|
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
|
|
|
SCREW FIXOS 4.0*36MM
|
Facility
|
IP
|
$3,642.42
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$473.51 |
| Max. Negotiated Rate |
$3,496.72 |
| Rate for Payer: Aetna Commercial |
$2,804.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,841.09
|
| Rate for Payer: Cash Price |
$1,821.21
|
| Rate for Payer: Cigna Commercial |
$3,023.21
|
| Rate for Payer: First Health Commercial |
$3,460.30
|
| Rate for Payer: Humana Commercial |
$3,096.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,986.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,688.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,092.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,205.33
|
| Rate for Payer: Ohio Health Group HMO |
$2,731.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$728.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$473.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,129.15
|
| Rate for Payer: PHCS Commercial |
$3,496.72
|
| Rate for Payer: United Healthcare All Payer |
$3,205.33
|
|
|
SCREW FIXOS 4.0*36MM
|
Facility
|
OP
|
$3,642.42
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$473.51 |
| Max. Negotiated Rate |
$3,496.72 |
| Rate for Payer: Aetna Commercial |
$2,804.66
|
| Rate for Payer: Anthem Medicaid |
$1,252.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,841.09
|
| Rate for Payer: Cash Price |
$1,821.21
|
| Rate for Payer: Cigna Commercial |
$3,023.21
|
| Rate for Payer: First Health Commercial |
$3,460.30
|
| Rate for Payer: Humana Commercial |
$3,096.06
|
| Rate for Payer: Humana KY Medicaid |
$1,252.63
|
| Rate for Payer: Kentucky WC Medicaid |
$1,265.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,986.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,688.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,092.73
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,277.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,205.33
|
| Rate for Payer: Ohio Health Group HMO |
$2,731.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$728.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$473.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,129.15
|
| Rate for Payer: PHCS Commercial |
$3,496.72
|
| Rate for Payer: United Healthcare All Payer |
$3,205.33
|
|
|
SCREW FIXOS 4.0*40MM
|
Facility
|
IP
|
$3,677.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$478.08 |
| Max. Negotiated Rate |
$3,530.46 |
| Rate for Payer: Aetna Commercial |
$2,831.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,868.50
|
| Rate for Payer: Cash Price |
$1,838.78
|
| Rate for Payer: Cigna Commercial |
$3,052.37
|
| Rate for Payer: First Health Commercial |
$3,493.68
|
| Rate for Payer: Humana Commercial |
$3,125.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,015.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,714.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,103.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,236.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,758.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$735.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$478.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,140.04
|
| Rate for Payer: PHCS Commercial |
$3,530.46
|
| Rate for Payer: United Healthcare All Payer |
$3,236.25
|
|
|
SCREW FIXOS 4.0*40MM
|
Facility
|
OP
|
$3,677.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$478.08 |
| Max. Negotiated Rate |
$3,530.46 |
| Rate for Payer: Aetna Commercial |
$2,831.72
|
| Rate for Payer: Anthem Medicaid |
$1,264.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,868.50
|
| Rate for Payer: Cash Price |
$1,838.78
|
| Rate for Payer: Cigna Commercial |
$3,052.37
|
| Rate for Payer: First Health Commercial |
$3,493.68
|
| Rate for Payer: Humana Commercial |
$3,125.93
|
| Rate for Payer: Humana KY Medicaid |
$1,264.71
|
| Rate for Payer: Kentucky WC Medicaid |
$1,277.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,015.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,714.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,103.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,290.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,236.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,758.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$735.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$478.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,140.04
|
| Rate for Payer: PHCS Commercial |
$3,530.46
|
| Rate for Payer: United Healthcare All Payer |
$3,236.25
|
|
|
SCREW FIXOS 4.0*42MM
|
Facility
|
OP
|
$3,649.42
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$474.42 |
| Max. Negotiated Rate |
$3,503.44 |
| Rate for Payer: Aetna Commercial |
$2,810.05
|
| Rate for Payer: Anthem Medicaid |
$1,255.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,846.55
|
| Rate for Payer: Cash Price |
$1,824.71
|
| Rate for Payer: Cigna Commercial |
$3,029.02
|
| Rate for Payer: First Health Commercial |
$3,466.95
|
| Rate for Payer: Humana Commercial |
$3,102.01
|
| Rate for Payer: Humana KY Medicaid |
$1,255.04
|
| Rate for Payer: Kentucky WC Medicaid |
$1,267.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,992.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,693.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,094.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,280.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,211.49
|
| Rate for Payer: Ohio Health Group HMO |
$2,737.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$729.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$474.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,131.32
|
| Rate for Payer: PHCS Commercial |
$3,503.44
|
| Rate for Payer: United Healthcare All Payer |
$3,211.49
|
|
|
SCREW FIXOS 4.0*42MM
|
Facility
|
IP
|
$3,649.42
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$474.42 |
| Max. Negotiated Rate |
$3,503.44 |
| Rate for Payer: Aetna Commercial |
$2,810.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,846.55
|
| Rate for Payer: Cash Price |
$1,824.71
|
| Rate for Payer: Cigna Commercial |
$3,029.02
|
| Rate for Payer: First Health Commercial |
$3,466.95
|
| Rate for Payer: Humana Commercial |
$3,102.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,992.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,693.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,094.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,211.49
|
| Rate for Payer: Ohio Health Group HMO |
$2,737.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$729.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$474.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,131.32
|
| Rate for Payer: PHCS Commercial |
$3,503.44
|
| Rate for Payer: United Healthcare All Payer |
$3,211.49
|
|
|
SCREW FLATHEAD CORT 3.0*12MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*12MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*14MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*14MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*16MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*16MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*20MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*20MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*22MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*22MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*24MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*24MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*26MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD CORT 3.0*26MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*10MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*10MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*12MM
|
Facility
|
OP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem Medicaid |
$614.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Humana KY Medicaid |
$614.72
|
| Rate for Payer: Kentucky WC Medicaid |
$620.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$627.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*12MM
|
Facility
|
IP
|
$1,787.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,376.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,394.25
|
| Rate for Payer: Cash Price |
$893.75
|
| Rate for Payer: Cigna Commercial |
$1,483.62
|
| Rate for Payer: First Health Commercial |
$1,698.12
|
| Rate for Payer: Humana Commercial |
$1,519.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,465.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,319.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$536.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,573.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,340.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$357.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$232.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$554.12
|
| Rate for Payer: PHCS Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Payer |
$1,573.00
|
|
