|
SCREW CORTEX TI 3.5*26
|
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*26
|
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
|
|
|
SCREW CORTEX TI 3.5*28
|
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*28
|
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
|
|
|
SCREW CORTEX TI 3.5*30
|
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
|
|
|
SCREW CORTEX TI 3.5*30
|
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*32
|
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*32
|
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
|
|
|
SCREW CORTEX TI 3.5*40
|
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*40
|
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
|
|
|
SCREW CORTICAL 4.5*40MM
|
Facility
|
IP
|
$1,525.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$1,464.60 |
| Rate for Payer: Aetna Commercial |
$1,174.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,189.98
|
| Rate for Payer: Cash Price |
$762.81
|
| Rate for Payer: Cigna Commercial |
$1,266.26
|
| Rate for Payer: First Health Commercial |
$1,449.34
|
| Rate for Payer: Humana Commercial |
$1,296.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,251.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,125.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$457.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,342.55
|
| Rate for Payer: Ohio Health Group HMO |
$1,144.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$305.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$198.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$472.94
|
| Rate for Payer: PHCS Commercial |
$1,464.60
|
| Rate for Payer: United Healthcare All Payer |
$1,342.55
|
|
|
SCREW CORTICAL 4.5*40MM
|
Facility
|
OP
|
$1,525.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$1,464.60 |
| Rate for Payer: Aetna Commercial |
$1,174.73
|
| Rate for Payer: Anthem Medicaid |
$524.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,189.98
|
| Rate for Payer: Cash Price |
$762.81
|
| Rate for Payer: Cigna Commercial |
$1,266.26
|
| Rate for Payer: First Health Commercial |
$1,449.34
|
| Rate for Payer: Humana Commercial |
$1,296.78
|
| Rate for Payer: Humana KY Medicaid |
$524.66
|
| Rate for Payer: Kentucky WC Medicaid |
$530.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,251.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,125.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$457.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$535.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,342.55
|
| Rate for Payer: Ohio Health Group HMO |
$1,144.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$305.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$198.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$472.94
|
| Rate for Payer: PHCS Commercial |
$1,464.60
|
| Rate for Payer: United Healthcare All Payer |
$1,342.55
|
|
|
SCREW CORTICAL FULL 3.5*22MM
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$1,632.00 |
| Rate for Payer: Aetna Commercial |
$1,309.00
|
| Rate for Payer: Anthem Medicaid |
$584.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,326.00
|
| Rate for Payer: Cash Price |
$850.00
|
| Rate for Payer: Cigna Commercial |
$1,411.00
|
| Rate for Payer: First Health Commercial |
$1,615.00
|
| Rate for Payer: Humana Commercial |
$1,445.00
|
| Rate for Payer: Humana KY Medicaid |
$584.63
|
| Rate for Payer: Kentucky WC Medicaid |
$590.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,394.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,254.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$510.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$596.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,496.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,275.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$340.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$221.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$527.00
|
| Rate for Payer: PHCS Commercial |
$1,632.00
|
| Rate for Payer: United Healthcare All Payer |
$1,496.00
|
|
|
SCREW CORTICAL FULL 3.5*22MM
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$1,632.00 |
| Rate for Payer: Aetna Commercial |
$1,309.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,326.00
|
| Rate for Payer: Cash Price |
$850.00
|
| Rate for Payer: Cigna Commercial |
$1,411.00
|
| Rate for Payer: First Health Commercial |
$1,615.00
|
| Rate for Payer: Humana Commercial |
$1,445.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,394.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,254.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$510.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,496.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,275.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$340.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$221.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$527.00
|
| Rate for Payer: PHCS Commercial |
$1,632.00
|
| Rate for Payer: United Healthcare All Payer |
$1,496.00
|
|
|
SCREW CORTICAL LP 3.5*14MM
|
Facility
|
IP
|
$1,728.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.64 |
| Max. Negotiated Rate |
$1,658.88 |
| Rate for Payer: Aetna Commercial |
$1,330.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,347.84
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: First Health Commercial |
$1,641.60
|
| Rate for Payer: Humana Commercial |
$1,468.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,416.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,520.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$345.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$224.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$535.68
|
| Rate for Payer: PHCS Commercial |
$1,658.88
|
| Rate for Payer: United Healthcare All Payer |
$1,520.64
|
|
|
SCREW CORTICAL LP 3.5*14MM
|
Facility
|
OP
|
$1,728.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.64 |
| Max. Negotiated Rate |
$1,658.88 |
| Rate for Payer: Aetna Commercial |
$1,330.56
|
| Rate for Payer: Anthem Medicaid |
$594.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,347.84
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: First Health Commercial |
$1,641.60
|
| Rate for Payer: Humana Commercial |
$1,468.80
|
| Rate for Payer: Humana KY Medicaid |
$594.26
|
| Rate for Payer: Kentucky WC Medicaid |
$600.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,416.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$606.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,520.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$345.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$224.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$535.68
|
| Rate for Payer: PHCS Commercial |
$1,658.88
|
| Rate for Payer: United Healthcare All Payer |
$1,520.64
|
|
|
SCREW CORTICAL LP 3.5*16MM
|
Facility
|
IP
|
$1,728.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.64 |
| Max. Negotiated Rate |
$1,658.88 |
| Rate for Payer: Aetna Commercial |
$1,330.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,347.84
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: First Health Commercial |
$1,641.60
|
| Rate for Payer: Humana Commercial |
$1,468.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,416.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,520.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$345.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$224.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$535.68
|
| Rate for Payer: PHCS Commercial |
$1,658.88
|
| Rate for Payer: United Healthcare All Payer |
$1,520.64
|
|
|
SCREW CORTICAL LP 3.5*16MM
|
Facility
|
OP
|
$1,728.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.64 |
| Max. Negotiated Rate |
$1,658.88 |
| Rate for Payer: Aetna Commercial |
$1,330.56
|
| Rate for Payer: Anthem Medicaid |
$594.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,347.84
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: First Health Commercial |
$1,641.60
|
| Rate for Payer: Humana Commercial |
$1,468.80
|
| Rate for Payer: Humana KY Medicaid |
$594.26
|
| Rate for Payer: Kentucky WC Medicaid |
$600.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,416.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$606.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,520.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$345.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$224.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$535.68
|
| Rate for Payer: PHCS Commercial |
$1,658.88
|
| Rate for Payer: United Healthcare All Payer |
$1,520.64
|
|
|
SCREW CORT PERI-LOC VLP 3.5*14
|
Facility
|
IP
|
$493.44
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$64.15 |
| Max. Negotiated Rate |
$473.70 |
| Rate for Payer: Aetna Commercial |
$379.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$384.88
|
| Rate for Payer: Cash Price |
$246.72
|
| Rate for Payer: Cigna Commercial |
$409.56
|
| Rate for Payer: First Health Commercial |
$468.77
|
| Rate for Payer: Humana Commercial |
$419.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$404.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$364.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$148.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$434.23
|
| Rate for Payer: Ohio Health Group HMO |
$370.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$98.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$64.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$152.97
|
| Rate for Payer: PHCS Commercial |
$473.70
|
| Rate for Payer: United Healthcare All Payer |
$434.23
|
|
|
SCREW CORT PERI-LOC VLP 3.5*14
|
Facility
|
OP
|
$493.44
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$64.15 |
| Max. Negotiated Rate |
$473.70 |
| Rate for Payer: Aetna Commercial |
$379.95
|
| Rate for Payer: Anthem Medicaid |
$169.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$384.88
|
| Rate for Payer: Cash Price |
$246.72
|
| Rate for Payer: Cigna Commercial |
$409.56
|
| Rate for Payer: First Health Commercial |
$468.77
|
| Rate for Payer: Humana Commercial |
$419.42
|
| Rate for Payer: Humana KY Medicaid |
$169.69
|
| Rate for Payer: Kentucky WC Medicaid |
$171.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$404.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$364.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$148.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$173.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$434.23
|
| Rate for Payer: Ohio Health Group HMO |
$370.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$98.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$64.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$152.97
|
| Rate for Payer: PHCS Commercial |
$473.70
|
| Rate for Payer: United Healthcare All Payer |
$434.23
|
|
|
SCREW CORT SELF-TAP TI 4.0*26
|
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 CORT SELF-TAP TI 4.0*26
|
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 CORT SELF-TAP TI 4.0*28
|
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 CORT SELF-TAP TI 4.0*28
|
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 CORT SELF-TAP TI 4.0*30
|
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
|
|
