|
SCREW CORT TI HTO 4.5*34
|
Facility
|
OP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem Medicaid |
$1,026.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Humana KY Medicaid |
$1,026.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,036.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,046.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*34
|
Facility
|
IP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*36
|
Facility
|
IP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*36
|
Facility
|
OP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem Medicaid |
$1,026.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Humana KY Medicaid |
$1,026.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,036.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,046.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*38
|
Facility
|
OP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem Medicaid |
$1,026.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Humana KY Medicaid |
$1,026.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,036.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,046.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*38
|
Facility
|
IP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*40
|
Facility
|
IP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*40
|
Facility
|
OP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem Medicaid |
$1,026.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Humana KY Medicaid |
$1,026.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,036.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,046.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*42
|
Facility
|
IP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*42
|
Facility
|
OP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem Medicaid |
$1,026.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Humana KY Medicaid |
$1,026.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,036.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,046.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*44
|
Facility
|
IP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CORT TI HTO 4.5*44
|
Facility
|
OP
|
$2,984.38
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,865.00 |
| Rate for Payer: Aetna Commercial |
$2,297.97
|
| Rate for Payer: Anthem Medicaid |
$1,026.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,327.82
|
| Rate for Payer: Cash Price |
$1,492.19
|
| Rate for Payer: Cigna Commercial |
$2,477.04
|
| Rate for Payer: First Health Commercial |
$2,835.16
|
| Rate for Payer: Humana Commercial |
$2,536.72
|
| Rate for Payer: Humana KY Medicaid |
$1,026.33
|
| Rate for Payer: Kentucky WC Medicaid |
$1,036.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,447.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,202.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$895.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,046.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,626.25
|
| Rate for Payer: Ohio Health Group HMO |
$2,238.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,387.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,596.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,059.22
|
| Rate for Payer: PHCS Commercial |
$2,865.00
|
| Rate for Payer: United Healthcare All Payer |
$2,626.25
|
|
|
SCREW CRTX VLP 3.5MMX18MM S-T
|
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 CRTX VLP 3.5MMX18MM S-T
|
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 CRTX VLP 3.5MMX48MM S-T
|
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 CRTX VLP 3.5MMX48MM S-T
|
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 CRTX VLP 3.5MMX50MM S-T
|
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 CRTX VLP 3.5MMX50MM S-T
|
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 DRILL BIT 3.2MM
|
Facility
|
OP
|
$1,870.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$561.00 |
| Max. Negotiated Rate |
$1,795.20 |
| Rate for Payer: Aetna Commercial |
$1,439.90
|
| Rate for Payer: Anthem Medicaid |
$643.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,458.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna Commercial |
$1,552.10
|
| Rate for Payer: First Health Commercial |
$1,776.50
|
| Rate for Payer: Humana Commercial |
$1,589.50
|
| Rate for Payer: Humana KY Medicaid |
$643.09
|
| Rate for Payer: Kentucky WC Medicaid |
$649.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,533.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,380.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$561.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$656.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,645.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,402.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,496.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,626.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,290.30
|
| Rate for Payer: PHCS Commercial |
$1,795.20
|
| Rate for Payer: United Healthcare All Payer |
$1,645.60
|
|
|
SCREW DRILL BIT 3.2MM
|
Facility
|
IP
|
$1,870.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$561.00 |
| Max. Negotiated Rate |
$1,795.20 |
| Rate for Payer: Aetna Commercial |
$1,439.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,458.60
|
| Rate for Payer: Cash Price |
$935.00
|
| Rate for Payer: Cigna Commercial |
$1,552.10
|
| Rate for Payer: First Health Commercial |
$1,776.50
|
| Rate for Payer: Humana Commercial |
$1,589.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,533.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,380.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$561.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,645.60
|
| Rate for Payer: Ohio Health Group HMO |
$1,402.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,496.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,626.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,290.30
|
| Rate for Payer: PHCS Commercial |
$1,795.20
|
| Rate for Payer: United Healthcare All Payer |
$1,645.60
|
|
|
SCREWDRIVER CANNULATED 9.0MM
|
Facility
|
OP
|
$3,454.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,036.24 |
| Max. Negotiated Rate |
$3,315.97 |
| Rate for Payer: Aetna Commercial |
$2,659.69
|
| Rate for Payer: Anthem Medicaid |
$1,187.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,694.23
|
| Rate for Payer: Cash Price |
$1,727.07
|
| Rate for Payer: Cigna Commercial |
$2,866.94
|
| Rate for Payer: First Health Commercial |
$3,281.43
|
| Rate for Payer: Humana Commercial |
$2,936.02
|
| Rate for Payer: Humana KY Medicaid |
$1,187.88
|
| Rate for Payer: Kentucky WC Medicaid |
$1,199.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,832.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,549.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,036.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,211.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,039.64
|
| Rate for Payer: Ohio Health Group HMO |
$2,590.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,763.31
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,005.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,383.36
|
| Rate for Payer: PHCS Commercial |
$3,315.97
|
| Rate for Payer: United Healthcare All Payer |
$3,039.64
|
|
|
SCREWDRIVER CANNULATED 9.0MM
|
Facility
|
IP
|
$3,454.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,036.24 |
| Max. Negotiated Rate |
$3,315.97 |
| Rate for Payer: Aetna Commercial |
$2,659.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,694.23
|
| Rate for Payer: Cash Price |
$1,727.07
|
| Rate for Payer: Cigna Commercial |
$2,866.94
|
| Rate for Payer: First Health Commercial |
$3,281.43
|
| Rate for Payer: Humana Commercial |
$2,936.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,832.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,549.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,036.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,039.64
|
| Rate for Payer: Ohio Health Group HMO |
$2,590.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,763.31
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,005.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,383.36
|
| Rate for Payer: PHCS Commercial |
$3,315.97
|
| Rate for Payer: United Healthcare All Payer |
$3,039.64
|
|
|
SCREW FIXOS 4.0*36MM
|
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 FIXOS 4.0*36MM
|
Facility
|
OP
|
$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 Medicaid |
$1,238.47
|
| 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: Humana KY Medicaid |
$1,238.47
|
| Rate for Payer: Kentucky WC Medicaid |
$1,251.07
|
| 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: Molina Healthcare Medicaid |
$1,263.32
|
| 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 FIXOS 4.0*42MM
|
Facility
|
OP
|
$3,552.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,065.88 |
| Max. Negotiated Rate |
$3,410.83 |
| Rate for Payer: Aetna Commercial |
$2,735.77
|
| Rate for Payer: Anthem Medicaid |
$1,221.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,771.30
|
| Rate for Payer: Cash Price |
$1,776.47
|
| Rate for Payer: Cigna Commercial |
$2,948.95
|
| Rate for Payer: First Health Commercial |
$3,375.30
|
| Rate for Payer: Humana Commercial |
$3,020.01
|
| Rate for Payer: Humana KY Medicaid |
$1,221.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,234.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,913.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,622.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,065.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,246.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,126.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,664.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,842.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,091.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,451.54
|
| Rate for Payer: PHCS Commercial |
$3,410.83
|
| Rate for Payer: United Healthcare All Payer |
$3,126.60
|
|
