|
SCREW 2.0*12 SNAP OFF
|
Facility
|
IP
|
$2,076.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.91 |
| Max. Negotiated Rate |
$1,993.20 |
| Rate for Payer: Aetna Commercial |
$1,598.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,619.48
|
| Rate for Payer: Cash Price |
$1,038.12
|
| Rate for Payer: Cigna Commercial |
$1,723.29
|
| Rate for Payer: First Health Commercial |
$1,972.44
|
| Rate for Payer: Humana Commercial |
$1,764.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,702.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,532.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$622.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,827.10
|
| Rate for Payer: Ohio Health Group HMO |
$1,557.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$415.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$269.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$643.64
|
| Rate for Payer: PHCS Commercial |
$1,993.20
|
| Rate for Payer: United Healthcare All Payer |
$1,827.10
|
|
|
SCREW 2.5X10 LOCKING
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 2.5X10 LOCKING
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 2.5X16 LOCKING
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 2.5X16 LOCKING
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 2.5X34 LOCKING
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 2.5X34 LOCKING
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 3.5*10
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 3.5*10
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 3.5*12
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 3.5*12
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW 3.5*14
|
Facility
|
IP
|
$1,805.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.65 |
| Max. Negotiated Rate |
$1,732.80 |
| Rate for Payer: Aetna Commercial |
$1,389.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,407.90
|
| Rate for Payer: Cash Price |
$902.50
|
| Rate for Payer: Cigna Commercial |
$1,498.15
|
| Rate for Payer: First Health Commercial |
$1,714.75
|
| Rate for Payer: Humana Commercial |
$1,534.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,480.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,332.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$541.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,588.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,353.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$559.55
|
| Rate for Payer: PHCS Commercial |
$1,732.80
|
| Rate for Payer: United Healthcare All Payer |
$1,588.40
|
|
|
SCREW 3.5*14
|
Facility
|
OP
|
$1,805.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.65 |
| Max. Negotiated Rate |
$1,732.80 |
| Rate for Payer: Aetna Commercial |
$1,389.85
|
| Rate for Payer: Anthem Medicaid |
$620.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,407.90
|
| Rate for Payer: Cash Price |
$902.50
|
| Rate for Payer: Cigna Commercial |
$1,498.15
|
| Rate for Payer: First Health Commercial |
$1,714.75
|
| Rate for Payer: Humana Commercial |
$1,534.25
|
| Rate for Payer: Humana KY Medicaid |
$620.74
|
| Rate for Payer: Kentucky WC Medicaid |
$627.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,480.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,332.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$541.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$633.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,588.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,353.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$559.55
|
| Rate for Payer: PHCS Commercial |
$1,732.80
|
| Rate for Payer: United Healthcare All Payer |
$1,588.40
|
|
|
SCREW 3.5*26
|
Facility
|
OP
|
$1,805.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.65 |
| Max. Negotiated Rate |
$1,732.80 |
| Rate for Payer: Aetna Commercial |
$1,389.85
|
| Rate for Payer: Anthem Medicaid |
$620.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,407.90
|
| Rate for Payer: Cash Price |
$902.50
|
| Rate for Payer: Cigna Commercial |
$1,498.15
|
| Rate for Payer: First Health Commercial |
$1,714.75
|
| Rate for Payer: Humana Commercial |
$1,534.25
|
| Rate for Payer: Humana KY Medicaid |
$620.74
|
| Rate for Payer: Kentucky WC Medicaid |
$627.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,480.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,332.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$541.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$633.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,588.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,353.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$559.55
|
| Rate for Payer: PHCS Commercial |
$1,732.80
|
| Rate for Payer: United Healthcare All Payer |
$1,588.40
|
|
|
SCREW 3.5*26
|
Facility
|
IP
|
$1,805.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.65 |
| Max. Negotiated Rate |
$1,732.80 |
| Rate for Payer: Aetna Commercial |
$1,389.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,407.90
|
| Rate for Payer: Cash Price |
$902.50
|
| Rate for Payer: Cigna Commercial |
$1,498.15
|
| Rate for Payer: First Health Commercial |
$1,714.75
|
| Rate for Payer: Humana Commercial |
$1,534.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,480.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,332.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$541.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,588.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,353.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$361.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$559.55
|
| Rate for Payer: PHCS Commercial |
$1,732.80
|
| Rate for Payer: United Healthcare All Payer |
$1,588.40
|
|
|
SCREW 3.5*44MM
|
Facility
|
IP
|
$1,512.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.62 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Aetna Commercial |
$1,164.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,179.75
|
| Rate for Payer: Cash Price |
$756.25
|
| Rate for Payer: Cigna Commercial |
$1,255.38
|
| Rate for Payer: First Health Commercial |
$1,436.88
|
| Rate for Payer: Humana Commercial |
$1,285.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,240.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,116.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$453.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,331.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,134.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$302.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$196.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$468.88
|
| Rate for Payer: PHCS Commercial |
$1,452.00
|
| Rate for Payer: United Healthcare All Payer |
$1,331.00
|
|
|
SCREW 3.5*44MM
|
Facility
|
OP
|
$1,512.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.62 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Aetna Commercial |
$1,164.62
|
| Rate for Payer: Anthem Medicaid |
$520.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,179.75
|
| Rate for Payer: Cash Price |
$756.25
|
| Rate for Payer: Cigna Commercial |
$1,255.38
|
| Rate for Payer: First Health Commercial |
$1,436.88
|
| Rate for Payer: Humana Commercial |
$1,285.62
|
| Rate for Payer: Humana KY Medicaid |
$520.15
|
| Rate for Payer: Kentucky WC Medicaid |
$525.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,240.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,116.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$453.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$530.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,331.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,134.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$302.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$196.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$468.88
|
| Rate for Payer: PHCS Commercial |
$1,452.00
|
| Rate for Payer: United Healthcare All Payer |
$1,331.00
|
|
|
SCREW 3.5MM*50
|
Facility
|
IP
|
$1,512.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.62 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Aetna Commercial |
$1,164.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,179.75
|
| Rate for Payer: Cash Price |
$756.25
|
| Rate for Payer: Cigna Commercial |
$1,255.38
|
| Rate for Payer: First Health Commercial |
$1,436.88
|
| Rate for Payer: Humana Commercial |
$1,285.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,240.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,116.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$453.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,331.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,134.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$302.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$196.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$468.88
|
| Rate for Payer: PHCS Commercial |
$1,452.00
|
| Rate for Payer: United Healthcare All Payer |
$1,331.00
|
|
|
SCREW 3.5MM*50
|
Facility
|
OP
|
$1,512.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.62 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Aetna Commercial |
$1,164.62
|
| Rate for Payer: Anthem Medicaid |
$520.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,179.75
|
| Rate for Payer: Cash Price |
$756.25
|
| Rate for Payer: Cigna Commercial |
$1,255.38
|
| Rate for Payer: First Health Commercial |
$1,436.88
|
| Rate for Payer: Humana Commercial |
$1,285.62
|
| Rate for Payer: Humana KY Medicaid |
$520.15
|
| Rate for Payer: Kentucky WC Medicaid |
$525.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,240.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,116.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$453.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$530.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,331.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,134.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$302.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$196.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$468.88
|
| Rate for Payer: PHCS Commercial |
$1,452.00
|
| Rate for Payer: United Healthcare All Payer |
$1,331.00
|
|
|
SCREW 6.5*95MM
|
Facility
|
OP
|
$1,981.47
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$257.59 |
| Max. Negotiated Rate |
$1,902.21 |
| Rate for Payer: Aetna Commercial |
$1,525.73
|
| Rate for Payer: Anthem Medicaid |
$681.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,545.55
|
| Rate for Payer: Cash Price |
$990.74
|
| Rate for Payer: Cigna Commercial |
$1,644.62
|
| Rate for Payer: First Health Commercial |
$1,882.40
|
| Rate for Payer: Humana Commercial |
$1,684.25
|
| Rate for Payer: Humana KY Medicaid |
$681.43
|
| Rate for Payer: Kentucky WC Medicaid |
$688.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,624.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,462.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$594.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$695.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,743.69
|
| Rate for Payer: Ohio Health Group HMO |
$1,486.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$396.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$257.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$614.26
|
| Rate for Payer: PHCS Commercial |
$1,902.21
|
| Rate for Payer: United Healthcare All Payer |
$1,743.69
|
|
|
SCREW 6.5*95MM
|
Facility
|
IP
|
$1,981.47
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$257.59 |
| Max. Negotiated Rate |
$1,902.21 |
| Rate for Payer: Aetna Commercial |
$1,525.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,545.55
|
| Rate for Payer: Cash Price |
$990.74
|
| Rate for Payer: Cigna Commercial |
$1,644.62
|
| Rate for Payer: First Health Commercial |
$1,882.40
|
| Rate for Payer: Humana Commercial |
$1,684.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,624.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,462.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$594.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,743.69
|
| Rate for Payer: Ohio Health Group HMO |
$1,486.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$396.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$257.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$614.26
|
| Rate for Payer: PHCS Commercial |
$1,902.21
|
| Rate for Payer: United Healthcare All Payer |
$1,743.69
|
|
|
SCREW ACETABULAR 6.5*30MM
|
Facility
|
OP
|
$735.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.55 |
| Max. Negotiated Rate |
$705.60 |
| Rate for Payer: Aetna Commercial |
$565.95
|
| Rate for Payer: Anthem Medicaid |
$252.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$573.30
|
| Rate for Payer: Cash Price |
$367.50
|
| Rate for Payer: Cigna Commercial |
$610.05
|
| Rate for Payer: First Health Commercial |
$698.25
|
| Rate for Payer: Humana Commercial |
$624.75
|
| Rate for Payer: Humana KY Medicaid |
$252.77
|
| Rate for Payer: Kentucky WC Medicaid |
$255.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$602.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$542.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$220.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$257.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$646.80
|
| Rate for Payer: Ohio Health Group HMO |
$551.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$147.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$95.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$227.85
|
| Rate for Payer: PHCS Commercial |
$705.60
|
| Rate for Payer: United Healthcare All Payer |
$646.80
|
|
|
SCREW ACETABULAR 6.5*30MM
|
Facility
|
IP
|
$735.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.55 |
| Max. Negotiated Rate |
$705.60 |
| Rate for Payer: Aetna Commercial |
$565.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$573.30
|
| Rate for Payer: Cash Price |
$367.50
|
| Rate for Payer: Cigna Commercial |
$610.05
|
| Rate for Payer: First Health Commercial |
$698.25
|
| Rate for Payer: Humana Commercial |
$624.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$602.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$542.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$220.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$646.80
|
| Rate for Payer: Ohio Health Group HMO |
$551.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$147.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$95.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$227.85
|
| Rate for Payer: PHCS Commercial |
$705.60
|
| Rate for Payer: United Healthcare All Payer |
$646.80
|
|
|
SCREW ASNIS CANN 5.0*60
|
Facility
|
OP
|
$2,086.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.23 |
| Max. Negotiated Rate |
$2,002.94 |
| Rate for Payer: Aetna Commercial |
$1,606.53
|
| Rate for Payer: Anthem Medicaid |
$717.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,627.39
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cigna Commercial |
$1,731.71
|
| Rate for Payer: First Health Commercial |
$1,982.08
|
| Rate for Payer: Humana Commercial |
$1,773.44
|
| Rate for Payer: Humana KY Medicaid |
$717.51
|
| Rate for Payer: Kentucky WC Medicaid |
$724.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,710.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,539.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$625.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$731.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,836.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,564.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$417.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$271.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$646.78
|
| Rate for Payer: PHCS Commercial |
$2,002.94
|
| Rate for Payer: United Healthcare All Payer |
$1,836.03
|
|
|
SCREW ASNIS CANN 5.0*60
|
Facility
|
IP
|
$2,086.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.23 |
| Max. Negotiated Rate |
$2,002.94 |
| Rate for Payer: Aetna Commercial |
$1,606.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,627.39
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cigna Commercial |
$1,731.71
|
| Rate for Payer: First Health Commercial |
$1,982.08
|
| Rate for Payer: Humana Commercial |
$1,773.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,710.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,539.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$625.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,836.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,564.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$417.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$271.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$646.78
|
| Rate for Payer: PHCS Commercial |
$2,002.94
|
| Rate for Payer: United Healthcare All Payer |
$1,836.03
|
|
