|
SCREW NON LCK 2.7*26MM
|
Facility
|
OP
|
$1,561.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.30 |
| Max. Negotiated Rate |
$1,498.56 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Anthem Medicaid |
$536.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,217.58
|
| Rate for Payer: Cash Price |
$780.50
|
| Rate for Payer: Cigna Commercial |
$1,295.63
|
| Rate for Payer: First Health Commercial |
$1,482.95
|
| Rate for Payer: Humana Commercial |
$1,326.85
|
| Rate for Payer: Humana KY Medicaid |
$536.83
|
| Rate for Payer: Kentucky WC Medicaid |
$542.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,280.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,152.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$547.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,373.68
|
| Rate for Payer: Ohio Health Group HMO |
$1,170.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,248.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,358.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.09
|
| Rate for Payer: PHCS Commercial |
$1,498.56
|
| Rate for Payer: United Healthcare All Payer |
$1,373.68
|
|
|
SCREW NON LCK 2.7*26MM
|
Facility
|
IP
|
$1,561.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.30 |
| Max. Negotiated Rate |
$1,498.56 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,217.58
|
| Rate for Payer: Cash Price |
$780.50
|
| Rate for Payer: Cigna Commercial |
$1,295.63
|
| Rate for Payer: First Health Commercial |
$1,482.95
|
| Rate for Payer: Humana Commercial |
$1,326.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,280.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,152.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,373.68
|
| Rate for Payer: Ohio Health Group HMO |
$1,170.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,248.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,358.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.09
|
| Rate for Payer: PHCS Commercial |
$1,498.56
|
| Rate for Payer: United Healthcare All Payer |
$1,373.68
|
|
|
SCREW NON-LOCKING 2.5*12MM
|
Facility
|
OP
|
$1,561.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.30 |
| Max. Negotiated Rate |
$1,498.56 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Anthem Medicaid |
$536.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,217.58
|
| Rate for Payer: Cash Price |
$780.50
|
| Rate for Payer: Cigna Commercial |
$1,295.63
|
| Rate for Payer: First Health Commercial |
$1,482.95
|
| Rate for Payer: Humana Commercial |
$1,326.85
|
| Rate for Payer: Humana KY Medicaid |
$536.83
|
| Rate for Payer: Kentucky WC Medicaid |
$542.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,280.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,152.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$547.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,373.68
|
| Rate for Payer: Ohio Health Group HMO |
$1,170.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,248.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,358.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.09
|
| Rate for Payer: PHCS Commercial |
$1,498.56
|
| Rate for Payer: United Healthcare All Payer |
$1,373.68
|
|
|
SCREW NON-LOCKING 2.5*12MM
|
Facility
|
IP
|
$1,561.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.30 |
| Max. Negotiated Rate |
$1,498.56 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,217.58
|
| Rate for Payer: Cash Price |
$780.50
|
| Rate for Payer: Cigna Commercial |
$1,295.63
|
| Rate for Payer: First Health Commercial |
$1,482.95
|
| Rate for Payer: Humana Commercial |
$1,326.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,280.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,152.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,373.68
|
| Rate for Payer: Ohio Health Group HMO |
$1,170.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,248.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,358.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.09
|
| Rate for Payer: PHCS Commercial |
$1,498.56
|
| Rate for Payer: United Healthcare All Payer |
$1,373.68
|
|
|
SCREW NON LOCKING 2.5X14MM
|
Facility
|
OP
|
$1,718.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.40 |
| Max. Negotiated Rate |
$1,649.28 |
| Rate for Payer: Aetna Commercial |
$1,322.86
|
| Rate for Payer: Anthem Medicaid |
$590.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,340.04
|
| Rate for Payer: Cash Price |
$859.00
|
| Rate for Payer: Cigna Commercial |
$1,425.94
|
| Rate for Payer: First Health Commercial |
$1,632.10
|
| Rate for Payer: Humana Commercial |
$1,460.30
|
| Rate for Payer: Humana KY Medicaid |
$590.82
|
| Rate for Payer: Kentucky WC Medicaid |
$596.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,408.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,267.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$602.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,511.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,288.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,374.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,494.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,185.42
|
| Rate for Payer: PHCS Commercial |
$1,649.28
|
| Rate for Payer: United Healthcare All Payer |
$1,511.84
|
|
|
SCREW NON LOCKING 2.5X14MM
|
Facility
|
IP
|
$1,718.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.40 |
| Max. Negotiated Rate |
$1,649.28 |
| Rate for Payer: Aetna Commercial |
$1,322.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,340.04
|
| Rate for Payer: Cash Price |
$859.00
|
| Rate for Payer: Cigna Commercial |
$1,425.94
|
| Rate for Payer: First Health Commercial |
$1,632.10
|
| Rate for Payer: Humana Commercial |
$1,460.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,408.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,267.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,511.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,288.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,374.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,494.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,185.42
|
| Rate for Payer: PHCS Commercial |
$1,649.28
|
| Rate for Payer: United Healthcare All Payer |
$1,511.84
|
|
|
SCREW NON-LOCKING 3.5*12MM
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Aetna Commercial |
$1,381.38
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem Medicaid |
$616.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,399.32
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,489.02
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,704.30
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana Commercial |
$1,524.90
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Humana KY Medicaid |
$616.96
|
| Rate for Payer: Kentucky WC Medicaid |
$623.24
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,471.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,323.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$538.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$629.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,578.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,345.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,435.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,560.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,237.86
|
| Rate for Payer: PHCS Commercial |
$1,722.24
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,578.72
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON-LOCKING 3.5*12MM
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Aetna Commercial |
$1,381.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,399.32
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: Cigna Commercial |
$1,489.02
|
| Rate for Payer: First Health Commercial |
$1,704.30
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,524.90
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,471.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,323.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$538.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,578.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,345.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,435.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,560.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,237.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: PHCS Commercial |
$1,722.24
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
| Rate for Payer: United Healthcare All Payer |
$1,578.72
|
|
|
SCREW NON-LOCKING 3.5*20MM
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON-LOCKING 3.5*20MM
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON LOCKING 3.5* 22MM
|
Facility
|
IP
|
$1,718.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.40 |
| Max. Negotiated Rate |
$1,649.28 |
| Rate for Payer: Aetna Commercial |
$1,322.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,340.04
|
| Rate for Payer: Cash Price |
$859.00
|
| Rate for Payer: Cigna Commercial |
$1,425.94
|
| Rate for Payer: First Health Commercial |
$1,632.10
|
| Rate for Payer: Humana Commercial |
$1,460.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,408.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,267.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,511.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,288.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,374.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,494.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,185.42
|
| Rate for Payer: PHCS Commercial |
$1,649.28
|
| Rate for Payer: United Healthcare All Payer |
$1,511.84
|
|
|
SCREW NON LOCKING 3.5* 22MM
|
Facility
|
OP
|
$1,718.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$515.40 |
| Max. Negotiated Rate |
$1,649.28 |
| Rate for Payer: Aetna Commercial |
$1,322.86
|
| Rate for Payer: Anthem Medicaid |
$590.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,340.04
|
| Rate for Payer: Cash Price |
$859.00
|
| Rate for Payer: Cigna Commercial |
$1,425.94
|
| Rate for Payer: First Health Commercial |
$1,632.10
|
| Rate for Payer: Humana Commercial |
$1,460.30
|
| Rate for Payer: Humana KY Medicaid |
$590.82
|
| Rate for Payer: Kentucky WC Medicaid |
$596.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,408.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,267.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$602.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,511.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,288.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,374.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,494.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,185.42
|
| Rate for Payer: PHCS Commercial |
$1,649.28
|
| Rate for Payer: United Healthcare All Payer |
$1,511.84
|
|
|
SCREW NON-LOCKING 3.5*24MM
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON-LOCKING 3.5*24MM
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON-LOCKING 3.5*30MM
|
Facility
|
IP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON-LOCKING 3.5*30MM
|
Facility
|
OP
|
$1,710.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,641.98 |
| Rate for Payer: Aetna Commercial |
$1,317.01
|
| Rate for Payer: Anthem Medicaid |
$588.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,334.11
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cigna Commercial |
$1,419.63
|
| Rate for Payer: First Health Commercial |
$1,624.88
|
| Rate for Payer: Humana Commercial |
$1,453.84
|
| Rate for Payer: Humana KY Medicaid |
$588.21
|
| Rate for Payer: Kentucky WC Medicaid |
$594.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,402.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,262.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$513.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$600.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,505.15
|
| Rate for Payer: Ohio Health Group HMO |
$1,282.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,368.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,488.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,180.18
|
| Rate for Payer: PHCS Commercial |
$1,641.98
|
| Rate for Payer: United Healthcare All Payer |
$1,505.15
|
|
|
SCREW NON-LOCKING 3.5MM 70MM
|
Facility
|
OP
|
$1,491.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$447.36 |
| Max. Negotiated Rate |
$1,431.54 |
| Rate for Payer: Aetna Commercial |
$1,148.22
|
| Rate for Payer: Anthem Medicaid |
$512.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,163.13
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cigna Commercial |
$1,237.69
|
| Rate for Payer: First Health Commercial |
$1,416.63
|
| Rate for Payer: Humana Commercial |
$1,267.51
|
| Rate for Payer: Humana KY Medicaid |
$512.82
|
| Rate for Payer: Kentucky WC Medicaid |
$518.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,222.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,100.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$447.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$523.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,312.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,118.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,192.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,297.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.92
|
| Rate for Payer: PHCS Commercial |
$1,431.54
|
| Rate for Payer: United Healthcare All Payer |
$1,312.25
|
|
|
SCREW NON-LOCKING 3.5MM 70MM
|
Facility
|
IP
|
$1,491.19
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$447.36 |
| Max. Negotiated Rate |
$1,431.54 |
| Rate for Payer: Aetna Commercial |
$1,148.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,163.13
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cigna Commercial |
$1,237.69
|
| Rate for Payer: First Health Commercial |
$1,416.63
|
| Rate for Payer: Humana Commercial |
$1,267.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,222.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,100.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$447.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,312.25
|
| Rate for Payer: Ohio Health Group HMO |
$1,118.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,192.95
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,297.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.92
|
| Rate for Payer: PHCS Commercial |
$1,431.54
|
| Rate for Payer: United Healthcare All Payer |
$1,312.25
|
|
|
SCREW NON-LOCKING T8 2*10
|
Facility
|
IP
|
$1,561.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.30 |
| Max. Negotiated Rate |
$1,498.56 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,217.58
|
| Rate for Payer: Cash Price |
$780.50
|
| Rate for Payer: Cigna Commercial |
$1,295.63
|
| Rate for Payer: First Health Commercial |
$1,482.95
|
| Rate for Payer: Humana Commercial |
$1,326.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,280.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,152.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,373.68
|
| Rate for Payer: Ohio Health Group HMO |
$1,170.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,248.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,358.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.09
|
| Rate for Payer: PHCS Commercial |
$1,498.56
|
| Rate for Payer: United Healthcare All Payer |
$1,373.68
|
|
|
SCREW NON-LOCKING T8 2*10
|
Facility
|
OP
|
$1,561.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.30 |
| Max. Negotiated Rate |
$1,498.56 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Anthem Medicaid |
$536.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,217.58
|
| Rate for Payer: Cash Price |
$780.50
|
| Rate for Payer: Cigna Commercial |
$1,295.63
|
| Rate for Payer: First Health Commercial |
$1,482.95
|
| Rate for Payer: Humana Commercial |
$1,326.85
|
| Rate for Payer: Humana KY Medicaid |
$536.83
|
| Rate for Payer: Kentucky WC Medicaid |
$542.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,280.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,152.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$468.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$547.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,373.68
|
| Rate for Payer: Ohio Health Group HMO |
$1,170.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,248.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,358.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.09
|
| Rate for Payer: PHCS Commercial |
$1,498.56
|
| Rate for Payer: United Healthcare All Payer |
$1,373.68
|
|
|
SCREW NON LOCKNG 4.5 CORT 34MM
|
Facility
|
IP
|
$813.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.12 |
| Max. Negotiated Rate |
$781.20 |
| Rate for Payer: Aetna Commercial |
$626.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$634.73
|
| Rate for Payer: Cash Price |
$406.88
|
| Rate for Payer: Cigna Commercial |
$675.41
|
| Rate for Payer: First Health Commercial |
$773.06
|
| Rate for Payer: Humana Commercial |
$691.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$667.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$600.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$716.10
|
| Rate for Payer: Ohio Health Group HMO |
$610.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$651.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$707.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$561.49
|
| Rate for Payer: PHCS Commercial |
$781.20
|
| Rate for Payer: United Healthcare All Payer |
$716.10
|
|
|
SCREW NON LOCKNG 4.5 CORT 34MM
|
Facility
|
OP
|
$813.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.12 |
| Max. Negotiated Rate |
$781.20 |
| Rate for Payer: Aetna Commercial |
$626.59
|
| Rate for Payer: Anthem Medicaid |
$279.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$634.73
|
| Rate for Payer: Cash Price |
$406.88
|
| Rate for Payer: Cigna Commercial |
$675.41
|
| Rate for Payer: First Health Commercial |
$773.06
|
| Rate for Payer: Humana Commercial |
$691.69
|
| Rate for Payer: Humana KY Medicaid |
$279.85
|
| Rate for Payer: Kentucky WC Medicaid |
$282.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$667.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$600.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$285.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$716.10
|
| Rate for Payer: Ohio Health Group HMO |
$610.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$651.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$707.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$561.49
|
| Rate for Payer: PHCS Commercial |
$781.20
|
| Rate for Payer: United Healthcare All Payer |
$716.10
|
|
|
SCREW NON LOCK PLATE 3.5*18MM
|
Facility
|
OP
|
$1,794.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$538.20 |
| Max. Negotiated Rate |
$1,722.24 |
| Rate for Payer: Aetna Commercial |
$1,381.38
|
| Rate for Payer: Anthem Medicaid |
$616.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,399.32
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,489.02
|
| Rate for Payer: First Health Commercial |
$1,704.30
|
| Rate for Payer: Humana Commercial |
$1,524.90
|
| Rate for Payer: Humana KY Medicaid |
$616.96
|
| Rate for Payer: Kentucky WC Medicaid |
$623.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,471.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,323.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$538.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$629.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,578.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,345.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,435.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,560.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,237.86
|
| Rate for Payer: PHCS Commercial |
$1,722.24
|
| Rate for Payer: United Healthcare All Payer |
$1,578.72
|
|
|
SCREW NON LOCK PLATE 3.5*18MM
|
Facility
|
IP
|
$1,794.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$538.20 |
| Max. Negotiated Rate |
$1,722.24 |
| Rate for Payer: Aetna Commercial |
$1,381.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,399.32
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,489.02
|
| Rate for Payer: First Health Commercial |
$1,704.30
|
| Rate for Payer: Humana Commercial |
$1,524.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,471.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,323.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$538.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,578.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,345.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,435.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,560.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,237.86
|
| Rate for Payer: PHCS Commercial |
$1,722.24
|
| Rate for Payer: United Healthcare All Payer |
$1,578.72
|
|
|
SCREW NON LOCK PLATE 3.5*20MM
|
Facility
|
OP
|
$1,794.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$538.20 |
| Max. Negotiated Rate |
$1,722.24 |
| Rate for Payer: Aetna Commercial |
$1,381.38
|
| Rate for Payer: Anthem Medicaid |
$616.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,399.32
|
| Rate for Payer: Cash Price |
$897.00
|
| Rate for Payer: Cigna Commercial |
$1,489.02
|
| Rate for Payer: First Health Commercial |
$1,704.30
|
| Rate for Payer: Humana Commercial |
$1,524.90
|
| Rate for Payer: Humana KY Medicaid |
$616.96
|
| Rate for Payer: Kentucky WC Medicaid |
$623.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,471.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,323.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$538.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$629.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,578.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,345.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,435.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,560.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,237.86
|
| Rate for Payer: PHCS Commercial |
$1,722.24
|
| Rate for Payer: United Healthcare All Payer |
$1,578.72
|
|
