|
SCREW HDLES COMP 5.0*75
|
Facility
|
OP
|
$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 Medicaid |
$1,669.20
|
| 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: Humana KY Medicaid |
$1,669.20
|
| Rate for Payer: Kentucky WC Medicaid |
$1,686.19
|
| 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: Molina Healthcare Medicaid |
$1,702.70
|
| 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
|
|
|
SCREW HDLES COMP 7.0*90
|
Facility
|
OP
|
$4,598.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,379.48 |
| Max. Negotiated Rate |
$4,414.33 |
| Rate for Payer: Aetna Commercial |
$3,540.66
|
| Rate for Payer: Anthem Medicaid |
$1,581.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,586.64
|
| Rate for Payer: Cash Price |
$2,299.13
|
| Rate for Payer: Cigna Commercial |
$3,816.56
|
| Rate for Payer: First Health Commercial |
$4,368.35
|
| Rate for Payer: Humana Commercial |
$3,908.52
|
| Rate for Payer: Humana KY Medicaid |
$1,581.34
|
| Rate for Payer: Kentucky WC Medicaid |
$1,597.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,770.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,393.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,379.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,613.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,046.47
|
| Rate for Payer: Ohio Health Group HMO |
$3,448.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,678.61
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,000.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,172.80
|
| Rate for Payer: PHCS Commercial |
$4,414.33
|
| Rate for Payer: United Healthcare All Payer |
$4,046.47
|
|
|
SCREW HDLES COMP 7.0*90
|
Facility
|
IP
|
$4,598.26
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,379.48 |
| Max. Negotiated Rate |
$4,414.33 |
| Rate for Payer: Aetna Commercial |
$3,540.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,586.64
|
| Rate for Payer: Cash Price |
$2,299.13
|
| Rate for Payer: Cigna Commercial |
$3,816.56
|
| Rate for Payer: First Health Commercial |
$4,368.35
|
| Rate for Payer: Humana Commercial |
$3,908.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,770.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,393.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,379.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,046.47
|
| Rate for Payer: Ohio Health Group HMO |
$3,448.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,678.61
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,000.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,172.80
|
| Rate for Payer: PHCS Commercial |
$4,414.33
|
| Rate for Payer: United Healthcare All Payer |
$4,046.47
|
|
|
SCREW HDLESS MTP 3.5MM
|
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 HDLESS MTP 3.5MM
|
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 HDLS CORT TI 5.0*50MM
|
Facility
|
OP
|
$4,231.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.38 |
| Max. Negotiated Rate |
$4,062.00 |
| Rate for Payer: Aetna Commercial |
$3,258.06
|
| Rate for Payer: Anthem Medicaid |
$1,455.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,300.38
|
| Rate for Payer: Cash Price |
$2,115.62
|
| Rate for Payer: Cigna Commercial |
$3,511.94
|
| Rate for Payer: First Health Commercial |
$4,019.69
|
| Rate for Payer: Humana Commercial |
$3,596.56
|
| Rate for Payer: Humana KY Medicaid |
$1,455.13
|
| Rate for Payer: Kentucky WC Medicaid |
$1,469.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,469.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,122.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,269.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,484.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,723.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,173.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,681.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,919.56
|
| Rate for Payer: PHCS Commercial |
$4,062.00
|
| Rate for Payer: United Healthcare All Payer |
$3,723.50
|
|
|
SCREW HDLS CORT TI 5.0*50MM
|
Facility
|
IP
|
$4,231.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.38 |
| Max. Negotiated Rate |
$4,062.00 |
| Rate for Payer: Aetna Commercial |
$3,258.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,300.38
|
| Rate for Payer: Cash Price |
$2,115.62
|
| Rate for Payer: Cigna Commercial |
$3,511.94
|
| Rate for Payer: First Health Commercial |
$4,019.69
|
| Rate for Payer: Humana Commercial |
$3,596.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,469.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,122.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,269.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,723.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,173.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,681.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,919.56
|
| Rate for Payer: PHCS Commercial |
$4,062.00
|
| Rate for Payer: United Healthcare All Payer |
$3,723.50
|
|
|
SCREW HDLS CORT TI 5.0*60
|
Facility
|
OP
|
$4,231.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.38 |
| Max. Negotiated Rate |
$4,062.00 |
| Rate for Payer: Aetna Commercial |
$3,258.06
|
| Rate for Payer: Anthem Medicaid |
$1,455.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,300.38
|
| Rate for Payer: Cash Price |
$2,115.62
|
| Rate for Payer: Cigna Commercial |
$3,511.94
|
| Rate for Payer: First Health Commercial |
$4,019.69
|
| Rate for Payer: Humana Commercial |
$3,596.56
|
| Rate for Payer: Humana KY Medicaid |
$1,455.13
|
| Rate for Payer: Kentucky WC Medicaid |
$1,469.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,469.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,122.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,269.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,484.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,723.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,173.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,681.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,919.56
|
| Rate for Payer: PHCS Commercial |
$4,062.00
|
| Rate for Payer: United Healthcare All Payer |
$3,723.50
|
|
|
SCREW HDLS CORT TI 5.0*60
|
Facility
|
IP
|
$4,231.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.38 |
| Max. Negotiated Rate |
$4,062.00 |
| Rate for Payer: Aetna Commercial |
$3,258.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,300.38
|
| Rate for Payer: Cash Price |
$2,115.62
|
| Rate for Payer: Cigna Commercial |
$3,511.94
|
| Rate for Payer: First Health Commercial |
$4,019.69
|
| Rate for Payer: Humana Commercial |
$3,596.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,469.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,122.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,269.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,723.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,173.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,681.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,919.56
|
| Rate for Payer: PHCS Commercial |
$4,062.00
|
| Rate for Payer: United Healthcare All Payer |
$3,723.50
|
|
|
SCREW HDLS CORT TI 5.0*65MM
|
Facility
|
OP
|
$4,231.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.38 |
| Max. Negotiated Rate |
$4,062.00 |
| Rate for Payer: Aetna Commercial |
$3,258.06
|
| Rate for Payer: Anthem Medicaid |
$1,455.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,300.38
|
| Rate for Payer: Cash Price |
$2,115.62
|
| Rate for Payer: Cigna Commercial |
$3,511.94
|
| Rate for Payer: First Health Commercial |
$4,019.69
|
| Rate for Payer: Humana Commercial |
$3,596.56
|
| Rate for Payer: Humana KY Medicaid |
$1,455.13
|
| Rate for Payer: Kentucky WC Medicaid |
$1,469.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,469.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,122.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,269.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,484.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,723.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,173.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,681.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,919.56
|
| Rate for Payer: PHCS Commercial |
$4,062.00
|
| Rate for Payer: United Healthcare All Payer |
$3,723.50
|
|
|
SCREW HDLS CORT TI 5.0*65MM
|
Facility
|
IP
|
$4,231.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.38 |
| Max. Negotiated Rate |
$4,062.00 |
| Rate for Payer: Aetna Commercial |
$3,258.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,300.38
|
| Rate for Payer: Cash Price |
$2,115.62
|
| Rate for Payer: Cigna Commercial |
$3,511.94
|
| Rate for Payer: First Health Commercial |
$4,019.69
|
| Rate for Payer: Humana Commercial |
$3,596.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,469.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,122.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,269.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,723.50
|
| Rate for Payer: Ohio Health Group HMO |
$3,173.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,681.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,919.56
|
| Rate for Payer: PHCS Commercial |
$4,062.00
|
| Rate for Payer: United Healthcare All Payer |
$3,723.50
|
|
|
SCREW HEADED 2.0*20MM
|
Facility
|
OP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem Medicaid |
$636.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Humana KY Medicaid |
$636.56
|
| Rate for Payer: Kentucky WC Medicaid |
$643.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$649.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW HEADED 2.0*20MM
|
Facility
|
IP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW HEADED 3.0*15MM
|
Facility
|
OP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem Medicaid |
$636.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Humana KY Medicaid |
$636.56
|
| Rate for Payer: Kentucky WC Medicaid |
$643.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$649.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW HEADED 3.0*15MM
|
Facility
|
IP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW HEADED 3.0*17
|
Facility
|
IP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW HEADED 3.0*17
|
Facility
|
OP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem Medicaid |
$636.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Humana KY Medicaid |
$636.56
|
| Rate for Payer: Kentucky WC Medicaid |
$643.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$649.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW HEADED MIS 33MM
|
Facility
|
IP
|
$1,192.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.60 |
| Max. Negotiated Rate |
$1,144.32 |
| Rate for Payer: Aetna Commercial |
$917.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$929.76
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cigna Commercial |
$989.36
|
| Rate for Payer: First Health Commercial |
$1,132.40
|
| Rate for Payer: Humana Commercial |
$1,013.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$977.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$879.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$357.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,048.96
|
| Rate for Payer: Ohio Health Group HMO |
$894.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$953.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,037.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$822.48
|
| Rate for Payer: PHCS Commercial |
$1,144.32
|
| Rate for Payer: United Healthcare All Payer |
$1,048.96
|
|
|
SCREW HEADED MIS 33MM
|
Facility
|
OP
|
$1,192.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.60 |
| Max. Negotiated Rate |
$1,144.32 |
| Rate for Payer: Aetna Commercial |
$917.84
|
| Rate for Payer: Anthem Medicaid |
$409.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$929.76
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cigna Commercial |
$989.36
|
| Rate for Payer: First Health Commercial |
$1,132.40
|
| Rate for Payer: Humana Commercial |
$1,013.20
|
| Rate for Payer: Humana KY Medicaid |
$409.93
|
| Rate for Payer: Kentucky WC Medicaid |
$414.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$977.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$879.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$357.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$418.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,048.96
|
| Rate for Payer: Ohio Health Group HMO |
$894.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$953.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,037.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$822.48
|
| Rate for Payer: PHCS Commercial |
$1,144.32
|
| Rate for Payer: United Healthcare All Payer |
$1,048.96
|
|
|
SCREW HEADLESS 2.5MM
|
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 HEADLESS 2.5MM
|
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 HEADLESS 3.5*28MM
|
Facility
|
IP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW HEADLESS 3.5*28MM
|
Facility
|
OP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem Medicaid |
$728.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Humana KY Medicaid |
$728.04
|
| Rate for Payer: Kentucky WC Medicaid |
$735.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$742.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW HEADLESS 3.5*30MM
|
Facility
|
IP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW HEADLESS 3.5*30MM
|
Facility
|
OP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem Medicaid |
$728.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Humana KY Medicaid |
$728.04
|
| Rate for Payer: Kentucky WC Medicaid |
$735.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$742.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
