facility
|
OP
|
$21,225.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,759.25 |
| Max. Negotiated Rate |
$20,376.00 |
| Rate for Payer: Aetna Commercial |
$16,343.25
|
| Rate for Payer: Anthem Medicaid |
$7,299.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,555.50
|
| Rate for Payer: Cash Price |
$10,612.50
|
| Rate for Payer: Cigna Commercial |
$17,616.75
|
| Rate for Payer: First Health Commercial |
$20,163.75
|
| Rate for Payer: Humana Commercial |
$18,041.25
|
| Rate for Payer: Humana KY Medicaid |
$7,299.28
|
| Rate for Payer: Kentucky WC Medicaid |
$7,373.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,404.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,664.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,367.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,445.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,678.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,918.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,245.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,759.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,579.75
|
| Rate for Payer: PHCS Commercial |
$20,376.00
|
| Rate for Payer: United Healthcare All Payer |
$18,678.00
|
|
|
REUNION PRESFIT HUM STEM 7*L91
|
Facility
|
IP
|
$21,225.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,759.25 |
| Max. Negotiated Rate |
$20,376.00 |
| Rate for Payer: Aetna Commercial |
$16,343.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,555.50
|
| Rate for Payer: Cash Price |
$10,612.50
|
| Rate for Payer: Cigna Commercial |
$17,616.75
|
| Rate for Payer: First Health Commercial |
$20,163.75
|
| Rate for Payer: Humana Commercial |
$18,041.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,404.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,664.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,367.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,678.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,918.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,245.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,759.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,579.75
|
| Rate for Payer: PHCS Commercial |
$20,376.00
|
| Rate for Payer: United Healthcare All Payer |
$18,678.00
|
|
