|
REUNION HUM HEAD STD SZ48*21MM
|
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*24MM
|
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*24MM
|
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 SZ52*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 SZ52*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 SZ52*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 SZ52*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 SZ52*23MM
|
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 SZ52*23MM
|
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 SZ52*26MM
|
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 SZ52*26MM
|
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 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 HUM HEAD STD 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 HUM HEAD STD SZ56*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 SZ56*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 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 HUM HEAD STD 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 HUM HEAD STD 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 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 MOD HUM STEM LNG SZ6 1
|
Facility
|
IP
|
$26,917.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,075.18 |
| Max. Negotiated Rate |
$25,840.56 |
| Rate for Payer: Aetna Commercial |
$20,726.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,995.46
|
| Rate for Payer: Cash Price |
$13,458.62
|
| Rate for Payer: Cigna Commercial |
$22,341.32
|
| Rate for Payer: First Health Commercial |
$25,571.39
|
| Rate for Payer: Humana Commercial |
$22,879.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$22,072.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,864.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,075.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,687.18
|
| Rate for Payer: Ohio Health Group HMO |
$20,187.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,533.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23,418.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,572.90
|
| Rate for Payer: PHCS Commercial |
$25,840.56
|
| Rate for Payer: United Healthcare All Payer |
$23,687.18
|
|
|
REUNION MOD HUM STEM LNG SZ6 1
|
Facility
|
OP
|
$26,917.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,075.18 |
| Max. Negotiated Rate |
$25,840.56 |
| Rate for Payer: Aetna Commercial |
$20,726.28
|
| Rate for Payer: Anthem Medicaid |
$9,256.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,995.46
|
| Rate for Payer: Cash Price |
$13,458.62
|
| Rate for Payer: Cigna Commercial |
$22,341.32
|
| Rate for Payer: First Health Commercial |
$25,571.39
|
| Rate for Payer: Humana Commercial |
$22,879.66
|
| Rate for Payer: Humana KY Medicaid |
$9,256.84
|
| Rate for Payer: Kentucky WC Medicaid |
$9,351.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$22,072.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,864.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,075.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,442.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,687.18
|
| Rate for Payer: Ohio Health Group HMO |
$20,187.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,533.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23,418.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,572.90
|
| Rate for Payer: PHCS Commercial |
$25,840.56
|
| Rate for Payer: United Healthcare All Payer |
$23,687.18
|
|
|
REUNION MOD HUM STEM LNG SZ8 2
|
Facility
|
OP
|
$26,917.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,075.18 |
| Max. Negotiated Rate |
$25,840.56 |
| Rate for Payer: Aetna Commercial |
$20,726.28
|
| Rate for Payer: Anthem Medicaid |
$9,256.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,995.46
|
| Rate for Payer: Cash Price |
$13,458.62
|
| Rate for Payer: Cigna Commercial |
$22,341.32
|
| Rate for Payer: First Health Commercial |
$25,571.39
|
| Rate for Payer: Humana Commercial |
$22,879.66
|
| Rate for Payer: Humana KY Medicaid |
$9,256.84
|
| Rate for Payer: Kentucky WC Medicaid |
$9,351.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$22,072.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,864.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,075.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,442.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,687.18
|
| Rate for Payer: Ohio Health Group HMO |
$20,187.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,533.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23,418.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,572.90
|
| Rate for Payer: PHCS Commercial |
$25,840.56
|
| Rate for Payer: United Healthcare All Payer |
$23,687.18
|
|
|
REUNION MOD HUM STEM LNG SZ8 2
|
Facility
|
IP
|
$26,917.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,075.18 |
| Max. Negotiated Rate |
$25,840.56 |
| Rate for Payer: Aetna Commercial |
$20,726.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,995.46
|
| Rate for Payer: Cash Price |
$13,458.62
|
| Rate for Payer: Cigna Commercial |
$22,341.32
|
| Rate for Payer: First Health Commercial |
$25,571.39
|
| Rate for Payer: Humana Commercial |
$22,879.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$22,072.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,864.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,075.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,687.18
|
| Rate for Payer: Ohio Health Group HMO |
$20,187.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,533.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23,418.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,572.90
|
| Rate for Payer: PHCS Commercial |
$25,840.56
|
| Rate for Payer: United Healthcare All Payer |
$23,687.18
|
|
|
REUNION NITINOL PILOT WIRE
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$238.80 |
| Max. Negotiated Rate |
$764.16 |
| Rate for Payer: Aetna Commercial |
$612.92
|
| Rate for Payer: Anthem Medicaid |
$273.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$620.88
|
| Rate for Payer: Cash Price |
$398.00
|
| Rate for Payer: Cigna Commercial |
$660.68
|
| Rate for Payer: First Health Commercial |
$756.20
|
| Rate for Payer: Humana Commercial |
$676.60
|
| Rate for Payer: Humana KY Medicaid |
$273.74
|
| Rate for Payer: Kentucky WC Medicaid |
$276.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$652.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$587.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$238.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$279.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$700.48
|
| Rate for Payer: Ohio Health Group HMO |
$597.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$636.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$692.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.24
|
| Rate for Payer: PHCS Commercial |
$764.16
|
| Rate for Payer: United Healthcare All Payer |
$700.48
|
|
|
REUNION NITINOL PILOT WIRE
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$238.80 |
| Max. Negotiated Rate |
$764.16 |
| Rate for Payer: Aetna Commercial |
$612.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$620.88
|
| Rate for Payer: Cash Price |
$398.00
|
| Rate for Payer: Cigna Commercial |
$660.68
|
| Rate for Payer: First Health Commercial |
$756.20
|
| Rate for Payer: Humana Commercial |
$676.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$652.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$587.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$238.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$700.48
|
| Rate for Payer: Ohio Health Group HMO |
$597.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$636.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$692.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$549.24
|
| Rate for Payer: PHCS Commercial |
$764.16
|
| Rate for Payer: United Healthcare All Payer |
$700.48
|
|
