|
SCREW LOCKING 4.5*26
|
Facility
|
IP
|
$2,032.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$264.22 |
| Max. Negotiated Rate |
$1,951.20 |
| Rate for Payer: Aetna Commercial |
$1,565.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,585.35
|
| Rate for Payer: Cash Price |
$1,016.25
|
| Rate for Payer: Cigna Commercial |
$1,686.98
|
| Rate for Payer: First Health Commercial |
$1,930.88
|
| Rate for Payer: Humana Commercial |
$1,727.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,666.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,499.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$609.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,788.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,524.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$406.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$264.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$630.08
|
| Rate for Payer: PHCS Commercial |
$1,951.20
|
| Rate for Payer: United Healthcare All Payer |
$1,788.60
|
|
|
SCREW LOCKING 4MM 4.0*24
|
Facility
|
OP
|
$1,845.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.94 |
| Max. Negotiated Rate |
$1,771.84 |
| Rate for Payer: Aetna Commercial |
$1,421.17
|
| Rate for Payer: Anthem Medicaid |
$634.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,439.62
|
| Rate for Payer: Cash Price |
$922.84
|
| Rate for Payer: Cigna Commercial |
$1,531.91
|
| Rate for Payer: First Health Commercial |
$1,753.39
|
| Rate for Payer: Humana Commercial |
$1,568.82
|
| Rate for Payer: Humana KY Medicaid |
$634.73
|
| Rate for Payer: Kentucky WC Medicaid |
$641.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,513.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,362.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$553.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$647.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,624.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,384.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$369.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.16
|
| Rate for Payer: PHCS Commercial |
$1,771.84
|
| Rate for Payer: United Healthcare All Payer |
$1,624.19
|
|
|
SCREW LOCKING 4MM 4.0*24
|
Facility
|
IP
|
$1,845.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.94 |
| Max. Negotiated Rate |
$1,771.84 |
| Rate for Payer: Aetna Commercial |
$1,421.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,439.62
|
| Rate for Payer: Cash Price |
$922.84
|
| Rate for Payer: Cigna Commercial |
$1,531.91
|
| Rate for Payer: First Health Commercial |
$1,753.39
|
| Rate for Payer: Humana Commercial |
$1,568.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,513.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,362.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$553.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,624.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,384.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$369.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.16
|
| Rate for Payer: PHCS Commercial |
$1,771.84
|
| Rate for Payer: United Healthcare All Payer |
$1,624.19
|
|
|
SCREW LOCKING 4MM 4.0*36
|
Facility
|
IP
|
$1,845.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.94 |
| Max. Negotiated Rate |
$1,771.84 |
| Rate for Payer: Aetna Commercial |
$1,421.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,439.62
|
| Rate for Payer: Cash Price |
$922.84
|
| Rate for Payer: Cigna Commercial |
$1,531.91
|
| Rate for Payer: First Health Commercial |
$1,753.39
|
| Rate for Payer: Humana Commercial |
$1,568.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,513.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,362.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$553.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,624.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,384.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$369.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.16
|
| Rate for Payer: PHCS Commercial |
$1,771.84
|
| Rate for Payer: United Healthcare All Payer |
$1,624.19
|
|
|
SCREW LOCKING 4MM 4.0*36
|
Facility
|
OP
|
$1,845.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.94 |
| Max. Negotiated Rate |
$1,771.84 |
| Rate for Payer: Aetna Commercial |
$1,421.17
|
| Rate for Payer: Anthem Medicaid |
$634.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,439.62
|
| Rate for Payer: Cash Price |
$922.84
|
| Rate for Payer: Cigna Commercial |
$1,531.91
|
| Rate for Payer: First Health Commercial |
$1,753.39
|
| Rate for Payer: Humana Commercial |
$1,568.82
|
| Rate for Payer: Humana KY Medicaid |
$634.73
|
| Rate for Payer: Kentucky WC Medicaid |
$641.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,513.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,362.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$553.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$647.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,624.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,384.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$369.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.16
|
| Rate for Payer: PHCS Commercial |
$1,771.84
|
| Rate for Payer: United Healthcare All Payer |
$1,624.19
|
|
|
SCREW LOCKING 4MM 4.0*38
|
Facility
|
IP
|
$1,845.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.94 |
| Max. Negotiated Rate |
$1,771.84 |
| Rate for Payer: Aetna Commercial |
$1,421.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,439.62
|
| Rate for Payer: Cash Price |
$922.84
|
| Rate for Payer: Cigna Commercial |
$1,531.91
|
| Rate for Payer: First Health Commercial |
$1,753.39
|
| Rate for Payer: Humana Commercial |
$1,568.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,513.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,362.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$553.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,624.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,384.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$369.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.16
|
| Rate for Payer: PHCS Commercial |
$1,771.84
|
| Rate for Payer: United Healthcare All Payer |
$1,624.19
|
|
|
SCREW LOCKING 4MM 4.0*38
|
Facility
|
OP
|
$1,845.67
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.94 |
| Max. Negotiated Rate |
$1,771.84 |
| Rate for Payer: Aetna Commercial |
$1,421.17
|
| Rate for Payer: Anthem Medicaid |
$634.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,439.62
|
| Rate for Payer: Cash Price |
$922.84
|
| Rate for Payer: Cigna Commercial |
$1,531.91
|
| Rate for Payer: First Health Commercial |
$1,753.39
|
| Rate for Payer: Humana Commercial |
$1,568.82
|
| Rate for Payer: Humana KY Medicaid |
$634.73
|
| Rate for Payer: Kentucky WC Medicaid |
$641.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,513.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,362.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$553.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$647.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,624.19
|
| Rate for Payer: Ohio Health Group HMO |
$1,384.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$369.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$239.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.16
|
| Rate for Payer: PHCS Commercial |
$1,771.84
|
| Rate for Payer: United Healthcare All Payer |
$1,624.19
|
|
|
SCREW LOCKING PLATE 2.7*10MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 2.7*10MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 2.7*14MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 2.7*14MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 2.7*18MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 2.7*18MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*14MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*14MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*18MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*18MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*20MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*20MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*22MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*22MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*24MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*24MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*26MM
|
Facility
|
OP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem Medicaid |
$668.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Humana KY Medicaid |
$668.89
|
| Rate for Payer: Kentucky WC Medicaid |
$675.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
|
SCREW LOCKING PLATE 3.5*26MM
|
Facility
|
IP
|
$1,945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.85 |
| Max. Negotiated Rate |
$1,867.20 |
| Rate for Payer: Aetna Commercial |
$1,497.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.10
|
| Rate for Payer: Cash Price |
$972.50
|
| Rate for Payer: Cigna Commercial |
$1,614.35
|
| Rate for Payer: First Health Commercial |
$1,847.75
|
| Rate for Payer: Humana Commercial |
$1,653.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,594.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,435.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,711.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,458.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$389.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$602.95
|
| Rate for Payer: PHCS Commercial |
$1,867.20
|
| Rate for Payer: United Healthcare All Payer |
$1,711.60
|
|
