|
ROD RADIUS RT 3.6MM*190MM
|
Facility
|
IP
|
$5,118.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.36 |
| Max. Negotiated Rate |
$4,913.40 |
| Rate for Payer: Aetna Commercial |
$3,940.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,992.13
|
| Rate for Payer: Cash Price |
$2,559.06
|
| Rate for Payer: Cigna Commercial |
$4,248.04
|
| Rate for Payer: First Health Commercial |
$4,862.21
|
| Rate for Payer: Humana Commercial |
$4,350.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,196.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,777.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,535.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,503.95
|
| Rate for Payer: Ohio Health Group HMO |
$3,838.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,023.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$665.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.62
|
| Rate for Payer: PHCS Commercial |
$4,913.40
|
| Rate for Payer: United Healthcare All Payer |
$4,503.95
|
|
|
ROD RADIUS RT 3.6MM*210MM
|
Facility
|
IP
|
$5,118.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.36 |
| Max. Negotiated Rate |
$4,913.40 |
| Rate for Payer: Aetna Commercial |
$3,940.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,992.13
|
| Rate for Payer: Cash Price |
$2,559.06
|
| Rate for Payer: Cigna Commercial |
$4,248.04
|
| Rate for Payer: First Health Commercial |
$4,862.21
|
| Rate for Payer: Humana Commercial |
$4,350.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,196.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,777.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,535.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,503.95
|
| Rate for Payer: Ohio Health Group HMO |
$3,838.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,023.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$665.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.62
|
| Rate for Payer: PHCS Commercial |
$4,913.40
|
| Rate for Payer: United Healthcare All Payer |
$4,503.95
|
|
|
ROD RADIUS RT 3.6MM*210MM
|
Facility
|
OP
|
$5,118.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.36 |
| Max. Negotiated Rate |
$4,913.40 |
| Rate for Payer: Aetna Commercial |
$3,940.95
|
| Rate for Payer: Anthem Medicaid |
$1,760.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,992.13
|
| Rate for Payer: Cash Price |
$2,559.06
|
| Rate for Payer: Cigna Commercial |
$4,248.04
|
| Rate for Payer: First Health Commercial |
$4,862.21
|
| Rate for Payer: Humana Commercial |
$4,350.40
|
| Rate for Payer: Humana KY Medicaid |
$1,760.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,778.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,196.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,777.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,535.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,795.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,503.95
|
| Rate for Payer: Ohio Health Group HMO |
$3,838.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,023.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$665.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.62
|
| Rate for Payer: PHCS Commercial |
$4,913.40
|
| Rate for Payer: United Healthcare All Payer |
$4,503.95
|
|
|
ROD RADIUS RT 3.6MM*230MM
|
Facility
|
IP
|
$5,118.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.36 |
| Max. Negotiated Rate |
$4,913.40 |
| Rate for Payer: Aetna Commercial |
$3,940.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,992.13
|
| Rate for Payer: Cash Price |
$2,559.06
|
| Rate for Payer: Cigna Commercial |
$4,248.04
|
| Rate for Payer: First Health Commercial |
$4,862.21
|
| Rate for Payer: Humana Commercial |
$4,350.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,196.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,777.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,535.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,503.95
|
| Rate for Payer: Ohio Health Group HMO |
$3,838.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,023.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$665.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.62
|
| Rate for Payer: PHCS Commercial |
$4,913.40
|
| Rate for Payer: United Healthcare All Payer |
$4,503.95
|
|
|
ROD RADIUS RT 3.6MM*230MM
|
Facility
|
OP
|
$5,118.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.36 |
| Max. Negotiated Rate |
$4,913.40 |
| Rate for Payer: Aetna Commercial |
$3,940.95
|
| Rate for Payer: Anthem Medicaid |
$1,760.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,992.13
|
| Rate for Payer: Cash Price |
$2,559.06
|
| Rate for Payer: Cigna Commercial |
$4,248.04
|
| Rate for Payer: First Health Commercial |
$4,862.21
|
| Rate for Payer: Humana Commercial |
$4,350.40
|
| Rate for Payer: Humana KY Medicaid |
$1,760.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,778.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,196.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,777.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,535.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,795.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,503.95
|
| Rate for Payer: Ohio Health Group HMO |
$3,838.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,023.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$665.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.62
|
| Rate for Payer: PHCS Commercial |
$4,913.40
|
| Rate for Payer: United Healthcare All Payer |
$4,503.95
|
|
|
ROD SHORT QC
|
Facility
|
OP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem Medicaid |
$3,222.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Humana KY Medicaid |
$3,222.34
|
| Rate for Payer: Kentucky WC Medicaid |
$3,255.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,287.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
ROD SHORT QC
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
ROD THREADED 30MM
|
Facility
|
IP
|
$552.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.79 |
| Max. Negotiated Rate |
$530.11 |
| Rate for Payer: Aetna Commercial |
$425.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$430.72
|
| Rate for Payer: Cash Price |
$276.10
|
| Rate for Payer: Cigna Commercial |
$458.33
|
| Rate for Payer: First Health Commercial |
$524.59
|
| Rate for Payer: Humana Commercial |
$469.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$452.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$407.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$165.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$485.94
|
| Rate for Payer: Ohio Health Group HMO |
$414.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$110.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$71.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$171.18
|
| Rate for Payer: PHCS Commercial |
$530.11
|
| Rate for Payer: United Healthcare All Payer |
$485.94
|
|
|
ROD THREADED 30MM
|
Facility
|
OP
|
$552.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.79 |
| Max. Negotiated Rate |
$530.11 |
| Rate for Payer: Aetna Commercial |
$425.19
|
| Rate for Payer: Anthem Medicaid |
$189.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$430.72
|
| Rate for Payer: Cash Price |
$276.10
|
| Rate for Payer: Cigna Commercial |
$458.33
|
| Rate for Payer: First Health Commercial |
$524.59
|
| Rate for Payer: Humana Commercial |
$469.37
|
| Rate for Payer: Humana KY Medicaid |
$189.90
|
| Rate for Payer: Kentucky WC Medicaid |
$191.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$452.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$407.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$165.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$193.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$485.94
|
| Rate for Payer: Ohio Health Group HMO |
$414.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$110.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$71.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$171.18
|
| Rate for Payer: PHCS Commercial |
$530.11
|
| Rate for Payer: United Healthcare All Payer |
$485.94
|
|
|
ROD THREADED 350MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
ROD THREADED 350MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
ROD THREADED SLOTTED 40MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
ROD THREADED SLOTTED 40MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
ROD THREADED SLOTTED 60MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
ROD THREADED SLOTTED 60MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
ROD TO ROD COUPLING 8/8MM
|
Facility
|
IP
|
$3,962.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.06 |
| Max. Negotiated Rate |
$3,803.52 |
| Rate for Payer: Aetna Commercial |
$3,050.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,090.36
|
| Rate for Payer: Cash Price |
$1,981.00
|
| Rate for Payer: Cigna Commercial |
$3,288.46
|
| Rate for Payer: First Health Commercial |
$3,763.90
|
| Rate for Payer: Humana Commercial |
$3,367.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,248.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,923.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,188.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,486.56
|
| Rate for Payer: Ohio Health Group HMO |
$2,971.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$792.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$515.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,228.22
|
| Rate for Payer: PHCS Commercial |
$3,803.52
|
| Rate for Payer: United Healthcare All Payer |
$3,486.56
|
|
|
ROD TO ROD COUPLING 8/8MM
|
Facility
|
OP
|
$3,962.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.06 |
| Max. Negotiated Rate |
$3,803.52 |
| Rate for Payer: Aetna Commercial |
$3,050.74
|
| Rate for Payer: Anthem Medicaid |
$1,362.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,090.36
|
| Rate for Payer: Cash Price |
$1,981.00
|
| Rate for Payer: Cigna Commercial |
$3,288.46
|
| Rate for Payer: First Health Commercial |
$3,763.90
|
| Rate for Payer: Humana Commercial |
$3,367.70
|
| Rate for Payer: Humana KY Medicaid |
$1,362.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,376.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,248.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,923.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,188.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,389.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,486.56
|
| Rate for Payer: Ohio Health Group HMO |
$2,971.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$792.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$515.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,228.22
|
| Rate for Payer: PHCS Commercial |
$3,803.52
|
| Rate for Payer: United Healthcare All Payer |
$3,486.56
|
|
|
ROGER CLIP-ON MIC
|
Professional
|
Both
|
$640.00
|
|
| Hospital Charge Code |
22200664
|
|
Hospital Revenue Code
|
222
|
| Min. Negotiated Rate |
$224.00 |
| Max. Negotiated Rate |
$640.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$640.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Multiplan PHCS |
$384.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$448.00
|
| Rate for Payer: UHCCP Medicaid |
$224.00
|
|
|
ROLLER MESSAGE TABLE NEURO
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
HCPCS 97039
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$122.88 |
| Rate for Payer: Aetna Commercial |
$98.56
|
| Rate for Payer: Anthem Medicaid |
$44.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$99.84
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cigna Commercial |
$106.24
|
| Rate for Payer: First Health Commercial |
$121.60
|
| Rate for Payer: Humana Commercial |
$108.80
|
| Rate for Payer: Humana KY Medicaid |
$44.02
|
| Rate for Payer: Kentucky WC Medicaid |
$44.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$104.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$94.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$38.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$44.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$112.64
|
| Rate for Payer: Ohio Health Group HMO |
$96.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$39.68
|
| Rate for Payer: PHCS Commercial |
$122.88
|
| Rate for Payer: United Healthcare All Payer |
$112.64
|
|
|
ROLLER MESSAGE TABLE NEURO
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
HCPCS 97039
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$122.88 |
| Rate for Payer: Aetna Commercial |
$98.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$99.84
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cigna Commercial |
$106.24
|
| Rate for Payer: First Health Commercial |
$121.60
|
| Rate for Payer: Humana Commercial |
$108.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$104.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$94.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$38.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$112.64
|
| Rate for Payer: Ohio Health Group HMO |
$96.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$39.68
|
| Rate for Payer: PHCS Commercial |
$122.88
|
| Rate for Payer: United Healthcare All Payer |
$112.64
|
|
|
ROMAZICON(FLUMAZENIL) .5MG/5ML
|
Facility
|
IP
|
$113.50
|
|
|
Service Code
|
NDC 36000014801
|
| Hospital Charge Code |
25003422
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$108.96 |
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$88.53
|
| Rate for Payer: Cash Price |
$56.75
|
| Rate for Payer: Cigna Commercial |
$94.20
|
| Rate for Payer: First Health Commercial |
$107.82
|
| Rate for Payer: Humana Commercial |
$96.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$93.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$83.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$34.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$99.88
|
| Rate for Payer: Ohio Health Group HMO |
$85.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$22.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$35.18
|
| Rate for Payer: PHCS Commercial |
$108.96
|
| Rate for Payer: United Healthcare All Payer |
$99.88
|
|
|
ROMAZICON(FLUMAZENIL) .5MG/5ML
|
Facility
|
OP
|
$113.50
|
|
|
Service Code
|
NDC 36000014801
|
| Hospital Charge Code |
25003422
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$108.96 |
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Anthem Medicaid |
$39.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$88.53
|
| Rate for Payer: Cash Price |
$56.75
|
| Rate for Payer: Cigna Commercial |
$94.20
|
| Rate for Payer: First Health Commercial |
$107.82
|
| Rate for Payer: Humana Commercial |
$96.48
|
| Rate for Payer: Humana KY Medicaid |
$39.03
|
| Rate for Payer: Kentucky WC Medicaid |
$39.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$93.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$83.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$34.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$39.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$99.88
|
| Rate for Payer: Ohio Health Group HMO |
$85.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$22.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$35.18
|
| Rate for Payer: PHCS Commercial |
$108.96
|
| Rate for Payer: United Healthcare All Payer |
$99.88
|
|
|
RONDEC(CARBIN/PSEUDOEPH)SY 5ML
|
Facility
|
IP
|
$4.83
|
|
|
Service Code
|
NDC 16477010116
|
| Hospital Charge Code |
25001346
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.77
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cigna Commercial |
$4.01
|
| Rate for Payer: First Health Commercial |
$4.59
|
| Rate for Payer: Humana Commercial |
$4.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$4.25
|
| Rate for Payer: Ohio Health Group HMO |
$3.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$0.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$0.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.50
|
| Rate for Payer: PHCS Commercial |
$4.64
|
| Rate for Payer: United Healthcare All Payer |
$4.25
|
|
|
RONDEC(CARBIN/PSEUDOEPH)SY 5ML
|
Facility
|
OP
|
$4.83
|
|
|
Service Code
|
NDC 16477010116
|
| Hospital Charge Code |
25001346
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Anthem Medicaid |
$1.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.77
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cigna Commercial |
$4.01
|
| Rate for Payer: First Health Commercial |
$4.59
|
| Rate for Payer: Humana Commercial |
$4.11
|
| Rate for Payer: Humana KY Medicaid |
$1.66
|
| Rate for Payer: Kentucky WC Medicaid |
$1.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$1.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$4.25
|
| Rate for Payer: Ohio Health Group HMO |
$3.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$0.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$0.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.50
|
| Rate for Payer: PHCS Commercial |
$4.64
|
| Rate for Payer: United Healthcare All Payer |
$4.25
|
|
|
ROPIVACAINE 0.2% 1MG/ML SDV
|
Facility
|
OP
|
$3.85
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
636T0201
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$3.70 |
| Rate for Payer: Aetna Commercial |
$2.96
|
| Rate for Payer: Anthem Medicaid |
$1.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.00
|
| Rate for Payer: Cash Price |
$1.93
|
| Rate for Payer: Cigna Commercial |
$3.20
|
| Rate for Payer: First Health Commercial |
$3.66
|
| Rate for Payer: Humana Commercial |
$3.27
|
| Rate for Payer: Humana KY Medicaid |
$1.32
|
| Rate for Payer: Kentucky WC Medicaid |
$1.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$1.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$3.39
|
| Rate for Payer: Ohio Health Group HMO |
$2.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$0.77
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$0.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.19
|
| Rate for Payer: PHCS Commercial |
$3.70
|
| Rate for Payer: United Healthcare All Payer |
$3.39
|
|
