|
SCREW POLYAX LCK MINIT8 2.7*12
|
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 POLYAX LCK MINIT8 2.7*12
|
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 POLYAX LOCKING 2.4*14
|
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 POLYAX LOCKING 2.4*14
|
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 POLY LCK MINI T8 2*10M
|
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 POLY LCK MINI T8 2*10M
|
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 QCKFIX TI CANN PT 2.4*12
|
Facility
|
OP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem Medicaid |
$636.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Humana KY Medicaid |
$636.56
|
| Rate for Payer: Kentucky WC Medicaid |
$643.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$649.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW QCKFIX TI CANN PT 2.4*12
|
Facility
|
IP
|
$1,851.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$555.30 |
| Max. Negotiated Rate |
$1,776.96 |
| Rate for Payer: Aetna Commercial |
$1,425.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,443.78
|
| Rate for Payer: Cash Price |
$925.50
|
| Rate for Payer: Cigna Commercial |
$1,536.33
|
| Rate for Payer: First Health Commercial |
$1,758.45
|
| Rate for Payer: Humana Commercial |
$1,573.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,517.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,366.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$555.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,628.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,388.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,480.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,610.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,277.19
|
| Rate for Payer: PHCS Commercial |
$1,776.96
|
| Rate for Payer: United Healthcare All Payer |
$1,628.88
|
|
|
SCREW RECON 2.7*15 LCKING
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW RECON 2.7*15 LCKING
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW RECON 3.5*16 LOCKING
|
Facility
|
IP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW RECON 3.5*16 LOCKING
|
Facility
|
OP
|
$1,946.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$1,868.16 |
| Rate for Payer: Aetna Commercial |
$1,498.42
|
| Rate for Payer: Anthem Medicaid |
$669.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,517.88
|
| Rate for Payer: Cash Price |
$973.00
|
| Rate for Payer: Cigna Commercial |
$1,615.18
|
| Rate for Payer: First Health Commercial |
$1,848.70
|
| Rate for Payer: Humana Commercial |
$1,654.10
|
| Rate for Payer: Humana KY Medicaid |
$669.23
|
| Rate for Payer: Kentucky WC Medicaid |
$676.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,595.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,436.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$583.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$682.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,712.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,459.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,556.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,693.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,342.74
|
| Rate for Payer: PHCS Commercial |
$1,868.16
|
| Rate for Payer: United Healthcare All Payer |
$1,712.48
|
|
|
SCREW RECON 3.5*16 NON LCKING
|
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 RECON 3.5*16 NON LCKING
|
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 RIB LCK TI 2.3*7MM
|
Facility
|
OP
|
$2,197.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$659.33 |
| Max. Negotiated Rate |
$2,109.84 |
| Rate for Payer: Aetna Commercial |
$1,692.27
|
| Rate for Payer: Anthem Medicaid |
$755.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,714.24
|
| Rate for Payer: Cash Price |
$1,098.88
|
| Rate for Payer: Cigna Commercial |
$1,824.13
|
| Rate for Payer: First Health Commercial |
$2,087.86
|
| Rate for Payer: Humana Commercial |
$1,868.09
|
| Rate for Payer: Humana KY Medicaid |
$755.81
|
| Rate for Payer: Kentucky WC Medicaid |
$763.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,802.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,621.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$659.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$770.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,934.02
|
| Rate for Payer: Ohio Health Group HMO |
$1,648.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,758.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,912.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,516.45
|
| Rate for Payer: PHCS Commercial |
$2,109.84
|
| Rate for Payer: United Healthcare All Payer |
$1,934.02
|
|
|
SCREW RIB LCK TI 2.3*7MM
|
Facility
|
IP
|
$2,197.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$659.33 |
| Max. Negotiated Rate |
$2,109.84 |
| Rate for Payer: Aetna Commercial |
$1,692.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,714.24
|
| Rate for Payer: Cash Price |
$1,098.88
|
| Rate for Payer: Cigna Commercial |
$1,824.13
|
| Rate for Payer: First Health Commercial |
$2,087.86
|
| Rate for Payer: Humana Commercial |
$1,868.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,802.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,621.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$659.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,934.02
|
| Rate for Payer: Ohio Health Group HMO |
$1,648.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,758.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,912.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,516.45
|
| Rate for Payer: PHCS Commercial |
$2,109.84
|
| Rate for Payer: United Healthcare All Payer |
$1,934.02
|
|
|
SCREW RIB LCK TI 2.3*7MM 4/PK
|
Facility
|
OP
|
$2,197.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$659.33 |
| Max. Negotiated Rate |
$2,109.84 |
| Rate for Payer: Aetna Commercial |
$1,692.27
|
| Rate for Payer: Anthem Medicaid |
$755.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,714.24
|
| Rate for Payer: Cash Price |
$1,098.88
|
| Rate for Payer: Cigna Commercial |
$1,824.13
|
| Rate for Payer: First Health Commercial |
$2,087.86
|
| Rate for Payer: Humana Commercial |
$1,868.09
|
| Rate for Payer: Humana KY Medicaid |
$755.81
|
| Rate for Payer: Kentucky WC Medicaid |
$763.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,802.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,621.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$659.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$770.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,934.02
|
| Rate for Payer: Ohio Health Group HMO |
$1,648.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,758.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,912.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,516.45
|
| Rate for Payer: PHCS Commercial |
$2,109.84
|
| Rate for Payer: United Healthcare All Payer |
$1,934.02
|
|
|
SCREW RIB LCK TI 2.3*7MM 4/PK
|
Facility
|
IP
|
$2,197.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$659.33 |
| Max. Negotiated Rate |
$2,109.84 |
| Rate for Payer: Aetna Commercial |
$1,692.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,714.24
|
| Rate for Payer: Cash Price |
$1,098.88
|
| Rate for Payer: Cigna Commercial |
$1,824.13
|
| Rate for Payer: First Health Commercial |
$2,087.86
|
| Rate for Payer: Humana Commercial |
$1,868.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,802.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,621.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$659.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,934.02
|
| Rate for Payer: Ohio Health Group HMO |
$1,648.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,758.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,912.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,516.45
|
| Rate for Payer: PHCS Commercial |
$2,109.84
|
| Rate for Payer: United Healthcare All Payer |
$1,934.02
|
|
|
SCREWS CANCELLOUS 4.0*14MM
|
Facility
|
IP
|
$792.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$237.63 |
| Max. Negotiated Rate |
$760.42 |
| Rate for Payer: Aetna Commercial |
$609.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$617.84
|
| Rate for Payer: Cash Price |
$396.05
|
| Rate for Payer: Cigna Commercial |
$657.44
|
| Rate for Payer: First Health Commercial |
$752.50
|
| Rate for Payer: Humana Commercial |
$673.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$649.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$584.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$237.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$697.05
|
| Rate for Payer: Ohio Health Group HMO |
$594.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$633.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$689.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$546.55
|
| Rate for Payer: PHCS Commercial |
$760.42
|
| Rate for Payer: United Healthcare All Payer |
$697.05
|
|
|
SCREWS CANCELLOUS 4.0*14MM
|
Facility
|
OP
|
$792.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$237.63 |
| Max. Negotiated Rate |
$760.42 |
| Rate for Payer: Aetna Commercial |
$609.92
|
| Rate for Payer: Anthem Medicaid |
$272.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$617.84
|
| Rate for Payer: Cash Price |
$396.05
|
| Rate for Payer: Cigna Commercial |
$657.44
|
| Rate for Payer: First Health Commercial |
$752.50
|
| Rate for Payer: Humana Commercial |
$673.28
|
| Rate for Payer: Humana KY Medicaid |
$272.40
|
| Rate for Payer: Kentucky WC Medicaid |
$275.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$649.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$584.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$237.63
|
| Rate for Payer: Molina Healthcare Medicaid |
$277.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$697.05
|
| Rate for Payer: Ohio Health Group HMO |
$594.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$633.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$689.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$546.55
|
| Rate for Payer: PHCS Commercial |
$760.42
|
| Rate for Payer: United Healthcare All Payer |
$697.05
|
|
|
SCREW SHORT HEADLESS 3.0*44MM
|
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 SHORT HEADLESS 3.0*44MM
|
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 SHORT HEADLESS 4.0*38
|
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 SHORT HEADLESS 4.0*38
|
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 SHORT HEADLESS 4.0*42
|
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
|
|
