|
SCREW COMPRESSION 40MM
|
Facility
|
IP
|
$3,601.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,080.38 |
| Max. Negotiated Rate |
$3,457.20 |
| Rate for Payer: Aetna Commercial |
$2,772.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,808.97
|
| Rate for Payer: Cash Price |
$1,800.62
|
| Rate for Payer: Cigna Commercial |
$2,989.04
|
| Rate for Payer: First Health Commercial |
$3,421.19
|
| Rate for Payer: Humana Commercial |
$3,061.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,953.03
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,657.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,080.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,169.10
|
| Rate for Payer: Ohio Health Group HMO |
$2,700.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,881.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,133.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,484.86
|
| Rate for Payer: PHCS Commercial |
$3,457.20
|
| Rate for Payer: United Healthcare All Payer |
$3,169.10
|
|
|
SCREW COMPTIBLE SHELL 6.5*40M
|
Facility
|
OP
|
$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 Medicaid |
$257.93
|
| 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: Humana KY Medicaid |
$257.93
|
| Rate for Payer: Kentucky WC Medicaid |
$260.55
|
| 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: Molina Healthcare Medicaid |
$263.10
|
| 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 COMPTIBLE SHELL 6.5*40M
|
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 CON 6.5*35MM
|
Facility
|
IP
|
$4,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,275.00 |
| Max. Negotiated Rate |
$4,080.00 |
| Rate for Payer: Aetna Commercial |
$3,272.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,315.00
|
| Rate for Payer: Cash Price |
$2,125.00
|
| Rate for Payer: Cigna Commercial |
$3,527.50
|
| Rate for Payer: First Health Commercial |
$4,037.50
|
| Rate for Payer: Humana Commercial |
$3,612.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,485.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,136.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,275.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,740.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,187.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,697.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,932.50
|
| Rate for Payer: PHCS Commercial |
$4,080.00
|
| Rate for Payer: United Healthcare All Payer |
$3,740.00
|
|
|
SCREW CON 6.5*35MM
|
Facility
|
OP
|
$4,250.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,275.00 |
| Max. Negotiated Rate |
$4,080.00 |
| Rate for Payer: Aetna Commercial |
$3,272.50
|
| Rate for Payer: Anthem Medicaid |
$1,461.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,315.00
|
| Rate for Payer: Cash Price |
$2,125.00
|
| Rate for Payer: Cigna Commercial |
$3,527.50
|
| Rate for Payer: First Health Commercial |
$4,037.50
|
| Rate for Payer: Humana Commercial |
$3,612.50
|
| Rate for Payer: Humana KY Medicaid |
$1,461.58
|
| Rate for Payer: Kentucky WC Medicaid |
$1,476.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,485.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,136.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,275.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,490.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,740.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,187.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,697.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,932.50
|
| Rate for Payer: PHCS Commercial |
$4,080.00
|
| Rate for Payer: United Healthcare All Payer |
$3,740.00
|
|
|
SCREW CORT BONE 4.5*32MM
|
Facility
|
IP
|
$813.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.12 |
| Max. Negotiated Rate |
$781.20 |
| Rate for Payer: Aetna Commercial |
$626.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$634.73
|
| Rate for Payer: Cash Price |
$406.88
|
| Rate for Payer: Cigna Commercial |
$675.41
|
| Rate for Payer: First Health Commercial |
$773.06
|
| Rate for Payer: Humana Commercial |
$691.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$667.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$600.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$716.10
|
| Rate for Payer: Ohio Health Group HMO |
$610.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$651.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$707.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$561.49
|
| Rate for Payer: PHCS Commercial |
$781.20
|
| Rate for Payer: United Healthcare All Payer |
$716.10
|
|
|
SCREW CORT BONE 4.5*32MM
|
Facility
|
OP
|
$813.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.12 |
| Max. Negotiated Rate |
$781.20 |
| Rate for Payer: Aetna Commercial |
$626.59
|
| Rate for Payer: Anthem Medicaid |
$279.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$634.73
|
| Rate for Payer: Cash Price |
$406.88
|
| Rate for Payer: Cigna Commercial |
$675.41
|
| Rate for Payer: First Health Commercial |
$773.06
|
| Rate for Payer: Humana Commercial |
$691.69
|
| Rate for Payer: Humana KY Medicaid |
$279.85
|
| Rate for Payer: Kentucky WC Medicaid |
$282.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$667.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$600.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$285.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$716.10
|
| Rate for Payer: Ohio Health Group HMO |
$610.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$651.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$707.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$561.49
|
| Rate for Payer: PHCS Commercial |
$781.20
|
| Rate for Payer: United Healthcare All Payer |
$716.10
|
|
|
SCREW CORTEX 3.5*45 SELF TAP
|
Facility
|
OP
|
$1,733.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$519.96 |
| Max. Negotiated Rate |
$1,663.87 |
| Rate for Payer: Aetna Commercial |
$1,334.56
|
| Rate for Payer: Anthem Medicaid |
$596.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,351.90
|
| Rate for Payer: Cash Price |
$866.60
|
| Rate for Payer: Cigna Commercial |
$1,438.56
|
| Rate for Payer: First Health Commercial |
$1,646.54
|
| Rate for Payer: Humana Commercial |
$1,473.22
|
| Rate for Payer: Humana KY Medicaid |
$596.05
|
| Rate for Payer: Kentucky WC Medicaid |
$602.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,421.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,279.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$519.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$608.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,525.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,299.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,386.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,507.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,195.91
|
| Rate for Payer: PHCS Commercial |
$1,663.87
|
| Rate for Payer: United Healthcare All Payer |
$1,525.22
|
|
|
SCREW CORTEX 3.5*45 SELF TAP
|
Facility
|
IP
|
$1,733.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$519.96 |
| Max. Negotiated Rate |
$1,663.87 |
| Rate for Payer: Aetna Commercial |
$1,334.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,351.90
|
| Rate for Payer: Cash Price |
$866.60
|
| Rate for Payer: Cigna Commercial |
$1,438.56
|
| Rate for Payer: First Health Commercial |
$1,646.54
|
| Rate for Payer: Humana Commercial |
$1,473.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,421.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,279.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$519.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,525.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,299.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,386.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,507.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,195.91
|
| Rate for Payer: PHCS Commercial |
$1,663.87
|
| Rate for Payer: United Healthcare All Payer |
$1,525.22
|
|
|
SCREW CORTEX 3.5*55 SELF TAP
|
Facility
|
IP
|
$1,485.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,158.30
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cigna Commercial |
$1,232.55
|
| Rate for Payer: First Health Commercial |
$1,410.75
|
| Rate for Payer: Humana Commercial |
$1,262.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,217.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,095.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,306.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,113.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,188.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,291.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,024.65
|
| Rate for Payer: PHCS Commercial |
$1,425.60
|
| Rate for Payer: United Healthcare All Payer |
$1,306.80
|
|
|
SCREW CORTEX 3.5*55 SELF TAP
|
Facility
|
OP
|
$1,485.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Anthem Medicaid |
$510.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,158.30
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cigna Commercial |
$1,232.55
|
| Rate for Payer: First Health Commercial |
$1,410.75
|
| Rate for Payer: Humana Commercial |
$1,262.25
|
| Rate for Payer: Humana KY Medicaid |
$510.69
|
| Rate for Payer: Kentucky WC Medicaid |
$515.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,217.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,095.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$520.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,306.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,113.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,188.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,291.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,024.65
|
| Rate for Payer: PHCS Commercial |
$1,425.60
|
| Rate for Payer: United Healthcare All Payer |
$1,306.80
|
|
|
SCREW CORTEX 3.5*60 SELF TAP
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$351.00 |
| Max. Negotiated Rate |
$1,123.20 |
| Rate for Payer: Aetna Commercial |
$900.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$912.60
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$971.10
|
| Rate for Payer: First Health Commercial |
$1,111.50
|
| Rate for Payer: Humana Commercial |
$994.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$959.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$863.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$351.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,029.60
|
| Rate for Payer: Ohio Health Group HMO |
$877.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$936.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,017.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$807.30
|
| Rate for Payer: PHCS Commercial |
$1,123.20
|
| Rate for Payer: United Healthcare All Payer |
$1,029.60
|
|
|
SCREW CORTEX 3.5*60 SELF TAP
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$351.00 |
| Max. Negotiated Rate |
$1,123.20 |
| Rate for Payer: Aetna Commercial |
$900.90
|
| Rate for Payer: Anthem Medicaid |
$402.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$912.60
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$971.10
|
| Rate for Payer: First Health Commercial |
$1,111.50
|
| Rate for Payer: Humana Commercial |
$994.50
|
| Rate for Payer: Humana KY Medicaid |
$402.36
|
| Rate for Payer: Kentucky WC Medicaid |
$406.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$959.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$863.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$351.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$410.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,029.60
|
| Rate for Payer: Ohio Health Group HMO |
$877.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$936.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,017.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$807.30
|
| Rate for Payer: PHCS Commercial |
$1,123.20
|
| Rate for Payer: United Healthcare All Payer |
$1,029.60
|
|
|
SCREW CORTEX 3.5*65 SELF TAP
|
Facility
|
IP
|
$1,485.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,158.30
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cigna Commercial |
$1,232.55
|
| Rate for Payer: First Health Commercial |
$1,410.75
|
| Rate for Payer: Humana Commercial |
$1,262.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,217.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,095.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,306.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,113.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,188.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,291.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,024.65
|
| Rate for Payer: PHCS Commercial |
$1,425.60
|
| Rate for Payer: United Healthcare All Payer |
$1,306.80
|
|
|
SCREW CORTEX 3.5*65 SELF TAP
|
Facility
|
OP
|
$1,485.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Anthem Medicaid |
$510.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,158.30
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cigna Commercial |
$1,232.55
|
| Rate for Payer: First Health Commercial |
$1,410.75
|
| Rate for Payer: Humana Commercial |
$1,262.25
|
| Rate for Payer: Humana KY Medicaid |
$510.69
|
| Rate for Payer: Kentucky WC Medicaid |
$515.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,217.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,095.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$520.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,306.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,113.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,188.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,291.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,024.65
|
| Rate for Payer: PHCS Commercial |
$1,425.60
|
| Rate for Payer: United Healthcare All Payer |
$1,306.80
|
|
|
SCREW CORTEX 3.5*90 SELF TAP
|
Facility
|
IP
|
$1,485.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,158.30
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cigna Commercial |
$1,232.55
|
| Rate for Payer: First Health Commercial |
$1,410.75
|
| Rate for Payer: Humana Commercial |
$1,262.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,217.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,095.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,306.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,113.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,188.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,291.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,024.65
|
| Rate for Payer: PHCS Commercial |
$1,425.60
|
| Rate for Payer: United Healthcare All Payer |
$1,306.80
|
|
|
SCREW CORTEX 3.5*90 SELF TAP
|
Facility
|
OP
|
$1,485.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Anthem Medicaid |
$510.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,158.30
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cigna Commercial |
$1,232.55
|
| Rate for Payer: First Health Commercial |
$1,410.75
|
| Rate for Payer: Humana Commercial |
$1,262.25
|
| Rate for Payer: Humana KY Medicaid |
$510.69
|
| Rate for Payer: Kentucky WC Medicaid |
$515.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,217.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,095.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$520.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,306.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,113.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,188.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,291.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,024.65
|
| Rate for Payer: PHCS Commercial |
$1,425.60
|
| Rate for Payer: United Healthcare All Payer |
$1,306.80
|
|
|
SCREW CORTEX 3.5MM 20MM
|
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 CORTEX 3.5MM 20MM
|
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 CORTEX TI 3.5*24
|
Facility
|
IP
|
$560.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$538.32 |
| Rate for Payer: Aetna Commercial |
$431.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$437.38
|
| Rate for Payer: Cash Price |
$280.38
|
| Rate for Payer: Cigna Commercial |
$465.42
|
| Rate for Payer: First Health Commercial |
$532.71
|
| Rate for Payer: Humana Commercial |
$476.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$459.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$413.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$493.46
|
| Rate for Payer: Ohio Health Group HMO |
$420.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$448.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$386.92
|
| Rate for Payer: PHCS Commercial |
$538.32
|
| Rate for Payer: United Healthcare All Payer |
$493.46
|
|
|
SCREW CORTEX TI 3.5*24
|
Facility
|
OP
|
$560.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$538.32 |
| Rate for Payer: Aetna Commercial |
$431.78
|
| Rate for Payer: Anthem Medicaid |
$192.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$437.38
|
| Rate for Payer: Cash Price |
$280.38
|
| Rate for Payer: Cigna Commercial |
$465.42
|
| Rate for Payer: First Health Commercial |
$532.71
|
| Rate for Payer: Humana Commercial |
$476.64
|
| Rate for Payer: Humana KY Medicaid |
$192.84
|
| Rate for Payer: Kentucky WC Medicaid |
$194.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$459.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$413.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$196.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$493.46
|
| Rate for Payer: Ohio Health Group HMO |
$420.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$448.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$386.92
|
| Rate for Payer: PHCS Commercial |
$538.32
|
| Rate for Payer: United Healthcare All Payer |
$493.46
|
|
|
SCREW CORTEX TI 3.5*26
|
Facility
|
OP
|
$560.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$538.32 |
| Rate for Payer: Aetna Commercial |
$431.78
|
| Rate for Payer: Anthem Medicaid |
$192.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$437.38
|
| Rate for Payer: Cash Price |
$280.38
|
| Rate for Payer: Cigna Commercial |
$465.42
|
| Rate for Payer: First Health Commercial |
$532.71
|
| Rate for Payer: Humana Commercial |
$476.64
|
| Rate for Payer: Humana KY Medicaid |
$192.84
|
| Rate for Payer: Kentucky WC Medicaid |
$194.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$459.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$413.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$196.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$493.46
|
| Rate for Payer: Ohio Health Group HMO |
$420.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$448.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$386.92
|
| Rate for Payer: PHCS Commercial |
$538.32
|
| Rate for Payer: United Healthcare All Payer |
$493.46
|
|
|
SCREW CORTEX TI 3.5*26
|
Facility
|
IP
|
$560.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$538.32 |
| Rate for Payer: Aetna Commercial |
$431.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$437.38
|
| Rate for Payer: Cash Price |
$280.38
|
| Rate for Payer: Cigna Commercial |
$465.42
|
| Rate for Payer: First Health Commercial |
$532.71
|
| Rate for Payer: Humana Commercial |
$476.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$459.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$413.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$493.46
|
| Rate for Payer: Ohio Health Group HMO |
$420.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$448.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$386.92
|
| Rate for Payer: PHCS Commercial |
$538.32
|
| Rate for Payer: United Healthcare All Payer |
$493.46
|
|
|
SCREW CORTEX TI 3.5*28
|
Facility
|
IP
|
$560.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$538.32 |
| Rate for Payer: Aetna Commercial |
$431.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$437.38
|
| Rate for Payer: Cash Price |
$280.38
|
| Rate for Payer: Cigna Commercial |
$465.42
|
| Rate for Payer: First Health Commercial |
$532.71
|
| Rate for Payer: Humana Commercial |
$476.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$459.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$413.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$493.46
|
| Rate for Payer: Ohio Health Group HMO |
$420.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$448.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$386.92
|
| Rate for Payer: PHCS Commercial |
$538.32
|
| Rate for Payer: United Healthcare All Payer |
$493.46
|
|
|
SCREW CORTEX TI 3.5*28
|
Facility
|
OP
|
$560.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.22 |
| Max. Negotiated Rate |
$538.32 |
| Rate for Payer: Aetna Commercial |
$431.78
|
| Rate for Payer: Anthem Medicaid |
$192.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$437.38
|
| Rate for Payer: Cash Price |
$280.38
|
| Rate for Payer: Cigna Commercial |
$465.42
|
| Rate for Payer: First Health Commercial |
$532.71
|
| Rate for Payer: Humana Commercial |
$476.64
|
| Rate for Payer: Humana KY Medicaid |
$192.84
|
| Rate for Payer: Kentucky WC Medicaid |
$194.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$459.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$413.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$196.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$493.46
|
| Rate for Payer: Ohio Health Group HMO |
$420.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$448.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$386.92
|
| Rate for Payer: PHCS Commercial |
$538.32
|
| Rate for Payer: United Healthcare All Payer |
$493.46
|
|
