|
REUNION RSA CONC GLENO 32*6
|
Facility
|
IP
|
$9,387.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.25 |
| Max. Negotiated Rate |
$9,012.00 |
| Rate for Payer: Aetna Commercial |
$7,228.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,322.25
|
| Rate for Payer: Cash Price |
$4,693.75
|
| Rate for Payer: Cigna Commercial |
$7,791.62
|
| Rate for Payer: First Health Commercial |
$8,918.12
|
| Rate for Payer: Humana Commercial |
$7,979.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,697.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,927.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,816.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,261.00
|
| Rate for Payer: Ohio Health Group HMO |
$7,040.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,510.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,167.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,477.38
|
| Rate for Payer: PHCS Commercial |
$9,012.00
|
| Rate for Payer: United Healthcare All Payer |
$8,261.00
|
|
|
REUNION RSA CONC GLENO 32*6
|
Facility
|
OP
|
$9,387.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.25 |
| Max. Negotiated Rate |
$9,012.00 |
| Rate for Payer: Aetna Commercial |
$7,228.38
|
| Rate for Payer: Anthem Medicaid |
$3,228.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,322.25
|
| Rate for Payer: Cash Price |
$4,693.75
|
| Rate for Payer: Cigna Commercial |
$7,791.62
|
| Rate for Payer: First Health Commercial |
$8,918.12
|
| Rate for Payer: Humana Commercial |
$7,979.38
|
| Rate for Payer: Humana KY Medicaid |
$3,228.36
|
| Rate for Payer: Kentucky WC Medicaid |
$3,261.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,697.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,927.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,816.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,293.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,261.00
|
| Rate for Payer: Ohio Health Group HMO |
$7,040.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,510.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,167.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,477.38
|
| Rate for Payer: PHCS Commercial |
$9,012.00
|
| Rate for Payer: United Healthcare All Payer |
$8,261.00
|
|
|
REUNION RSA CONC GLENO 36*2
|
Facility
|
OP
|
$9,387.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.25 |
| Max. Negotiated Rate |
$9,012.00 |
| Rate for Payer: Aetna Commercial |
$7,228.38
|
| Rate for Payer: Anthem Medicaid |
$3,228.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,322.25
|
| Rate for Payer: Cash Price |
$4,693.75
|
| Rate for Payer: Cigna Commercial |
$7,791.62
|
| Rate for Payer: First Health Commercial |
$8,918.12
|
| Rate for Payer: Humana Commercial |
$7,979.38
|
| Rate for Payer: Humana KY Medicaid |
$3,228.36
|
| Rate for Payer: Kentucky WC Medicaid |
$3,261.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,697.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,927.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,816.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,293.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,261.00
|
| Rate for Payer: Ohio Health Group HMO |
$7,040.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,510.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,167.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,477.38
|
| Rate for Payer: PHCS Commercial |
$9,012.00
|
| Rate for Payer: United Healthcare All Payer |
$8,261.00
|
|
|
REUNION RSA CONC GLENO 36*2
|
Facility
|
IP
|
$9,387.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.25 |
| Max. Negotiated Rate |
$9,012.00 |
| Rate for Payer: Aetna Commercial |
$7,228.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,322.25
|
| Rate for Payer: Cash Price |
$4,693.75
|
| Rate for Payer: Cigna Commercial |
$7,791.62
|
| Rate for Payer: First Health Commercial |
$8,918.12
|
| Rate for Payer: Humana Commercial |
$7,979.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,697.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,927.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,816.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,261.00
|
| Rate for Payer: Ohio Health Group HMO |
$7,040.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,510.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,167.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,477.38
|
| Rate for Payer: PHCS Commercial |
$9,012.00
|
| Rate for Payer: United Healthcare All Payer |
$8,261.00
|
|
|
REUNION RSA CONC GLENO 36*6
|
Facility
|
OP
|
$9,387.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.25 |
| Max. Negotiated Rate |
$9,012.00 |
| Rate for Payer: Aetna Commercial |
$7,228.38
|
| Rate for Payer: Anthem Medicaid |
$3,228.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,322.25
|
| Rate for Payer: Cash Price |
$4,693.75
|
| Rate for Payer: Cigna Commercial |
$7,791.62
|
| Rate for Payer: First Health Commercial |
$8,918.12
|
| Rate for Payer: Humana Commercial |
$7,979.38
|
| Rate for Payer: Humana KY Medicaid |
$3,228.36
|
| Rate for Payer: Kentucky WC Medicaid |
$3,261.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,697.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,927.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,816.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,293.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,261.00
|
| Rate for Payer: Ohio Health Group HMO |
$7,040.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,510.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,167.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,477.38
|
| Rate for Payer: PHCS Commercial |
$9,012.00
|
| Rate for Payer: United Healthcare All Payer |
$8,261.00
|
|
|
REUNION RSA CONC GLENO 36*6
|
Facility
|
IP
|
$9,387.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.25 |
| Max. Negotiated Rate |
$9,012.00 |
| Rate for Payer: Aetna Commercial |
$7,228.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,322.25
|
| Rate for Payer: Cash Price |
$4,693.75
|
| Rate for Payer: Cigna Commercial |
$7,791.62
|
| Rate for Payer: First Health Commercial |
$8,918.12
|
| Rate for Payer: Humana Commercial |
$7,979.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,697.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,927.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,816.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,261.00
|
| Rate for Payer: Ohio Health Group HMO |
$7,040.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,510.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,167.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,477.38
|
| Rate for Payer: PHCS Commercial |
$9,012.00
|
| Rate for Payer: United Healthcare All Payer |
$8,261.00
|
|
|
REUNION RSA 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 RSA 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
|
|
|
REUNION SP KEELED GLENOID SZ40
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ40
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ44
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ44
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ48
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ48
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ52
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ52
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ56
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP KEELED GLENOID SZ56
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP PEGGED GLENOID SZ 4
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP PEGGED GLENOID SZ 4
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP PEGGED GLENOID SZ48
|
Facility
|
OP
|
$8,631.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,589.59 |
| Max. Negotiated Rate |
$8,286.67 |
| Rate for Payer: Aetna Commercial |
$6,646.60
|
| Rate for Payer: Anthem Medicaid |
$2,968.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,732.92
|
| Rate for Payer: Cash Price |
$4,315.98
|
| Rate for Payer: Cigna Commercial |
$7,164.52
|
| Rate for Payer: First Health Commercial |
$8,200.35
|
| Rate for Payer: Humana Commercial |
$7,337.16
|
| Rate for Payer: Humana KY Medicaid |
$2,968.53
|
| Rate for Payer: Kentucky WC Medicaid |
$2,998.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,078.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,589.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,028.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,596.12
|
| Rate for Payer: Ohio Health Group HMO |
$6,473.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,905.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,509.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,956.05
|
| Rate for Payer: PHCS Commercial |
$8,286.67
|
| Rate for Payer: United Healthcare All Payer |
$7,596.12
|
|
|
REUNION SP PEGGED GLENOID SZ48
|
Facility
|
IP
|
$8,631.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,589.59 |
| Max. Negotiated Rate |
$8,286.67 |
| Rate for Payer: Aetna Commercial |
$6,646.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,732.92
|
| Rate for Payer: Cash Price |
$4,315.98
|
| Rate for Payer: Cigna Commercial |
$7,164.52
|
| Rate for Payer: First Health Commercial |
$8,200.35
|
| Rate for Payer: Humana Commercial |
$7,337.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,078.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,589.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,596.12
|
| Rate for Payer: Ohio Health Group HMO |
$6,473.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,905.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,509.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,956.05
|
| Rate for Payer: PHCS Commercial |
$8,286.67
|
| Rate for Payer: United Healthcare All Payer |
$7,596.12
|
|
|
REUNION SP PEGGED GLENOID SZ 5
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP PEGGED GLENOID SZ 5
|
Facility
|
IP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
|
REUNION SP PEGGED GLENOID SZ56
|
Facility
|
OP
|
$16,295.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,888.65 |
| Max. Negotiated Rate |
$15,643.68 |
| Rate for Payer: Aetna Commercial |
$12,547.53
|
| Rate for Payer: Anthem Medicaid |
$5,604.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,710.49
|
| Rate for Payer: Cash Price |
$8,147.75
|
| Rate for Payer: Cigna Commercial |
$13,525.26
|
| Rate for Payer: First Health Commercial |
$15,480.73
|
| Rate for Payer: Humana Commercial |
$13,851.17
|
| Rate for Payer: Humana KY Medicaid |
$5,604.02
|
| Rate for Payer: Kentucky WC Medicaid |
$5,661.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,362.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,026.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,888.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,716.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,340.04
|
| Rate for Payer: Ohio Health Group HMO |
$12,221.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,036.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,177.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,243.90
|
| Rate for Payer: PHCS Commercial |
$15,643.68
|
| Rate for Payer: United Healthcare All Payer |
$14,340.04
|
|
