|
SCREW LOCKING PLATE 3.5*40MM
|
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*40MM
|
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 T10 FT 2.7*26
|
Facility
|
OP
|
$1,925.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$250.35 |
| Max. Negotiated Rate |
$1,848.72 |
| Rate for Payer: Aetna Commercial |
$1,482.83
|
| Rate for Payer: Anthem Medicaid |
$662.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,502.08
|
| Rate for Payer: Cash Price |
$962.88
|
| Rate for Payer: Cigna Commercial |
$1,598.37
|
| Rate for Payer: First Health Commercial |
$1,829.46
|
| Rate for Payer: Humana Commercial |
$1,636.89
|
| Rate for Payer: Humana KY Medicaid |
$662.27
|
| Rate for Payer: Kentucky WC Medicaid |
$669.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,579.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,421.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$577.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$675.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,694.66
|
| Rate for Payer: Ohio Health Group HMO |
$1,444.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$385.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$250.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$596.98
|
| Rate for Payer: PHCS Commercial |
$1,848.72
|
| Rate for Payer: United Healthcare All Payer |
$1,694.66
|
|
|
SCREW LOCKING T10 FT 2.7*26
|
Facility
|
IP
|
$1,925.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$250.35 |
| Max. Negotiated Rate |
$1,848.72 |
| Rate for Payer: Aetna Commercial |
$1,482.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,502.08
|
| Rate for Payer: Cash Price |
$962.88
|
| Rate for Payer: Cigna Commercial |
$1,598.37
|
| Rate for Payer: First Health Commercial |
$1,829.46
|
| Rate for Payer: Humana Commercial |
$1,636.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,579.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,421.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$577.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,694.66
|
| Rate for Payer: Ohio Health Group HMO |
$1,444.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$385.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$250.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$596.98
|
| Rate for Payer: PHCS Commercial |
$1,848.72
|
| Rate for Payer: United Healthcare All Payer |
$1,694.66
|
|
|
SCREW LOCKING T10 FT 2.7*32
|
Facility
|
IP
|
$2,122.03
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.86 |
| Max. Negotiated Rate |
$2,037.15 |
| Rate for Payer: Aetna Commercial |
$1,633.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,655.18
|
| Rate for Payer: Cash Price |
$1,061.02
|
| Rate for Payer: Cigna Commercial |
$1,761.28
|
| Rate for Payer: First Health Commercial |
$2,015.93
|
| Rate for Payer: Humana Commercial |
$1,803.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,740.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,566.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$636.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,867.39
|
| Rate for Payer: Ohio Health Group HMO |
$1,591.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$424.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$275.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$657.83
|
| Rate for Payer: PHCS Commercial |
$2,037.15
|
| Rate for Payer: United Healthcare All Payer |
$1,867.39
|
|
|
SCREW LOCKING T10 FT 2.7*32
|
Facility
|
OP
|
$2,122.03
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.86 |
| Max. Negotiated Rate |
$2,037.15 |
| Rate for Payer: Aetna Commercial |
$1,633.96
|
| Rate for Payer: Anthem Medicaid |
$729.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,655.18
|
| Rate for Payer: Cash Price |
$1,061.02
|
| Rate for Payer: Cigna Commercial |
$1,761.28
|
| Rate for Payer: First Health Commercial |
$2,015.93
|
| Rate for Payer: Humana Commercial |
$1,803.73
|
| Rate for Payer: Humana KY Medicaid |
$729.77
|
| Rate for Payer: Kentucky WC Medicaid |
$737.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,740.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,566.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$636.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$744.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,867.39
|
| Rate for Payer: Ohio Health Group HMO |
$1,591.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$424.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$275.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$657.83
|
| Rate for Payer: PHCS Commercial |
$2,037.15
|
| Rate for Payer: United Healthcare All Payer |
$1,867.39
|
|
|
SCREW LONG PACK 2.7MM
|
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 LONG PACK 2.7MM
|
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 LONG PACK 3.0MM
|
Facility
|
OP
|
$5,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$695.50 |
| Max. Negotiated Rate |
$5,136.00 |
| Rate for Payer: Aetna Commercial |
$4,119.50
|
| Rate for Payer: Anthem Medicaid |
$1,839.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,173.00
|
| Rate for Payer: Cash Price |
$2,675.00
|
| Rate for Payer: Cigna Commercial |
$4,440.50
|
| Rate for Payer: First Health Commercial |
$5,082.50
|
| Rate for Payer: Humana Commercial |
$4,547.50
|
| Rate for Payer: Humana KY Medicaid |
$1,839.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,858.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,387.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,948.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,605.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,876.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,708.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,012.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,070.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$695.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,658.50
|
| Rate for Payer: PHCS Commercial |
$5,136.00
|
| Rate for Payer: United Healthcare All Payer |
$4,708.00
|
|
|
SCREW LONG PACK 3.0MM
|
Facility
|
IP
|
$5,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$695.50 |
| Max. Negotiated Rate |
$5,136.00 |
| Rate for Payer: Aetna Commercial |
$4,119.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,173.00
|
| Rate for Payer: Cash Price |
$2,675.00
|
| Rate for Payer: Cigna Commercial |
$4,440.50
|
| Rate for Payer: First Health Commercial |
$5,082.50
|
| Rate for Payer: Humana Commercial |
$4,547.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,387.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,948.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,605.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,708.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,012.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,070.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$695.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,658.50
|
| Rate for Payer: PHCS Commercial |
$5,136.00
|
| Rate for Payer: United Healthcare All Payer |
$4,708.00
|
|
|
SCREW LO-PRO TM SS 3.5*70 CORT
|
Facility
|
OP
|
$765.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.50 |
| Max. Negotiated Rate |
$734.76 |
| Rate for Payer: Aetna Commercial |
$589.34
|
| Rate for Payer: Anthem Medicaid |
$263.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$597.00
|
| Rate for Payer: Cash Price |
$382.69
|
| Rate for Payer: Cigna Commercial |
$635.27
|
| Rate for Payer: First Health Commercial |
$727.11
|
| Rate for Payer: Humana Commercial |
$650.57
|
| Rate for Payer: Humana KY Medicaid |
$263.21
|
| Rate for Payer: Kentucky WC Medicaid |
$265.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$627.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$564.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$229.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$268.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$673.53
|
| Rate for Payer: Ohio Health Group HMO |
$574.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$153.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$99.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$237.27
|
| Rate for Payer: PHCS Commercial |
$734.76
|
| Rate for Payer: United Healthcare All Payer |
$673.53
|
|
|
SCREW LO-PRO TM SS 3.5*70 CORT
|
Facility
|
IP
|
$765.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.50 |
| Max. Negotiated Rate |
$734.76 |
| Rate for Payer: Aetna Commercial |
$589.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$597.00
|
| Rate for Payer: Cash Price |
$382.69
|
| Rate for Payer: Cigna Commercial |
$635.27
|
| Rate for Payer: First Health Commercial |
$727.11
|
| Rate for Payer: Humana Commercial |
$650.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$627.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$564.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$229.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$673.53
|
| Rate for Payer: Ohio Health Group HMO |
$574.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$153.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$99.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$237.27
|
| Rate for Payer: PHCS Commercial |
$734.76
|
| Rate for Payer: United Healthcare All Payer |
$673.53
|
|
|
SCREW LOW-PRO 3.5*28MM
|
Facility
|
IP
|
$1,728.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.64 |
| Max. Negotiated Rate |
$1,658.88 |
| Rate for Payer: Aetna Commercial |
$1,330.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,347.84
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: First Health Commercial |
$1,641.60
|
| Rate for Payer: Humana Commercial |
$1,468.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,416.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,520.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$345.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$224.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$535.68
|
| Rate for Payer: PHCS Commercial |
$1,658.88
|
| Rate for Payer: United Healthcare All Payer |
$1,520.64
|
|
|
SCREW LOW-PRO 3.5*28MM
|
Facility
|
OP
|
$1,728.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.64 |
| Max. Negotiated Rate |
$1,658.88 |
| Rate for Payer: Aetna Commercial |
$1,330.56
|
| Rate for Payer: Anthem Medicaid |
$594.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,347.84
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cigna Commercial |
$1,434.24
|
| Rate for Payer: First Health Commercial |
$1,641.60
|
| Rate for Payer: Humana Commercial |
$1,468.80
|
| Rate for Payer: Humana KY Medicaid |
$594.26
|
| Rate for Payer: Kentucky WC Medicaid |
$600.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,416.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,275.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$518.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$606.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,520.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,296.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$345.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$224.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$535.68
|
| Rate for Payer: PHCS Commercial |
$1,658.88
|
| Rate for Payer: United Healthcare All Payer |
$1,520.64
|
|
|
SCREW LP 4.5*44
|
Facility
|
IP
|
$1,525.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$1,464.60 |
| Rate for Payer: Aetna Commercial |
$1,174.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,189.98
|
| Rate for Payer: Cash Price |
$762.81
|
| Rate for Payer: Cigna Commercial |
$1,266.26
|
| Rate for Payer: First Health Commercial |
$1,449.34
|
| Rate for Payer: Humana Commercial |
$1,296.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,251.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,125.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$457.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,342.55
|
| Rate for Payer: Ohio Health Group HMO |
$1,144.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$305.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$198.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$472.94
|
| Rate for Payer: PHCS Commercial |
$1,464.60
|
| Rate for Payer: United Healthcare All Payer |
$1,342.55
|
|
|
SCREW LP 4.5*44
|
Facility
|
OP
|
$1,525.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$1,464.60 |
| Rate for Payer: Aetna Commercial |
$1,174.73
|
| Rate for Payer: Anthem Medicaid |
$524.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,189.98
|
| Rate for Payer: Cash Price |
$762.81
|
| Rate for Payer: Cigna Commercial |
$1,266.26
|
| Rate for Payer: First Health Commercial |
$1,449.34
|
| Rate for Payer: Humana Commercial |
$1,296.78
|
| Rate for Payer: Humana KY Medicaid |
$524.66
|
| Rate for Payer: Kentucky WC Medicaid |
$530.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,251.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,125.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$457.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$535.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,342.55
|
| Rate for Payer: Ohio Health Group HMO |
$1,144.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$305.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$198.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$472.94
|
| Rate for Payer: PHCS Commercial |
$1,464.60
|
| Rate for Payer: United Healthcare All Payer |
$1,342.55
|
|
|
SCREW LP 4.5*50
|
Facility
|
IP
|
$1,525.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$1,464.60 |
| Rate for Payer: Aetna Commercial |
$1,174.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,189.98
|
| Rate for Payer: Cash Price |
$762.81
|
| Rate for Payer: Cigna Commercial |
$1,266.26
|
| Rate for Payer: First Health Commercial |
$1,449.34
|
| Rate for Payer: Humana Commercial |
$1,296.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,251.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,125.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$457.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,342.55
|
| Rate for Payer: Ohio Health Group HMO |
$1,144.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$305.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$198.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$472.94
|
| Rate for Payer: PHCS Commercial |
$1,464.60
|
| Rate for Payer: United Healthcare All Payer |
$1,342.55
|
|
|
SCREW LP 4.5*50
|
Facility
|
OP
|
$1,525.62
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$1,464.60 |
| Rate for Payer: Aetna Commercial |
$1,174.73
|
| Rate for Payer: Anthem Medicaid |
$524.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,189.98
|
| Rate for Payer: Cash Price |
$762.81
|
| Rate for Payer: Cigna Commercial |
$1,266.26
|
| Rate for Payer: First Health Commercial |
$1,449.34
|
| Rate for Payer: Humana Commercial |
$1,296.78
|
| Rate for Payer: Humana KY Medicaid |
$524.66
|
| Rate for Payer: Kentucky WC Medicaid |
$530.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,251.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,125.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$457.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$535.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,342.55
|
| Rate for Payer: Ohio Health Group HMO |
$1,144.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$305.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$198.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$472.94
|
| Rate for Payer: PHCS Commercial |
$1,464.60
|
| Rate for Payer: United Healthcare All Payer |
$1,342.55
|
|
|
SCREW LP FIXED ANG LCK 3.5*10
|
Facility
|
OP
|
$1,547.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$1,485.60 |
| Rate for Payer: Aetna Commercial |
$1,191.58
|
| Rate for Payer: Anthem Medicaid |
$532.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,207.05
|
| Rate for Payer: Cash Price |
$773.75
|
| Rate for Payer: Cigna Commercial |
$1,284.42
|
| Rate for Payer: First Health Commercial |
$1,470.12
|
| Rate for Payer: Humana Commercial |
$1,315.38
|
| Rate for Payer: Humana KY Medicaid |
$532.19
|
| Rate for Payer: Kentucky WC Medicaid |
$537.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,268.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,142.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$464.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$542.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,361.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,160.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$309.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$201.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$479.72
|
| Rate for Payer: PHCS Commercial |
$1,485.60
|
| Rate for Payer: United Healthcare All Payer |
$1,361.80
|
|
|
SCREW LP FIXED ANG LCK 3.5*10
|
Facility
|
IP
|
$1,547.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$1,485.60 |
| Rate for Payer: Aetna Commercial |
$1,191.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,207.05
|
| Rate for Payer: Cash Price |
$773.75
|
| Rate for Payer: Cigna Commercial |
$1,284.42
|
| Rate for Payer: First Health Commercial |
$1,470.12
|
| Rate for Payer: Humana Commercial |
$1,315.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,268.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,142.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$464.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,361.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,160.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$309.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$201.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$479.72
|
| Rate for Payer: PHCS Commercial |
$1,485.60
|
| Rate for Payer: United Healthcare All Payer |
$1,361.80
|
|
|
SCREW LP FIXED ANG LCK 3.5*12
|
Facility
|
OP
|
$1,562.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$1,499.88 |
| Rate for Payer: Aetna Commercial |
$1,203.03
|
| Rate for Payer: Anthem Medicaid |
$537.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,218.66
|
| Rate for Payer: Cash Price |
$781.19
|
| Rate for Payer: Cigna Commercial |
$1,296.78
|
| Rate for Payer: First Health Commercial |
$1,484.26
|
| Rate for Payer: Humana Commercial |
$1,328.02
|
| Rate for Payer: Humana KY Medicaid |
$537.30
|
| Rate for Payer: Kentucky WC Medicaid |
$542.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,281.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,153.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$548.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,374.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,171.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$312.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$484.34
|
| Rate for Payer: PHCS Commercial |
$1,499.88
|
| Rate for Payer: United Healthcare All Payer |
$1,374.89
|
|
|
SCREW LP FIXED ANG LCK 3.5*12
|
Facility
|
IP
|
$1,562.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$1,499.88 |
| Rate for Payer: Aetna Commercial |
$1,203.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,218.66
|
| Rate for Payer: Cash Price |
$781.19
|
| Rate for Payer: Cigna Commercial |
$1,296.78
|
| Rate for Payer: First Health Commercial |
$1,484.26
|
| Rate for Payer: Humana Commercial |
$1,328.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,281.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,153.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,374.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,171.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$312.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$484.34
|
| Rate for Payer: PHCS Commercial |
$1,499.88
|
| Rate for Payer: United Healthcare All Payer |
$1,374.89
|
|
|
SCREW LP FIXED ANG LCK 3.5*14
|
Facility
|
IP
|
$1,562.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$1,499.88 |
| Rate for Payer: Aetna Commercial |
$1,203.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,218.66
|
| Rate for Payer: Cash Price |
$781.19
|
| Rate for Payer: Cigna Commercial |
$1,296.78
|
| Rate for Payer: First Health Commercial |
$1,484.26
|
| Rate for Payer: Humana Commercial |
$1,328.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,281.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,153.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,374.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,171.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$312.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$484.34
|
| Rate for Payer: PHCS Commercial |
$1,499.88
|
| Rate for Payer: United Healthcare All Payer |
$1,374.89
|
|
|
SCREW LP FIXED ANG LCK 3.5*14
|
Facility
|
OP
|
$1,562.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$1,499.88 |
| Rate for Payer: Aetna Commercial |
$1,203.03
|
| Rate for Payer: Anthem Medicaid |
$537.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,218.66
|
| Rate for Payer: Cash Price |
$781.19
|
| Rate for Payer: Cigna Commercial |
$1,296.78
|
| Rate for Payer: First Health Commercial |
$1,484.26
|
| Rate for Payer: Humana Commercial |
$1,328.02
|
| Rate for Payer: Humana KY Medicaid |
$537.30
|
| Rate for Payer: Kentucky WC Medicaid |
$542.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,281.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,153.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$548.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,374.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,171.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$312.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$484.34
|
| Rate for Payer: PHCS Commercial |
$1,499.88
|
| Rate for Payer: United Healthcare All Payer |
$1,374.89
|
|
|
SCREW LP FIXED ANG LCK 3.5*16
|
Facility
|
IP
|
$1,562.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$1,499.88 |
| Rate for Payer: Aetna Commercial |
$1,203.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,218.66
|
| Rate for Payer: Cash Price |
$781.19
|
| Rate for Payer: Cigna Commercial |
$1,296.78
|
| Rate for Payer: First Health Commercial |
$1,484.26
|
| Rate for Payer: Humana Commercial |
$1,328.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,281.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,153.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,374.89
|
| Rate for Payer: Ohio Health Group HMO |
$1,171.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$312.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$203.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$484.34
|
| Rate for Payer: PHCS Commercial |
$1,499.88
|
| Rate for Payer: United Healthcare All Payer |
$1,374.89
|
|
