|
SCREW LP FIXED ANG LCK 3.5*16
|
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*18
|
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*18
|
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*20
|
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*20
|
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 NL TI COR 3.5*26MM
|
Facility
|
IP
|
$1,108.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.04 |
| Max. Negotiated Rate |
$1,063.68 |
| Rate for Payer: Aetna Commercial |
$853.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$864.24
|
| Rate for Payer: Cash Price |
$554.00
|
| Rate for Payer: Cigna Commercial |
$919.64
|
| Rate for Payer: First Health Commercial |
$1,052.60
|
| Rate for Payer: Humana Commercial |
$941.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$908.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$817.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$332.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$975.04
|
| Rate for Payer: Ohio Health Group HMO |
$831.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$221.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$144.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$343.48
|
| Rate for Payer: PHCS Commercial |
$1,063.68
|
| Rate for Payer: United Healthcare All Payer |
$975.04
|
|
|
SCREW LP NL TI COR 3.5*26MM
|
Facility
|
OP
|
$1,108.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.04 |
| Max. Negotiated Rate |
$1,063.68 |
| Rate for Payer: Aetna Commercial |
$853.16
|
| Rate for Payer: Anthem Medicaid |
$381.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$864.24
|
| Rate for Payer: Cash Price |
$554.00
|
| Rate for Payer: Cigna Commercial |
$919.64
|
| Rate for Payer: First Health Commercial |
$1,052.60
|
| Rate for Payer: Humana Commercial |
$941.80
|
| Rate for Payer: Humana KY Medicaid |
$381.04
|
| Rate for Payer: Kentucky WC Medicaid |
$384.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$908.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$817.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$332.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$388.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$975.04
|
| Rate for Payer: Ohio Health Group HMO |
$831.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$221.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$144.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$343.48
|
| Rate for Payer: PHCS Commercial |
$1,063.68
|
| Rate for Payer: United Healthcare All Payer |
$975.04
|
|
|
SCREW LP NON LCK CORT 3.5*10
|
Facility
|
OP
|
$1,108.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.04 |
| Max. Negotiated Rate |
$1,063.68 |
| Rate for Payer: Aetna Commercial |
$853.16
|
| Rate for Payer: Anthem Medicaid |
$381.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$864.24
|
| Rate for Payer: Cash Price |
$554.00
|
| Rate for Payer: Cigna Commercial |
$919.64
|
| Rate for Payer: First Health Commercial |
$1,052.60
|
| Rate for Payer: Humana Commercial |
$941.80
|
| Rate for Payer: Humana KY Medicaid |
$381.04
|
| Rate for Payer: Kentucky WC Medicaid |
$384.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$908.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$817.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$332.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$388.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$975.04
|
| Rate for Payer: Ohio Health Group HMO |
$831.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$221.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$144.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$343.48
|
| Rate for Payer: PHCS Commercial |
$1,063.68
|
| Rate for Payer: United Healthcare All Payer |
$975.04
|
|
|
SCREW LP NON LCK CORT 3.5*10
|
Facility
|
IP
|
$1,108.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.04 |
| Max. Negotiated Rate |
$1,063.68 |
| Rate for Payer: Aetna Commercial |
$853.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$864.24
|
| Rate for Payer: Cash Price |
$554.00
|
| Rate for Payer: Cigna Commercial |
$919.64
|
| Rate for Payer: First Health Commercial |
$1,052.60
|
| Rate for Payer: Humana Commercial |
$941.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$908.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$817.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$332.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$975.04
|
| Rate for Payer: Ohio Health Group HMO |
$831.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$221.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$144.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$343.48
|
| Rate for Payer: PHCS Commercial |
$1,063.68
|
| Rate for Payer: United Healthcare All Payer |
$975.04
|
|
|
SCREW LP NON LCK CORT 3.5*12
|
Facility
|
IP
|
$1,120.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.72 |
| Max. Negotiated Rate |
$1,076.06 |
| Rate for Payer: Aetna Commercial |
$863.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$874.30
|
| Rate for Payer: Cash Price |
$560.45
|
| Rate for Payer: Cigna Commercial |
$930.35
|
| Rate for Payer: First Health Commercial |
$1,064.86
|
| Rate for Payer: Humana Commercial |
$952.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$919.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$827.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$336.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$986.39
|
| Rate for Payer: Ohio Health Group HMO |
$840.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$224.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$145.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$347.48
|
| Rate for Payer: PHCS Commercial |
$1,076.06
|
| Rate for Payer: United Healthcare All Payer |
$986.39
|
|
|
SCREW LP NON LCK CORT 3.5*12
|
Facility
|
OP
|
$1,120.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.72 |
| Max. Negotiated Rate |
$1,076.06 |
| Rate for Payer: Aetna Commercial |
$863.09
|
| Rate for Payer: Anthem Medicaid |
$385.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$874.30
|
| Rate for Payer: Cash Price |
$560.45
|
| Rate for Payer: Cigna Commercial |
$930.35
|
| Rate for Payer: First Health Commercial |
$1,064.86
|
| Rate for Payer: Humana Commercial |
$952.76
|
| Rate for Payer: Humana KY Medicaid |
$385.48
|
| Rate for Payer: Kentucky WC Medicaid |
$389.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$919.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$827.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$336.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$393.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$986.39
|
| Rate for Payer: Ohio Health Group HMO |
$840.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$224.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$145.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$347.48
|
| Rate for Payer: PHCS Commercial |
$1,076.06
|
| Rate for Payer: United Healthcare All Payer |
$986.39
|
|
|
SCREW LP NON LCK CORT 3.5*13
|
Facility
|
IP
|
$1,120.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.72 |
| Max. Negotiated Rate |
$1,076.06 |
| Rate for Payer: Aetna Commercial |
$863.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$874.30
|
| Rate for Payer: Cash Price |
$560.45
|
| Rate for Payer: Cigna Commercial |
$930.35
|
| Rate for Payer: First Health Commercial |
$1,064.86
|
| Rate for Payer: Humana Commercial |
$952.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$919.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$827.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$336.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$986.39
|
| Rate for Payer: Ohio Health Group HMO |
$840.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$224.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$145.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$347.48
|
| Rate for Payer: PHCS Commercial |
$1,076.06
|
| Rate for Payer: United Healthcare All Payer |
$986.39
|
|
|
SCREW LP NON LCK CORT 3.5*13
|
Facility
|
OP
|
$1,120.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.72 |
| Max. Negotiated Rate |
$1,076.06 |
| Rate for Payer: Aetna Commercial |
$863.09
|
| Rate for Payer: Anthem Medicaid |
$385.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$874.30
|
| Rate for Payer: Cash Price |
$560.45
|
| Rate for Payer: Cigna Commercial |
$930.35
|
| Rate for Payer: First Health Commercial |
$1,064.86
|
| Rate for Payer: Humana Commercial |
$952.76
|
| Rate for Payer: Humana KY Medicaid |
$385.48
|
| Rate for Payer: Kentucky WC Medicaid |
$389.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$919.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$827.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$336.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$393.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$986.39
|
| Rate for Payer: Ohio Health Group HMO |
$840.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$224.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$145.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$347.48
|
| Rate for Payer: PHCS Commercial |
$1,076.06
|
| Rate for Payer: United Healthcare All Payer |
$986.39
|
|
|
SCREW LP TM SS CORT 3.5*54MM
|
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 LP TM SS CORT 3.5*54MM
|
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 LP TM SS CORT 3.5*65MM
|
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 LP TM SS CORT 3.5*65MM
|
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 MINI MONSTER 3.0*30
|
Facility
|
OP
|
$1,997.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.68 |
| Max. Negotiated Rate |
$1,917.60 |
| Rate for Payer: Aetna Commercial |
$1,538.08
|
| Rate for Payer: Anthem Medicaid |
$686.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,558.05
|
| Rate for Payer: Cash Price |
$998.75
|
| Rate for Payer: Cigna Commercial |
$1,657.92
|
| Rate for Payer: First Health Commercial |
$1,897.62
|
| Rate for Payer: Humana Commercial |
$1,697.88
|
| Rate for Payer: Humana KY Medicaid |
$686.94
|
| Rate for Payer: Kentucky WC Medicaid |
$693.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,637.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,474.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$599.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$700.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,757.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,498.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$399.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$259.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$619.22
|
| Rate for Payer: PHCS Commercial |
$1,917.60
|
| Rate for Payer: United Healthcare All Payer |
$1,757.80
|
|
|
SCREW MINI MONSTER 3.0*30
|
Facility
|
IP
|
$1,997.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.68 |
| Max. Negotiated Rate |
$1,917.60 |
| Rate for Payer: Aetna Commercial |
$1,538.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,558.05
|
| Rate for Payer: Cash Price |
$998.75
|
| Rate for Payer: Cigna Commercial |
$1,657.92
|
| Rate for Payer: First Health Commercial |
$1,897.62
|
| Rate for Payer: Humana Commercial |
$1,697.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,637.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,474.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$599.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,757.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,498.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$399.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$259.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$619.22
|
| Rate for Payer: PHCS Commercial |
$1,917.60
|
| Rate for Payer: United Healthcare All Payer |
$1,757.80
|
|
|
SCREW MINI MONSTER HL 3.5*38
|
Facility
|
IP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
SCREW MINI MONSTER HL 3.5*38
|
Facility
|
OP
|
$2,102.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$2,018.40 |
| Rate for Payer: Aetna Commercial |
$1,618.92
|
| Rate for Payer: Anthem Medicaid |
$723.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,639.95
|
| Rate for Payer: Cash Price |
$1,051.25
|
| Rate for Payer: Cigna Commercial |
$1,745.08
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: Humana Commercial |
$1,787.12
|
| Rate for Payer: Humana KY Medicaid |
$723.05
|
| Rate for Payer: Kentucky WC Medicaid |
$730.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,724.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,551.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$737.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,850.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,576.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.78
|
| Rate for Payer: PHCS Commercial |
$2,018.40
|
| Rate for Payer: United Healthcare All Payer |
$1,850.20
|
|
|
SCREW MIS HEADED 33MM
|
Facility
|
IP
|
$1,144.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.74 |
| Max. Negotiated Rate |
$1,098.36 |
| Rate for Payer: Aetna Commercial |
$880.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$892.41
|
| Rate for Payer: Cash Price |
$572.06
|
| Rate for Payer: Cigna Commercial |
$949.62
|
| Rate for Payer: First Health Commercial |
$1,086.91
|
| Rate for Payer: Humana Commercial |
$972.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$938.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$844.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$343.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,006.83
|
| Rate for Payer: Ohio Health Group HMO |
$858.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$228.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$148.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$354.68
|
| Rate for Payer: PHCS Commercial |
$1,098.36
|
| Rate for Payer: United Healthcare All Payer |
$1,006.83
|
|
|
SCREW MIS HEADED 33MM
|
Facility
|
OP
|
$1,144.12
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.74 |
| Max. Negotiated Rate |
$1,098.36 |
| Rate for Payer: Aetna Commercial |
$880.97
|
| Rate for Payer: Anthem Medicaid |
$393.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$892.41
|
| Rate for Payer: Cash Price |
$572.06
|
| Rate for Payer: Cigna Commercial |
$949.62
|
| Rate for Payer: First Health Commercial |
$1,086.91
|
| Rate for Payer: Humana Commercial |
$972.50
|
| Rate for Payer: Humana KY Medicaid |
$393.46
|
| Rate for Payer: Kentucky WC Medicaid |
$397.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$938.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$844.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$343.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$401.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,006.83
|
| Rate for Payer: Ohio Health Group HMO |
$858.09
|
| Rate for Payer: Ohio Health Group PPO Differential |
$228.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$148.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$354.68
|
| Rate for Payer: PHCS Commercial |
$1,098.36
|
| Rate for Payer: United Healthcare All Payer |
$1,006.83
|
|
|
SCREW NCB CORT ST 50X30MM
|
Facility
|
OP
|
$2,211.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.49 |
| Max. Negotiated Rate |
$2,123.00 |
| Rate for Payer: Aetna Commercial |
$1,702.82
|
| Rate for Payer: Anthem Medicaid |
$760.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,724.94
|
| Rate for Payer: Cash Price |
$1,105.73
|
| Rate for Payer: Cigna Commercial |
$1,835.51
|
| Rate for Payer: First Health Commercial |
$2,100.89
|
| Rate for Payer: Humana Commercial |
$1,879.74
|
| Rate for Payer: Humana KY Medicaid |
$760.52
|
| Rate for Payer: Kentucky WC Medicaid |
$768.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,813.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,632.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$663.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$775.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,946.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,658.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$442.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$287.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$685.55
|
| Rate for Payer: PHCS Commercial |
$2,123.00
|
| Rate for Payer: United Healthcare All Payer |
$1,946.08
|
|
|
SCREW NCB CORT ST 50X30MM
|
Facility
|
IP
|
$2,211.46
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.49 |
| Max. Negotiated Rate |
$2,123.00 |
| Rate for Payer: Aetna Commercial |
$1,702.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,724.94
|
| Rate for Payer: Cash Price |
$1,105.73
|
| Rate for Payer: Cigna Commercial |
$1,835.51
|
| Rate for Payer: First Health Commercial |
$2,100.89
|
| Rate for Payer: Humana Commercial |
$1,879.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,813.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,632.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$663.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,946.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,658.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$442.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$287.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$685.55
|
| Rate for Payer: PHCS Commercial |
$2,123.00
|
| Rate for Payer: United Healthcare All Payer |
$1,946.08
|
|
