SCREW TIT LAG 3.0*15MM
|
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 3.0*15MM
|
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 3.0*16MM
|
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 3.0*16MM
|
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 TRANSVERSE 3.5MM
|
Facility
|
IP
|
$4,300.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$559.00 |
Max. Negotiated Rate |
$4,128.00 |
Rate for Payer: Aetna Commercial |
$3,311.00
|
Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
Rate for Payer: Cash Price |
$2,150.00
|
Rate for Payer: Cigna Commercial |
$3,569.00
|
Rate for Payer: First Health Commercial |
$4,085.00
|
Rate for Payer: Humana Commercial |
$3,655.00
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
Rate for Payer: PHCS Commercial |
$4,128.00
|
Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
SCREW TRANSVERSE 3.5MM
|
Facility
|
OP
|
$4,300.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$559.00 |
Max. Negotiated Rate |
$4,128.00 |
Rate for Payer: Aetna Commercial |
$3,311.00
|
Rate for Payer: Anthem Medicaid |
$1,478.77
|
Rate for Payer: Anthem POS/PPO/Traditional |
$3,354.00
|
Rate for Payer: Cash Price |
$2,150.00
|
Rate for Payer: Cigna Commercial |
$3,569.00
|
Rate for Payer: First Health Commercial |
$4,085.00
|
Rate for Payer: Humana Commercial |
$3,655.00
|
Rate for Payer: Humana KY Medicaid |
$1,478.77
|
Rate for Payer: Kentucky WC Medicaid |
$1,493.82
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$3,526.00
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,173.40
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$1,290.00
|
Rate for Payer: Molina Healthcare Medicaid |
$1,508.44
|
Rate for Payer: Ohio Health Choice Commercial |
$3,784.00
|
Rate for Payer: Ohio Health Group HMO |
$3,225.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$860.00
|
Rate for Payer: Ohio Health Group PPO No Differential |
$559.00
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,333.00
|
Rate for Payer: PHCS Commercial |
$4,128.00
|
Rate for Payer: United Healthcare All Payer |
$3,784.00
|
|
SCREW UNICORTICAL NCB 5.0*10MM
|
Facility
|
IP
|
$2,128.68
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$276.73 |
Max. Negotiated Rate |
$2,043.53 |
Rate for Payer: Aetna Commercial |
$1,639.08
|
Rate for Payer: Anthem POS/PPO/Traditional |
$1,660.37
|
Rate for Payer: Cash Price |
$1,064.34
|
Rate for Payer: Cigna Commercial |
$1,766.80
|
Rate for Payer: First Health Commercial |
$2,022.25
|
Rate for Payer: Humana Commercial |
$1,809.38
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$1,745.52
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,570.97
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$638.60
|
Rate for Payer: Ohio Health Choice Commercial |
$1,873.24
|
Rate for Payer: Ohio Health Group HMO |
$1,596.51
|
Rate for Payer: Ohio Health Group PPO Differential |
$425.74
|
Rate for Payer: Ohio Health Group PPO No Differential |
$276.73
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$659.89
|
Rate for Payer: PHCS Commercial |
$2,043.53
|
Rate for Payer: United Healthcare All Payer |
$1,873.24
|
|
SCREW UNICORTICAL NCB 5.0*10MM
|
Facility
|
OP
|
$2,128.68
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$276.73 |
Max. Negotiated Rate |
$2,043.53 |
Rate for Payer: Aetna Commercial |
$1,639.08
|
Rate for Payer: Anthem Medicaid |
$732.05
|
Rate for Payer: Anthem POS/PPO/Traditional |
$1,660.37
|
Rate for Payer: Cash Price |
$1,064.34
|
Rate for Payer: Cigna Commercial |
$1,766.80
|
Rate for Payer: First Health Commercial |
$2,022.25
|
Rate for Payer: Humana Commercial |
$1,809.38
|
Rate for Payer: Humana KY Medicaid |
$732.05
|
Rate for Payer: Kentucky WC Medicaid |
$739.50
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$1,745.52
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,570.97
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$638.60
|
Rate for Payer: Molina Healthcare Medicaid |
$746.74
|
Rate for Payer: Ohio Health Choice Commercial |
$1,873.24
|
Rate for Payer: Ohio Health Group HMO |
$1,596.51
|
Rate for Payer: Ohio Health Group PPO Differential |
$425.74
|
Rate for Payer: Ohio Health Group PPO No Differential |
$276.73
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$659.89
|
Rate for Payer: PHCS Commercial |
$2,043.53
|
Rate for Payer: United Healthcare All Payer |
$1,873.24
|
|
SCREW VA LCK SLF-TAP 3.5*80MM
|
Facility
|
OP
|
$3,264.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$424.32 |
Max. Negotiated Rate |
$3,133.44 |
Rate for Payer: Aetna Commercial |
$2,513.28
|
Rate for Payer: Anthem Medicaid |
$1,122.49
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,545.92
|
Rate for Payer: Cash Price |
$1,632.00
|
Rate for Payer: Cigna Commercial |
$2,709.12
|
Rate for Payer: First Health Commercial |
$3,100.80
|
Rate for Payer: Humana Commercial |
$2,774.40
|
Rate for Payer: Humana KY Medicaid |
$1,122.49
|
Rate for Payer: Kentucky WC Medicaid |
$1,133.91
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,676.48
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,408.83
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$979.20
|
Rate for Payer: Molina Healthcare Medicaid |
$1,145.01
|
Rate for Payer: Ohio Health Choice Commercial |
$2,872.32
|
Rate for Payer: Ohio Health Group HMO |
$2,448.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$652.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$424.32
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,011.84
|
Rate for Payer: PHCS Commercial |
$3,133.44
|
Rate for Payer: United Healthcare All Payer |
$2,872.32
|
|
SCREW VA LCK SLF-TAP 3.5*80MM
|
Facility
|
IP
|
$3,264.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$424.32 |
Max. Negotiated Rate |
$3,133.44 |
Rate for Payer: Aetna Commercial |
$2,513.28
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,545.92
|
Rate for Payer: Cash Price |
$1,632.00
|
Rate for Payer: Cigna Commercial |
$2,709.12
|
Rate for Payer: First Health Commercial |
$3,100.80
|
Rate for Payer: Humana Commercial |
$2,774.40
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,676.48
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,408.83
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$979.20
|
Rate for Payer: Ohio Health Choice Commercial |
$2,872.32
|
Rate for Payer: Ohio Health Group HMO |
$2,448.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$652.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$424.32
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,011.84
|
Rate for Payer: PHCS Commercial |
$3,133.44
|
Rate for Payer: United Healthcare All Payer |
$2,872.32
|
|
SCREW VALCP 3.5 60MM
|
Facility
|
OP
|
$3,264.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$424.32 |
Max. Negotiated Rate |
$3,133.44 |
Rate for Payer: Aetna Commercial |
$2,513.28
|
Rate for Payer: Anthem Medicaid |
$1,122.49
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,545.92
|
Rate for Payer: Cash Price |
$1,632.00
|
Rate for Payer: Cigna Commercial |
$2,709.12
|
Rate for Payer: First Health Commercial |
$3,100.80
|
Rate for Payer: Humana Commercial |
$2,774.40
|
Rate for Payer: Humana KY Medicaid |
$1,122.49
|
Rate for Payer: Kentucky WC Medicaid |
$1,133.91
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,676.48
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,408.83
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$979.20
|
Rate for Payer: Molina Healthcare Medicaid |
$1,145.01
|
Rate for Payer: Ohio Health Choice Commercial |
$2,872.32
|
Rate for Payer: Ohio Health Group HMO |
$2,448.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$652.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$424.32
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,011.84
|
Rate for Payer: PHCS Commercial |
$3,133.44
|
Rate for Payer: United Healthcare All Payer |
$2,872.32
|
|
SCREW VALCP 3.5 60MM
|
Facility
|
IP
|
$3,264.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$424.32 |
Max. Negotiated Rate |
$3,133.44 |
Rate for Payer: Aetna Commercial |
$2,513.28
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,545.92
|
Rate for Payer: Cash Price |
$1,632.00
|
Rate for Payer: Cigna Commercial |
$2,709.12
|
Rate for Payer: First Health Commercial |
$3,100.80
|
Rate for Payer: Humana Commercial |
$2,774.40
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,676.48
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,408.83
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$979.20
|
Rate for Payer: Ohio Health Choice Commercial |
$2,872.32
|
Rate for Payer: Ohio Health Group HMO |
$2,448.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$652.80
|
Rate for Payer: Ohio Health Group PPO No Differential |
$424.32
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,011.84
|
Rate for Payer: PHCS Commercial |
$3,133.44
|
Rate for Payer: United Healthcare All Payer |
$2,872.32
|
|
SCREW VAL KREU TI 2.4*10MM
|
Facility
|
OP
|
$3,232.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$420.22 |
Max. Negotiated Rate |
$3,103.20 |
Rate for Payer: Aetna Commercial |
$2,489.02
|
Rate for Payer: Anthem Medicaid |
$1,111.66
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,521.35
|
Rate for Payer: Cash Price |
$1,616.25
|
Rate for Payer: Cigna Commercial |
$2,682.98
|
Rate for Payer: First Health Commercial |
$3,070.88
|
Rate for Payer: Humana Commercial |
$2,747.62
|
Rate for Payer: Humana KY Medicaid |
$1,111.66
|
Rate for Payer: Kentucky WC Medicaid |
$1,122.97
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,650.65
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,385.58
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$969.75
|
Rate for Payer: Molina Healthcare Medicaid |
$1,133.96
|
Rate for Payer: Ohio Health Choice Commercial |
$2,844.60
|
Rate for Payer: Ohio Health Group HMO |
$2,424.38
|
Rate for Payer: Ohio Health Group PPO Differential |
$646.50
|
Rate for Payer: Ohio Health Group PPO No Differential |
$420.22
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,002.08
|
Rate for Payer: PHCS Commercial |
$3,103.20
|
Rate for Payer: United Healthcare All Payer |
$2,844.60
|
|
SCREW VAL KREU TI 2.4*10MM
|
Facility
|
IP
|
$3,232.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$420.22 |
Max. Negotiated Rate |
$3,103.20 |
Rate for Payer: Aetna Commercial |
$2,489.02
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,521.35
|
Rate for Payer: Cash Price |
$1,616.25
|
Rate for Payer: Cigna Commercial |
$2,682.98
|
Rate for Payer: First Health Commercial |
$3,070.88
|
Rate for Payer: Humana Commercial |
$2,747.62
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,650.65
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,385.58
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$969.75
|
Rate for Payer: Ohio Health Choice Commercial |
$2,844.60
|
Rate for Payer: Ohio Health Group HMO |
$2,424.38
|
Rate for Payer: Ohio Health Group PPO Differential |
$646.50
|
Rate for Payer: Ohio Health Group PPO No Differential |
$420.22
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,002.08
|
Rate for Payer: PHCS Commercial |
$3,103.20
|
Rate for Payer: United Healthcare All Payer |
$2,844.60
|
|
SCREW VAL KREU TI 2.4*12MM
|
Facility
|
IP
|
$3,232.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$420.22 |
Max. Negotiated Rate |
$3,103.20 |
Rate for Payer: Aetna Commercial |
$2,489.02
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,521.35
|
Rate for Payer: Cash Price |
$1,616.25
|
Rate for Payer: Cigna Commercial |
$2,682.98
|
Rate for Payer: First Health Commercial |
$3,070.88
|
Rate for Payer: Humana Commercial |
$2,747.62
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,650.65
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,385.58
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$969.75
|
Rate for Payer: Ohio Health Choice Commercial |
$2,844.60
|
Rate for Payer: Ohio Health Group HMO |
$2,424.38
|
Rate for Payer: Ohio Health Group PPO Differential |
$646.50
|
Rate for Payer: Ohio Health Group PPO No Differential |
$420.22
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,002.08
|
Rate for Payer: PHCS Commercial |
$3,103.20
|
Rate for Payer: United Healthcare All Payer |
$2,844.60
|
|
SCREW VAL KREU TI 2.4*12MM
|
Facility
|
OP
|
$3,232.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$420.22 |
Max. Negotiated Rate |
$3,103.20 |
Rate for Payer: Aetna Commercial |
$2,489.02
|
Rate for Payer: Anthem Medicaid |
$1,111.66
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,521.35
|
Rate for Payer: Cash Price |
$1,616.25
|
Rate for Payer: Cigna Commercial |
$2,682.98
|
Rate for Payer: First Health Commercial |
$3,070.88
|
Rate for Payer: Humana Commercial |
$2,747.62
|
Rate for Payer: Humana KY Medicaid |
$1,111.66
|
Rate for Payer: Kentucky WC Medicaid |
$1,122.97
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,650.65
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,385.58
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$969.75
|
Rate for Payer: Molina Healthcare Medicaid |
$1,133.96
|
Rate for Payer: Ohio Health Choice Commercial |
$2,844.60
|
Rate for Payer: Ohio Health Group HMO |
$2,424.38
|
Rate for Payer: Ohio Health Group PPO Differential |
$646.50
|
Rate for Payer: Ohio Health Group PPO No Differential |
$420.22
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,002.08
|
Rate for Payer: PHCS Commercial |
$3,103.20
|
Rate for Payer: United Healthcare All Payer |
$2,844.60
|
|
SCREW VAL KREU TI 2.4*14MM
|
Facility
|
IP
|
$3,232.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$420.22 |
Max. Negotiated Rate |
$3,103.20 |
Rate for Payer: Aetna Commercial |
$2,489.02
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,521.35
|
Rate for Payer: Cash Price |
$1,616.25
|
Rate for Payer: Cigna Commercial |
$2,682.98
|
Rate for Payer: First Health Commercial |
$3,070.88
|
Rate for Payer: Humana Commercial |
$2,747.62
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,650.65
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,385.58
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$969.75
|
Rate for Payer: Ohio Health Choice Commercial |
$2,844.60
|
Rate for Payer: Ohio Health Group HMO |
$2,424.38
|
Rate for Payer: Ohio Health Group PPO Differential |
$646.50
|
Rate for Payer: Ohio Health Group PPO No Differential |
$420.22
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,002.08
|
Rate for Payer: PHCS Commercial |
$3,103.20
|
Rate for Payer: United Healthcare All Payer |
$2,844.60
|
|
SCREW VAL KREU TI 2.4*14MM
|
Facility
|
OP
|
$3,232.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
27000285
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$420.22 |
Max. Negotiated Rate |
$3,103.20 |
Rate for Payer: Aetna Commercial |
$2,489.02
|
Rate for Payer: Anthem Medicaid |
$1,111.66
|
Rate for Payer: Anthem POS/PPO/Traditional |
$2,521.35
|
Rate for Payer: Cash Price |
$1,616.25
|
Rate for Payer: Cigna Commercial |
$2,682.98
|
Rate for Payer: First Health Commercial |
$3,070.88
|
Rate for Payer: Humana Commercial |
$2,747.62
|
Rate for Payer: Humana KY Medicaid |
$1,111.66
|
Rate for Payer: Kentucky WC Medicaid |
$1,122.97
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$2,650.65
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,385.58
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$969.75
|
Rate for Payer: Molina Healthcare Medicaid |
$1,133.96
|
Rate for Payer: Ohio Health Choice Commercial |
$2,844.60
|
Rate for Payer: Ohio Health Group HMO |
$2,424.38
|
Rate for Payer: Ohio Health Group PPO Differential |
$646.50
|
Rate for Payer: Ohio Health Group PPO No Differential |
$420.22
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,002.08
|
Rate for Payer: PHCS Commercial |
$3,103.20
|
Rate for Payer: United Healthcare All Payer |
$2,844.60
|
|
SCREW VALOR 5MM 50MM L
|
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 VALOR 5MM 50MM L
|
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 VALOR 5MM 55MM L
|
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 VALOR 5MM 55MM L
|
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 VALOR 5MM 70MM L
|
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 VALOR 5MM 70MM L
|
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 VALOR 5MM L 25MM
|
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
|
|