|
SCREW COMPRESSION 30MM
|
Facility
|
OP
|
$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 Medicaid |
$1,069.00
|
| 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: Humana KY Medicaid |
$1,069.00
|
| Rate for Payer: Kentucky WC Medicaid |
$1,079.88
|
| 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: Molina Healthcare Medicaid |
$1,090.45
|
| 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
|
|
|
SCREW COMPRESSION 32.3MM
|
Facility
|
OP
|
$1,101.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.15 |
| Max. Negotiated Rate |
$1,057.08 |
| Rate for Payer: Aetna Commercial |
$847.86
|
| Rate for Payer: Anthem Medicaid |
$378.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$858.87
|
| Rate for Payer: Cash Price |
$550.56
|
| Rate for Payer: Cigna Commercial |
$913.93
|
| Rate for Payer: First Health Commercial |
$1,046.06
|
| Rate for Payer: Humana Commercial |
$935.95
|
| Rate for Payer: Humana KY Medicaid |
$378.68
|
| Rate for Payer: Kentucky WC Medicaid |
$382.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$902.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$812.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$330.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$386.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$968.99
|
| Rate for Payer: Ohio Health Group HMO |
$825.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$220.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$143.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$341.35
|
| Rate for Payer: PHCS Commercial |
$1,057.08
|
| Rate for Payer: United Healthcare All Payer |
$968.99
|
|
|
SCREW COMPRESSION 32.3MM
|
Facility
|
IP
|
$1,101.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.15 |
| Max. Negotiated Rate |
$1,057.08 |
| Rate for Payer: Aetna Commercial |
$847.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$858.87
|
| Rate for Payer: Cash Price |
$550.56
|
| Rate for Payer: Cigna Commercial |
$913.93
|
| Rate for Payer: First Health Commercial |
$1,046.06
|
| Rate for Payer: Humana Commercial |
$935.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$902.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$812.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$330.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$968.99
|
| Rate for Payer: Ohio Health Group HMO |
$825.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$220.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$143.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$341.35
|
| Rate for Payer: PHCS Commercial |
$1,057.08
|
| Rate for Payer: United Healthcare All Payer |
$968.99
|
|
|
SCREW COMPRESSION 40MM
|
Facility
|
IP
|
$3,126.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$406.39 |
| Max. Negotiated Rate |
$3,001.06 |
| Rate for Payer: Aetna Commercial |
$2,407.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,438.36
|
| Rate for Payer: Cash Price |
$1,563.05
|
| Rate for Payer: Cigna Commercial |
$2,594.66
|
| Rate for Payer: First Health Commercial |
$2,969.80
|
| Rate for Payer: Humana Commercial |
$2,657.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,563.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,307.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$937.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,750.97
|
| Rate for Payer: Ohio Health Group HMO |
$2,344.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$625.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$406.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$969.09
|
| Rate for Payer: PHCS Commercial |
$3,001.06
|
| Rate for Payer: United Healthcare All Payer |
$2,750.97
|
|
|
SCREW COMPRESSION 40MM
|
Facility
|
OP
|
$3,126.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$406.39 |
| Max. Negotiated Rate |
$3,001.06 |
| Rate for Payer: Aetna Commercial |
$2,407.10
|
| Rate for Payer: Anthem Medicaid |
$1,075.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,438.36
|
| Rate for Payer: Cash Price |
$1,563.05
|
| Rate for Payer: Cigna Commercial |
$2,594.66
|
| Rate for Payer: First Health Commercial |
$2,969.80
|
| Rate for Payer: Humana Commercial |
$2,657.18
|
| Rate for Payer: Humana KY Medicaid |
$1,075.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,086.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,563.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,307.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$937.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,096.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,750.97
|
| Rate for Payer: Ohio Health Group HMO |
$2,344.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$625.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$406.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$969.09
|
| Rate for Payer: PHCS Commercial |
$3,001.06
|
| Rate for Payer: United Healthcare All Payer |
$2,750.97
|
|
|
SCREW COMPTIBLE SHELL 6.5*40M
|
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 COMPTIBLE SHELL 6.5*40M
|
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 CON 6.5*35MM
|
Facility
|
OP
|
$4,300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.00 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$3,311.00
|
| Rate for Payer: Anthem Medicaid |
$1,478.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
| Rate for Payer: Cash Price |
$2,150.00
|
| Rate for Payer: Cigna Commercial |
$3,569.00
|
| Rate for Payer: First Health Commercial |
$4,085.00
|
| Rate for Payer: Humana Commercial |
$3,655.00
|
| Rate for Payer: Humana KY Medicaid |
$1,478.77
|
| Rate for Payer: Kentucky WC Medicaid |
$1,493.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,508.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
| Rate for Payer: PHCS Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
|
SCREW CON 6.5*35MM
|
Facility
|
IP
|
$4,300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.00 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$3,311.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
| Rate for Payer: Cash Price |
$2,150.00
|
| Rate for Payer: Cigna Commercial |
$3,569.00
|
| Rate for Payer: First Health Commercial |
$4,085.00
|
| Rate for Payer: Humana Commercial |
$3,655.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
| Rate for Payer: PHCS Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
|
SCREW CORT BONE 4.5*32MM
|
Facility
|
OP
|
$792.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.01 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Aetna Commercial |
$610.13
|
| Rate for Payer: Anthem Medicaid |
$272.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$618.06
|
| Rate for Payer: Cash Price |
$396.19
|
| Rate for Payer: Cigna Commercial |
$657.68
|
| Rate for Payer: First Health Commercial |
$752.76
|
| Rate for Payer: Humana Commercial |
$673.52
|
| Rate for Payer: Humana KY Medicaid |
$272.50
|
| Rate for Payer: Kentucky WC Medicaid |
$275.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$649.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$584.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$237.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$277.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$697.29
|
| Rate for Payer: Ohio Health Group HMO |
$594.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$158.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$103.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$245.64
|
| Rate for Payer: PHCS Commercial |
$760.68
|
| Rate for Payer: United Healthcare All Payer |
$697.29
|
|
|
SCREW CORT BONE 4.5*32MM
|
Facility
|
IP
|
$792.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.01 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Aetna Commercial |
$610.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$618.06
|
| Rate for Payer: Cash Price |
$396.19
|
| Rate for Payer: Cigna Commercial |
$657.68
|
| Rate for Payer: First Health Commercial |
$752.76
|
| Rate for Payer: Humana Commercial |
$673.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$649.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$584.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$237.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$697.29
|
| Rate for Payer: Ohio Health Group HMO |
$594.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$158.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$103.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$245.64
|
| Rate for Payer: PHCS Commercial |
$760.68
|
| Rate for Payer: United Healthcare All Payer |
$697.29
|
|
|
SCREW CORTEX 3.5*45 SELF TAP
|
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 CORTEX 3.5*45 SELF TAP
|
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 CORTEX 3.5*55 SELF TAP
|
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 CORTEX 3.5*55 SELF TAP
|
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 CORTEX 3.5*60 SELF TAP
|
Facility
|
OP
|
$1,125.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.28 |
| Max. Negotiated Rate |
$1,080.19 |
| Rate for Payer: Aetna Commercial |
$866.40
|
| Rate for Payer: Anthem Medicaid |
$386.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$877.66
|
| Rate for Payer: Cash Price |
$562.60
|
| Rate for Payer: Cigna Commercial |
$933.92
|
| Rate for Payer: First Health Commercial |
$1,068.94
|
| Rate for Payer: Humana Commercial |
$956.42
|
| Rate for Payer: Humana KY Medicaid |
$386.96
|
| Rate for Payer: Kentucky WC Medicaid |
$390.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$922.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$830.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$337.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$394.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$990.18
|
| Rate for Payer: Ohio Health Group HMO |
$843.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$225.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$348.81
|
| Rate for Payer: PHCS Commercial |
$1,080.19
|
| Rate for Payer: United Healthcare All Payer |
$990.18
|
|
|
SCREW CORTEX 3.5*60 SELF TAP
|
Facility
|
IP
|
$1,125.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.28 |
| Max. Negotiated Rate |
$1,080.19 |
| Rate for Payer: Aetna Commercial |
$866.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$877.66
|
| Rate for Payer: Cash Price |
$562.60
|
| Rate for Payer: Cigna Commercial |
$933.92
|
| Rate for Payer: First Health Commercial |
$1,068.94
|
| Rate for Payer: Humana Commercial |
$956.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$922.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$830.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$337.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$990.18
|
| Rate for Payer: Ohio Health Group HMO |
$843.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$225.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$348.81
|
| Rate for Payer: PHCS Commercial |
$1,080.19
|
| Rate for Payer: United Healthcare All Payer |
$990.18
|
|
|
SCREW CORTEX 3.5*65 SELF TAP
|
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 CORTEX 3.5*65 SELF TAP
|
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 CORTEX 3.5*90 SELF TAP
|
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 CORTEX 3.5*90 SELF TAP
|
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 CORTEX 3.5MM 20MM
|
Facility
|
IP
|
$1,159.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.75 |
| Max. Negotiated Rate |
$1,113.22 |
| Rate for Payer: Aetna Commercial |
$892.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$904.49
|
| Rate for Payer: Cash Price |
$579.80
|
| Rate for Payer: Cigna Commercial |
$962.47
|
| Rate for Payer: First Health Commercial |
$1,101.62
|
| Rate for Payer: Humana Commercial |
$985.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$950.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$855.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$347.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,020.45
|
| Rate for Payer: Ohio Health Group HMO |
$869.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$231.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$150.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$359.48
|
| Rate for Payer: PHCS Commercial |
$1,113.22
|
| Rate for Payer: United Healthcare All Payer |
$1,020.45
|
|
|
SCREW CORTEX 3.5MM 20MM
|
Facility
|
OP
|
$1,159.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.75 |
| Max. Negotiated Rate |
$1,113.22 |
| Rate for Payer: Aetna Commercial |
$892.89
|
| Rate for Payer: Anthem Medicaid |
$398.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$904.49
|
| Rate for Payer: Cash Price |
$579.80
|
| Rate for Payer: Cigna Commercial |
$962.47
|
| Rate for Payer: First Health Commercial |
$1,101.62
|
| Rate for Payer: Humana Commercial |
$985.66
|
| Rate for Payer: Humana KY Medicaid |
$398.79
|
| Rate for Payer: Kentucky WC Medicaid |
$402.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$950.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$855.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$347.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$406.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,020.45
|
| Rate for Payer: Ohio Health Group HMO |
$869.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$231.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$150.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$359.48
|
| Rate for Payer: PHCS Commercial |
$1,113.22
|
| Rate for Payer: United Healthcare All Payer |
$1,020.45
|
|
|
SCREW CORTEX TI 3.5*24
|
Facility
|
IP
|
$735.32
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.59 |
| Max. Negotiated Rate |
$705.91 |
| Rate for Payer: Aetna Commercial |
$566.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$573.55
|
| Rate for Payer: Cash Price |
$367.66
|
| Rate for Payer: Cigna Commercial |
$610.32
|
| Rate for Payer: First Health Commercial |
$698.55
|
| Rate for Payer: Humana Commercial |
$625.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$602.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$542.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$220.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$647.08
|
| Rate for Payer: Ohio Health Group HMO |
$551.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$147.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$95.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$227.95
|
| Rate for Payer: PHCS Commercial |
$705.91
|
| Rate for Payer: United Healthcare All Payer |
$647.08
|
|
|
SCREW CORTEX TI 3.5*24
|
Facility
|
OP
|
$735.32
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.59 |
| Max. Negotiated Rate |
$705.91 |
| Rate for Payer: Aetna Commercial |
$566.20
|
| Rate for Payer: Anthem Medicaid |
$252.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$573.55
|
| Rate for Payer: Cash Price |
$367.66
|
| Rate for Payer: Cigna Commercial |
$610.32
|
| Rate for Payer: First Health Commercial |
$698.55
|
| Rate for Payer: Humana Commercial |
$625.02
|
| Rate for Payer: Humana KY Medicaid |
$252.88
|
| Rate for Payer: Kentucky WC Medicaid |
$255.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$602.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$542.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$220.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$257.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$647.08
|
| Rate for Payer: Ohio Health Group HMO |
$551.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$147.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$95.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$227.95
|
| Rate for Payer: PHCS Commercial |
$705.91
|
| Rate for Payer: United Healthcare All Payer |
$647.08
|
|
