|
SCREW ACETABULAR 6.5*30MM
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
SCREW ACUTRAK 3 40*22MM STD
|
Facility
|
OP
|
$7,704.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,311.45 |
| Max. Negotiated Rate |
$7,396.66 |
| Rate for Payer: Aetna Commercial |
$5,932.73
|
| Rate for Payer: Anthem Medicaid |
$2,649.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,009.78
|
| Rate for Payer: Cash Price |
$3,852.43
|
| Rate for Payer: Cigna Commercial |
$6,395.03
|
| Rate for Payer: First Health Commercial |
$7,319.61
|
| Rate for Payer: Humana Commercial |
$6,549.12
|
| Rate for Payer: Humana KY Medicaid |
$2,649.70
|
| Rate for Payer: Kentucky WC Medicaid |
$2,676.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,317.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,686.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,311.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,702.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,780.27
|
| Rate for Payer: Ohio Health Group HMO |
$5,778.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,163.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,703.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,316.35
|
| Rate for Payer: PHCS Commercial |
$7,396.66
|
| Rate for Payer: United Healthcare All Payer |
$6,780.27
|
|
|
SCREW ACUTRAK 3 40*22MM STD
|
Facility
|
IP
|
$7,704.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,311.45 |
| Max. Negotiated Rate |
$7,396.66 |
| Rate for Payer: Aetna Commercial |
$5,932.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,009.78
|
| Rate for Payer: Cash Price |
$3,852.43
|
| Rate for Payer: Cigna Commercial |
$6,395.03
|
| Rate for Payer: First Health Commercial |
$7,319.61
|
| Rate for Payer: Humana Commercial |
$6,549.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,317.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,686.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,311.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,780.27
|
| Rate for Payer: Ohio Health Group HMO |
$5,778.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,163.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,703.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,316.35
|
| Rate for Payer: PHCS Commercial |
$7,396.66
|
| Rate for Payer: United Healthcare All Payer |
$6,780.27
|
|
|
SCREW ACUTRAK 3 4*26MM STD
|
Facility
|
OP
|
$7,704.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,311.45 |
| Max. Negotiated Rate |
$7,396.66 |
| Rate for Payer: Aetna Commercial |
$5,932.73
|
| Rate for Payer: Anthem Medicaid |
$2,649.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,009.78
|
| Rate for Payer: Cash Price |
$3,852.43
|
| Rate for Payer: Cigna Commercial |
$6,395.03
|
| Rate for Payer: First Health Commercial |
$7,319.61
|
| Rate for Payer: Humana Commercial |
$6,549.12
|
| Rate for Payer: Humana KY Medicaid |
$2,649.70
|
| Rate for Payer: Kentucky WC Medicaid |
$2,676.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,317.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,686.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,311.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,702.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,780.27
|
| Rate for Payer: Ohio Health Group HMO |
$5,778.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,163.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,703.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,316.35
|
| Rate for Payer: PHCS Commercial |
$7,396.66
|
| Rate for Payer: United Healthcare All Payer |
$6,780.27
|
|
|
SCREW ACUTRAK 3 4*26MM STD
|
Facility
|
IP
|
$7,704.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,311.45 |
| Max. Negotiated Rate |
$7,396.66 |
| Rate for Payer: Aetna Commercial |
$5,932.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,009.78
|
| Rate for Payer: Cash Price |
$3,852.43
|
| Rate for Payer: Cigna Commercial |
$6,395.03
|
| Rate for Payer: First Health Commercial |
$7,319.61
|
| Rate for Payer: Humana Commercial |
$6,549.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,317.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,686.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,311.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,780.27
|
| Rate for Payer: Ohio Health Group HMO |
$5,778.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,163.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,703.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,316.35
|
| Rate for Payer: PHCS Commercial |
$7,396.66
|
| Rate for Payer: United Healthcare All Payer |
$6,780.27
|
|
|
SCREW ASNIS CANN 5.0*60
|
Facility
|
IP
|
$1,866.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.86 |
| Max. Negotiated Rate |
$1,791.55 |
| Rate for Payer: Aetna Commercial |
$1,436.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,455.64
|
| Rate for Payer: Cash Price |
$933.10
|
| Rate for Payer: Cigna Commercial |
$1,548.95
|
| Rate for Payer: First Health Commercial |
$1,772.89
|
| Rate for Payer: Humana Commercial |
$1,586.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,530.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,377.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$559.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,642.26
|
| Rate for Payer: Ohio Health Group HMO |
$1,399.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,492.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,623.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,287.68
|
| Rate for Payer: PHCS Commercial |
$1,791.55
|
| Rate for Payer: United Healthcare All Payer |
$1,642.26
|
|
|
SCREW ASNIS CANN 5.0*60
|
Facility
|
OP
|
$1,866.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.86 |
| Max. Negotiated Rate |
$1,791.55 |
| Rate for Payer: Aetna Commercial |
$1,436.97
|
| Rate for Payer: Anthem Medicaid |
$641.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,455.64
|
| Rate for Payer: Cash Price |
$933.10
|
| Rate for Payer: Cigna Commercial |
$1,548.95
|
| Rate for Payer: First Health Commercial |
$1,772.89
|
| Rate for Payer: Humana Commercial |
$1,586.27
|
| Rate for Payer: Humana KY Medicaid |
$641.79
|
| Rate for Payer: Kentucky WC Medicaid |
$648.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,530.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,377.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$559.86
|
| Rate for Payer: Molina Healthcare Medicaid |
$654.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,642.26
|
| Rate for Payer: Ohio Health Group HMO |
$1,399.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,492.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,623.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,287.68
|
| Rate for Payer: PHCS Commercial |
$1,791.55
|
| Rate for Payer: United Healthcare All Payer |
$1,642.26
|
|
|
SCREW AUTOFIX 2.0*30MM
|
Facility
|
OP
|
$1,759.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
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
|
|
|
SCREW AUTOFIX 2.0*30MM
|
Facility
|
IP
|
$1,759.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
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
|
|
|
SCREW BIOCRYL INTRFERENCE 8*30
|
Facility
|
OP
|
$3,260.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.00 |
| Max. Negotiated Rate |
$3,129.60 |
| Rate for Payer: Aetna Commercial |
$2,510.20
|
| Rate for Payer: Anthem Medicaid |
$1,121.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,542.80
|
| Rate for Payer: Cash Price |
$1,630.00
|
| Rate for Payer: Cigna Commercial |
$2,705.80
|
| Rate for Payer: First Health Commercial |
$3,097.00
|
| Rate for Payer: Humana Commercial |
$2,771.00
|
| Rate for Payer: Humana KY Medicaid |
$1,121.11
|
| Rate for Payer: Kentucky WC Medicaid |
$1,132.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,673.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,405.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$978.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,143.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,868.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,445.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,608.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,836.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,249.40
|
| Rate for Payer: PHCS Commercial |
$3,129.60
|
| Rate for Payer: United Healthcare All Payer |
$2,868.80
|
|
|
SCREW BIOCRYL INTRFERENCE 8*30
|
Facility
|
IP
|
$3,260.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.00 |
| Max. Negotiated Rate |
$3,129.60 |
| Rate for Payer: Aetna Commercial |
$2,510.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,542.80
|
| Rate for Payer: Cash Price |
$1,630.00
|
| Rate for Payer: Cigna Commercial |
$2,705.80
|
| Rate for Payer: First Health Commercial |
$3,097.00
|
| Rate for Payer: Humana Commercial |
$2,771.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,673.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,405.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$978.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,868.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,445.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,608.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,836.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,249.40
|
| Rate for Payer: PHCS Commercial |
$3,129.60
|
| Rate for Payer: United Healthcare All Payer |
$2,868.80
|
|
|
SCREW BONE NANO 28*2.0
|
Facility
|
IP
|
$7,985.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,395.77 |
| Max. Negotiated Rate |
$7,666.46 |
| Rate for Payer: Aetna Commercial |
$6,149.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,229.00
|
| Rate for Payer: Cash Price |
$3,992.95
|
| Rate for Payer: Cigna Commercial |
$6,628.30
|
| Rate for Payer: First Health Commercial |
$7,586.60
|
| Rate for Payer: Humana Commercial |
$6,788.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,548.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,893.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,395.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,027.59
|
| Rate for Payer: Ohio Health Group HMO |
$5,989.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,388.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,947.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,510.27
|
| Rate for Payer: PHCS Commercial |
$7,666.46
|
| Rate for Payer: United Healthcare All Payer |
$7,027.59
|
|
|
SCREW BONE NANO 28*2.0
|
Facility
|
OP
|
$7,985.90
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,395.77 |
| Max. Negotiated Rate |
$7,666.46 |
| Rate for Payer: Aetna Commercial |
$6,149.14
|
| Rate for Payer: Anthem Medicaid |
$2,746.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,229.00
|
| Rate for Payer: Cash Price |
$3,992.95
|
| Rate for Payer: Cigna Commercial |
$6,628.30
|
| Rate for Payer: First Health Commercial |
$7,586.60
|
| Rate for Payer: Humana Commercial |
$6,788.02
|
| Rate for Payer: Humana KY Medicaid |
$2,746.35
|
| Rate for Payer: Kentucky WC Medicaid |
$2,774.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,548.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,893.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,395.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,801.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,027.59
|
| Rate for Payer: Ohio Health Group HMO |
$5,989.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,388.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,947.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,510.27
|
| Rate for Payer: PHCS Commercial |
$7,666.46
|
| Rate for Payer: United Healthcare All Payer |
$7,027.59
|
|
|
SCREW BONE NL T10 FT 2.7*28
|
Facility
|
IP
|
$1,491.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$447.36 |
| Max. Negotiated Rate |
$1,431.54 |
| Rate for Payer: Aetna Commercial |
$1,148.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,163.13
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cigna Commercial |
$1,237.69
|
| Rate for Payer: First Health Commercial |
$1,416.63
|
| Rate for Payer: Humana Commercial |
$1,267.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,222.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,100.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$447.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,312.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,118.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,192.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,297.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.92
|
| Rate for Payer: PHCS Commercial |
$1,431.54
|
| Rate for Payer: United Healthcare All Payer |
$1,312.25
|
|
|
SCREW BONE NL T10 FT 2.7*28
|
Facility
|
OP
|
$1,491.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$447.36 |
| Max. Negotiated Rate |
$1,431.54 |
| Rate for Payer: Aetna Commercial |
$1,148.22
|
| Rate for Payer: Anthem Medicaid |
$512.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,163.13
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cigna Commercial |
$1,237.69
|
| Rate for Payer: First Health Commercial |
$1,416.63
|
| Rate for Payer: Humana Commercial |
$1,267.51
|
| Rate for Payer: Humana KY Medicaid |
$512.82
|
| Rate for Payer: Kentucky WC Medicaid |
$518.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,222.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,100.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$447.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$523.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,312.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,118.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,192.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,297.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.92
|
| Rate for Payer: PHCS Commercial |
$1,431.54
|
| Rate for Payer: United Healthcare All Payer |
$1,312.25
|
|
|
SCREW BONE NL T10 FT 2.7*30
|
Facility
|
IP
|
$1,540.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.03 |
| Max. Negotiated Rate |
$1,478.50 |
| Rate for Payer: Aetna Commercial |
$1,185.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,201.28
|
| Rate for Payer: Cash Price |
$770.05
|
| Rate for Payer: Cigna Commercial |
$1,278.28
|
| Rate for Payer: First Health Commercial |
$1,463.10
|
| Rate for Payer: Humana Commercial |
$1,309.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,136.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$462.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,355.29
|
| Rate for Payer: Ohio Health Group HMO |
$1,155.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,232.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.67
|
| Rate for Payer: PHCS Commercial |
$1,478.50
|
| Rate for Payer: United Healthcare All Payer |
$1,355.29
|
|
|
SCREW BONE NL T10 FT 2.7*30
|
Facility
|
OP
|
$1,540.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.03 |
| Max. Negotiated Rate |
$1,478.50 |
| Rate for Payer: Aetna Commercial |
$1,185.88
|
| Rate for Payer: Anthem Medicaid |
$529.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,201.28
|
| Rate for Payer: Cash Price |
$770.05
|
| Rate for Payer: Cigna Commercial |
$1,278.28
|
| Rate for Payer: First Health Commercial |
$1,463.10
|
| Rate for Payer: Humana Commercial |
$1,309.09
|
| Rate for Payer: Humana KY Medicaid |
$529.64
|
| Rate for Payer: Kentucky WC Medicaid |
$535.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,136.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$462.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$540.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,355.29
|
| Rate for Payer: Ohio Health Group HMO |
$1,155.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,232.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.67
|
| Rate for Payer: PHCS Commercial |
$1,478.50
|
| Rate for Payer: United Healthcare All Payer |
$1,355.29
|
|
|
SCREW BONE T10 FT 3.5*34
|
Facility
|
IP
|
$1,491.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$447.36 |
| Max. Negotiated Rate |
$1,431.54 |
| Rate for Payer: Aetna Commercial |
$1,148.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,163.13
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cigna Commercial |
$1,237.69
|
| Rate for Payer: First Health Commercial |
$1,416.63
|
| Rate for Payer: Humana Commercial |
$1,267.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,222.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,100.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$447.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,312.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,118.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,192.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,297.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.92
|
| Rate for Payer: PHCS Commercial |
$1,431.54
|
| Rate for Payer: United Healthcare All Payer |
$1,312.25
|
|
|
SCREW BONE T10 FT 3.5*34
|
Facility
|
OP
|
$1,491.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$447.36 |
| Max. Negotiated Rate |
$1,431.54 |
| Rate for Payer: Aetna Commercial |
$1,148.22
|
| Rate for Payer: Anthem Medicaid |
$512.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,163.13
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cigna Commercial |
$1,237.69
|
| Rate for Payer: First Health Commercial |
$1,416.63
|
| Rate for Payer: Humana Commercial |
$1,267.51
|
| Rate for Payer: Humana KY Medicaid |
$512.82
|
| Rate for Payer: Kentucky WC Medicaid |
$518.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,222.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,100.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$447.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$523.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,312.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,118.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,192.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,297.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.92
|
| Rate for Payer: PHCS Commercial |
$1,431.54
|
| Rate for Payer: United Healthcare All Payer |
$1,312.25
|
|
|
SCREW BONE T10 FT 3.5*38
|
Facility
|
IP
|
$1,756.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.81 |
| Max. Negotiated Rate |
$1,685.80 |
| Rate for Payer: Aetna Commercial |
$1,352.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,369.71
|
| Rate for Payer: Cash Price |
$878.02
|
| Rate for Payer: Cigna Commercial |
$1,457.51
|
| Rate for Payer: First Health Commercial |
$1,668.24
|
| Rate for Payer: Humana Commercial |
$1,492.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,439.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,295.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$526.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,545.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,317.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,404.83
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,527.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,211.67
|
| Rate for Payer: PHCS Commercial |
$1,685.80
|
| Rate for Payer: United Healthcare All Payer |
$1,545.32
|
|
|
SCREW BONE T10 FT 3.5*38
|
Facility
|
OP
|
$1,756.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.81 |
| Max. Negotiated Rate |
$1,685.80 |
| Rate for Payer: Aetna Commercial |
$1,352.15
|
| Rate for Payer: Anthem Medicaid |
$603.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,369.71
|
| Rate for Payer: Cash Price |
$878.02
|
| Rate for Payer: Cigna Commercial |
$1,457.51
|
| Rate for Payer: First Health Commercial |
$1,668.24
|
| Rate for Payer: Humana Commercial |
$1,492.63
|
| Rate for Payer: Humana KY Medicaid |
$603.90
|
| Rate for Payer: Kentucky WC Medicaid |
$610.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,439.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,295.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$526.81
|
| Rate for Payer: Molina Healthcare Medicaid |
$616.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,545.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,317.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,404.83
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,527.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,211.67
|
| Rate for Payer: PHCS Commercial |
$1,685.80
|
| Rate for Payer: United Healthcare All Payer |
$1,545.32
|
|
|
SCREW BONE T10 FT 3.5*50
|
Facility
|
OP
|
$1,210.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,161.60 |
| Rate for Payer: Aetna Commercial |
$931.70
|
| Rate for Payer: Anthem Medicaid |
$416.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$943.80
|
| Rate for Payer: Cash Price |
$605.00
|
| Rate for Payer: Cigna Commercial |
$1,004.30
|
| Rate for Payer: First Health Commercial |
$1,149.50
|
| Rate for Payer: Humana Commercial |
$1,028.50
|
| Rate for Payer: Humana KY Medicaid |
$416.12
|
| Rate for Payer: Kentucky WC Medicaid |
$420.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$992.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$892.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$363.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$424.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,064.80
|
| Rate for Payer: Ohio Health Group HMO |
$907.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$968.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,052.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$834.90
|
| Rate for Payer: PHCS Commercial |
$1,161.60
|
| Rate for Payer: United Healthcare All Payer |
$1,064.80
|
|
|
SCREW BONE T10 FT 3.5*50
|
Facility
|
IP
|
$1,210.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,161.60 |
| Rate for Payer: Aetna Commercial |
$931.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$943.80
|
| Rate for Payer: Cash Price |
$605.00
|
| Rate for Payer: Cigna Commercial |
$1,004.30
|
| Rate for Payer: First Health Commercial |
$1,149.50
|
| Rate for Payer: Humana Commercial |
$1,028.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$992.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$892.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$363.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,064.80
|
| Rate for Payer: Ohio Health Group HMO |
$907.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$968.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,052.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$834.90
|
| Rate for Payer: PHCS Commercial |
$1,161.60
|
| Rate for Payer: United Healthcare All Payer |
$1,064.80
|
|
|
SCREW BONE T8 FT 2.4*10
|
Facility
|
IP
|
$1,738.22
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.47 |
| Max. Negotiated Rate |
$1,668.69 |
| Rate for Payer: Aetna Commercial |
$1,338.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,355.81
|
| Rate for Payer: Cash Price |
$869.11
|
| Rate for Payer: Cigna Commercial |
$1,442.72
|
| Rate for Payer: First Health Commercial |
$1,651.31
|
| Rate for Payer: Humana Commercial |
$1,477.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,425.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,282.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,529.63
|
| Rate for Payer: Ohio Health Group HMO |
$1,303.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,390.58
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,512.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,199.37
|
| Rate for Payer: PHCS Commercial |
$1,668.69
|
| Rate for Payer: United Healthcare All Payer |
$1,529.63
|
|
|
SCREW BONE T8 FT 2.4*10
|
Facility
|
OP
|
$1,738.22
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.47 |
| Max. Negotiated Rate |
$1,668.69 |
| Rate for Payer: Aetna Commercial |
$1,338.43
|
| Rate for Payer: Anthem Medicaid |
$597.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,355.81
|
| Rate for Payer: Cash Price |
$869.11
|
| Rate for Payer: Cigna Commercial |
$1,442.72
|
| Rate for Payer: First Health Commercial |
$1,651.31
|
| Rate for Payer: Humana Commercial |
$1,477.49
|
| Rate for Payer: Humana KY Medicaid |
$597.77
|
| Rate for Payer: Kentucky WC Medicaid |
$603.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,425.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,282.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$609.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,529.63
|
| Rate for Payer: Ohio Health Group HMO |
$1,303.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,390.58
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,512.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,199.37
|
| Rate for Payer: PHCS Commercial |
$1,668.69
|
| Rate for Payer: United Healthcare All Payer |
$1,529.63
|
|
