|
SCREW LOCKING 4.5*26
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
SCREW LOCKING 4.5*26
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.30 |
| Max. Negotiated Rate |
$1,959.36 |
| Rate for Payer: Aetna Commercial |
$1,571.57
|
| Rate for Payer: Anthem Medicaid |
$701.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,591.98
|
| Rate for Payer: Cash Price |
$1,020.50
|
| Rate for Payer: Cigna Commercial |
$1,694.03
|
| Rate for Payer: First Health Commercial |
$1,938.95
|
| Rate for Payer: Humana Commercial |
$1,734.85
|
| Rate for Payer: Humana KY Medicaid |
$701.90
|
| Rate for Payer: Kentucky WC Medicaid |
$709.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,673.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,506.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$612.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$715.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,796.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,530.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,632.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,775.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,408.29
|
| Rate for Payer: PHCS Commercial |
$1,959.36
|
| Rate for Payer: United Healthcare All Payer |
$1,796.08
|
|
|
SCREW LOCKING 4MM 4.0*24
|
Facility
|
OP
|
$1,752.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$1,682.11 |
| Rate for Payer: Aetna Commercial |
$1,349.19
|
| Rate for Payer: Anthem Medicaid |
$602.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,366.72
|
| Rate for Payer: Cash Price |
$876.10
|
| Rate for Payer: Cigna Commercial |
$1,454.33
|
| Rate for Payer: First Health Commercial |
$1,664.59
|
| Rate for Payer: Humana Commercial |
$1,489.37
|
| Rate for Payer: Humana KY Medicaid |
$602.58
|
| Rate for Payer: Kentucky WC Medicaid |
$608.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,436.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,293.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,541.94
|
| Rate for Payer: Ohio Health Group HMO |
$1,314.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,401.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,524.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,209.02
|
| Rate for Payer: PHCS Commercial |
$1,682.11
|
| Rate for Payer: United Healthcare All Payer |
$1,541.94
|
|
|
SCREW LOCKING 4MM 4.0*24
|
Facility
|
IP
|
$1,752.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$1,682.11 |
| Rate for Payer: Aetna Commercial |
$1,349.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,366.72
|
| Rate for Payer: Cash Price |
$876.10
|
| Rate for Payer: Cigna Commercial |
$1,454.33
|
| Rate for Payer: First Health Commercial |
$1,664.59
|
| Rate for Payer: Humana Commercial |
$1,489.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,436.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,293.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,541.94
|
| Rate for Payer: Ohio Health Group HMO |
$1,314.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,401.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,524.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,209.02
|
| Rate for Payer: PHCS Commercial |
$1,682.11
|
| Rate for Payer: United Healthcare All Payer |
$1,541.94
|
|
|
SCREW LOCKING 4MM 4.0*36
|
Facility
|
OP
|
$1,752.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$1,682.11 |
| Rate for Payer: Aetna Commercial |
$1,349.19
|
| Rate for Payer: Anthem Medicaid |
$602.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,366.72
|
| Rate for Payer: Cash Price |
$876.10
|
| Rate for Payer: Cigna Commercial |
$1,454.33
|
| Rate for Payer: First Health Commercial |
$1,664.59
|
| Rate for Payer: Humana Commercial |
$1,489.37
|
| Rate for Payer: Humana KY Medicaid |
$602.58
|
| Rate for Payer: Kentucky WC Medicaid |
$608.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,436.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,293.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,541.94
|
| Rate for Payer: Ohio Health Group HMO |
$1,314.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,401.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,524.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,209.02
|
| Rate for Payer: PHCS Commercial |
$1,682.11
|
| Rate for Payer: United Healthcare All Payer |
$1,541.94
|
|
|
SCREW LOCKING 4MM 4.0*36
|
Facility
|
IP
|
$1,752.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$1,682.11 |
| Rate for Payer: Aetna Commercial |
$1,349.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,366.72
|
| Rate for Payer: Cash Price |
$876.10
|
| Rate for Payer: Cigna Commercial |
$1,454.33
|
| Rate for Payer: First Health Commercial |
$1,664.59
|
| Rate for Payer: Humana Commercial |
$1,489.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,436.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,293.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,541.94
|
| Rate for Payer: Ohio Health Group HMO |
$1,314.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,401.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,524.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,209.02
|
| Rate for Payer: PHCS Commercial |
$1,682.11
|
| Rate for Payer: United Healthcare All Payer |
$1,541.94
|
|
|
SCREW LOCKING 4MM 4.0*38
|
Facility
|
IP
|
$1,797.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.34 |
| Max. Negotiated Rate |
$1,725.89 |
| Rate for Payer: Aetna Commercial |
$1,384.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.28
|
| Rate for Payer: Cash Price |
$898.90
|
| Rate for Payer: Cigna Commercial |
$1,492.17
|
| Rate for Payer: First Health Commercial |
$1,707.91
|
| Rate for Payer: Humana Commercial |
$1,528.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,240.48
|
| Rate for Payer: PHCS Commercial |
$1,725.89
|
| Rate for Payer: United Healthcare All Payer |
$1,582.06
|
|
|
SCREW LOCKING 4MM 4.0*38
|
Facility
|
OP
|
$1,797.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.34 |
| Max. Negotiated Rate |
$1,725.89 |
| Rate for Payer: Aetna Commercial |
$1,384.31
|
| Rate for Payer: Anthem Medicaid |
$618.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.28
|
| Rate for Payer: Cash Price |
$898.90
|
| Rate for Payer: Cigna Commercial |
$1,492.17
|
| Rate for Payer: First Health Commercial |
$1,707.91
|
| Rate for Payer: Humana Commercial |
$1,528.13
|
| Rate for Payer: Humana KY Medicaid |
$618.26
|
| Rate for Payer: Kentucky WC Medicaid |
$624.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,438.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,564.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,240.48
|
| Rate for Payer: PHCS Commercial |
$1,725.89
|
| Rate for Payer: United Healthcare All Payer |
$1,582.06
|
|
|
SCREW LOCKING PLATE 2.7*10MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 2.7*10MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 2.7*14MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 2.7*14MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 2.7*18MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 2.7*18MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*14MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*14MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*18MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*18MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*20MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*20MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*22MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*22MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*24MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*24MM
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW LOCKING PLATE 3.5*26MM
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
