|
SCREW LP TM SS CORT 3.5*56MM
|
Facility
|
OP
|
$783.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.12 |
| Max. Negotiated Rate |
$752.40 |
| Rate for Payer: Aetna Commercial |
$603.49
|
| Rate for Payer: Anthem Medicaid |
$269.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$611.33
|
| Rate for Payer: Cash Price |
$391.88
|
| Rate for Payer: Cigna Commercial |
$650.51
|
| Rate for Payer: First Health Commercial |
$744.56
|
| Rate for Payer: Humana Commercial |
$666.19
|
| Rate for Payer: Humana KY Medicaid |
$269.53
|
| Rate for Payer: Kentucky WC Medicaid |
$272.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$642.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$578.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$235.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$274.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$689.70
|
| Rate for Payer: Ohio Health Group HMO |
$587.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$627.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$681.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.79
|
| Rate for Payer: PHCS Commercial |
$752.40
|
| Rate for Payer: United Healthcare All Payer |
$689.70
|
|
|
SCREW LP TM SS CORT 3.5*56MM
|
Facility
|
IP
|
$783.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.12 |
| Max. Negotiated Rate |
$752.40 |
| Rate for Payer: Aetna Commercial |
$603.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$611.33
|
| Rate for Payer: Cash Price |
$391.88
|
| Rate for Payer: Cigna Commercial |
$650.51
|
| Rate for Payer: First Health Commercial |
$744.56
|
| Rate for Payer: Humana Commercial |
$666.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$642.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$578.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$235.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$689.70
|
| Rate for Payer: Ohio Health Group HMO |
$587.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$627.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$681.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.79
|
| Rate for Payer: PHCS Commercial |
$752.40
|
| Rate for Payer: United Healthcare All Payer |
$689.70
|
|
|
SCREW LP TM SS CORT 3.5*58MM
|
Facility
|
OP
|
$783.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.12 |
| Max. Negotiated Rate |
$752.40 |
| Rate for Payer: Aetna Commercial |
$603.49
|
| Rate for Payer: Anthem Medicaid |
$269.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$611.33
|
| Rate for Payer: Cash Price |
$391.88
|
| Rate for Payer: Cigna Commercial |
$650.51
|
| Rate for Payer: First Health Commercial |
$744.56
|
| Rate for Payer: Humana Commercial |
$666.19
|
| Rate for Payer: Humana KY Medicaid |
$269.53
|
| Rate for Payer: Kentucky WC Medicaid |
$272.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$642.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$578.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$235.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$274.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$689.70
|
| Rate for Payer: Ohio Health Group HMO |
$587.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$627.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$681.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.79
|
| Rate for Payer: PHCS Commercial |
$752.40
|
| Rate for Payer: United Healthcare All Payer |
$689.70
|
|
|
SCREW LP TM SS CORT 3.5*58MM
|
Facility
|
IP
|
$783.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.12 |
| Max. Negotiated Rate |
$752.40 |
| Rate for Payer: Aetna Commercial |
$603.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$611.33
|
| Rate for Payer: Cash Price |
$391.88
|
| Rate for Payer: Cigna Commercial |
$650.51
|
| Rate for Payer: First Health Commercial |
$744.56
|
| Rate for Payer: Humana Commercial |
$666.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$642.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$578.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$235.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$689.70
|
| Rate for Payer: Ohio Health Group HMO |
$587.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$627.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$681.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.79
|
| Rate for Payer: PHCS Commercial |
$752.40
|
| Rate for Payer: United Healthcare All Payer |
$689.70
|
|
|
SCREW LP TM SS CORT 3.5*65MM
|
Facility
|
OP
|
$783.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.12 |
| Max. Negotiated Rate |
$752.40 |
| Rate for Payer: Aetna Commercial |
$603.49
|
| Rate for Payer: Anthem Medicaid |
$269.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$611.33
|
| Rate for Payer: Cash Price |
$391.88
|
| Rate for Payer: Cigna Commercial |
$650.51
|
| Rate for Payer: First Health Commercial |
$744.56
|
| Rate for Payer: Humana Commercial |
$666.19
|
| Rate for Payer: Humana KY Medicaid |
$269.53
|
| Rate for Payer: Kentucky WC Medicaid |
$272.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$642.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$578.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$235.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$274.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$689.70
|
| Rate for Payer: Ohio Health Group HMO |
$587.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$627.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$681.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.79
|
| Rate for Payer: PHCS Commercial |
$752.40
|
| Rate for Payer: United Healthcare All Payer |
$689.70
|
|
|
SCREW LP TM SS CORT 3.5*65MM
|
Facility
|
IP
|
$783.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.12 |
| Max. Negotiated Rate |
$752.40 |
| Rate for Payer: Aetna Commercial |
$603.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$611.33
|
| Rate for Payer: Cash Price |
$391.88
|
| Rate for Payer: Cigna Commercial |
$650.51
|
| Rate for Payer: First Health Commercial |
$744.56
|
| Rate for Payer: Humana Commercial |
$666.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$642.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$578.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$235.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$689.70
|
| Rate for Payer: Ohio Health Group HMO |
$587.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$627.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$681.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$540.79
|
| Rate for Payer: PHCS Commercial |
$752.40
|
| Rate for Payer: United Healthcare All Payer |
$689.70
|
|
|
SCREW MINI MONSTER 2.5*26 HL
|
Facility
|
IP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW MINI MONSTER 2.5*26 HL
|
Facility
|
OP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem Medicaid |
$728.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Humana KY Medicaid |
$728.04
|
| Rate for Payer: Kentucky WC Medicaid |
$735.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$742.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW MINI MONSTER 3.0*30
|
Facility
|
OP
|
$2,003.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$600.90 |
| Max. Negotiated Rate |
$1,922.88 |
| Rate for Payer: Aetna Commercial |
$1,542.31
|
| Rate for Payer: Anthem Medicaid |
$688.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,562.34
|
| Rate for Payer: Cash Price |
$1,001.50
|
| Rate for Payer: Cigna Commercial |
$1,662.49
|
| Rate for Payer: First Health Commercial |
$1,902.85
|
| Rate for Payer: Humana Commercial |
$1,702.55
|
| Rate for Payer: Humana KY Medicaid |
$688.83
|
| Rate for Payer: Kentucky WC Medicaid |
$695.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,642.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,478.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$702.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,762.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,502.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,602.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,742.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,382.07
|
| Rate for Payer: PHCS Commercial |
$1,922.88
|
| Rate for Payer: United Healthcare All Payer |
$1,762.64
|
|
|
SCREW MINI MONSTER 3.0*30
|
Facility
|
IP
|
$2,003.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$600.90 |
| Max. Negotiated Rate |
$1,922.88 |
| Rate for Payer: Aetna Commercial |
$1,542.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,562.34
|
| Rate for Payer: Cash Price |
$1,001.50
|
| Rate for Payer: Cigna Commercial |
$1,662.49
|
| Rate for Payer: First Health Commercial |
$1,902.85
|
| Rate for Payer: Humana Commercial |
$1,702.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,642.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,478.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,762.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,502.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,602.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,742.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,382.07
|
| Rate for Payer: PHCS Commercial |
$1,922.88
|
| Rate for Payer: United Healthcare All Payer |
$1,762.64
|
|
|
SCREW MINI MONSTER 3.5*26
|
Facility
|
OP
|
$1,778.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.64 |
| Max. Negotiated Rate |
$1,707.65 |
| Rate for Payer: Aetna Commercial |
$1,369.68
|
| Rate for Payer: Anthem Medicaid |
$611.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,387.46
|
| Rate for Payer: Cash Price |
$889.40
|
| Rate for Payer: Cigna Commercial |
$1,476.40
|
| Rate for Payer: First Health Commercial |
$1,689.86
|
| Rate for Payer: Humana Commercial |
$1,511.98
|
| Rate for Payer: Humana KY Medicaid |
$611.73
|
| Rate for Payer: Kentucky WC Medicaid |
$617.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,458.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,312.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$533.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$624.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,565.34
|
| Rate for Payer: Ohio Health Group HMO |
$1,334.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,423.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,547.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,227.37
|
| Rate for Payer: PHCS Commercial |
$1,707.65
|
| Rate for Payer: United Healthcare All Payer |
$1,565.34
|
|
|
SCREW MINI MONSTER 3.5*26
|
Facility
|
IP
|
$1,778.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.64 |
| Max. Negotiated Rate |
$1,707.65 |
| Rate for Payer: Aetna Commercial |
$1,369.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,387.46
|
| Rate for Payer: Cash Price |
$889.40
|
| Rate for Payer: Cigna Commercial |
$1,476.40
|
| Rate for Payer: First Health Commercial |
$1,689.86
|
| Rate for Payer: Humana Commercial |
$1,511.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,458.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,312.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$533.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,565.34
|
| Rate for Payer: Ohio Health Group HMO |
$1,334.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,423.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,547.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,227.37
|
| Rate for Payer: PHCS Commercial |
$1,707.65
|
| Rate for Payer: United Healthcare All Payer |
$1,565.34
|
|
|
SCREW MINI MONSTER 4.0*40 HL
|
Facility
|
IP
|
$2,193.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$657.90 |
| Max. Negotiated Rate |
$2,105.28 |
| Rate for Payer: Aetna Commercial |
$1,688.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,710.54
|
| Rate for Payer: Cash Price |
$1,096.50
|
| Rate for Payer: Cigna Commercial |
$1,820.19
|
| Rate for Payer: First Health Commercial |
$2,083.35
|
| Rate for Payer: Humana Commercial |
$1,864.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,798.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,618.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$657.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,929.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,644.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,907.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,513.17
|
| Rate for Payer: PHCS Commercial |
$2,105.28
|
| Rate for Payer: United Healthcare All Payer |
$1,929.84
|
|
|
SCREW MINI MONSTER 4.0*40 HL
|
Facility
|
OP
|
$2,193.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$657.90 |
| Max. Negotiated Rate |
$2,105.28 |
| Rate for Payer: Aetna Commercial |
$1,688.61
|
| Rate for Payer: Anthem Medicaid |
$754.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,710.54
|
| Rate for Payer: Cash Price |
$1,096.50
|
| Rate for Payer: Cigna Commercial |
$1,820.19
|
| Rate for Payer: First Health Commercial |
$2,083.35
|
| Rate for Payer: Humana Commercial |
$1,864.05
|
| Rate for Payer: Humana KY Medicaid |
$754.17
|
| Rate for Payer: Kentucky WC Medicaid |
$761.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,798.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,618.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$657.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$769.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,929.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,644.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,754.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,907.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,513.17
|
| Rate for Payer: PHCS Commercial |
$2,105.28
|
| Rate for Payer: United Healthcare All Payer |
$1,929.84
|
|
|
SCREW MINI MONSTER HL 3.5*38
|
Facility
|
IP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW MINI MONSTER HL 3.5*38
|
Facility
|
OP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem Medicaid |
$728.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Humana KY Medicaid |
$728.04
|
| Rate for Payer: Kentucky WC Medicaid |
$735.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$742.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW MINI SHORT 2.5*22 HL
|
Facility
|
IP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW MINI SHORT 2.5*22 HL
|
Facility
|
OP
|
$2,117.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$635.10 |
| Max. Negotiated Rate |
$2,032.32 |
| Rate for Payer: Aetna Commercial |
$1,630.09
|
| Rate for Payer: Anthem Medicaid |
$728.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,651.26
|
| Rate for Payer: Cash Price |
$1,058.50
|
| Rate for Payer: Cigna Commercial |
$1,757.11
|
| Rate for Payer: First Health Commercial |
$2,011.15
|
| Rate for Payer: Humana Commercial |
$1,799.45
|
| Rate for Payer: Humana KY Medicaid |
$728.04
|
| Rate for Payer: Kentucky WC Medicaid |
$735.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,735.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,562.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$635.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$742.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,862.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,587.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,693.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,841.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,460.73
|
| Rate for Payer: PHCS Commercial |
$2,032.32
|
| Rate for Payer: United Healthcare All Payer |
$1,862.96
|
|
|
SCREW MIS HEADED 33MM
|
Facility
|
OP
|
$1,192.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.60 |
| Max. Negotiated Rate |
$1,144.32 |
| Rate for Payer: Aetna Commercial |
$917.84
|
| Rate for Payer: Anthem Medicaid |
$409.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$929.76
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cigna Commercial |
$989.36
|
| Rate for Payer: First Health Commercial |
$1,132.40
|
| Rate for Payer: Humana Commercial |
$1,013.20
|
| Rate for Payer: Humana KY Medicaid |
$409.93
|
| Rate for Payer: Kentucky WC Medicaid |
$414.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$977.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$879.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$357.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$418.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,048.96
|
| Rate for Payer: Ohio Health Group HMO |
$894.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$953.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,037.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$822.48
|
| Rate for Payer: PHCS Commercial |
$1,144.32
|
| Rate for Payer: United Healthcare All Payer |
$1,048.96
|
|
|
SCREW MIS HEADED 33MM
|
Facility
|
IP
|
$1,192.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.60 |
| Max. Negotiated Rate |
$1,144.32 |
| Rate for Payer: Aetna Commercial |
$917.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$929.76
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cigna Commercial |
$989.36
|
| Rate for Payer: First Health Commercial |
$1,132.40
|
| Rate for Payer: Humana Commercial |
$1,013.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$977.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$879.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$357.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,048.96
|
| Rate for Payer: Ohio Health Group HMO |
$894.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$953.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,037.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$822.48
|
| Rate for Payer: PHCS Commercial |
$1,144.32
|
| Rate for Payer: United Healthcare All Payer |
$1,048.96
|
|
|
SCREW MONSTER MINI SHRT HEAD
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW MONSTER MINI SHRT HEAD
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
SCREW NCB CORT ST 50X30MM
|
Facility
|
OP
|
$2,235.29
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.59 |
| Max. Negotiated Rate |
$2,145.88 |
| Rate for Payer: Aetna Commercial |
$1,721.17
|
| Rate for Payer: Anthem Medicaid |
$768.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,743.53
|
| Rate for Payer: Cash Price |
$1,117.65
|
| Rate for Payer: Cigna Commercial |
$1,855.29
|
| Rate for Payer: First Health Commercial |
$2,123.53
|
| Rate for Payer: Humana Commercial |
$1,900.00
|
| Rate for Payer: Humana KY Medicaid |
$768.72
|
| Rate for Payer: Kentucky WC Medicaid |
$776.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,832.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,649.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$670.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$784.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,967.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,676.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,788.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,944.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,542.35
|
| Rate for Payer: PHCS Commercial |
$2,145.88
|
| Rate for Payer: United Healthcare All Payer |
$1,967.06
|
|
|
SCREW NCB CORT ST 50X30MM
|
Facility
|
IP
|
$2,235.29
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$670.59 |
| Max. Negotiated Rate |
$2,145.88 |
| Rate for Payer: Aetna Commercial |
$1,721.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,743.53
|
| Rate for Payer: Cash Price |
$1,117.65
|
| Rate for Payer: Cigna Commercial |
$1,855.29
|
| Rate for Payer: First Health Commercial |
$2,123.53
|
| Rate for Payer: Humana Commercial |
$1,900.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,832.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,649.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$670.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,967.06
|
| Rate for Payer: Ohio Health Group HMO |
$1,676.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,788.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,944.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,542.35
|
| Rate for Payer: PHCS Commercial |
$2,145.88
|
| Rate for Payer: United Healthcare All Payer |
$1,967.06
|
|
|
SCREW NCB CORT ST 50X32MM
|
Facility
|
OP
|
$2,208.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$662.41 |
| Max. Negotiated Rate |
$2,119.73 |
| Rate for Payer: Aetna Commercial |
$1,700.20
|
| Rate for Payer: Anthem Medicaid |
$759.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,722.28
|
| Rate for Payer: Cash Price |
$1,104.02
|
| Rate for Payer: Cigna Commercial |
$1,832.68
|
| Rate for Payer: First Health Commercial |
$2,097.65
|
| Rate for Payer: Humana Commercial |
$1,876.84
|
| Rate for Payer: Humana KY Medicaid |
$759.35
|
| Rate for Payer: Kentucky WC Medicaid |
$767.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,810.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,629.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$662.41
|
| Rate for Payer: Molina Healthcare Medicaid |
$774.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,943.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,656.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,766.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,921.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,523.55
|
| Rate for Payer: PHCS Commercial |
$2,119.73
|
| Rate for Payer: United Healthcare All Payer |
$1,943.08
|
|
