|
ROD FIBULA 3.6*110MM
|
Facility
|
IP
|
$7,241.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,172.39 |
| Max. Negotiated Rate |
$6,951.65 |
| Rate for Payer: Aetna Commercial |
$5,575.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,648.21
|
| Rate for Payer: Cash Price |
$3,620.65
|
| Rate for Payer: Cigna Commercial |
$6,010.28
|
| Rate for Payer: First Health Commercial |
$6,879.23
|
| Rate for Payer: Humana Commercial |
$6,155.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,937.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,344.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,172.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,372.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,430.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,793.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,299.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,996.50
|
| Rate for Payer: PHCS Commercial |
$6,951.65
|
| Rate for Payer: United Healthcare All Payer |
$6,372.34
|
|
|
ROD FIBULA 3.6*145MM
|
Facility
|
IP
|
$6,869.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,060.70 |
| Max. Negotiated Rate |
$6,594.24 |
| Rate for Payer: Aetna Commercial |
$5,289.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,357.82
|
| Rate for Payer: Cash Price |
$3,434.50
|
| Rate for Payer: Cigna Commercial |
$5,701.27
|
| Rate for Payer: First Health Commercial |
$6,525.55
|
| Rate for Payer: Humana Commercial |
$5,838.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,632.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,069.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,060.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,044.72
|
| Rate for Payer: Ohio Health Group HMO |
$5,151.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,495.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,976.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,739.61
|
| Rate for Payer: PHCS Commercial |
$6,594.24
|
| Rate for Payer: United Healthcare All Payer |
$6,044.72
|
|
|
ROD FIBULA 3.6*145MM
|
Facility
|
OP
|
$6,869.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,060.70 |
| Max. Negotiated Rate |
$6,594.24 |
| Rate for Payer: Aetna Commercial |
$5,289.13
|
| Rate for Payer: Anthem Medicaid |
$2,362.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,357.82
|
| Rate for Payer: Cash Price |
$3,434.50
|
| Rate for Payer: Cigna Commercial |
$5,701.27
|
| Rate for Payer: First Health Commercial |
$6,525.55
|
| Rate for Payer: Humana Commercial |
$5,838.65
|
| Rate for Payer: Humana KY Medicaid |
$2,362.25
|
| Rate for Payer: Kentucky WC Medicaid |
$2,386.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,632.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,069.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,060.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,409.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,044.72
|
| Rate for Payer: Ohio Health Group HMO |
$5,151.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,495.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,976.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,739.61
|
| Rate for Payer: PHCS Commercial |
$6,594.24
|
| Rate for Payer: United Healthcare All Payer |
$6,044.72
|
|
|
ROD HUMERAL POLARUS 11*150MM
|
Facility
|
OP
|
$11,243.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,373.11 |
| Max. Negotiated Rate |
$10,793.95 |
| Rate for Payer: Aetna Commercial |
$8,657.65
|
| Rate for Payer: Anthem Medicaid |
$3,866.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,770.09
|
| Rate for Payer: Cash Price |
$5,621.85
|
| Rate for Payer: Cigna Commercial |
$9,332.27
|
| Rate for Payer: First Health Commercial |
$10,681.51
|
| Rate for Payer: Humana Commercial |
$9,557.15
|
| Rate for Payer: Humana KY Medicaid |
$3,866.71
|
| Rate for Payer: Kentucky WC Medicaid |
$3,906.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,219.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,297.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,373.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,944.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,894.46
|
| Rate for Payer: Ohio Health Group HMO |
$8,432.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,994.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,782.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,758.15
|
| Rate for Payer: PHCS Commercial |
$10,793.95
|
| Rate for Payer: United Healthcare All Payer |
$9,894.46
|
|
|
ROD HUMERAL POLARUS 11*150MM
|
Facility
|
IP
|
$11,243.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,373.11 |
| Max. Negotiated Rate |
$10,793.95 |
| Rate for Payer: Aetna Commercial |
$8,657.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,770.09
|
| Rate for Payer: Cash Price |
$5,621.85
|
| Rate for Payer: Cigna Commercial |
$9,332.27
|
| Rate for Payer: First Health Commercial |
$10,681.51
|
| Rate for Payer: Humana Commercial |
$9,557.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,219.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,297.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,373.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,894.46
|
| Rate for Payer: Ohio Health Group HMO |
$8,432.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,994.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,782.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,758.15
|
| Rate for Payer: PHCS Commercial |
$10,793.95
|
| Rate for Payer: United Healthcare All Payer |
$9,894.46
|
|
|
ROD HUMERAL POLARUS 8*200MM
|
Facility
|
IP
|
$9,343.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,803.11 |
| Max. Negotiated Rate |
$8,969.95 |
| Rate for Payer: Aetna Commercial |
$7,194.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,288.09
|
| Rate for Payer: Cash Price |
$4,671.85
|
| Rate for Payer: Cigna Commercial |
$7,755.27
|
| Rate for Payer: First Health Commercial |
$8,876.51
|
| Rate for Payer: Humana Commercial |
$7,942.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,661.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,895.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,222.46
|
| Rate for Payer: Ohio Health Group HMO |
$7,007.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,474.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,129.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,447.15
|
| Rate for Payer: PHCS Commercial |
$8,969.95
|
| Rate for Payer: United Healthcare All Payer |
$8,222.46
|
|
|
ROD HUMERAL POLARUS 8*200MM
|
Facility
|
OP
|
$9,343.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,803.11 |
| Max. Negotiated Rate |
$8,969.95 |
| Rate for Payer: Aetna Commercial |
$7,194.65
|
| Rate for Payer: Anthem Medicaid |
$3,213.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,288.09
|
| Rate for Payer: Cash Price |
$4,671.85
|
| Rate for Payer: Cigna Commercial |
$7,755.27
|
| Rate for Payer: First Health Commercial |
$8,876.51
|
| Rate for Payer: Humana Commercial |
$7,942.15
|
| Rate for Payer: Humana KY Medicaid |
$3,213.30
|
| Rate for Payer: Kentucky WC Medicaid |
$3,246.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,661.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,895.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,277.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,222.46
|
| Rate for Payer: Ohio Health Group HMO |
$7,007.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,474.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,129.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,447.15
|
| Rate for Payer: PHCS Commercial |
$8,969.95
|
| Rate for Payer: United Healthcare All Payer |
$8,222.46
|
|
|
ROD HUMERAL POLARUS 8*220MM
|
Facility
|
IP
|
$8,285.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,485.56 |
| Max. Negotiated Rate |
$7,953.79 |
| Rate for Payer: Aetna Commercial |
$6,379.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,462.46
|
| Rate for Payer: Cash Price |
$4,142.60
|
| Rate for Payer: Cigna Commercial |
$6,876.72
|
| Rate for Payer: First Health Commercial |
$7,870.94
|
| Rate for Payer: Humana Commercial |
$7,042.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,793.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,114.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,485.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,290.98
|
| Rate for Payer: Ohio Health Group HMO |
$6,213.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,628.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,208.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,716.79
|
| Rate for Payer: PHCS Commercial |
$7,953.79
|
| Rate for Payer: United Healthcare All Payer |
$7,290.98
|
|
|
ROD HUMERAL POLARUS 8*220MM
|
Facility
|
OP
|
$8,285.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,485.56 |
| Max. Negotiated Rate |
$7,953.79 |
| Rate for Payer: Aetna Commercial |
$6,379.60
|
| Rate for Payer: Anthem Medicaid |
$2,849.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,462.46
|
| Rate for Payer: Cash Price |
$4,142.60
|
| Rate for Payer: Cigna Commercial |
$6,876.72
|
| Rate for Payer: First Health Commercial |
$7,870.94
|
| Rate for Payer: Humana Commercial |
$7,042.42
|
| Rate for Payer: Humana KY Medicaid |
$2,849.28
|
| Rate for Payer: Kentucky WC Medicaid |
$2,878.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,793.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,114.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,485.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,906.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,290.98
|
| Rate for Payer: Ohio Health Group HMO |
$6,213.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,628.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,208.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,716.79
|
| Rate for Payer: PHCS Commercial |
$7,953.79
|
| Rate for Payer: United Healthcare All Payer |
$7,290.98
|
|
|
ROD HUMERAL POLARUS 8*240MM
|
Facility
|
IP
|
$8,285.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,485.56 |
| Max. Negotiated Rate |
$7,953.79 |
| Rate for Payer: Aetna Commercial |
$6,379.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,462.46
|
| Rate for Payer: Cash Price |
$4,142.60
|
| Rate for Payer: Cigna Commercial |
$6,876.72
|
| Rate for Payer: First Health Commercial |
$7,870.94
|
| Rate for Payer: Humana Commercial |
$7,042.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,793.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,114.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,485.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,290.98
|
| Rate for Payer: Ohio Health Group HMO |
$6,213.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,628.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,208.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,716.79
|
| Rate for Payer: PHCS Commercial |
$7,953.79
|
| Rate for Payer: United Healthcare All Payer |
$7,290.98
|
|
|
ROD HUMERAL POLARUS 8*240MM
|
Facility
|
OP
|
$8,285.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,485.56 |
| Max. Negotiated Rate |
$7,953.79 |
| Rate for Payer: Aetna Commercial |
$6,379.60
|
| Rate for Payer: Anthem Medicaid |
$2,849.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,462.46
|
| Rate for Payer: Cash Price |
$4,142.60
|
| Rate for Payer: Cigna Commercial |
$6,876.72
|
| Rate for Payer: First Health Commercial |
$7,870.94
|
| Rate for Payer: Humana Commercial |
$7,042.42
|
| Rate for Payer: Humana KY Medicaid |
$2,849.28
|
| Rate for Payer: Kentucky WC Medicaid |
$2,878.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,793.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,114.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,485.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,906.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,290.98
|
| Rate for Payer: Ohio Health Group HMO |
$6,213.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,628.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,208.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,716.79
|
| Rate for Payer: PHCS Commercial |
$7,953.79
|
| Rate for Payer: United Healthcare All Payer |
$7,290.98
|
|
|
ROD HUMERAL POLARUS 8*260MM
|
Facility
|
OP
|
$9,343.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,803.11 |
| Max. Negotiated Rate |
$8,969.95 |
| Rate for Payer: Aetna Commercial |
$7,194.65
|
| Rate for Payer: Anthem Medicaid |
$3,213.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,288.09
|
| Rate for Payer: Cash Price |
$4,671.85
|
| Rate for Payer: Cigna Commercial |
$7,755.27
|
| Rate for Payer: First Health Commercial |
$8,876.51
|
| Rate for Payer: Humana Commercial |
$7,942.15
|
| Rate for Payer: Humana KY Medicaid |
$3,213.30
|
| Rate for Payer: Kentucky WC Medicaid |
$3,246.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,661.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,895.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,277.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,222.46
|
| Rate for Payer: Ohio Health Group HMO |
$7,007.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,474.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,129.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,447.15
|
| Rate for Payer: PHCS Commercial |
$8,969.95
|
| Rate for Payer: United Healthcare All Payer |
$8,222.46
|
|
|
ROD HUMERAL POLARUS 8*260MM
|
Facility
|
IP
|
$9,343.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,803.11 |
| Max. Negotiated Rate |
$8,969.95 |
| Rate for Payer: Aetna Commercial |
$7,194.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,288.09
|
| Rate for Payer: Cash Price |
$4,671.85
|
| Rate for Payer: Cigna Commercial |
$7,755.27
|
| Rate for Payer: First Health Commercial |
$8,876.51
|
| Rate for Payer: Humana Commercial |
$7,942.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,661.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,895.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,222.46
|
| Rate for Payer: Ohio Health Group HMO |
$7,007.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,474.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,129.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,447.15
|
| Rate for Payer: PHCS Commercial |
$8,969.95
|
| Rate for Payer: United Healthcare All Payer |
$8,222.46
|
|
|
ROD HUMERAL POLARUS 8*280MM
|
Facility
|
IP
|
$9,343.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,803.11 |
| Max. Negotiated Rate |
$8,969.95 |
| Rate for Payer: Aetna Commercial |
$7,194.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,288.09
|
| Rate for Payer: Cash Price |
$4,671.85
|
| Rate for Payer: Cigna Commercial |
$7,755.27
|
| Rate for Payer: First Health Commercial |
$8,876.51
|
| Rate for Payer: Humana Commercial |
$7,942.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,661.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,895.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,222.46
|
| Rate for Payer: Ohio Health Group HMO |
$7,007.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,474.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,129.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,447.15
|
| Rate for Payer: PHCS Commercial |
$8,969.95
|
| Rate for Payer: United Healthcare All Payer |
$8,222.46
|
|
|
ROD HUMERAL POLARUS 8*280MM
|
Facility
|
OP
|
$9,343.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,803.11 |
| Max. Negotiated Rate |
$8,969.95 |
| Rate for Payer: Aetna Commercial |
$7,194.65
|
| Rate for Payer: Anthem Medicaid |
$3,213.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,288.09
|
| Rate for Payer: Cash Price |
$4,671.85
|
| Rate for Payer: Cigna Commercial |
$7,755.27
|
| Rate for Payer: First Health Commercial |
$8,876.51
|
| Rate for Payer: Humana Commercial |
$7,942.15
|
| Rate for Payer: Humana KY Medicaid |
$3,213.30
|
| Rate for Payer: Kentucky WC Medicaid |
$3,246.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,661.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,895.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,277.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,222.46
|
| Rate for Payer: Ohio Health Group HMO |
$7,007.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,474.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,129.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,447.15
|
| Rate for Payer: PHCS Commercial |
$8,969.95
|
| Rate for Payer: United Healthcare All Payer |
$8,222.46
|
|
|
ROD RADIUS LT 3.0MM*190MM
|
Facility
|
IP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.0MM*190MM
|
Facility
|
OP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem Medicaid |
$1,763.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Humana KY Medicaid |
$1,763.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,780.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,798.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.0MM*210MM
|
Facility
|
OP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem Medicaid |
$1,763.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Humana KY Medicaid |
$1,763.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,780.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,798.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.0MM*210MM
|
Facility
|
IP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.0MM*230MM
|
Facility
|
IP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.0MM*230MM
|
Facility
|
OP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem Medicaid |
$1,763.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Humana KY Medicaid |
$1,763.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,780.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,798.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.6MM*190MM
|
Facility
|
OP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem Medicaid |
$1,763.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Humana KY Medicaid |
$1,763.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,780.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,798.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.6MM*190MM
|
Facility
|
IP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.6MM*210MM
|
Facility
|
OP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem Medicaid |
$1,763.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Humana KY Medicaid |
$1,763.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,780.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,798.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
|
ROD RADIUS LT 3.6MM*210MM
|
Facility
|
IP
|
$5,126.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,537.97 |
| Max. Negotiated Rate |
$4,921.50 |
| Rate for Payer: Aetna Commercial |
$3,947.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,998.72
|
| Rate for Payer: Cash Price |
$2,563.28
|
| Rate for Payer: Cigna Commercial |
$4,255.04
|
| Rate for Payer: First Health Commercial |
$4,870.23
|
| Rate for Payer: Humana Commercial |
$4,357.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,203.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,783.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,537.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,511.37
|
| Rate for Payer: Ohio Health Group HMO |
$3,844.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,101.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,460.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,537.33
|
| Rate for Payer: PHCS Commercial |
$4,921.50
|
| Rate for Payer: United Healthcare All Payer |
$4,511.37
|
|
