|
REUNION HUMERAL HEAD SZ56*19MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ56*19MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ 56*22M
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ 56*22M
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ56*25MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ56*25MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ56*28MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUMERAL HEAD SZ56*28MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ40*14MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ40*14MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ40*17MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ40*17MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ40*20MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ40*20MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ44*16MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ44*16MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ44*19MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ44*19MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ44*22MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ44*22MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ48*15MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ48*15MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ48*18MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ48*18MM
|
Facility
|
IP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
|
REUNION HUM HEAD STD SZ48*21MM
|
Facility
|
OP
|
$12,825.47
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,847.64 |
| Max. Negotiated Rate |
$12,312.45 |
| Rate for Payer: Aetna Commercial |
$9,875.61
|
| Rate for Payer: Anthem Medicaid |
$4,410.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,003.87
|
| Rate for Payer: Cash Price |
$6,412.74
|
| Rate for Payer: Cigna Commercial |
$10,645.14
|
| Rate for Payer: First Health Commercial |
$12,184.20
|
| Rate for Payer: Humana Commercial |
$10,901.65
|
| Rate for Payer: Humana KY Medicaid |
$4,410.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,455.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,516.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,465.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,847.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,499.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,286.41
|
| Rate for Payer: Ohio Health Group HMO |
$9,619.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,260.38
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,158.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,849.57
|
| Rate for Payer: PHCS Commercial |
$12,312.45
|
| Rate for Payer: United Healthcare All Payer |
$11,286.41
|
|
