|
SCREW CANC TI FT 4.0*42
|
Facility
|
OP
|
$744.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.73 |
| Max. Negotiated Rate |
$714.28 |
| Rate for Payer: Aetna Commercial |
$572.91
|
| Rate for Payer: Anthem Medicaid |
$255.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$580.35
|
| Rate for Payer: Cash Price |
$372.02
|
| Rate for Payer: Cigna Commercial |
$617.55
|
| Rate for Payer: First Health Commercial |
$706.84
|
| Rate for Payer: Humana Commercial |
$632.43
|
| Rate for Payer: Humana KY Medicaid |
$255.88
|
| Rate for Payer: Kentucky WC Medicaid |
$258.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$610.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$549.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$223.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$261.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$654.76
|
| Rate for Payer: Ohio Health Group HMO |
$558.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$148.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$96.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$230.65
|
| Rate for Payer: PHCS Commercial |
$714.28
|
| Rate for Payer: United Healthcare All Payer |
$654.76
|
|
|
SCREW CANC TI FT 4.0*65
|
Facility
|
OP
|
$744.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.73 |
| Max. Negotiated Rate |
$714.28 |
| Rate for Payer: Aetna Commercial |
$572.91
|
| Rate for Payer: Anthem Medicaid |
$255.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$580.35
|
| Rate for Payer: Cash Price |
$372.02
|
| Rate for Payer: Cigna Commercial |
$617.55
|
| Rate for Payer: First Health Commercial |
$706.84
|
| Rate for Payer: Humana Commercial |
$632.43
|
| Rate for Payer: Humana KY Medicaid |
$255.88
|
| Rate for Payer: Kentucky WC Medicaid |
$258.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$610.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$549.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$223.21
|
| Rate for Payer: Molina Healthcare Medicaid |
$261.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$654.76
|
| Rate for Payer: Ohio Health Group HMO |
$558.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$148.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$96.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$230.65
|
| Rate for Payer: PHCS Commercial |
$714.28
|
| Rate for Payer: United Healthcare All Payer |
$654.76
|
|
|
SCREW CANC TI FT 4.0*65
|
Facility
|
IP
|
$744.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.73 |
| Max. Negotiated Rate |
$714.28 |
| Rate for Payer: Aetna Commercial |
$572.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$580.35
|
| Rate for Payer: Cash Price |
$372.02
|
| Rate for Payer: Cigna Commercial |
$617.55
|
| Rate for Payer: First Health Commercial |
$706.84
|
| Rate for Payer: Humana Commercial |
$632.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$610.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$549.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$223.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$654.76
|
| Rate for Payer: Ohio Health Group HMO |
$558.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$148.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$96.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$230.65
|
| Rate for Payer: PHCS Commercial |
$714.28
|
| Rate for Payer: United Healthcare All Payer |
$654.76
|
|
|
SCREW CANC TI FT 6.0*40
|
Facility
|
IP
|
$798.36
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.79 |
| Max. Negotiated Rate |
$766.43 |
| Rate for Payer: Aetna Commercial |
$614.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$622.72
|
| Rate for Payer: Cash Price |
$399.18
|
| Rate for Payer: Cigna Commercial |
$662.64
|
| Rate for Payer: First Health Commercial |
$758.44
|
| Rate for Payer: Humana Commercial |
$678.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$654.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$589.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$239.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$702.56
|
| Rate for Payer: Ohio Health Group HMO |
$598.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$159.67
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$103.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$247.49
|
| Rate for Payer: PHCS Commercial |
$766.43
|
| Rate for Payer: United Healthcare All Payer |
$702.56
|
|
|
SCREW CANC TI FT 6.0*40
|
Facility
|
OP
|
$798.36
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.79 |
| Max. Negotiated Rate |
$766.43 |
| Rate for Payer: Aetna Commercial |
$614.74
|
| Rate for Payer: Anthem Medicaid |
$274.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$622.72
|
| Rate for Payer: Cash Price |
$399.18
|
| Rate for Payer: Cigna Commercial |
$662.64
|
| Rate for Payer: First Health Commercial |
$758.44
|
| Rate for Payer: Humana Commercial |
$678.61
|
| Rate for Payer: Humana KY Medicaid |
$274.56
|
| Rate for Payer: Kentucky WC Medicaid |
$277.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$654.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$589.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$239.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$280.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$702.56
|
| Rate for Payer: Ohio Health Group HMO |
$598.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$159.67
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$103.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$247.49
|
| Rate for Payer: PHCS Commercial |
$766.43
|
| Rate for Payer: United Healthcare All Payer |
$702.56
|
|
|
SCREW CANC TI HTO 6.5*50
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CANC TI HTO 6.5*50
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CANC TI HTO 6.5*55
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CANC TI HTO 6.5*55
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CANN BLT 4.0*24
|
Facility
|
OP
|
$1,956.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$254.33 |
| Max. Negotiated Rate |
$1,878.12 |
| Rate for Payer: Aetna Commercial |
$1,506.41
|
| Rate for Payer: Anthem Medicaid |
$672.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,525.98
|
| Rate for Payer: Cash Price |
$978.19
|
| Rate for Payer: Cigna Commercial |
$1,623.80
|
| Rate for Payer: First Health Commercial |
$1,858.56
|
| Rate for Payer: Humana Commercial |
$1,662.92
|
| Rate for Payer: Humana KY Medicaid |
$672.80
|
| Rate for Payer: Kentucky WC Medicaid |
$679.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,604.23
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,443.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$586.91
|
| Rate for Payer: Molina Healthcare Medicaid |
$686.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,721.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,467.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$391.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$606.48
|
| Rate for Payer: PHCS Commercial |
$1,878.12
|
| Rate for Payer: United Healthcare All Payer |
$1,721.61
|
|
|
SCREW CANN BLT 4.0*24
|
Facility
|
IP
|
$1,956.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$254.33 |
| Max. Negotiated Rate |
$1,878.12 |
| Rate for Payer: Aetna Commercial |
$1,506.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,525.98
|
| Rate for Payer: Cash Price |
$978.19
|
| Rate for Payer: Cigna Commercial |
$1,623.80
|
| Rate for Payer: First Health Commercial |
$1,858.56
|
| Rate for Payer: Humana Commercial |
$1,662.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,604.23
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,443.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$586.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,721.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,467.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$391.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$606.48
|
| Rate for Payer: PHCS Commercial |
$1,878.12
|
| Rate for Payer: United Healthcare All Payer |
$1,721.61
|
|
|
SCREW CANN BLT 4.0*26
|
Facility
|
OP
|
$1,956.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$254.33 |
| Max. Negotiated Rate |
$1,878.12 |
| Rate for Payer: Aetna Commercial |
$1,506.41
|
| Rate for Payer: Anthem Medicaid |
$672.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,525.98
|
| Rate for Payer: Cash Price |
$978.19
|
| Rate for Payer: Cigna Commercial |
$1,623.80
|
| Rate for Payer: First Health Commercial |
$1,858.56
|
| Rate for Payer: Humana Commercial |
$1,662.92
|
| Rate for Payer: Humana KY Medicaid |
$672.80
|
| Rate for Payer: Kentucky WC Medicaid |
$679.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,604.23
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,443.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$586.91
|
| Rate for Payer: Molina Healthcare Medicaid |
$686.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,721.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,467.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$391.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$606.48
|
| Rate for Payer: PHCS Commercial |
$1,878.12
|
| Rate for Payer: United Healthcare All Payer |
$1,721.61
|
|
|
SCREW CANN BLT 4.0*26
|
Facility
|
IP
|
$1,956.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$254.33 |
| Max. Negotiated Rate |
$1,878.12 |
| Rate for Payer: Aetna Commercial |
$1,506.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,525.98
|
| Rate for Payer: Cash Price |
$978.19
|
| Rate for Payer: Cigna Commercial |
$1,623.80
|
| Rate for Payer: First Health Commercial |
$1,858.56
|
| Rate for Payer: Humana Commercial |
$1,662.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,604.23
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,443.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$586.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,721.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,467.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$391.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$606.48
|
| Rate for Payer: PHCS Commercial |
$1,878.12
|
| Rate for Payer: United Healthcare All Payer |
$1,721.61
|
|
|
SCREW CANN PT 4.0*32MM
|
Facility
|
IP
|
$1,754.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$228.02 |
| Max. Negotiated Rate |
$1,683.85 |
| Rate for Payer: Aetna Commercial |
$1,350.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,368.13
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cigna Commercial |
$1,455.83
|
| Rate for Payer: First Health Commercial |
$1,666.31
|
| Rate for Payer: Humana Commercial |
$1,490.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,438.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,294.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$526.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,543.53
|
| Rate for Payer: Ohio Health Group HMO |
$1,315.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$228.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$543.74
|
| Rate for Payer: PHCS Commercial |
$1,683.85
|
| Rate for Payer: United Healthcare All Payer |
$1,543.53
|
|
|
SCREW CANN PT 4.0*32MM
|
Facility
|
OP
|
$1,754.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$228.02 |
| Max. Negotiated Rate |
$1,683.85 |
| Rate for Payer: Aetna Commercial |
$1,350.59
|
| Rate for Payer: Anthem Medicaid |
$603.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,368.13
|
| Rate for Payer: Cash Price |
$877.00
|
| Rate for Payer: Cigna Commercial |
$1,455.83
|
| Rate for Payer: First Health Commercial |
$1,666.31
|
| Rate for Payer: Humana Commercial |
$1,490.91
|
| Rate for Payer: Humana KY Medicaid |
$603.20
|
| Rate for Payer: Kentucky WC Medicaid |
$609.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,438.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,294.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$526.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$615.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,543.53
|
| Rate for Payer: Ohio Health Group HMO |
$1,315.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$228.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$543.74
|
| Rate for Payer: PHCS Commercial |
$1,683.85
|
| Rate for Payer: United Healthcare All Payer |
$1,543.53
|
|
|
SCREW CANN PT SS 8.0*50*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*50*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*55*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*55*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*60*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*60*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*65*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*65*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN SHORT THRD 4.0 50MM
|
Facility
|
OP
|
$3,817.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$496.21 |
| Max. Negotiated Rate |
$3,664.32 |
| Rate for Payer: Aetna Commercial |
$2,939.09
|
| Rate for Payer: Anthem Medicaid |
$1,312.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,977.26
|
| Rate for Payer: Cash Price |
$1,908.50
|
| Rate for Payer: Cigna Commercial |
$3,168.11
|
| Rate for Payer: First Health Commercial |
$3,626.15
|
| Rate for Payer: Humana Commercial |
$3,244.45
|
| Rate for Payer: Humana KY Medicaid |
$1,312.67
|
| Rate for Payer: Kentucky WC Medicaid |
$1,326.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,129.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,816.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,145.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,339.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,358.96
|
| Rate for Payer: Ohio Health Group HMO |
$2,862.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$763.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$496.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,183.27
|
| Rate for Payer: PHCS Commercial |
$3,664.32
|
| Rate for Payer: United Healthcare All Payer |
$3,358.96
|
|
|
SCREW CANN SHORT THRD 4.0 50MM
|
Facility
|
IP
|
$3,817.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$496.21 |
| Max. Negotiated Rate |
$3,664.32 |
| Rate for Payer: Aetna Commercial |
$2,939.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,977.26
|
| Rate for Payer: Cash Price |
$1,908.50
|
| Rate for Payer: Cigna Commercial |
$3,168.11
|
| Rate for Payer: First Health Commercial |
$3,626.15
|
| Rate for Payer: Humana Commercial |
$3,244.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,129.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,816.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,145.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,358.96
|
| Rate for Payer: Ohio Health Group HMO |
$2,862.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$763.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$496.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,183.27
|
| Rate for Payer: PHCS Commercial |
$3,664.32
|
| Rate for Payer: United Healthcare All Payer |
$3,358.96
|
|
