|
SCREW CANN TAP JF55
|
Facility
|
IP
|
$2,058.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$267.64 |
| Max. Negotiated Rate |
$1,976.40 |
| Rate for Payer: Aetna Commercial |
$1,585.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,605.82
|
| Rate for Payer: Cash Price |
$1,029.38
|
| Rate for Payer: Cigna Commercial |
$1,708.76
|
| Rate for Payer: First Health Commercial |
$1,955.81
|
| Rate for Payer: Humana Commercial |
$1,749.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,688.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,519.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$617.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,811.70
|
| Rate for Payer: Ohio Health Group HMO |
$1,544.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$411.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$267.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$638.21
|
| Rate for Payer: PHCS Commercial |
$1,976.40
|
| Rate for Payer: United Healthcare All Payer |
$1,811.70
|
|
|
SCREW CANN TAP JF55
|
Facility
|
OP
|
$2,058.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$267.64 |
| Max. Negotiated Rate |
$1,976.40 |
| Rate for Payer: Aetna Commercial |
$1,585.24
|
| Rate for Payer: Anthem Medicaid |
$708.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,605.82
|
| Rate for Payer: Cash Price |
$1,029.38
|
| Rate for Payer: Cigna Commercial |
$1,708.76
|
| Rate for Payer: First Health Commercial |
$1,955.81
|
| Rate for Payer: Humana Commercial |
$1,749.94
|
| Rate for Payer: Humana KY Medicaid |
$708.00
|
| Rate for Payer: Kentucky WC Medicaid |
$715.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,688.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,519.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$617.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$722.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,811.70
|
| Rate for Payer: Ohio Health Group HMO |
$1,544.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$411.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$267.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$638.21
|
| Rate for Payer: PHCS Commercial |
$1,976.40
|
| Rate for Payer: United Healthcare All Payer |
$1,811.70
|
|
|
SCREW CANNULATED 6.5*85*20MM
|
Facility
|
IP
|
$1,988.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.47 |
| Max. Negotiated Rate |
$1,908.73 |
| Rate for Payer: Aetna Commercial |
$1,530.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,550.84
|
| Rate for Payer: Cash Price |
$994.13
|
| Rate for Payer: Cigna Commercial |
$1,650.26
|
| Rate for Payer: First Health Commercial |
$1,888.85
|
| Rate for Payer: Humana Commercial |
$1,690.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,630.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,467.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,749.67
|
| Rate for Payer: Ohio Health Group HMO |
$1,491.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$616.36
|
| Rate for Payer: PHCS Commercial |
$1,908.73
|
| Rate for Payer: United Healthcare All Payer |
$1,749.67
|
|
|
SCREW CANNULATED 6.5*85*20MM
|
Facility
|
OP
|
$1,988.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.47 |
| Max. Negotiated Rate |
$1,908.73 |
| Rate for Payer: Aetna Commercial |
$1,530.96
|
| Rate for Payer: Anthem Medicaid |
$683.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,550.84
|
| Rate for Payer: Cash Price |
$994.13
|
| Rate for Payer: Cigna Commercial |
$1,650.26
|
| Rate for Payer: First Health Commercial |
$1,888.85
|
| Rate for Payer: Humana Commercial |
$1,690.02
|
| Rate for Payer: Humana KY Medicaid |
$683.76
|
| Rate for Payer: Kentucky WC Medicaid |
$690.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,630.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,467.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,749.67
|
| Rate for Payer: Ohio Health Group HMO |
$1,491.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$616.36
|
| Rate for Payer: PHCS Commercial |
$1,908.73
|
| Rate for Payer: United Healthcare All Payer |
$1,749.67
|
|
|
SCREW CANNULATED 6.5*90*20
|
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 CANNULATED 6.5*90*20
|
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 CANNULATED 6.5*90*20MM
|
Facility
|
OP
|
$1,988.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.47 |
| Max. Negotiated Rate |
$1,908.73 |
| Rate for Payer: Aetna Commercial |
$1,530.96
|
| Rate for Payer: Anthem Medicaid |
$683.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,550.84
|
| Rate for Payer: Cash Price |
$994.13
|
| Rate for Payer: Cigna Commercial |
$1,650.26
|
| Rate for Payer: First Health Commercial |
$1,888.85
|
| Rate for Payer: Humana Commercial |
$1,690.02
|
| Rate for Payer: Humana KY Medicaid |
$683.76
|
| Rate for Payer: Kentucky WC Medicaid |
$690.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,630.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,467.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,749.67
|
| Rate for Payer: Ohio Health Group HMO |
$1,491.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$616.36
|
| Rate for Payer: PHCS Commercial |
$1,908.73
|
| Rate for Payer: United Healthcare All Payer |
$1,749.67
|
|
|
SCREW CANNULATED 6.5*90*20MM
|
Facility
|
IP
|
$1,988.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.47 |
| Max. Negotiated Rate |
$1,908.73 |
| Rate for Payer: Aetna Commercial |
$1,530.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,550.84
|
| Rate for Payer: Cash Price |
$994.13
|
| Rate for Payer: Cigna Commercial |
$1,650.26
|
| Rate for Payer: First Health Commercial |
$1,888.85
|
| Rate for Payer: Humana Commercial |
$1,690.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,630.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,467.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,749.67
|
| Rate for Payer: Ohio Health Group HMO |
$1,491.20
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$616.36
|
| Rate for Payer: PHCS Commercial |
$1,908.73
|
| Rate for Payer: United Healthcare All Payer |
$1,749.67
|
|
|
SCREW CANNULATED 6.5*95*20MM
|
Facility
|
OP
|
$3,393.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.19 |
| Max. Negotiated Rate |
$3,258.03 |
| Rate for Payer: Aetna Commercial |
$2,613.21
|
| Rate for Payer: Anthem Medicaid |
$1,167.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,647.15
|
| Rate for Payer: Cash Price |
$1,696.89
|
| Rate for Payer: Cigna Commercial |
$2,816.84
|
| Rate for Payer: First Health Commercial |
$3,224.09
|
| Rate for Payer: Humana Commercial |
$2,884.71
|
| Rate for Payer: Humana KY Medicaid |
$1,167.12
|
| Rate for Payer: Kentucky WC Medicaid |
$1,179.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,782.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,504.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,018.13
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,190.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,986.53
|
| Rate for Payer: Ohio Health Group HMO |
$2,545.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$678.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$441.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,052.07
|
| Rate for Payer: PHCS Commercial |
$3,258.03
|
| Rate for Payer: United Healthcare All Payer |
$2,986.53
|
|
|
SCREW CANNULATED 6.5*95*20MM
|
Facility
|
IP
|
$3,393.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.19 |
| Max. Negotiated Rate |
$3,258.03 |
| Rate for Payer: Aetna Commercial |
$2,613.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,647.15
|
| Rate for Payer: Cash Price |
$1,696.89
|
| Rate for Payer: Cigna Commercial |
$2,816.84
|
| Rate for Payer: First Health Commercial |
$3,224.09
|
| Rate for Payer: Humana Commercial |
$2,884.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,782.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,504.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,018.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,986.53
|
| Rate for Payer: Ohio Health Group HMO |
$2,545.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$678.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$441.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,052.07
|
| Rate for Payer: PHCS Commercial |
$3,258.03
|
| Rate for Payer: United Healthcare All Payer |
$2,986.53
|
|
|
SCREW CAN THREAD 3.5*24MM
|
Facility
|
OP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem Medicaid |
$723.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Humana KY Medicaid |
$723.05
|
| Rate for Payer: Kentucky WC Medicaid |
$730.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$737.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
SCREW CAN THREAD 3.5*24MM
|
Facility
|
IP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
SCREW CAN THREAD 3.5*26MM
|
Facility
|
OP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem Medicaid |
$723.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Humana KY Medicaid |
$723.05
|
| Rate for Payer: Kentucky WC Medicaid |
$730.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$737.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
SCREW CAN THREAD 3.5*26MM
|
Facility
|
IP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
SCREW COMP HDLESS 7.0*115 LT
|
Facility
|
IP
|
$4,625.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$601.26 |
| Max. Negotiated Rate |
$4,440.04 |
| Rate for Payer: Aetna Commercial |
$3,561.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,607.53
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cigna Commercial |
$3,838.78
|
| Rate for Payer: First Health Commercial |
$4,393.79
|
| Rate for Payer: Humana Commercial |
$3,931.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,792.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,413.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,387.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,070.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,468.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$925.01
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$601.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,433.76
|
| Rate for Payer: PHCS Commercial |
$4,440.04
|
| Rate for Payer: United Healthcare All Payer |
$4,070.04
|
|
|
SCREW COMP HDLESS 7.0*115 LT
|
Facility
|
OP
|
$4,625.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$601.26 |
| Max. Negotiated Rate |
$4,440.04 |
| Rate for Payer: Aetna Commercial |
$3,561.28
|
| Rate for Payer: Anthem Medicaid |
$1,590.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,607.53
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cigna Commercial |
$3,838.78
|
| Rate for Payer: First Health Commercial |
$4,393.79
|
| Rate for Payer: Humana Commercial |
$3,931.28
|
| Rate for Payer: Humana KY Medicaid |
$1,590.55
|
| Rate for Payer: Kentucky WC Medicaid |
$1,606.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,792.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,413.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,387.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,622.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,070.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,468.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$925.01
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$601.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,433.76
|
| Rate for Payer: PHCS Commercial |
$4,440.04
|
| Rate for Payer: United Healthcare All Payer |
$4,070.04
|
|
|
SCREW COMP HDLESS7.0*85 LT
|
Facility
|
IP
|
$4,625.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$601.26 |
| Max. Negotiated Rate |
$4,440.04 |
| Rate for Payer: Aetna Commercial |
$3,561.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,607.53
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cigna Commercial |
$3,838.78
|
| Rate for Payer: First Health Commercial |
$4,393.79
|
| Rate for Payer: Humana Commercial |
$3,931.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,792.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,413.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,387.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,070.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,468.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$925.01
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$601.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,433.76
|
| Rate for Payer: PHCS Commercial |
$4,440.04
|
| Rate for Payer: United Healthcare All Payer |
$4,070.04
|
|
|
SCREW COMP HDLESS7.0*85 LT
|
Facility
|
OP
|
$4,625.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$601.26 |
| Max. Negotiated Rate |
$4,440.04 |
| Rate for Payer: Aetna Commercial |
$3,561.28
|
| Rate for Payer: Anthem Medicaid |
$1,590.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,607.53
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cigna Commercial |
$3,838.78
|
| Rate for Payer: First Health Commercial |
$4,393.79
|
| Rate for Payer: Humana Commercial |
$3,931.28
|
| Rate for Payer: Humana KY Medicaid |
$1,590.55
|
| Rate for Payer: Kentucky WC Medicaid |
$1,606.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,792.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,413.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,387.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,622.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,070.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,468.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$925.01
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$601.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,433.76
|
| Rate for Payer: PHCS Commercial |
$4,440.04
|
| Rate for Payer: United Healthcare All Payer |
$4,070.04
|
|
|
SCREW COMP HDLESS7.0*95 LT
|
Facility
|
OP
|
$4,625.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$601.26 |
| Max. Negotiated Rate |
$4,440.04 |
| Rate for Payer: Aetna Commercial |
$3,561.28
|
| Rate for Payer: Anthem Medicaid |
$1,590.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,607.53
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cigna Commercial |
$3,838.78
|
| Rate for Payer: First Health Commercial |
$4,393.79
|
| Rate for Payer: Humana Commercial |
$3,931.28
|
| Rate for Payer: Humana KY Medicaid |
$1,590.55
|
| Rate for Payer: Kentucky WC Medicaid |
$1,606.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,792.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,413.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,387.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,622.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,070.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,468.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$925.01
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$601.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,433.76
|
| Rate for Payer: PHCS Commercial |
$4,440.04
|
| Rate for Payer: United Healthcare All Payer |
$4,070.04
|
|
|
SCREW COMP HDLESS7.0*95 LT
|
Facility
|
IP
|
$4,625.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$601.26 |
| Max. Negotiated Rate |
$4,440.04 |
| Rate for Payer: Aetna Commercial |
$3,561.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,607.53
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cigna Commercial |
$3,838.78
|
| Rate for Payer: First Health Commercial |
$4,393.79
|
| Rate for Payer: Humana Commercial |
$3,931.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,792.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,413.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,387.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,070.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,468.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$925.01
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$601.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,433.76
|
| Rate for Payer: PHCS Commercial |
$4,440.04
|
| Rate for Payer: United Healthcare All Payer |
$4,070.04
|
|
|
SCREW COMP HEADLESS 5.0*60 TI
|
Facility
|
IP
|
$5,164.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.38 |
| Max. Negotiated Rate |
$4,957.92 |
| Rate for Payer: Aetna Commercial |
$3,976.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,028.31
|
| Rate for Payer: Cash Price |
$2,582.25
|
| Rate for Payer: Cigna Commercial |
$4,286.54
|
| Rate for Payer: First Health Commercial |
$4,906.28
|
| Rate for Payer: Humana Commercial |
$4,389.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,234.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,811.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,549.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,544.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,873.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,032.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$671.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,601.00
|
| Rate for Payer: PHCS Commercial |
$4,957.92
|
| Rate for Payer: United Healthcare All Payer |
$4,544.76
|
|
|
SCREW COMP HEADLESS 5.0*60 TI
|
Facility
|
OP
|
$5,164.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.38 |
| Max. Negotiated Rate |
$4,957.92 |
| Rate for Payer: Aetna Commercial |
$3,976.66
|
| Rate for Payer: Anthem Medicaid |
$1,776.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,028.31
|
| Rate for Payer: Cash Price |
$2,582.25
|
| Rate for Payer: Cigna Commercial |
$4,286.54
|
| Rate for Payer: First Health Commercial |
$4,906.28
|
| Rate for Payer: Humana Commercial |
$4,389.82
|
| Rate for Payer: Humana KY Medicaid |
$1,776.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,794.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,234.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,811.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,549.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,811.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,544.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,873.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,032.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$671.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,601.00
|
| Rate for Payer: PHCS Commercial |
$4,957.92
|
| Rate for Payer: United Healthcare All Payer |
$4,544.76
|
|
|
SCREW COMP HEADLESS 5.0*65 TI
|
Facility
|
OP
|
$5,164.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.38 |
| Max. Negotiated Rate |
$4,957.92 |
| Rate for Payer: Aetna Commercial |
$3,976.66
|
| Rate for Payer: Anthem Medicaid |
$1,776.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,028.31
|
| Rate for Payer: Cash Price |
$2,582.25
|
| Rate for Payer: Cigna Commercial |
$4,286.54
|
| Rate for Payer: First Health Commercial |
$4,906.28
|
| Rate for Payer: Humana Commercial |
$4,389.82
|
| Rate for Payer: Humana KY Medicaid |
$1,776.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,794.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,234.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,811.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,549.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,811.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,544.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,873.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,032.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$671.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,601.00
|
| Rate for Payer: PHCS Commercial |
$4,957.92
|
| Rate for Payer: United Healthcare All Payer |
$4,544.76
|
|
|
SCREW COMP HEADLESS 5.0*65 TI
|
Facility
|
IP
|
$5,164.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.38 |
| Max. Negotiated Rate |
$4,957.92 |
| Rate for Payer: Aetna Commercial |
$3,976.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,028.31
|
| Rate for Payer: Cash Price |
$2,582.25
|
| Rate for Payer: Cigna Commercial |
$4,286.54
|
| Rate for Payer: First Health Commercial |
$4,906.28
|
| Rate for Payer: Humana Commercial |
$4,389.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,234.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,811.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,549.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,544.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,873.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,032.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$671.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,601.00
|
| Rate for Payer: PHCS Commercial |
$4,957.92
|
| Rate for Payer: United Healthcare All Payer |
$4,544.76
|
|
|
SCREW COMPRESSION 30MM
|
Facility
|
IP
|
$3,108.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$404.10 |
| Max. Negotiated Rate |
$2,984.12 |
| Rate for Payer: Aetna Commercial |
$2,393.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,424.60
|
| Rate for Payer: Cash Price |
$1,554.23
|
| Rate for Payer: Cigna Commercial |
$2,580.02
|
| Rate for Payer: First Health Commercial |
$2,953.04
|
| Rate for Payer: Humana Commercial |
$2,642.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,548.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,294.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$932.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,735.44
|
| Rate for Payer: Ohio Health Group HMO |
$2,331.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$621.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$404.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$963.62
|
| Rate for Payer: PHCS Commercial |
$2,984.12
|
| Rate for Payer: United Healthcare All Payer |
$2,735.44
|
|
