|
SCREW CORTEX TI 3.5*30
|
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*30
|
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*32
|
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*32
|
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*40
|
Facility
|
OP
|
$750.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.10 |
| Max. Negotiated Rate |
$720.34 |
| Rate for Payer: Aetna Commercial |
$577.77
|
| Rate for Payer: Anthem Medicaid |
$258.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.27
|
| Rate for Payer: Cash Price |
$375.18
|
| Rate for Payer: Cigna Commercial |
$622.79
|
| Rate for Payer: First Health Commercial |
$712.83
|
| Rate for Payer: Humana Commercial |
$637.80
|
| Rate for Payer: Humana KY Medicaid |
$258.05
|
| Rate for Payer: Kentucky WC Medicaid |
$260.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$263.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.31
|
| Rate for Payer: Ohio Health Group HMO |
$562.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.74
|
| Rate for Payer: PHCS Commercial |
$720.34
|
| Rate for Payer: United Healthcare All Payer |
$660.31
|
|
|
SCREW CORTEX TI 3.5*40
|
Facility
|
IP
|
$750.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.10 |
| Max. Negotiated Rate |
$720.34 |
| Rate for Payer: Aetna Commercial |
$577.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.27
|
| Rate for Payer: Cash Price |
$375.18
|
| Rate for Payer: Cigna Commercial |
$622.79
|
| Rate for Payer: First Health Commercial |
$712.83
|
| Rate for Payer: Humana Commercial |
$637.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.31
|
| Rate for Payer: Ohio Health Group HMO |
$562.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.74
|
| Rate for Payer: PHCS Commercial |
$720.34
|
| Rate for Payer: United Healthcare All Payer |
$660.31
|
|
|
SCREW CORTICAL 4.5*40MM
|
Facility
|
IP
|
$1,499.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$449.77 |
| Max. Negotiated Rate |
$1,439.28 |
| Rate for Payer: Aetna Commercial |
$1,154.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,169.41
|
| Rate for Payer: Cash Price |
$749.62
|
| Rate for Payer: Cigna Commercial |
$1,244.38
|
| Rate for Payer: First Health Commercial |
$1,424.29
|
| Rate for Payer: Humana Commercial |
$1,274.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,229.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,106.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$449.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,319.34
|
| Rate for Payer: Ohio Health Group HMO |
$1,124.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,199.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,304.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,034.48
|
| Rate for Payer: PHCS Commercial |
$1,439.28
|
| Rate for Payer: United Healthcare All Payer |
$1,319.34
|
|
|
SCREW CORTICAL 4.5*40MM
|
Facility
|
OP
|
$1,499.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$449.77 |
| Max. Negotiated Rate |
$1,439.28 |
| Rate for Payer: Aetna Commercial |
$1,154.42
|
| Rate for Payer: Anthem Medicaid |
$515.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,169.41
|
| Rate for Payer: Cash Price |
$749.62
|
| Rate for Payer: Cigna Commercial |
$1,244.38
|
| Rate for Payer: First Health Commercial |
$1,424.29
|
| Rate for Payer: Humana Commercial |
$1,274.36
|
| Rate for Payer: Humana KY Medicaid |
$515.59
|
| Rate for Payer: Kentucky WC Medicaid |
$520.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,229.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,106.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$449.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$525.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,319.34
|
| Rate for Payer: Ohio Health Group HMO |
$1,124.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,199.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,304.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,034.48
|
| Rate for Payer: PHCS Commercial |
$1,439.28
|
| Rate for Payer: United Healthcare All Payer |
$1,319.34
|
|
|
SCREW CORTICAL FULL 3.5*22MM
|
Facility
|
IP
|
$1,680.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$504.00 |
| Max. Negotiated Rate |
$1,612.80 |
| Rate for Payer: Aetna Commercial |
$1,293.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,310.40
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cigna Commercial |
$1,394.40
|
| Rate for Payer: First Health Commercial |
$1,596.00
|
| Rate for Payer: Humana Commercial |
$1,428.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,377.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,239.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$504.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,478.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,260.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,344.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,461.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,159.20
|
| Rate for Payer: PHCS Commercial |
$1,612.80
|
| Rate for Payer: United Healthcare All Payer |
$1,478.40
|
|
|
SCREW CORTICAL FULL 3.5*22MM
|
Facility
|
OP
|
$1,680.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$504.00 |
| Max. Negotiated Rate |
$1,612.80 |
| Rate for Payer: Aetna Commercial |
$1,293.60
|
| Rate for Payer: Anthem Medicaid |
$577.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,310.40
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cigna Commercial |
$1,394.40
|
| Rate for Payer: First Health Commercial |
$1,596.00
|
| Rate for Payer: Humana Commercial |
$1,428.00
|
| Rate for Payer: Humana KY Medicaid |
$577.75
|
| Rate for Payer: Kentucky WC Medicaid |
$583.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,377.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,239.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$504.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$589.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,478.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,260.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,344.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,461.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,159.20
|
| Rate for Payer: PHCS Commercial |
$1,612.80
|
| Rate for Payer: United Healthcare All Payer |
$1,478.40
|
|
|
SCREW CORTICAL LP 3.5*14MM
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW CORTICAL LP 3.5*14MM
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW CORTICAL LP 3.5*16MM
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW CORTICAL LP 3.5*16MM
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW CORT PERI-LOC VLP 3.5*14
|
Facility
|
OP
|
$498.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$478.44 |
| Rate for Payer: Aetna Commercial |
$383.75
|
| Rate for Payer: Anthem Medicaid |
$171.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$388.74
|
| Rate for Payer: Cash Price |
$249.19
|
| Rate for Payer: Cigna Commercial |
$413.66
|
| Rate for Payer: First Health Commercial |
$473.46
|
| Rate for Payer: Humana Commercial |
$423.62
|
| Rate for Payer: Humana KY Medicaid |
$171.39
|
| Rate for Payer: Kentucky WC Medicaid |
$173.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$408.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$367.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$149.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$174.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$438.57
|
| Rate for Payer: Ohio Health Group HMO |
$373.79
|
| Rate for Payer: Ohio Health Group PPO Differential |
$398.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$433.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$343.88
|
| Rate for Payer: PHCS Commercial |
$478.44
|
| Rate for Payer: United Healthcare All Payer |
$438.57
|
|
|
SCREW CORT PERI-LOC VLP 3.5*14
|
Facility
|
IP
|
$498.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$478.44 |
| Rate for Payer: Aetna Commercial |
$383.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$388.74
|
| Rate for Payer: Cash Price |
$249.19
|
| Rate for Payer: Cigna Commercial |
$413.66
|
| Rate for Payer: First Health Commercial |
$473.46
|
| Rate for Payer: Humana Commercial |
$423.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$408.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$367.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$149.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$438.57
|
| Rate for Payer: Ohio Health Group HMO |
$373.79
|
| Rate for Payer: Ohio Health Group PPO Differential |
$398.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$433.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$343.88
|
| Rate for Payer: PHCS Commercial |
$478.44
|
| Rate for Payer: United Healthcare All Payer |
$438.57
|
|
|
SCREW CORT SELF-TAP TI 4.0*26
|
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 CORT SELF-TAP TI 4.0*26
|
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 CORT SELF-TAP TI 4.0*28
|
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 CORT SELF-TAP TI 4.0*28
|
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 CORT SELF-TAP TI 4.0*30
|
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 CORT SELF-TAP TI 4.0*30
|
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 CORT SELF-TAP TI 4.0*36
|
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 CORT SELF-TAP TI 4.0*36
|
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 CORT SELF-TAP TI 4.0*38
|
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
|
|
