|
SCORPIO P/S FEMORAL SZ 13 LT
|
Facility
|
IP
|
$11,162.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,348.89 |
| Max. Negotiated Rate |
$10,716.44 |
| Rate for Payer: Aetna Commercial |
$8,595.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,707.11
|
| Rate for Payer: Cash Price |
$5,581.48
|
| Rate for Payer: Cigna Commercial |
$9,265.26
|
| Rate for Payer: First Health Commercial |
$10,604.81
|
| Rate for Payer: Humana Commercial |
$9,488.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,153.63
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,238.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,348.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,823.40
|
| Rate for Payer: Ohio Health Group HMO |
$8,372.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,930.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,711.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,702.44
|
| Rate for Payer: PHCS Commercial |
$10,716.44
|
| Rate for Payer: United Healthcare All Payer |
$9,823.40
|
|
|
SCORPIO P/S FEMORAL SZ 13 RT
|
Facility
|
OP
|
$13,088.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,926.69 |
| Max. Negotiated Rate |
$12,565.42 |
| Rate for Payer: Aetna Commercial |
$10,078.51
|
| Rate for Payer: Anthem Medicaid |
$4,501.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,209.40
|
| Rate for Payer: Cash Price |
$6,544.49
|
| Rate for Payer: Cigna Commercial |
$10,863.85
|
| Rate for Payer: First Health Commercial |
$12,434.53
|
| Rate for Payer: Humana Commercial |
$11,125.63
|
| Rate for Payer: Humana KY Medicaid |
$4,501.30
|
| Rate for Payer: Kentucky WC Medicaid |
$4,547.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,732.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,659.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,926.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,591.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,518.30
|
| Rate for Payer: Ohio Health Group HMO |
$9,816.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,471.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,387.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,031.40
|
| Rate for Payer: PHCS Commercial |
$12,565.42
|
| Rate for Payer: United Healthcare All Payer |
$11,518.30
|
|
|
SCORPIO P/S FEMORAL SZ 13 RT
|
Facility
|
IP
|
$13,088.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,926.69 |
| Max. Negotiated Rate |
$12,565.42 |
| Rate for Payer: Aetna Commercial |
$10,078.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,209.40
|
| Rate for Payer: Cash Price |
$6,544.49
|
| Rate for Payer: Cigna Commercial |
$10,863.85
|
| Rate for Payer: First Health Commercial |
$12,434.53
|
| Rate for Payer: Humana Commercial |
$11,125.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,732.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,659.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,926.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,518.30
|
| Rate for Payer: Ohio Health Group HMO |
$9,816.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,471.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,387.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,031.40
|
| Rate for Payer: PHCS Commercial |
$12,565.42
|
| Rate for Payer: United Healthcare All Payer |
$11,518.30
|
|
|
SCORPIO P/S FEMORAL SZ 3 LT
|
Facility
|
IP
|
$11,673.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,502.15 |
| Max. Negotiated Rate |
$11,206.87 |
| Rate for Payer: Aetna Commercial |
$8,988.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,105.58
|
| Rate for Payer: Cash Price |
$5,836.91
|
| Rate for Payer: Cigna Commercial |
$9,689.27
|
| Rate for Payer: First Health Commercial |
$11,090.13
|
| Rate for Payer: Humana Commercial |
$9,922.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,572.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,615.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,502.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,272.96
|
| Rate for Payer: Ohio Health Group HMO |
$8,755.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,339.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,156.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,054.94
|
| Rate for Payer: PHCS Commercial |
$11,206.87
|
| Rate for Payer: United Healthcare All Payer |
$10,272.96
|
|
|
SCORPIO P/S FEMORAL SZ 3 LT
|
Facility
|
OP
|
$11,673.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,502.15 |
| Max. Negotiated Rate |
$11,206.87 |
| Rate for Payer: Aetna Commercial |
$8,988.84
|
| Rate for Payer: Anthem Medicaid |
$4,014.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,105.58
|
| Rate for Payer: Cash Price |
$5,836.91
|
| Rate for Payer: Cigna Commercial |
$9,689.27
|
| Rate for Payer: First Health Commercial |
$11,090.13
|
| Rate for Payer: Humana Commercial |
$9,922.75
|
| Rate for Payer: Humana KY Medicaid |
$4,014.63
|
| Rate for Payer: Kentucky WC Medicaid |
$4,055.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,572.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,615.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,502.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,095.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,272.96
|
| Rate for Payer: Ohio Health Group HMO |
$8,755.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,339.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,156.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,054.94
|
| Rate for Payer: PHCS Commercial |
$11,206.87
|
| Rate for Payer: United Healthcare All Payer |
$10,272.96
|
|
|
SCORPIO P/S FEMORAL SZ 5 LT
|
Facility
|
IP
|
$13,003.83
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,901.15 |
| Max. Negotiated Rate |
$12,483.68 |
| Rate for Payer: Aetna Commercial |
$10,012.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,142.99
|
| Rate for Payer: Cash Price |
$6,501.92
|
| Rate for Payer: Cigna Commercial |
$10,793.18
|
| Rate for Payer: First Health Commercial |
$12,353.64
|
| Rate for Payer: Humana Commercial |
$11,053.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,663.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,596.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,901.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,443.37
|
| Rate for Payer: Ohio Health Group HMO |
$9,752.87
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,403.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,313.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,972.64
|
| Rate for Payer: PHCS Commercial |
$12,483.68
|
| Rate for Payer: United Healthcare All Payer |
$11,443.37
|
|
|
SCORPIO P/S FEMORAL SZ 5 LT
|
Facility
|
OP
|
$13,003.83
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,901.15 |
| Max. Negotiated Rate |
$12,483.68 |
| Rate for Payer: Aetna Commercial |
$10,012.95
|
| Rate for Payer: Anthem Medicaid |
$4,472.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,142.99
|
| Rate for Payer: Cash Price |
$6,501.92
|
| Rate for Payer: Cigna Commercial |
$10,793.18
|
| Rate for Payer: First Health Commercial |
$12,353.64
|
| Rate for Payer: Humana Commercial |
$11,053.26
|
| Rate for Payer: Humana KY Medicaid |
$4,472.02
|
| Rate for Payer: Kentucky WC Medicaid |
$4,517.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,663.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,596.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,901.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,561.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,443.37
|
| Rate for Payer: Ohio Health Group HMO |
$9,752.87
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,403.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,313.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,972.64
|
| Rate for Payer: PHCS Commercial |
$12,483.68
|
| Rate for Payer: United Healthcare All Payer |
$11,443.37
|
|
|
SCORPIO P/S FEMORAL SZ 5 RT
|
Facility
|
OP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem Medicaid |
$4,635.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Humana KY Medicaid |
$4,635.59
|
| Rate for Payer: Kentucky WC Medicaid |
$4,682.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,728.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 5 RT
|
Facility
|
IP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 7 LT
|
Facility
|
OP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem Medicaid |
$4,635.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Humana KY Medicaid |
$4,635.59
|
| Rate for Payer: Kentucky WC Medicaid |
$4,682.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,728.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 7 LT
|
Facility
|
IP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 7 RT
|
Facility
|
OP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem Medicaid |
$4,635.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Humana KY Medicaid |
$4,635.59
|
| Rate for Payer: Kentucky WC Medicaid |
$4,682.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,728.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 7 RT
|
Facility
|
IP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 9 LT
|
Facility
|
IP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 9 LT
|
Facility
|
OP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem Medicaid |
$4,635.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Humana KY Medicaid |
$4,635.59
|
| Rate for Payer: Kentucky WC Medicaid |
$4,682.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,728.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 9 RT
|
Facility
|
IP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S FEMORAL SZ 9 RT
|
Facility
|
OP
|
$13,479.46
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,043.84 |
| Max. Negotiated Rate |
$12,940.28 |
| Rate for Payer: Aetna Commercial |
$10,379.18
|
| Rate for Payer: Anthem Medicaid |
$4,635.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,513.98
|
| Rate for Payer: Cash Price |
$6,739.73
|
| Rate for Payer: Cigna Commercial |
$11,187.95
|
| Rate for Payer: First Health Commercial |
$12,805.49
|
| Rate for Payer: Humana Commercial |
$11,457.54
|
| Rate for Payer: Humana KY Medicaid |
$4,635.59
|
| Rate for Payer: Kentucky WC Medicaid |
$4,682.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,053.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,947.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,043.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,728.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,861.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,109.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,783.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,727.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,300.83
|
| Rate for Payer: PHCS Commercial |
$12,940.28
|
| Rate for Payer: United Healthcare All Payer |
$11,861.92
|
|
|
SCORPIO P/S TIBIAL INST SZ 3
|
Facility
|
IP
|
$4,901.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,470.30 |
| Max. Negotiated Rate |
$4,704.96 |
| Rate for Payer: Aetna Commercial |
$3,773.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,822.78
|
| Rate for Payer: Cash Price |
$2,450.50
|
| Rate for Payer: Cigna Commercial |
$4,067.83
|
| Rate for Payer: First Health Commercial |
$4,655.95
|
| Rate for Payer: Humana Commercial |
$4,165.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,018.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,616.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,470.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,312.88
|
| Rate for Payer: Ohio Health Group HMO |
$3,675.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,920.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,263.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,381.69
|
| Rate for Payer: PHCS Commercial |
$4,704.96
|
| Rate for Payer: United Healthcare All Payer |
$4,312.88
|
|
|
SCORPIO P/S TIBIAL INST SZ 3
|
Facility
|
OP
|
$4,901.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,470.30 |
| Max. Negotiated Rate |
$4,704.96 |
| Rate for Payer: Aetna Commercial |
$3,773.77
|
| Rate for Payer: Anthem Medicaid |
$1,685.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,822.78
|
| Rate for Payer: Cash Price |
$2,450.50
|
| Rate for Payer: Cigna Commercial |
$4,067.83
|
| Rate for Payer: First Health Commercial |
$4,655.95
|
| Rate for Payer: Humana Commercial |
$4,165.85
|
| Rate for Payer: Humana KY Medicaid |
$1,685.45
|
| Rate for Payer: Kentucky WC Medicaid |
$1,702.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,018.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,616.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,470.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,719.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,312.88
|
| Rate for Payer: Ohio Health Group HMO |
$3,675.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,920.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,263.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,381.69
|
| Rate for Payer: PHCS Commercial |
$4,704.96
|
| Rate for Payer: United Healthcare All Payer |
$4,312.88
|
|
|
SCORPIO TIBIAL BASE SZ 11
|
Facility
|
OP
|
$8,863.36
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,659.01 |
| Max. Negotiated Rate |
$8,508.83 |
| Rate for Payer: Aetna Commercial |
$6,824.79
|
| Rate for Payer: Anthem Medicaid |
$3,048.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,913.42
|
| Rate for Payer: Cash Price |
$4,431.68
|
| Rate for Payer: Cigna Commercial |
$7,356.59
|
| Rate for Payer: First Health Commercial |
$8,420.19
|
| Rate for Payer: Humana Commercial |
$7,533.86
|
| Rate for Payer: Humana KY Medicaid |
$3,048.11
|
| Rate for Payer: Kentucky WC Medicaid |
$3,079.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,267.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,541.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,659.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,109.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,799.76
|
| Rate for Payer: Ohio Health Group HMO |
$6,647.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,090.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,711.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,115.72
|
| Rate for Payer: PHCS Commercial |
$8,508.83
|
| Rate for Payer: United Healthcare All Payer |
$7,799.76
|
|
|
SCORPIO TIBIAL BASE SZ 11
|
Facility
|
IP
|
$8,863.36
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,659.01 |
| Max. Negotiated Rate |
$8,508.83 |
| Rate for Payer: Aetna Commercial |
$6,824.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,913.42
|
| Rate for Payer: Cash Price |
$4,431.68
|
| Rate for Payer: Cigna Commercial |
$7,356.59
|
| Rate for Payer: First Health Commercial |
$8,420.19
|
| Rate for Payer: Humana Commercial |
$7,533.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,267.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,541.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,659.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,799.76
|
| Rate for Payer: Ohio Health Group HMO |
$6,647.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,090.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,711.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,115.72
|
| Rate for Payer: PHCS Commercial |
$8,508.83
|
| Rate for Payer: United Healthcare All Payer |
$7,799.76
|
|
|
SCORPIO TIBIAL BASE SZ 13
|
Facility
|
IP
|
$8,691.08
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,607.32 |
| Max. Negotiated Rate |
$8,343.44 |
| Rate for Payer: Aetna Commercial |
$6,692.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,779.04
|
| Rate for Payer: Cash Price |
$4,345.54
|
| Rate for Payer: Cigna Commercial |
$7,213.60
|
| Rate for Payer: First Health Commercial |
$8,256.53
|
| Rate for Payer: Humana Commercial |
$7,387.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,126.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,414.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,607.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,648.15
|
| Rate for Payer: Ohio Health Group HMO |
$6,518.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,952.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,561.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,996.85
|
| Rate for Payer: PHCS Commercial |
$8,343.44
|
| Rate for Payer: United Healthcare All Payer |
$7,648.15
|
|
|
SCORPIO TIBIAL BASE SZ 13
|
Facility
|
OP
|
$8,691.08
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,607.32 |
| Max. Negotiated Rate |
$8,343.44 |
| Rate for Payer: Aetna Commercial |
$6,692.13
|
| Rate for Payer: Anthem Medicaid |
$2,988.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,779.04
|
| Rate for Payer: Cash Price |
$4,345.54
|
| Rate for Payer: Cigna Commercial |
$7,213.60
|
| Rate for Payer: First Health Commercial |
$8,256.53
|
| Rate for Payer: Humana Commercial |
$7,387.42
|
| Rate for Payer: Humana KY Medicaid |
$2,988.86
|
| Rate for Payer: Kentucky WC Medicaid |
$3,019.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,126.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,414.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,607.32
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,048.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,648.15
|
| Rate for Payer: Ohio Health Group HMO |
$6,518.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,952.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,561.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,996.85
|
| Rate for Payer: PHCS Commercial |
$8,343.44
|
| Rate for Payer: United Healthcare All Payer |
$7,648.15
|
|
|
SCORPIO TIBIAL BASE SZ 3
|
Facility
|
OP
|
$8,691.08
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,607.32 |
| Max. Negotiated Rate |
$8,343.44 |
| Rate for Payer: Aetna Commercial |
$6,692.13
|
| Rate for Payer: Anthem Medicaid |
$2,988.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,779.04
|
| Rate for Payer: Cash Price |
$4,345.54
|
| Rate for Payer: Cigna Commercial |
$7,213.60
|
| Rate for Payer: First Health Commercial |
$8,256.53
|
| Rate for Payer: Humana Commercial |
$7,387.42
|
| Rate for Payer: Humana KY Medicaid |
$2,988.86
|
| Rate for Payer: Kentucky WC Medicaid |
$3,019.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,126.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,414.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,607.32
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,048.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,648.15
|
| Rate for Payer: Ohio Health Group HMO |
$6,518.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,952.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,561.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,996.85
|
| Rate for Payer: PHCS Commercial |
$8,343.44
|
| Rate for Payer: United Healthcare All Payer |
$7,648.15
|
|
|
SCORPIO TIBIAL BASE SZ 3
|
Facility
|
IP
|
$8,691.08
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,607.32 |
| Max. Negotiated Rate |
$8,343.44 |
| Rate for Payer: Aetna Commercial |
$6,692.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,779.04
|
| Rate for Payer: Cash Price |
$4,345.54
|
| Rate for Payer: Cigna Commercial |
$7,213.60
|
| Rate for Payer: First Health Commercial |
$8,256.53
|
| Rate for Payer: Humana Commercial |
$7,387.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,126.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,414.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,607.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,648.15
|
| Rate for Payer: Ohio Health Group HMO |
$6,518.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,952.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,561.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,996.85
|
| Rate for Payer: PHCS Commercial |
$8,343.44
|
| Rate for Payer: United Healthcare All Payer |
$7,648.15
|
|
