|
SCREW CANN BLT 4.0*26
|
Facility
|
OP
|
$1,958.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.50 |
| Max. Negotiated Rate |
$1,880.02 |
| Rate for Payer: Aetna Commercial |
$1,507.93
|
| Rate for Payer: Anthem Medicaid |
$673.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,527.51
|
| Rate for Payer: Cash Price |
$979.18
|
| Rate for Payer: Cigna Commercial |
$1,625.43
|
| Rate for Payer: First Health Commercial |
$1,860.43
|
| Rate for Payer: Humana Commercial |
$1,664.60
|
| Rate for Payer: Humana KY Medicaid |
$673.48
|
| Rate for Payer: Kentucky WC Medicaid |
$680.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,605.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,445.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$587.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$686.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,723.35
|
| Rate for Payer: Ohio Health Group HMO |
$1,468.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,566.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,703.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,351.26
|
| Rate for Payer: PHCS Commercial |
$1,880.02
|
| Rate for Payer: United Healthcare All Payer |
$1,723.35
|
|
|
SCREW CANN BLT 4.0*46
|
Facility
|
IP
|
$1,958.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.50 |
| Max. Negotiated Rate |
$1,880.02 |
| Rate for Payer: Aetna Commercial |
$1,507.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,527.51
|
| Rate for Payer: Cash Price |
$979.18
|
| Rate for Payer: Cigna Commercial |
$1,625.43
|
| Rate for Payer: First Health Commercial |
$1,860.43
|
| Rate for Payer: Humana Commercial |
$1,664.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,605.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,445.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$587.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,723.35
|
| Rate for Payer: Ohio Health Group HMO |
$1,468.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,566.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,703.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,351.26
|
| Rate for Payer: PHCS Commercial |
$1,880.02
|
| Rate for Payer: United Healthcare All Payer |
$1,723.35
|
|
|
SCREW CANN BLT 4.0*46
|
Facility
|
OP
|
$1,958.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.50 |
| Max. Negotiated Rate |
$1,880.02 |
| Rate for Payer: Aetna Commercial |
$1,507.93
|
| Rate for Payer: Anthem Medicaid |
$673.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,527.51
|
| Rate for Payer: Cash Price |
$979.18
|
| Rate for Payer: Cigna Commercial |
$1,625.43
|
| Rate for Payer: First Health Commercial |
$1,860.43
|
| Rate for Payer: Humana Commercial |
$1,664.60
|
| Rate for Payer: Humana KY Medicaid |
$673.48
|
| Rate for Payer: Kentucky WC Medicaid |
$680.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,605.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,445.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$587.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$686.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,723.35
|
| Rate for Payer: Ohio Health Group HMO |
$1,468.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,566.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,703.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,351.26
|
| Rate for Payer: PHCS Commercial |
$1,880.02
|
| Rate for Payer: United Healthcare All Payer |
$1,723.35
|
|
|
SCREW CANN BLT 4.0*48
|
Facility
|
IP
|
$1,958.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.50 |
| Max. Negotiated Rate |
$1,880.02 |
| Rate for Payer: Aetna Commercial |
$1,507.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,527.51
|
| Rate for Payer: Cash Price |
$979.18
|
| Rate for Payer: Cigna Commercial |
$1,625.43
|
| Rate for Payer: First Health Commercial |
$1,860.43
|
| Rate for Payer: Humana Commercial |
$1,664.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,605.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,445.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$587.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,723.35
|
| Rate for Payer: Ohio Health Group HMO |
$1,468.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,566.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,703.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,351.26
|
| Rate for Payer: PHCS Commercial |
$1,880.02
|
| Rate for Payer: United Healthcare All Payer |
$1,723.35
|
|
|
SCREW CANN BLT 4.0*48
|
Facility
|
OP
|
$1,958.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.50 |
| Max. Negotiated Rate |
$1,880.02 |
| Rate for Payer: Aetna Commercial |
$1,507.93
|
| Rate for Payer: Anthem Medicaid |
$673.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,527.51
|
| Rate for Payer: Cash Price |
$979.18
|
| Rate for Payer: Cigna Commercial |
$1,625.43
|
| Rate for Payer: First Health Commercial |
$1,860.43
|
| Rate for Payer: Humana Commercial |
$1,664.60
|
| Rate for Payer: Humana KY Medicaid |
$673.48
|
| Rate for Payer: Kentucky WC Medicaid |
$680.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,605.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,445.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$587.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$686.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,723.35
|
| Rate for Payer: Ohio Health Group HMO |
$1,468.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,566.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,703.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,351.26
|
| Rate for Payer: PHCS Commercial |
$1,880.02
|
| Rate for Payer: United Healthcare All Payer |
$1,723.35
|
|
|
SCREW CANN PT 4.0*32MM
|
Facility
|
OP
|
$1,919.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.82 |
| Max. Negotiated Rate |
$1,842.62 |
| Rate for Payer: Aetna Commercial |
$1,477.94
|
| Rate for Payer: Anthem Medicaid |
$660.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,497.13
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cigna Commercial |
$1,593.10
|
| Rate for Payer: First Health Commercial |
$1,823.43
|
| Rate for Payer: Humana Commercial |
$1,631.49
|
| Rate for Payer: Humana KY Medicaid |
$660.08
|
| Rate for Payer: Kentucky WC Medicaid |
$666.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,573.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,416.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$673.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,689.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,439.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,535.52
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,669.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,324.39
|
| Rate for Payer: PHCS Commercial |
$1,842.62
|
| Rate for Payer: United Healthcare All Payer |
$1,689.07
|
|
|
SCREW CANN PT 4.0*32MM
|
Facility
|
IP
|
$1,919.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$575.82 |
| Max. Negotiated Rate |
$1,842.62 |
| Rate for Payer: Aetna Commercial |
$1,477.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,497.13
|
| Rate for Payer: Cash Price |
$959.70
|
| Rate for Payer: Cigna Commercial |
$1,593.10
|
| Rate for Payer: First Health Commercial |
$1,823.43
|
| Rate for Payer: Humana Commercial |
$1,631.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,573.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,416.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$575.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,689.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,439.55
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,535.52
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,669.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,324.39
|
| Rate for Payer: PHCS Commercial |
$1,842.62
|
| Rate for Payer: United Healthcare All Payer |
$1,689.07
|
|
|
SCREW CANN PT SS 8.0*50*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*50*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*55*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*55*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*60*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*60*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*65*22
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN PT SS 8.0*65*22
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW CANN SHORT THRD 4.0 50MM
|
Facility
|
IP
|
$3,732.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,119.75 |
| Max. Negotiated Rate |
$3,583.20 |
| Rate for Payer: Aetna Commercial |
$2,874.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,911.35
|
| Rate for Payer: Cash Price |
$1,866.25
|
| Rate for Payer: Cigna Commercial |
$3,097.97
|
| Rate for Payer: First Health Commercial |
$3,545.88
|
| Rate for Payer: Humana Commercial |
$3,172.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,060.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,754.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,119.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,284.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,799.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,986.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,247.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,575.43
|
| Rate for Payer: PHCS Commercial |
$3,583.20
|
| Rate for Payer: United Healthcare All Payer |
$3,284.60
|
|
|
SCREW CANN SHORT THRD 4.0 50MM
|
Facility
|
OP
|
$3,732.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,119.75 |
| Max. Negotiated Rate |
$3,583.20 |
| Rate for Payer: Aetna Commercial |
$2,874.03
|
| Rate for Payer: Anthem Medicaid |
$1,283.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,911.35
|
| Rate for Payer: Cash Price |
$1,866.25
|
| Rate for Payer: Cigna Commercial |
$3,097.97
|
| Rate for Payer: First Health Commercial |
$3,545.88
|
| Rate for Payer: Humana Commercial |
$3,172.62
|
| Rate for Payer: Humana KY Medicaid |
$1,283.61
|
| Rate for Payer: Kentucky WC Medicaid |
$1,296.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,060.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,754.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,119.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,309.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,284.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,799.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,986.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,247.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,575.43
|
| Rate for Payer: PHCS Commercial |
$3,583.20
|
| Rate for Payer: United Healthcare All Payer |
$3,284.60
|
|
|
SCREW CANN TAP JF55
|
Facility
|
IP
|
$2,069.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.85 |
| Max. Negotiated Rate |
$1,986.72 |
| Rate for Payer: Aetna Commercial |
$1,593.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,614.21
|
| Rate for Payer: Cash Price |
$1,034.75
|
| Rate for Payer: Cigna Commercial |
$1,717.68
|
| Rate for Payer: First Health Commercial |
$1,966.03
|
| Rate for Payer: Humana Commercial |
$1,759.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,696.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,527.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$620.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,821.16
|
| Rate for Payer: Ohio Health Group HMO |
$1,552.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,655.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,800.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,427.95
|
| Rate for Payer: PHCS Commercial |
$1,986.72
|
| Rate for Payer: United Healthcare All Payer |
$1,821.16
|
|
|
SCREW CANN TAP JF55
|
Facility
|
OP
|
$2,069.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.85 |
| Max. Negotiated Rate |
$1,986.72 |
| Rate for Payer: Aetna Commercial |
$1,593.52
|
| Rate for Payer: Anthem Medicaid |
$711.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,614.21
|
| Rate for Payer: Cash Price |
$1,034.75
|
| Rate for Payer: Cigna Commercial |
$1,717.68
|
| Rate for Payer: First Health Commercial |
$1,966.03
|
| Rate for Payer: Humana Commercial |
$1,759.08
|
| Rate for Payer: Humana KY Medicaid |
$711.70
|
| Rate for Payer: Kentucky WC Medicaid |
$718.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,696.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,527.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$620.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$725.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,821.16
|
| Rate for Payer: Ohio Health Group HMO |
$1,552.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,655.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,800.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,427.95
|
| Rate for Payer: PHCS Commercial |
$1,986.72
|
| Rate for Payer: United Healthcare All Payer |
$1,821.16
|
|
|
SCREW CANNULATED 6.5*85*20MM
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
SCREW CANNULATED 6.5*85*20MM
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
SCREW CANNULATED 6.5*90*20
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
SCREW CANNULATED 6.5*90*20
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
SCREW CANNULATED 6.5*90*20MM
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
SCREW CANNULATED 6.5*90*20MM
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
