|
ACE PLATE COMPRESSION 3.5MM 6H
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
ACE PLATE COMPRESSION 3.5MM 6H
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
ACE PLATE COMPRESSION 3.5MM 7H
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
ACE PLATE COMPRESSION 3.5MM 7H
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
ACE PLATE COMPRESSION 3.5MM 8H
|
Facility
|
IP
|
$1,980.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.06 |
| Max. Negotiated Rate |
$1,900.99 |
| Rate for Payer: Aetna Commercial |
$1,524.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,544.56
|
| Rate for Payer: Cash Price |
$990.10
|
| Rate for Payer: Cigna Commercial |
$1,643.57
|
| Rate for Payer: First Health Commercial |
$1,881.19
|
| Rate for Payer: Humana Commercial |
$1,683.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,623.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$594.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,742.58
|
| Rate for Payer: Ohio Health Group HMO |
$1,485.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,584.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,722.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,366.34
|
| Rate for Payer: PHCS Commercial |
$1,900.99
|
| Rate for Payer: United Healthcare All Payer |
$1,742.58
|
|
|
ACE PLATE COMPRESSION 3.5MM 8H
|
Facility
|
OP
|
$1,980.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.06 |
| Max. Negotiated Rate |
$1,900.99 |
| Rate for Payer: Aetna Commercial |
$1,524.75
|
| Rate for Payer: Anthem Medicaid |
$680.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,544.56
|
| Rate for Payer: Cash Price |
$990.10
|
| Rate for Payer: Cigna Commercial |
$1,643.57
|
| Rate for Payer: First Health Commercial |
$1,881.19
|
| Rate for Payer: Humana Commercial |
$1,683.17
|
| Rate for Payer: Humana KY Medicaid |
$680.99
|
| Rate for Payer: Kentucky WC Medicaid |
$687.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,623.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$594.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$694.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,742.58
|
| Rate for Payer: Ohio Health Group HMO |
$1,485.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,584.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,722.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,366.34
|
| Rate for Payer: PHCS Commercial |
$1,900.99
|
| Rate for Payer: United Healthcare All Payer |
$1,742.58
|
|
|
ACE PLATE COMPRESSION 3.5MM 9H
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
ACE PLATE COMPRESSION 3.5MM 9H
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
ACE PLATE (L) 6 HOLE RIGHT
|
Facility
|
OP
|
$3,092.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$927.60 |
| Max. Negotiated Rate |
$2,968.32 |
| Rate for Payer: Aetna Commercial |
$2,380.84
|
| Rate for Payer: Anthem Medicaid |
$1,063.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,411.76
|
| Rate for Payer: Cash Price |
$1,546.00
|
| Rate for Payer: Cigna Commercial |
$2,566.36
|
| Rate for Payer: First Health Commercial |
$2,937.40
|
| Rate for Payer: Humana Commercial |
$2,628.20
|
| Rate for Payer: Humana KY Medicaid |
$1,063.34
|
| Rate for Payer: Kentucky WC Medicaid |
$1,074.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,535.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,281.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$927.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,084.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,720.96
|
| Rate for Payer: Ohio Health Group HMO |
$2,319.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,473.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,690.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,133.48
|
| Rate for Payer: PHCS Commercial |
$2,968.32
|
| Rate for Payer: United Healthcare All Payer |
$2,720.96
|
|
|
ACE PLATE (L) 6 HOLE RIGHT
|
Facility
|
IP
|
$3,092.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$927.60 |
| Max. Negotiated Rate |
$2,968.32 |
| Rate for Payer: Aetna Commercial |
$2,380.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,411.76
|
| Rate for Payer: Cash Price |
$1,546.00
|
| Rate for Payer: Cigna Commercial |
$2,566.36
|
| Rate for Payer: First Health Commercial |
$2,937.40
|
| Rate for Payer: Humana Commercial |
$2,628.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,535.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,281.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$927.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,720.96
|
| Rate for Payer: Ohio Health Group HMO |
$2,319.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,473.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,690.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,133.48
|
| Rate for Payer: PHCS Commercial |
$2,968.32
|
| Rate for Payer: United Healthcare All Payer |
$2,720.96
|
|
|
ACE PLATE TUBULAR 12 HOLE
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,113.60 |
| Rate for Payer: Aetna Commercial |
$893.20
|
| Rate for Payer: Anthem Medicaid |
$398.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$904.80
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$962.80
|
| Rate for Payer: First Health Commercial |
$1,102.00
|
| Rate for Payer: Humana Commercial |
$986.00
|
| Rate for Payer: Humana KY Medicaid |
$398.92
|
| Rate for Payer: Kentucky WC Medicaid |
$402.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$951.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$856.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$348.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$406.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,020.80
|
| Rate for Payer: Ohio Health Group HMO |
$870.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$928.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,009.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$800.40
|
| Rate for Payer: PHCS Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Payer |
$1,020.80
|
|
|
ACE PLATE TUBULAR 12 HOLE
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,113.60 |
| Rate for Payer: Aetna Commercial |
$893.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$904.80
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$962.80
|
| Rate for Payer: First Health Commercial |
$1,102.00
|
| Rate for Payer: Humana Commercial |
$986.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$951.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$856.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$348.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,020.80
|
| Rate for Payer: Ohio Health Group HMO |
$870.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$928.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,009.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$800.40
|
| Rate for Payer: PHCS Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Payer |
$1,020.80
|
|
|
ACE PLATE TUBULAR 3 HOLE
|
Facility
|
IP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$1,075.20 |
| Rate for Payer: Aetna Commercial |
$862.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$873.60
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cigna Commercial |
$929.60
|
| Rate for Payer: First Health Commercial |
$1,064.00
|
| Rate for Payer: Humana Commercial |
$952.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$918.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$826.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$336.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$985.60
|
| Rate for Payer: Ohio Health Group HMO |
$840.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$896.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$974.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$772.80
|
| Rate for Payer: PHCS Commercial |
$1,075.20
|
| Rate for Payer: United Healthcare All Payer |
$985.60
|
|
|
ACE PLATE TUBULAR 3 HOLE
|
Facility
|
OP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$1,075.20 |
| Rate for Payer: Aetna Commercial |
$862.40
|
| Rate for Payer: Anthem Medicaid |
$385.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$873.60
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cigna Commercial |
$929.60
|
| Rate for Payer: First Health Commercial |
$1,064.00
|
| Rate for Payer: Humana Commercial |
$952.00
|
| Rate for Payer: Humana KY Medicaid |
$385.17
|
| Rate for Payer: Kentucky WC Medicaid |
$389.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$918.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$826.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$336.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$392.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$985.60
|
| Rate for Payer: Ohio Health Group HMO |
$840.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$896.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$974.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$772.80
|
| Rate for Payer: PHCS Commercial |
$1,075.20
|
| Rate for Payer: United Healthcare All Payer |
$985.60
|
|
|
ACE PLATE TUBULAR 4 HOLE
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,113.60 |
| Rate for Payer: Aetna Commercial |
$893.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$904.80
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$962.80
|
| Rate for Payer: First Health Commercial |
$1,102.00
|
| Rate for Payer: Humana Commercial |
$986.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$951.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$856.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$348.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,020.80
|
| Rate for Payer: Ohio Health Group HMO |
$870.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$928.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,009.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$800.40
|
| Rate for Payer: PHCS Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Payer |
$1,020.80
|
|
|
ACE PLATE TUBULAR 4 HOLE
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,113.60 |
| Rate for Payer: Aetna Commercial |
$893.20
|
| Rate for Payer: Anthem Medicaid |
$398.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$904.80
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cigna Commercial |
$962.80
|
| Rate for Payer: First Health Commercial |
$1,102.00
|
| Rate for Payer: Humana Commercial |
$986.00
|
| Rate for Payer: Humana KY Medicaid |
$398.92
|
| Rate for Payer: Kentucky WC Medicaid |
$402.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$951.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$856.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$348.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$406.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,020.80
|
| Rate for Payer: Ohio Health Group HMO |
$870.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$928.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,009.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$800.40
|
| Rate for Payer: PHCS Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Payer |
$1,020.80
|
|
|
ACE PLATE TUBULAR 5 HOLE
|
Facility
|
OP
|
$1,687.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$506.28 |
| Max. Negotiated Rate |
$1,620.10 |
| Rate for Payer: Aetna Commercial |
$1,299.45
|
| Rate for Payer: Anthem Medicaid |
$580.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.33
|
| Rate for Payer: Cash Price |
$843.80
|
| Rate for Payer: Cigna Commercial |
$1,400.71
|
| Rate for Payer: First Health Commercial |
$1,603.22
|
| Rate for Payer: Humana Commercial |
$1,434.46
|
| Rate for Payer: Humana KY Medicaid |
$580.37
|
| Rate for Payer: Kentucky WC Medicaid |
$586.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$506.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$592.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,485.09
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,350.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,468.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,164.44
|
| Rate for Payer: PHCS Commercial |
$1,620.10
|
| Rate for Payer: United Healthcare All Payer |
$1,485.09
|
|
|
ACE PLATE TUBULAR 5 HOLE
|
Facility
|
IP
|
$1,687.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$506.28 |
| Max. Negotiated Rate |
$1,620.10 |
| Rate for Payer: Aetna Commercial |
$1,299.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.33
|
| Rate for Payer: Cash Price |
$843.80
|
| Rate for Payer: Cigna Commercial |
$1,400.71
|
| Rate for Payer: First Health Commercial |
$1,603.22
|
| Rate for Payer: Humana Commercial |
$1,434.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$506.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,485.09
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,350.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,468.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,164.44
|
| Rate for Payer: PHCS Commercial |
$1,620.10
|
| Rate for Payer: United Healthcare All Payer |
$1,485.09
|
|
|
ACE PLATE TUBULAR 6 HOLE
|
Facility
|
OP
|
$1,759.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.94 |
| Max. Negotiated Rate |
$1,689.41 |
| Rate for Payer: Aetna Commercial |
$1,355.05
|
| Rate for Payer: Anthem Medicaid |
$605.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.64
|
| Rate for Payer: Cash Price |
$879.90
|
| Rate for Payer: Cigna Commercial |
$1,460.63
|
| Rate for Payer: First Health Commercial |
$1,671.81
|
| Rate for Payer: Humana Commercial |
$1,495.83
|
| Rate for Payer: Humana KY Medicaid |
$605.20
|
| Rate for Payer: Kentucky WC Medicaid |
$611.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,443.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$617.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,548.62
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,531.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,214.26
|
| Rate for Payer: PHCS Commercial |
$1,689.41
|
| Rate for Payer: United Healthcare All Payer |
$1,548.62
|
|
|
ACE PLATE TUBULAR 6 HOLE
|
Facility
|
IP
|
$1,759.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.94 |
| Max. Negotiated Rate |
$1,689.41 |
| Rate for Payer: Aetna Commercial |
$1,355.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,372.64
|
| Rate for Payer: Cash Price |
$879.90
|
| Rate for Payer: Cigna Commercial |
$1,460.63
|
| Rate for Payer: First Health Commercial |
$1,671.81
|
| Rate for Payer: Humana Commercial |
$1,495.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,443.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,298.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$527.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,548.62
|
| Rate for Payer: Ohio Health Group HMO |
$1,319.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,407.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,531.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,214.26
|
| Rate for Payer: PHCS Commercial |
$1,689.41
|
| Rate for Payer: United Healthcare All Payer |
$1,548.62
|
|
|
ACE PLATE TUBULAR 7 HOLE
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
ACE PLATE TUBULAR 7 HOLE
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
ACE PLATE TUBULAR 8 HOLE
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
ACE PLATE TUBULAR 8 HOLE
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
ACE SCREW CANC F/THRD 4.0*60MM
|
Facility
|
OP
|
$815.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.50 |
| Max. Negotiated Rate |
$782.40 |
| Rate for Payer: Aetna Commercial |
$627.55
|
| Rate for Payer: Anthem Medicaid |
$280.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$635.70
|
| Rate for Payer: Cash Price |
$407.50
|
| Rate for Payer: Cigna Commercial |
$676.45
|
| Rate for Payer: First Health Commercial |
$774.25
|
| Rate for Payer: Humana Commercial |
$692.75
|
| Rate for Payer: Humana KY Medicaid |
$280.28
|
| Rate for Payer: Kentucky WC Medicaid |
$283.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$668.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$601.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$285.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$717.20
|
| Rate for Payer: Ohio Health Group HMO |
$611.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$652.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$709.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$562.35
|
| Rate for Payer: PHCS Commercial |
$782.40
|
| Rate for Payer: United Healthcare All Payer |
$717.20
|
|
