|
SCREW KREULOCK COMP SS 2.7X16M
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK COMP SS 2.7X16M
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*10
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*10
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*12
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*12
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*14
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*14
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*16
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*16
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*18
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*18
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*20
|
Facility
|
IP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW KREULOCK TI 3.0*20
|
Facility
|
OP
|
$3,161.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.47 |
| Max. Negotiated Rate |
$3,035.10 |
| Rate for Payer: Aetna Commercial |
$2,434.40
|
| Rate for Payer: Anthem Medicaid |
$1,087.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,466.02
|
| Rate for Payer: Cash Price |
$1,580.78
|
| Rate for Payer: Cigna Commercial |
$2,624.09
|
| Rate for Payer: First Health Commercial |
$3,003.48
|
| Rate for Payer: Humana Commercial |
$2,687.33
|
| Rate for Payer: Humana KY Medicaid |
$1,087.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,098.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,592.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,333.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,109.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,782.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,371.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,529.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,750.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,181.48
|
| Rate for Payer: PHCS Commercial |
$3,035.10
|
| Rate for Payer: United Healthcare All Payer |
$2,782.17
|
|
|
SCREW LAG 2.0*24MM
|
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 LAG 2.0*24MM
|
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 LCK 2.5*8MM
|
Facility
|
IP
|
$1,718.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.40 |
| Max. Negotiated Rate |
$1,649.28 |
| Rate for Payer: Aetna Commercial |
$1,322.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,340.04
|
| Rate for Payer: Cash Price |
$859.00
|
| Rate for Payer: Cigna Commercial |
$1,425.94
|
| Rate for Payer: First Health Commercial |
$1,632.10
|
| Rate for Payer: Humana Commercial |
$1,460.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,408.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,267.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,511.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,288.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,374.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,494.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,185.42
|
| Rate for Payer: PHCS Commercial |
$1,649.28
|
| Rate for Payer: United Healthcare All Payer |
$1,511.84
|
|
|
SCREW LCK 2.5*8MM
|
Facility
|
OP
|
$1,718.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.40 |
| Max. Negotiated Rate |
$1,649.28 |
| Rate for Payer: Aetna Commercial |
$1,322.86
|
| Rate for Payer: Anthem Medicaid |
$590.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,340.04
|
| Rate for Payer: Cash Price |
$859.00
|
| Rate for Payer: Cigna Commercial |
$1,425.94
|
| Rate for Payer: First Health Commercial |
$1,632.10
|
| Rate for Payer: Humana Commercial |
$1,460.30
|
| Rate for Payer: Humana KY Medicaid |
$590.82
|
| Rate for Payer: Kentucky WC Medicaid |
$596.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,408.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,267.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$602.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,511.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,288.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,374.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,494.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,185.42
|
| Rate for Payer: PHCS Commercial |
$1,649.28
|
| Rate for Payer: United Healthcare All Payer |
$1,511.84
|
|
|
SCREW LCK 3.5*20
|
Facility
|
IP
|
$1,965.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$589.50 |
| Max. Negotiated Rate |
$1,886.40 |
| Rate for Payer: Aetna Commercial |
$1,513.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,532.70
|
| Rate for Payer: Cash Price |
$982.50
|
| Rate for Payer: Cigna Commercial |
$1,630.95
|
| Rate for Payer: First Health Commercial |
$1,866.75
|
| Rate for Payer: Humana Commercial |
$1,670.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,611.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,450.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$589.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,729.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,473.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,572.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,355.85
|
| Rate for Payer: PHCS Commercial |
$1,886.40
|
| Rate for Payer: United Healthcare All Payer |
$1,729.20
|
|
|
SCREW LCK 3.5*20
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$589.50 |
| Max. Negotiated Rate |
$1,886.40 |
| Rate for Payer: Aetna Commercial |
$1,513.05
|
| Rate for Payer: Anthem Medicaid |
$675.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,532.70
|
| Rate for Payer: Cash Price |
$982.50
|
| Rate for Payer: Cigna Commercial |
$1,630.95
|
| Rate for Payer: First Health Commercial |
$1,866.75
|
| Rate for Payer: Humana Commercial |
$1,670.25
|
| Rate for Payer: Humana KY Medicaid |
$675.76
|
| Rate for Payer: Kentucky WC Medicaid |
$682.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,611.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,450.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$589.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$689.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,729.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,473.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,572.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,355.85
|
| Rate for Payer: PHCS Commercial |
$1,886.40
|
| Rate for Payer: United Healthcare All Payer |
$1,729.20
|
|
|
SCREW LCK 3.5*22
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$589.50 |
| Max. Negotiated Rate |
$1,886.40 |
| Rate for Payer: Aetna Commercial |
$1,513.05
|
| Rate for Payer: Anthem Medicaid |
$675.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,532.70
|
| Rate for Payer: Cash Price |
$982.50
|
| Rate for Payer: Cigna Commercial |
$1,630.95
|
| Rate for Payer: First Health Commercial |
$1,866.75
|
| Rate for Payer: Humana Commercial |
$1,670.25
|
| Rate for Payer: Humana KY Medicaid |
$675.76
|
| Rate for Payer: Kentucky WC Medicaid |
$682.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,611.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,450.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$589.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$689.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,729.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,473.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,572.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,355.85
|
| Rate for Payer: PHCS Commercial |
$1,886.40
|
| Rate for Payer: United Healthcare All Payer |
$1,729.20
|
|
|
SCREW LCK 3.5*22
|
Facility
|
IP
|
$1,965.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$589.50 |
| Max. Negotiated Rate |
$1,886.40 |
| Rate for Payer: Aetna Commercial |
$1,513.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,532.70
|
| Rate for Payer: Cash Price |
$982.50
|
| Rate for Payer: Cigna Commercial |
$1,630.95
|
| Rate for Payer: First Health Commercial |
$1,866.75
|
| Rate for Payer: Humana Commercial |
$1,670.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,611.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,450.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$589.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,729.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,473.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,572.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,355.85
|
| Rate for Payer: PHCS Commercial |
$1,886.40
|
| Rate for Payer: United Healthcare All Payer |
$1,729.20
|
|
|
SCREW LCK 3.5MM * 48MM
|
Facility
|
OP
|
$3,346.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,003.88 |
| Max. Negotiated Rate |
$3,212.40 |
| Rate for Payer: Aetna Commercial |
$2,576.61
|
| Rate for Payer: Anthem Medicaid |
$1,150.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,610.07
|
| Rate for Payer: Cash Price |
$1,673.12
|
| Rate for Payer: Cigna Commercial |
$2,777.39
|
| Rate for Payer: First Health Commercial |
$3,178.94
|
| Rate for Payer: Humana Commercial |
$2,844.31
|
| Rate for Payer: Humana KY Medicaid |
$1,150.78
|
| Rate for Payer: Kentucky WC Medicaid |
$1,162.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,743.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,469.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,003.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,173.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,944.70
|
| Rate for Payer: Ohio Health Group HMO |
$2,509.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,677.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,911.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,308.91
|
| Rate for Payer: PHCS Commercial |
$3,212.40
|
| Rate for Payer: United Healthcare All Payer |
$2,944.70
|
|
|
SCREW LCK 3.5MM * 48MM
|
Facility
|
IP
|
$3,346.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,003.88 |
| Max. Negotiated Rate |
$3,212.40 |
| Rate for Payer: Aetna Commercial |
$2,576.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,610.07
|
| Rate for Payer: Cash Price |
$1,673.12
|
| Rate for Payer: Cigna Commercial |
$2,777.39
|
| Rate for Payer: First Health Commercial |
$3,178.94
|
| Rate for Payer: Humana Commercial |
$2,844.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,743.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,469.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,003.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,944.70
|
| Rate for Payer: Ohio Health Group HMO |
$2,509.69
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,677.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,911.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,308.91
|
| Rate for Payer: PHCS Commercial |
$3,212.40
|
| Rate for Payer: United Healthcare All Payer |
$2,944.70
|
|
|
SCREW LCKING 2.4MM*26MM T7 S
|
Facility
|
IP
|
$1,814.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$544.24 |
| Max. Negotiated Rate |
$1,741.57 |
| Rate for Payer: Aetna Commercial |
$1,396.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,415.03
|
| Rate for Payer: Cash Price |
$907.07
|
| Rate for Payer: Cigna Commercial |
$1,505.74
|
| Rate for Payer: First Health Commercial |
$1,723.43
|
| Rate for Payer: Humana Commercial |
$1,542.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,487.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,338.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$544.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,596.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,360.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,451.31
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,578.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,251.76
|
| Rate for Payer: PHCS Commercial |
$1,741.57
|
| Rate for Payer: United Healthcare All Payer |
$1,596.44
|
|
