|
SCREW FLATHEAD HYBRID 3.0*20MM
|
Facility
|
OP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem Medicaid |
$610.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Humana KY Medicaid |
$610.42
|
| Rate for Payer: Kentucky WC Medicaid |
$616.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$622.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*20MM
|
Facility
|
IP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*22MM
|
Facility
|
OP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem Medicaid |
$610.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Humana KY Medicaid |
$610.42
|
| Rate for Payer: Kentucky WC Medicaid |
$616.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$622.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*22MM
|
Facility
|
IP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*24MM
|
Facility
|
OP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem Medicaid |
$610.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Humana KY Medicaid |
$610.42
|
| Rate for Payer: Kentucky WC Medicaid |
$616.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$622.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*24MM
|
Facility
|
IP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*26MM
|
Facility
|
OP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem Medicaid |
$610.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Humana KY Medicaid |
$610.42
|
| Rate for Payer: Kentucky WC Medicaid |
$616.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$622.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FLATHEAD HYBRID 3.0*26MM
|
Facility
|
IP
|
$1,775.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,704.00 |
| Rate for Payer: Aetna Commercial |
$1,366.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,384.50
|
| Rate for Payer: Cash Price |
$887.50
|
| Rate for Payer: Cigna Commercial |
$1,473.25
|
| Rate for Payer: First Health Commercial |
$1,686.25
|
| Rate for Payer: Humana Commercial |
$1,508.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,455.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,309.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$532.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,562.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,331.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,544.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,224.75
|
| Rate for Payer: PHCS Commercial |
$1,704.00
|
| Rate for Payer: United Healthcare All Payer |
$1,562.00
|
|
|
SCREW FSTPTCH MTP 3.0MM
|
Facility
|
OP
|
$4,812.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,443.75 |
| Max. Negotiated Rate |
$4,620.00 |
| Rate for Payer: Aetna Commercial |
$3,705.62
|
| Rate for Payer: Anthem Medicaid |
$1,655.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,753.75
|
| Rate for Payer: Cash Price |
$2,406.25
|
| Rate for Payer: Cigna Commercial |
$3,994.38
|
| Rate for Payer: First Health Commercial |
$4,571.88
|
| Rate for Payer: Humana Commercial |
$4,090.62
|
| Rate for Payer: Humana KY Medicaid |
$1,655.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,671.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,946.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,551.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,443.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,688.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,235.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,609.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,850.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,186.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,320.62
|
| Rate for Payer: PHCS Commercial |
$4,620.00
|
| Rate for Payer: United Healthcare All Payer |
$4,235.00
|
|
|
SCREW FSTPTCH MTP 3.0MM
|
Facility
|
IP
|
$4,812.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,443.75 |
| Max. Negotiated Rate |
$4,620.00 |
| Rate for Payer: Aetna Commercial |
$3,705.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,753.75
|
| Rate for Payer: Cash Price |
$2,406.25
|
| Rate for Payer: Cigna Commercial |
$3,994.38
|
| Rate for Payer: First Health Commercial |
$4,571.88
|
| Rate for Payer: Humana Commercial |
$4,090.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,946.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,551.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,443.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,235.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,609.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,850.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,186.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,320.62
|
| Rate for Payer: PHCS Commercial |
$4,620.00
|
| Rate for Payer: United Healthcare All Payer |
$4,235.00
|
|
|
SCREW FT 3.5 MINI 36MM
|
Facility
|
IP
|
$3,312.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$993.75 |
| Max. Negotiated Rate |
$3,180.00 |
| Rate for Payer: Aetna Commercial |
$2,550.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,583.75
|
| Rate for Payer: Cash Price |
$1,656.25
|
| Rate for Payer: Cigna Commercial |
$2,749.38
|
| Rate for Payer: First Health Commercial |
$3,146.88
|
| Rate for Payer: Humana Commercial |
$2,815.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,716.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,444.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$993.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,915.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,484.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,650.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,881.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,285.62
|
| Rate for Payer: PHCS Commercial |
$3,180.00
|
| Rate for Payer: United Healthcare All Payer |
$2,915.00
|
|
|
SCREW FT 3.5 MINI 36MM
|
Facility
|
OP
|
$3,312.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$993.75 |
| Max. Negotiated Rate |
$3,180.00 |
| Rate for Payer: Aetna Commercial |
$2,550.62
|
| Rate for Payer: Anthem Medicaid |
$1,139.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,583.75
|
| Rate for Payer: Cash Price |
$1,656.25
|
| Rate for Payer: Cigna Commercial |
$2,749.38
|
| Rate for Payer: First Health Commercial |
$3,146.88
|
| Rate for Payer: Humana Commercial |
$2,815.62
|
| Rate for Payer: Humana KY Medicaid |
$1,139.17
|
| Rate for Payer: Kentucky WC Medicaid |
$1,150.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,716.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,444.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$993.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,162.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,915.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,484.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,650.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,881.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,285.62
|
| Rate for Payer: PHCS Commercial |
$3,180.00
|
| Rate for Payer: United Healthcare All Payer |
$2,915.00
|
|
|
SCREW FT CORT NON-LOCK 4.5*22M
|
Facility
|
IP
|
$1,220.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.24 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$940.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$952.22
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cigna Commercial |
$1,013.26
|
| Rate for Payer: First Health Commercial |
$1,159.76
|
| Rate for Payer: Humana Commercial |
$1,037.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,001.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,074.30
|
| Rate for Payer: Ohio Health Group HMO |
$915.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$976.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,062.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$842.35
|
| Rate for Payer: PHCS Commercial |
$1,171.97
|
| Rate for Payer: United Healthcare All Payer |
$1,074.30
|
|
|
SCREW FT CORT NON-LOCK 4.5*22M
|
Facility
|
OP
|
$1,220.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.24 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$940.02
|
| Rate for Payer: Anthem Medicaid |
$419.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$952.22
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cigna Commercial |
$1,013.26
|
| Rate for Payer: First Health Commercial |
$1,159.76
|
| Rate for Payer: Humana Commercial |
$1,037.68
|
| Rate for Payer: Humana KY Medicaid |
$419.83
|
| Rate for Payer: Kentucky WC Medicaid |
$424.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,001.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$428.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,074.30
|
| Rate for Payer: Ohio Health Group HMO |
$915.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$976.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,062.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$842.35
|
| Rate for Payer: PHCS Commercial |
$1,171.97
|
| Rate for Payer: United Healthcare All Payer |
$1,074.30
|
|
|
SCREW FT CORT NON-LOCK 4.5*30M
|
Facility
|
IP
|
$1,220.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.24 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$940.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$952.22
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cigna Commercial |
$1,013.26
|
| Rate for Payer: First Health Commercial |
$1,159.76
|
| Rate for Payer: Humana Commercial |
$1,037.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,001.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,074.30
|
| Rate for Payer: Ohio Health Group HMO |
$915.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$976.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,062.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$842.35
|
| Rate for Payer: PHCS Commercial |
$1,171.97
|
| Rate for Payer: United Healthcare All Payer |
$1,074.30
|
|
|
SCREW FT CORT NON-LOCK 4.5*30M
|
Facility
|
OP
|
$1,220.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.24 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$940.02
|
| Rate for Payer: Anthem Medicaid |
$419.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$952.22
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cigna Commercial |
$1,013.26
|
| Rate for Payer: First Health Commercial |
$1,159.76
|
| Rate for Payer: Humana Commercial |
$1,037.68
|
| Rate for Payer: Humana KY Medicaid |
$419.83
|
| Rate for Payer: Kentucky WC Medicaid |
$424.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,001.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$428.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,074.30
|
| Rate for Payer: Ohio Health Group HMO |
$915.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$976.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,062.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$842.35
|
| Rate for Payer: PHCS Commercial |
$1,171.97
|
| Rate for Payer: United Healthcare All Payer |
$1,074.30
|
|
|
SCREW FT CORT NON-LOCK 4.5*32M
|
Facility
|
OP
|
$1,220.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.24 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$940.02
|
| Rate for Payer: Anthem Medicaid |
$419.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$952.22
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cigna Commercial |
$1,013.26
|
| Rate for Payer: First Health Commercial |
$1,159.76
|
| Rate for Payer: Humana Commercial |
$1,037.68
|
| Rate for Payer: Humana KY Medicaid |
$419.83
|
| Rate for Payer: Kentucky WC Medicaid |
$424.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,001.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$428.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,074.30
|
| Rate for Payer: Ohio Health Group HMO |
$915.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$976.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,062.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$842.35
|
| Rate for Payer: PHCS Commercial |
$1,171.97
|
| Rate for Payer: United Healthcare All Payer |
$1,074.30
|
|
|
SCREW FT CORT NON-LOCK 4.5*32M
|
Facility
|
IP
|
$1,220.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.24 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$940.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$952.22
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cigna Commercial |
$1,013.26
|
| Rate for Payer: First Health Commercial |
$1,159.76
|
| Rate for Payer: Humana Commercial |
$1,037.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,001.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,074.30
|
| Rate for Payer: Ohio Health Group HMO |
$915.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$976.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,062.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$842.35
|
| Rate for Payer: PHCS Commercial |
$1,171.97
|
| Rate for Payer: United Healthcare All Payer |
$1,074.30
|
|
|
SCREW FULLY THREAD 4.0 32/36MM
|
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 FULLY THREAD 4.0 32/36MM
|
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 FULLY THREAD 4.0 38/42MM
|
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 FULLY THREAD 4.0 38/42MM
|
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 HDLES COMP 5.0*70
|
Facility
|
IP
|
$3,625.81
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,087.74 |
| Max. Negotiated Rate |
$3,480.78 |
| Rate for Payer: Aetna Commercial |
$2,791.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,828.13
|
| Rate for Payer: Cash Price |
$1,812.91
|
| Rate for Payer: Cigna Commercial |
$3,009.42
|
| Rate for Payer: First Health Commercial |
$3,444.52
|
| Rate for Payer: Humana Commercial |
$3,081.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,973.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,675.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,087.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,190.71
|
| Rate for Payer: Ohio Health Group HMO |
$2,719.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,900.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,154.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,501.81
|
| Rate for Payer: PHCS Commercial |
$3,480.78
|
| Rate for Payer: United Healthcare All Payer |
$3,190.71
|
|
|
SCREW HDLES COMP 5.0*70
|
Facility
|
OP
|
$3,625.81
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,087.74 |
| Max. Negotiated Rate |
$3,480.78 |
| Rate for Payer: Aetna Commercial |
$2,791.87
|
| Rate for Payer: Anthem Medicaid |
$1,246.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,828.13
|
| Rate for Payer: Cash Price |
$1,812.91
|
| Rate for Payer: Cigna Commercial |
$3,009.42
|
| Rate for Payer: First Health Commercial |
$3,444.52
|
| Rate for Payer: Humana Commercial |
$3,081.94
|
| Rate for Payer: Humana KY Medicaid |
$1,246.92
|
| Rate for Payer: Kentucky WC Medicaid |
$1,259.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,973.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,675.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,087.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,271.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,190.71
|
| Rate for Payer: Ohio Health Group HMO |
$2,719.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,900.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,154.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,501.81
|
| Rate for Payer: PHCS Commercial |
$3,480.78
|
| Rate for Payer: United Healthcare All Payer |
$3,190.71
|
|
|
SCREW HDLES COMP 5.0*75
|
Facility
|
IP
|
$4,853.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,456.12 |
| Max. Negotiated Rate |
$4,659.60 |
| Rate for Payer: Aetna Commercial |
$3,737.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,785.93
|
| Rate for Payer: Cash Price |
$2,426.88
|
| Rate for Payer: Cigna Commercial |
$4,028.61
|
| Rate for Payer: First Health Commercial |
$4,611.06
|
| Rate for Payer: Humana Commercial |
$4,125.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,980.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,582.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,456.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,271.30
|
| Rate for Payer: Ohio Health Group HMO |
$3,640.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,883.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,222.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,349.09
|
| Rate for Payer: PHCS Commercial |
$4,659.60
|
| Rate for Payer: United Healthcare All Payer |
$4,271.30
|
|
