|
SCREW CORT TI HTO 4.5*30
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*30
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*32
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*32
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*34
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*34
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*36
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*36
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*38
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*38
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*40
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*40
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*42
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*42
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*44
|
Facility
|
IP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CORT TI HTO 4.5*44
|
Facility
|
OP
|
$3,118.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$405.44 |
| Max. Negotiated Rate |
$2,994.00 |
| Rate for Payer: Aetna Commercial |
$2,401.44
|
| Rate for Payer: Anthem Medicaid |
$1,072.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,432.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cigna Commercial |
$2,588.56
|
| Rate for Payer: First Health Commercial |
$2,962.81
|
| Rate for Payer: Humana Commercial |
$2,650.94
|
| Rate for Payer: Humana KY Medicaid |
$1,072.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,083.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,557.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,301.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$935.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,094.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,744.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,339.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$623.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$405.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.81
|
| Rate for Payer: PHCS Commercial |
$2,994.00
|
| Rate for Payer: United Healthcare All Payer |
$2,744.50
|
|
|
SCREW CRTX VLP 3.5MMX18MM S-T
|
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 CRTX VLP 3.5MMX18MM S-T
|
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 CRTX VLP 3.5MMX48MM S-T
|
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 CRTX VLP 3.5MMX48MM S-T
|
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 CRTX VLP 3.5MMX50MM S-T
|
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 CRTX VLP 3.5MMX50MM S-T
|
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 DRILL BIT 3.2MM
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$1,443.75
|
| Rate for Payer: Anthem Medicaid |
$644.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,462.50
|
| Rate for Payer: Cash Price |
$937.50
|
| Rate for Payer: Cigna Commercial |
$1,556.25
|
| Rate for Payer: First Health Commercial |
$1,781.25
|
| Rate for Payer: Humana Commercial |
$1,593.75
|
| Rate for Payer: Humana KY Medicaid |
$644.81
|
| Rate for Payer: Kentucky WC Medicaid |
$651.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,537.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,383.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$562.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$657.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,650.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,406.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$375.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$243.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$581.25
|
| Rate for Payer: PHCS Commercial |
$1,800.00
|
| Rate for Payer: United Healthcare All Payer |
$1,650.00
|
|
|
SCREW DRILL BIT 3.2MM
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$1,443.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,462.50
|
| Rate for Payer: Cash Price |
$937.50
|
| Rate for Payer: Cigna Commercial |
$1,556.25
|
| Rate for Payer: First Health Commercial |
$1,781.25
|
| Rate for Payer: Humana Commercial |
$1,593.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,537.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,383.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$562.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,650.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,406.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$375.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$243.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$581.25
|
| Rate for Payer: PHCS Commercial |
$1,800.00
|
| Rate for Payer: United Healthcare All Payer |
$1,650.00
|
|
|
SCREWDRIVER CANNULATED 9.0MM
|
Facility
|
IP
|
$3,557.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.44 |
| Max. Negotiated Rate |
$3,414.91 |
| Rate for Payer: Aetna Commercial |
$2,739.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,774.62
|
| Rate for Payer: Cash Price |
$1,778.60
|
| Rate for Payer: Cigna Commercial |
$2,952.48
|
| Rate for Payer: First Health Commercial |
$3,379.34
|
| Rate for Payer: Humana Commercial |
$3,023.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,916.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,625.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,067.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,130.34
|
| Rate for Payer: Ohio Health Group HMO |
$2,667.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$711.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$462.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,102.73
|
| Rate for Payer: PHCS Commercial |
$3,414.91
|
| Rate for Payer: United Healthcare All Payer |
$3,130.34
|
|
