|
SOLAR HUMERAL HEAD 45*15
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 45*15
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 45*18
|
Facility
|
IP
|
$7,229.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$939.85 |
| Max. Negotiated Rate |
$6,940.45 |
| Rate for Payer: Aetna Commercial |
$5,566.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,639.12
|
| Rate for Payer: Cash Price |
$3,614.82
|
| Rate for Payer: Cigna Commercial |
$6,000.60
|
| Rate for Payer: First Health Commercial |
$6,868.16
|
| Rate for Payer: Humana Commercial |
$6,145.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,928.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,335.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,168.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,362.08
|
| Rate for Payer: Ohio Health Group HMO |
$5,422.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,445.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$939.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,241.19
|
| Rate for Payer: PHCS Commercial |
$6,940.45
|
| Rate for Payer: United Healthcare All Payer |
$6,362.08
|
|
|
SOLAR HUMERAL HEAD 45*18
|
Facility
|
OP
|
$7,229.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$939.85 |
| Max. Negotiated Rate |
$6,940.45 |
| Rate for Payer: Aetna Commercial |
$5,566.82
|
| Rate for Payer: Anthem Medicaid |
$2,486.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,639.12
|
| Rate for Payer: Cash Price |
$3,614.82
|
| Rate for Payer: Cigna Commercial |
$6,000.60
|
| Rate for Payer: First Health Commercial |
$6,868.16
|
| Rate for Payer: Humana Commercial |
$6,145.19
|
| Rate for Payer: Humana KY Medicaid |
$2,486.27
|
| Rate for Payer: Kentucky WC Medicaid |
$2,511.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,928.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,335.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,168.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,536.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,362.08
|
| Rate for Payer: Ohio Health Group HMO |
$5,422.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,445.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$939.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,241.19
|
| Rate for Payer: PHCS Commercial |
$6,940.45
|
| Rate for Payer: United Healthcare All Payer |
$6,362.08
|
|
|
SOLAR HUMERAL HEAD 45*21
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 45*21
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 45*24
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 45*24
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*15
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*15
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*18
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*18
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*21
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*21
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 50*24
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Aetna Commercial |
$5,566.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,639.12
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cash Price |
$3,614.82
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: Cigna Commercial |
$6,000.60
|
| Rate for Payer: First Health Commercial |
$6,868.16
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$6,145.19
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,928.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,335.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,168.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,362.08
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group HMO |
$5,422.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,445.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$939.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,241.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: PHCS Commercial |
$6,940.45
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
| Rate for Payer: United Healthcare All Payer |
$6,362.08
|
|
|
SOLAR HUMERAL HEAD 50*24
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Aetna Commercial |
$5,566.82
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem Medicaid |
$2,486.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,639.12
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cash Price |
$3,614.82
|
| Rate for Payer: Cigna Commercial |
$6,000.60
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,868.16
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana Commercial |
$6,145.19
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Humana KY Medicaid |
$2,486.27
|
| Rate for Payer: Kentucky WC Medicaid |
$2,511.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,928.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,335.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,168.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,536.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,362.08
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group HMO |
$5,422.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,445.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$939.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,241.19
|
| Rate for Payer: PHCS Commercial |
$6,940.45
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,362.08
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*18
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*18
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*21
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*21
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*24
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*24
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*28
|
Facility
|
IP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*28
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
|
SOLAR HUMERAL HEAD 55*34
|
Facility
|
OP
|
$7,051.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$916.70 |
| Max. Negotiated Rate |
$6,769.46 |
| Rate for Payer: Aetna Commercial |
$5,429.67
|
| Rate for Payer: Anthem Medicaid |
$2,425.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,500.19
|
| Rate for Payer: Cash Price |
$3,525.76
|
| Rate for Payer: Cigna Commercial |
$5,852.76
|
| Rate for Payer: First Health Commercial |
$6,698.94
|
| Rate for Payer: Humana Commercial |
$5,993.79
|
| Rate for Payer: Humana KY Medicaid |
$2,425.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,449.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,782.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,204.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,115.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,473.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,205.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,288.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,410.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$916.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,185.97
|
| Rate for Payer: PHCS Commercial |
$6,769.46
|
| Rate for Payer: United Healthcare All Payer |
$6,205.34
|
|
