|
SCREW T2 F/T LOCKING 4*35MM
|
Facility
|
OP
|
$2,159.58
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.75 |
| Max. Negotiated Rate |
$2,073.20 |
| Rate for Payer: Aetna Commercial |
$1,662.88
|
| Rate for Payer: Anthem Medicaid |
$742.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,684.47
|
| Rate for Payer: Cash Price |
$1,079.79
|
| Rate for Payer: Cigna Commercial |
$1,792.45
|
| Rate for Payer: First Health Commercial |
$2,051.60
|
| Rate for Payer: Humana Commercial |
$1,835.64
|
| Rate for Payer: Humana KY Medicaid |
$742.68
|
| Rate for Payer: Kentucky WC Medicaid |
$750.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,770.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,593.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$647.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$757.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,900.43
|
| Rate for Payer: Ohio Health Group HMO |
$1,619.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$431.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$280.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$669.47
|
| Rate for Payer: PHCS Commercial |
$2,073.20
|
| Rate for Payer: United Healthcare All Payer |
$1,900.43
|
|
|
SCREW THREAD SHORT 4.0*30MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*30MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*32MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*32MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*34MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*34MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*36MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*36MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*40MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*40MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*50MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4.0*50MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4*42MM
|
Facility
|
OP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem Medicaid |
$747.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Humana KY Medicaid |
$747.12
|
| Rate for Payer: Kentucky WC Medicaid |
$754.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$762.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAD SHORT 4*42MM
|
Facility
|
IP
|
$2,172.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$2,085.60 |
| Rate for Payer: Aetna Commercial |
$1,672.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,694.55
|
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Cigna Commercial |
$1,803.18
|
| Rate for Payer: First Health Commercial |
$2,063.88
|
| Rate for Payer: Humana Commercial |
$1,846.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,781.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,603.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$651.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,911.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,629.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$434.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$282.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$673.48
|
| Rate for Payer: PHCS Commercial |
$2,085.60
|
| Rate for Payer: United Healthcare All Payer |
$1,911.80
|
|
|
SCREW THREAT SHORT 3.0*30MM
|
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 THREAT SHORT 3.0*30MM
|
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 TI CORTEX 4.5*30
|
Facility
|
OP
|
$752.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.86 |
| Max. Negotiated Rate |
$722.67 |
| Rate for Payer: Aetna Commercial |
$579.64
|
| Rate for Payer: Anthem Medicaid |
$258.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$587.17
|
| Rate for Payer: Cash Price |
$376.39
|
| Rate for Payer: Cigna Commercial |
$624.81
|
| Rate for Payer: First Health Commercial |
$715.14
|
| Rate for Payer: Humana Commercial |
$639.86
|
| Rate for Payer: Humana KY Medicaid |
$258.88
|
| Rate for Payer: Kentucky WC Medicaid |
$261.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$617.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$555.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$264.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$662.45
|
| Rate for Payer: Ohio Health Group HMO |
$564.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$233.36
|
| Rate for Payer: PHCS Commercial |
$722.67
|
| Rate for Payer: United Healthcare All Payer |
$662.45
|
|
|
SCREW TI CORTEX 4.5*30
|
Facility
|
IP
|
$752.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.86 |
| Max. Negotiated Rate |
$722.67 |
| Rate for Payer: Aetna Commercial |
$579.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$587.17
|
| Rate for Payer: Cash Price |
$376.39
|
| Rate for Payer: Cigna Commercial |
$624.81
|
| Rate for Payer: First Health Commercial |
$715.14
|
| Rate for Payer: Humana Commercial |
$639.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$617.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$555.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$662.45
|
| Rate for Payer: Ohio Health Group HMO |
$564.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$233.36
|
| Rate for Payer: PHCS Commercial |
$722.67
|
| Rate for Payer: United Healthcare All Payer |
$662.45
|
|
|
SCREW TI CORTEX 4.5*34
|
Facility
|
IP
|
$752.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.86 |
| Max. Negotiated Rate |
$722.67 |
| Rate for Payer: Aetna Commercial |
$579.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$587.17
|
| Rate for Payer: Cash Price |
$376.39
|
| Rate for Payer: Cigna Commercial |
$624.81
|
| Rate for Payer: First Health Commercial |
$715.14
|
| Rate for Payer: Humana Commercial |
$639.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$617.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$555.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$662.45
|
| Rate for Payer: Ohio Health Group HMO |
$564.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$233.36
|
| Rate for Payer: PHCS Commercial |
$722.67
|
| Rate for Payer: United Healthcare All Payer |
$662.45
|
|
|
SCREW TI CORTEX 4.5*34
|
Facility
|
OP
|
$752.78
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.86 |
| Max. Negotiated Rate |
$722.67 |
| Rate for Payer: Aetna Commercial |
$579.64
|
| Rate for Payer: Anthem Medicaid |
$258.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$587.17
|
| Rate for Payer: Cash Price |
$376.39
|
| Rate for Payer: Cigna Commercial |
$624.81
|
| Rate for Payer: First Health Commercial |
$715.14
|
| Rate for Payer: Humana Commercial |
$639.86
|
| Rate for Payer: Humana KY Medicaid |
$258.88
|
| Rate for Payer: Kentucky WC Medicaid |
$261.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$617.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$555.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$264.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$662.45
|
| Rate for Payer: Ohio Health Group HMO |
$564.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$233.36
|
| Rate for Payer: PHCS Commercial |
$722.67
|
| Rate for Payer: United Healthcare All Payer |
$662.45
|
|
|
SCREW TIT LAG 2.0*10MM
|
Facility
|
OP
|
$1,857.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.48 |
| Max. Negotiated Rate |
$1,783.20 |
| Rate for Payer: Aetna Commercial |
$1,430.28
|
| Rate for Payer: Anthem Medicaid |
$638.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,448.85
|
| Rate for Payer: Cash Price |
$928.75
|
| Rate for Payer: Cigna Commercial |
$1,541.72
|
| Rate for Payer: First Health Commercial |
$1,764.62
|
| Rate for Payer: Humana Commercial |
$1,578.88
|
| Rate for Payer: Humana KY Medicaid |
$638.79
|
| Rate for Payer: Kentucky WC Medicaid |
$645.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,523.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,370.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$557.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$651.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,634.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,393.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$371.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$241.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$575.82
|
| Rate for Payer: PHCS Commercial |
$1,783.20
|
| Rate for Payer: United Healthcare All Payer |
$1,634.60
|
|
|
SCREW TIT LAG 2.0*10MM
|
Facility
|
IP
|
$1,857.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.48 |
| Max. Negotiated Rate |
$1,783.20 |
| Rate for Payer: Aetna Commercial |
$1,430.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,448.85
|
| Rate for Payer: Cash Price |
$928.75
|
| Rate for Payer: Cigna Commercial |
$1,541.72
|
| Rate for Payer: First Health Commercial |
$1,764.62
|
| Rate for Payer: Humana Commercial |
$1,578.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,523.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,370.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$557.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,634.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,393.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$371.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$241.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$575.82
|
| Rate for Payer: PHCS Commercial |
$1,783.20
|
| Rate for Payer: United Healthcare All Payer |
$1,634.60
|
|
|
SCREW TIT LAG 2.0*12MM
|
Facility
|
OP
|
$1,857.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.48 |
| Max. Negotiated Rate |
$1,783.20 |
| Rate for Payer: Aetna Commercial |
$1,430.28
|
| Rate for Payer: Anthem Medicaid |
$638.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,448.85
|
| Rate for Payer: Cash Price |
$928.75
|
| Rate for Payer: Cigna Commercial |
$1,541.72
|
| Rate for Payer: First Health Commercial |
$1,764.62
|
| Rate for Payer: Humana Commercial |
$1,578.88
|
| Rate for Payer: Humana KY Medicaid |
$638.79
|
| Rate for Payer: Kentucky WC Medicaid |
$645.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,523.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,370.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$557.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$651.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,634.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,393.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$371.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$241.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$575.82
|
| Rate for Payer: PHCS Commercial |
$1,783.20
|
| Rate for Payer: United Healthcare All Payer |
$1,634.60
|
|
|
SCREW TIT LAG 2.0*12MM
|
Facility
|
IP
|
$1,857.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.48 |
| Max. Negotiated Rate |
$1,783.20 |
| Rate for Payer: Aetna Commercial |
$1,430.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,448.85
|
| Rate for Payer: Cash Price |
$928.75
|
| Rate for Payer: Cigna Commercial |
$1,541.72
|
| Rate for Payer: First Health Commercial |
$1,764.62
|
| Rate for Payer: Humana Commercial |
$1,578.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,523.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,370.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$557.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,634.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,393.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$371.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$241.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$575.82
|
| Rate for Payer: PHCS Commercial |
$1,783.20
|
| Rate for Payer: United Healthcare All Payer |
$1,634.60
|
|
