|
SCREW HEADLESS 4.0MM 42MM
|
Facility
|
IP
|
$3,747.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$487.11 |
| Max. Negotiated Rate |
$3,597.12 |
| Rate for Payer: Aetna Commercial |
$2,885.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,922.66
|
| Rate for Payer: Cash Price |
$1,873.50
|
| Rate for Payer: Cigna Commercial |
$3,110.01
|
| Rate for Payer: First Health Commercial |
$3,559.65
|
| Rate for Payer: Humana Commercial |
$3,184.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,072.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,765.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,124.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,297.36
|
| Rate for Payer: Ohio Health Group HMO |
$2,810.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$749.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,161.57
|
| Rate for Payer: PHCS Commercial |
$3,597.12
|
| Rate for Payer: United Healthcare All Payer |
$3,297.36
|
|
|
SCREW HEADLESS 4.0MM 42MM
|
Facility
|
OP
|
$3,747.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$487.11 |
| Max. Negotiated Rate |
$3,597.12 |
| Rate for Payer: Aetna Commercial |
$2,885.19
|
| Rate for Payer: Anthem Medicaid |
$1,288.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,922.66
|
| Rate for Payer: Cash Price |
$1,873.50
|
| Rate for Payer: Cigna Commercial |
$3,110.01
|
| Rate for Payer: First Health Commercial |
$3,559.65
|
| Rate for Payer: Humana Commercial |
$3,184.95
|
| Rate for Payer: Humana KY Medicaid |
$1,288.59
|
| Rate for Payer: Kentucky WC Medicaid |
$1,301.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,072.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,765.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,124.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,314.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,297.36
|
| Rate for Payer: Ohio Health Group HMO |
$2,810.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$749.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,161.57
|
| Rate for Payer: PHCS Commercial |
$3,597.12
|
| Rate for Payer: United Healthcare All Payer |
$3,297.36
|
|
|
SCREW HEADLESS COMPRSSN 3.0*30
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.25 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$685.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$445.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,061.75
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
SCREW HEADLESS COMPRSSN 3.0*30
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.25 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$685.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$445.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,061.75
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
SCREW HEADLESS H 3.0X26MM_T
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem Medicaid |
$705.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Humana KY Medicaid |
$705.00
|
| Rate for Payer: Kentucky WC Medicaid |
$712.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$615.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$719.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$635.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
SCREW HEADLESS H 3.0X26MM_T
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$615.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$635.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
SCREW HEADLESS H 3.0X30MM_T
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem Medicaid |
$705.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Humana KY Medicaid |
$705.00
|
| Rate for Payer: Kentucky WC Medicaid |
$712.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$615.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$719.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$635.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
SCREW HEADLESS H 3.0X30MM_T
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$615.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$635.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
SCREW HP LOCKING 2.7 12/14MM
|
Facility
|
OP
|
$4,912.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$638.62 |
| Max. Negotiated Rate |
$4,716.00 |
| Rate for Payer: Aetna Commercial |
$3,782.62
|
| Rate for Payer: Anthem Medicaid |
$1,689.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,831.75
|
| Rate for Payer: Cash Price |
$2,456.25
|
| Rate for Payer: Cigna Commercial |
$4,077.38
|
| Rate for Payer: First Health Commercial |
$4,666.88
|
| Rate for Payer: Humana Commercial |
$4,175.62
|
| Rate for Payer: Humana KY Medicaid |
$1,689.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,706.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,028.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,625.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,473.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,723.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,323.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,684.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$982.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$638.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,522.88
|
| Rate for Payer: PHCS Commercial |
$4,716.00
|
| Rate for Payer: United Healthcare All Payer |
$4,323.00
|
|
|
SCREW HP LOCKING 2.7 12/14MM
|
Facility
|
IP
|
$4,912.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$638.62 |
| Max. Negotiated Rate |
$4,716.00 |
| Rate for Payer: Aetna Commercial |
$3,782.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,831.75
|
| Rate for Payer: Cash Price |
$2,456.25
|
| Rate for Payer: Cigna Commercial |
$4,077.38
|
| Rate for Payer: First Health Commercial |
$4,666.88
|
| Rate for Payer: Humana Commercial |
$4,175.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,028.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,625.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,473.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,323.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,684.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$982.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$638.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,522.88
|
| Rate for Payer: PHCS Commercial |
$4,716.00
|
| Rate for Payer: United Healthcare All Payer |
$4,323.00
|
|
|
SCREW HP LOCKING 2.7 16MM
|
Facility
|
OP
|
$4,912.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$638.62 |
| Max. Negotiated Rate |
$4,716.00 |
| Rate for Payer: Aetna Commercial |
$3,782.62
|
| Rate for Payer: Anthem Medicaid |
$1,689.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,831.75
|
| Rate for Payer: Cash Price |
$2,456.25
|
| Rate for Payer: Cigna Commercial |
$4,077.38
|
| Rate for Payer: First Health Commercial |
$4,666.88
|
| Rate for Payer: Humana Commercial |
$4,175.62
|
| Rate for Payer: Humana KY Medicaid |
$1,689.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,706.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,028.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,625.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,473.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,723.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,323.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,684.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$982.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$638.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,522.88
|
| Rate for Payer: PHCS Commercial |
$4,716.00
|
| Rate for Payer: United Healthcare All Payer |
$4,323.00
|
|
|
SCREW HP LOCKING 2.7 16MM
|
Facility
|
IP
|
$4,912.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$638.62 |
| Max. Negotiated Rate |
$4,716.00 |
| Rate for Payer: Aetna Commercial |
$3,782.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,831.75
|
| Rate for Payer: Cash Price |
$2,456.25
|
| Rate for Payer: Cigna Commercial |
$4,077.38
|
| Rate for Payer: First Health Commercial |
$4,666.88
|
| Rate for Payer: Humana Commercial |
$4,175.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,028.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,625.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,473.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,323.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,684.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$982.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$638.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,522.88
|
| Rate for Payer: PHCS Commercial |
$4,716.00
|
| Rate for Payer: United Healthcare All Payer |
$4,323.00
|
|
|
SCREW HTO CRT TI 26MM
|
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 HTO CRT TI 26MM
|
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 INTERFAG 4.0MM
|
Facility
|
IP
|
$4,300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.00 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$3,311.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
| Rate for Payer: Cash Price |
$2,150.00
|
| Rate for Payer: Cigna Commercial |
$3,569.00
|
| Rate for Payer: First Health Commercial |
$4,085.00
|
| Rate for Payer: Humana Commercial |
$3,655.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
| Rate for Payer: PHCS Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
|
SCREW INTERFAG 4.0MM
|
Facility
|
OP
|
$4,300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.00 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$3,311.00
|
| Rate for Payer: Anthem Medicaid |
$1,478.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
| Rate for Payer: Cash Price |
$2,150.00
|
| Rate for Payer: Cigna Commercial |
$3,569.00
|
| Rate for Payer: First Health Commercial |
$4,085.00
|
| Rate for Payer: Humana Commercial |
$3,655.00
|
| Rate for Payer: Humana KY Medicaid |
$1,478.77
|
| Rate for Payer: Kentucky WC Medicaid |
$1,493.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,508.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
| Rate for Payer: PHCS Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
|
SCREW INTERFRAG 3.0MM
|
Facility
|
IP
|
$4,300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.00 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$3,311.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
| Rate for Payer: Cash Price |
$2,150.00
|
| Rate for Payer: Cigna Commercial |
$3,569.00
|
| Rate for Payer: First Health Commercial |
$4,085.00
|
| Rate for Payer: Humana Commercial |
$3,655.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
| Rate for Payer: PHCS Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
|
SCREW INTERFRAG 3.0MM
|
Facility
|
OP
|
$4,300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.00 |
| Max. Negotiated Rate |
$4,128.00 |
| Rate for Payer: Aetna Commercial |
$3,311.00
|
| Rate for Payer: Anthem Medicaid |
$1,478.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
| Rate for Payer: Cash Price |
$2,150.00
|
| Rate for Payer: Cigna Commercial |
$3,569.00
|
| Rate for Payer: First Health Commercial |
$4,085.00
|
| Rate for Payer: Humana Commercial |
$3,655.00
|
| Rate for Payer: Humana KY Medicaid |
$1,478.77
|
| Rate for Payer: Kentucky WC Medicaid |
$1,493.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,508.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
| Rate for Payer: PHCS Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
|
SCREW KREULCK VAL TI 2.4*18
|
Facility
|
IP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
|
SCREW KREULCK VAL TI 2.4*18
|
Facility
|
OP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem Medicaid |
$1,129.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Humana KY Medicaid |
$1,129.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,140.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,152.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
|
SCREW KREULCK VAL TI 2.4*20
|
Facility
|
OP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem Medicaid |
$1,129.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Humana KY Medicaid |
$1,129.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,140.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,152.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
|
SCREW KREULCK VAL TI 2.4*20
|
Facility
|
IP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
|
SCREW KREULCK VAL TI 2.4*22
|
Facility
|
OP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem Medicaid |
$1,129.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Humana KY Medicaid |
$1,129.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,140.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,152.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
|
SCREW KREULCK VAL TI 2.4*22
|
Facility
|
IP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
|
SCREW KREULOCK AR-8935CL-12
|
Facility
|
IP
|
$3,284.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.94 |
| Max. Negotiated Rate |
$3,152.76 |
| Rate for Payer: Aetna Commercial |
$2,528.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,561.61
|
| Rate for Payer: Cash Price |
$1,642.06
|
| Rate for Payer: Cigna Commercial |
$2,725.82
|
| Rate for Payer: First Health Commercial |
$3,119.91
|
| Rate for Payer: Humana Commercial |
$2,791.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,692.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,423.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$985.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,890.03
|
| Rate for Payer: Ohio Health Group HMO |
$2,463.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$656.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$426.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,018.08
|
| Rate for Payer: PHCS Commercial |
$3,152.76
|
| Rate for Payer: United Healthcare All Payer |
$2,890.03
|
|
