|
SCREW LP CORT TI 5.0*24MM
|
Facility
|
IP
|
$3,481.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,044.38 |
| Max. Negotiated Rate |
$3,342.00 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,715.38
|
| Rate for Payer: Cash Price |
$1,740.62
|
| Rate for Payer: Cigna Commercial |
$2,889.44
|
| Rate for Payer: First Health Commercial |
$3,307.19
|
| Rate for Payer: Humana Commercial |
$2,959.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,854.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,569.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,044.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,063.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,610.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,785.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,028.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,402.06
|
| Rate for Payer: PHCS Commercial |
$3,342.00
|
| Rate for Payer: United Healthcare All Payer |
$3,063.50
|
|
|
SCREW LP CORT TI 5.0*24MM
|
Facility
|
OP
|
$3,481.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,044.38 |
| Max. Negotiated Rate |
$3,342.00 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Anthem Medicaid |
$1,197.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,715.38
|
| Rate for Payer: Cash Price |
$1,740.62
|
| Rate for Payer: Cigna Commercial |
$2,889.44
|
| Rate for Payer: First Health Commercial |
$3,307.19
|
| Rate for Payer: Humana Commercial |
$2,959.06
|
| Rate for Payer: Humana KY Medicaid |
$1,197.20
|
| Rate for Payer: Kentucky WC Medicaid |
$1,209.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,854.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,569.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,044.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,221.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,063.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,610.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,785.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,028.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,402.06
|
| Rate for Payer: PHCS Commercial |
$3,342.00
|
| Rate for Payer: United Healthcare All Payer |
$3,063.50
|
|
|
SCREW LP CORT TI 5.0*32MM
|
Facility
|
OP
|
$3,481.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,044.38 |
| Max. Negotiated Rate |
$3,342.00 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Anthem Medicaid |
$1,197.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,715.38
|
| Rate for Payer: Cash Price |
$1,740.62
|
| Rate for Payer: Cigna Commercial |
$2,889.44
|
| Rate for Payer: First Health Commercial |
$3,307.19
|
| Rate for Payer: Humana Commercial |
$2,959.06
|
| Rate for Payer: Humana KY Medicaid |
$1,197.20
|
| Rate for Payer: Kentucky WC Medicaid |
$1,209.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,854.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,569.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,044.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,221.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,063.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,610.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,785.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,028.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,402.06
|
| Rate for Payer: PHCS Commercial |
$3,342.00
|
| Rate for Payer: United Healthcare All Payer |
$3,063.50
|
|
|
SCREW LP CORT TI 5.0*32MM
|
Facility
|
IP
|
$3,481.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,044.38 |
| Max. Negotiated Rate |
$3,342.00 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,715.38
|
| Rate for Payer: Cash Price |
$1,740.62
|
| Rate for Payer: Cigna Commercial |
$2,889.44
|
| Rate for Payer: First Health Commercial |
$3,307.19
|
| Rate for Payer: Humana Commercial |
$2,959.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,854.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,569.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,044.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,063.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,610.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,785.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,028.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,402.06
|
| Rate for Payer: PHCS Commercial |
$3,342.00
|
| Rate for Payer: United Healthcare All Payer |
$3,063.50
|
|
|
SCREW LP FIXED ANG LCK 3.5*10
|
Facility
|
OP
|
$1,523.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.90 |
| Max. Negotiated Rate |
$1,462.08 |
| Rate for Payer: Aetna Commercial |
$1,172.71
|
| Rate for Payer: Anthem Medicaid |
$523.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,187.94
|
| Rate for Payer: Cash Price |
$761.50
|
| Rate for Payer: Cigna Commercial |
$1,264.09
|
| Rate for Payer: First Health Commercial |
$1,446.85
|
| Rate for Payer: Humana Commercial |
$1,294.55
|
| Rate for Payer: Humana KY Medicaid |
$523.76
|
| Rate for Payer: Kentucky WC Medicaid |
$529.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,248.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,123.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$456.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$534.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,340.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,142.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,218.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,325.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,050.87
|
| Rate for Payer: PHCS Commercial |
$1,462.08
|
| Rate for Payer: United Healthcare All Payer |
$1,340.24
|
|
|
SCREW LP FIXED ANG LCK 3.5*10
|
Facility
|
IP
|
$1,523.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.90 |
| Max. Negotiated Rate |
$1,462.08 |
| Rate for Payer: Aetna Commercial |
$1,172.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,187.94
|
| Rate for Payer: Cash Price |
$761.50
|
| Rate for Payer: Cigna Commercial |
$1,264.09
|
| Rate for Payer: First Health Commercial |
$1,446.85
|
| Rate for Payer: Humana Commercial |
$1,294.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,248.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,123.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$456.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,340.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,142.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,218.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,325.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,050.87
|
| Rate for Payer: PHCS Commercial |
$1,462.08
|
| Rate for Payer: United Healthcare All Payer |
$1,340.24
|
|
|
SCREW LP FIXED ANG LCK 3.5*12
|
Facility
|
IP
|
$1,539.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.75 |
| Max. Negotiated Rate |
$1,477.58 |
| Rate for Payer: Aetna Commercial |
$1,185.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,200.54
|
| Rate for Payer: Cash Price |
$769.58
|
| Rate for Payer: Cigna Commercial |
$1,277.49
|
| Rate for Payer: First Health Commercial |
$1,462.19
|
| Rate for Payer: Humana Commercial |
$1,308.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,135.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$461.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,354.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,154.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,231.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.01
|
| Rate for Payer: PHCS Commercial |
$1,477.58
|
| Rate for Payer: United Healthcare All Payer |
$1,354.45
|
|
|
SCREW LP FIXED ANG LCK 3.5*12
|
Facility
|
OP
|
$1,539.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.75 |
| Max. Negotiated Rate |
$1,477.58 |
| Rate for Payer: Aetna Commercial |
$1,185.15
|
| Rate for Payer: Anthem Medicaid |
$529.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,200.54
|
| Rate for Payer: Cash Price |
$769.58
|
| Rate for Payer: Cigna Commercial |
$1,277.49
|
| Rate for Payer: First Health Commercial |
$1,462.19
|
| Rate for Payer: Humana Commercial |
$1,308.28
|
| Rate for Payer: Humana KY Medicaid |
$529.31
|
| Rate for Payer: Kentucky WC Medicaid |
$534.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,135.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$461.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$539.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,354.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,154.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,231.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.01
|
| Rate for Payer: PHCS Commercial |
$1,477.58
|
| Rate for Payer: United Healthcare All Payer |
$1,354.45
|
|
|
SCREW LP FIXED ANG LCK 3.5*14
|
Facility
|
OP
|
$1,539.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.75 |
| Max. Negotiated Rate |
$1,477.58 |
| Rate for Payer: Aetna Commercial |
$1,185.15
|
| Rate for Payer: Anthem Medicaid |
$529.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,200.54
|
| Rate for Payer: Cash Price |
$769.58
|
| Rate for Payer: Cigna Commercial |
$1,277.49
|
| Rate for Payer: First Health Commercial |
$1,462.19
|
| Rate for Payer: Humana Commercial |
$1,308.28
|
| Rate for Payer: Humana KY Medicaid |
$529.31
|
| Rate for Payer: Kentucky WC Medicaid |
$534.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,135.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$461.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$539.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,354.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,154.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,231.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.01
|
| Rate for Payer: PHCS Commercial |
$1,477.58
|
| Rate for Payer: United Healthcare All Payer |
$1,354.45
|
|
|
SCREW LP FIXED ANG LCK 3.5*14
|
Facility
|
IP
|
$1,539.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.75 |
| Max. Negotiated Rate |
$1,477.58 |
| Rate for Payer: Aetna Commercial |
$1,185.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,200.54
|
| Rate for Payer: Cash Price |
$769.58
|
| Rate for Payer: Cigna Commercial |
$1,277.49
|
| Rate for Payer: First Health Commercial |
$1,462.19
|
| Rate for Payer: Humana Commercial |
$1,308.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,135.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$461.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,354.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,154.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,231.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.01
|
| Rate for Payer: PHCS Commercial |
$1,477.58
|
| Rate for Payer: United Healthcare All Payer |
$1,354.45
|
|
|
SCREW LP FIXED ANG LCK 3.5*16
|
Facility
|
OP
|
$1,539.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.75 |
| Max. Negotiated Rate |
$1,477.58 |
| Rate for Payer: Aetna Commercial |
$1,185.15
|
| Rate for Payer: Anthem Medicaid |
$529.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,200.54
|
| Rate for Payer: Cash Price |
$769.58
|
| Rate for Payer: Cigna Commercial |
$1,277.49
|
| Rate for Payer: First Health Commercial |
$1,462.19
|
| Rate for Payer: Humana Commercial |
$1,308.28
|
| Rate for Payer: Humana KY Medicaid |
$529.31
|
| Rate for Payer: Kentucky WC Medicaid |
$534.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,135.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$461.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$539.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,354.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,154.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,231.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.01
|
| Rate for Payer: PHCS Commercial |
$1,477.58
|
| Rate for Payer: United Healthcare All Payer |
$1,354.45
|
|
|
SCREW LP FIXED ANG LCK 3.5*16
|
Facility
|
IP
|
$1,539.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$461.75 |
| Max. Negotiated Rate |
$1,477.58 |
| Rate for Payer: Aetna Commercial |
$1,185.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,200.54
|
| Rate for Payer: Cash Price |
$769.58
|
| Rate for Payer: Cigna Commercial |
$1,277.49
|
| Rate for Payer: First Health Commercial |
$1,462.19
|
| Rate for Payer: Humana Commercial |
$1,308.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,262.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,135.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$461.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,354.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,154.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,231.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,339.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,062.01
|
| Rate for Payer: PHCS Commercial |
$1,477.58
|
| Rate for Payer: United Healthcare All Payer |
$1,354.45
|
|
|
SCREW LP FIXED ANG LCK 3.5*18
|
Facility
|
OP
|
$1,523.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.90 |
| Max. Negotiated Rate |
$1,462.08 |
| Rate for Payer: Aetna Commercial |
$1,172.71
|
| Rate for Payer: Anthem Medicaid |
$523.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,187.94
|
| Rate for Payer: Cash Price |
$761.50
|
| Rate for Payer: Cigna Commercial |
$1,264.09
|
| Rate for Payer: First Health Commercial |
$1,446.85
|
| Rate for Payer: Humana Commercial |
$1,294.55
|
| Rate for Payer: Humana KY Medicaid |
$523.76
|
| Rate for Payer: Kentucky WC Medicaid |
$529.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,248.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,123.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$456.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$534.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,340.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,142.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,218.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,325.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,050.87
|
| Rate for Payer: PHCS Commercial |
$1,462.08
|
| Rate for Payer: United Healthcare All Payer |
$1,340.24
|
|
|
SCREW LP FIXED ANG LCK 3.5*18
|
Facility
|
IP
|
$1,523.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.90 |
| Max. Negotiated Rate |
$1,462.08 |
| Rate for Payer: Aetna Commercial |
$1,172.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,187.94
|
| Rate for Payer: Cash Price |
$761.50
|
| Rate for Payer: Cigna Commercial |
$1,264.09
|
| Rate for Payer: First Health Commercial |
$1,446.85
|
| Rate for Payer: Humana Commercial |
$1,294.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,248.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,123.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$456.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,340.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,142.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,218.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,325.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,050.87
|
| Rate for Payer: PHCS Commercial |
$1,462.08
|
| Rate for Payer: United Healthcare All Payer |
$1,340.24
|
|
|
SCREW LP FIXED ANG LCK 3.5*20
|
Facility
|
OP
|
$1,523.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.90 |
| Max. Negotiated Rate |
$1,462.08 |
| Rate for Payer: Aetna Commercial |
$1,172.71
|
| Rate for Payer: Anthem Medicaid |
$523.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,187.94
|
| Rate for Payer: Cash Price |
$761.50
|
| Rate for Payer: Cigna Commercial |
$1,264.09
|
| Rate for Payer: First Health Commercial |
$1,446.85
|
| Rate for Payer: Humana Commercial |
$1,294.55
|
| Rate for Payer: Humana KY Medicaid |
$523.76
|
| Rate for Payer: Kentucky WC Medicaid |
$529.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,248.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,123.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$456.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$534.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,340.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,142.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,218.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,325.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,050.87
|
| Rate for Payer: PHCS Commercial |
$1,462.08
|
| Rate for Payer: United Healthcare All Payer |
$1,340.24
|
|
|
SCREW LP FIXED ANG LCK 3.5*20
|
Facility
|
IP
|
$1,523.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$456.90 |
| Max. Negotiated Rate |
$1,462.08 |
| Rate for Payer: Aetna Commercial |
$1,172.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,187.94
|
| Rate for Payer: Cash Price |
$761.50
|
| Rate for Payer: Cigna Commercial |
$1,264.09
|
| Rate for Payer: First Health Commercial |
$1,446.85
|
| Rate for Payer: Humana Commercial |
$1,294.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,248.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,123.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$456.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,340.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,142.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,218.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,325.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,050.87
|
| Rate for Payer: PHCS Commercial |
$1,462.08
|
| Rate for Payer: United Healthcare All Payer |
$1,340.24
|
|
|
SCREW LP LOCKING SS 3.5*35MM
|
Facility
|
IP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*35MM
|
Facility
|
OP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem Medicaid |
$597.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Humana KY Medicaid |
$597.35
|
| Rate for Payer: Kentucky WC Medicaid |
$603.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$609.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*42MM
|
Facility
|
IP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*42MM
|
Facility
|
OP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem Medicaid |
$597.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Humana KY Medicaid |
$597.35
|
| Rate for Payer: Kentucky WC Medicaid |
$603.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$609.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*44MM
|
Facility
|
OP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem Medicaid |
$597.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Humana KY Medicaid |
$597.35
|
| Rate for Payer: Kentucky WC Medicaid |
$603.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$609.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*44MM
|
Facility
|
IP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*46MM
|
Facility
|
IP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*46MM
|
Facility
|
OP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem Medicaid |
$597.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Humana KY Medicaid |
$597.35
|
| Rate for Payer: Kentucky WC Medicaid |
$603.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$609.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
|
SCREW LP LOCKING SS 3.5*48MM
|
Facility
|
OP
|
$1,737.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$521.10 |
| Max. Negotiated Rate |
$1,667.52 |
| Rate for Payer: Aetna Commercial |
$1,337.49
|
| Rate for Payer: Anthem Medicaid |
$597.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,354.86
|
| Rate for Payer: Cash Price |
$868.50
|
| Rate for Payer: Cigna Commercial |
$1,441.71
|
| Rate for Payer: First Health Commercial |
$1,650.15
|
| Rate for Payer: Humana Commercial |
$1,476.45
|
| Rate for Payer: Humana KY Medicaid |
$597.35
|
| Rate for Payer: Kentucky WC Medicaid |
$603.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,424.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,281.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$521.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$609.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,528.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,302.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,389.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,511.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,198.53
|
| Rate for Payer: PHCS Commercial |
$1,667.52
|
| Rate for Payer: United Healthcare All Payer |
$1,528.56
|
|
