|
SOLAR HUMERAL HEAD 55*34
|
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 STEM PUREFIX
|
Facility
|
OP
|
$18,096.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,352.48 |
| Max. Negotiated Rate |
$17,372.16 |
| Rate for Payer: Aetna Commercial |
$13,933.92
|
| Rate for Payer: Anthem Medicaid |
$6,223.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,114.88
|
| Rate for Payer: Cash Price |
$9,048.00
|
| Rate for Payer: Cigna Commercial |
$15,019.68
|
| Rate for Payer: First Health Commercial |
$17,191.20
|
| Rate for Payer: Humana Commercial |
$15,381.60
|
| Rate for Payer: Humana KY Medicaid |
$6,223.21
|
| Rate for Payer: Kentucky WC Medicaid |
$6,286.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,838.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,354.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,428.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,348.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,924.48
|
| Rate for Payer: Ohio Health Group HMO |
$13,572.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,619.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,352.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,609.76
|
| Rate for Payer: PHCS Commercial |
$17,372.16
|
| Rate for Payer: United Healthcare All Payer |
$15,924.48
|
|
|
SOLAR HUMERAL STEM PUREFIX
|
Facility
|
IP
|
$18,096.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,352.48 |
| Max. Negotiated Rate |
$17,372.16 |
| Rate for Payer: Aetna Commercial |
$13,933.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,114.88
|
| Rate for Payer: Cash Price |
$9,048.00
|
| Rate for Payer: Cigna Commercial |
$15,019.68
|
| Rate for Payer: First Health Commercial |
$17,191.20
|
| Rate for Payer: Humana Commercial |
$15,381.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,838.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,354.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,428.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,924.48
|
| Rate for Payer: Ohio Health Group HMO |
$13,572.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,619.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,352.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,609.76
|
| Rate for Payer: PHCS Commercial |
$17,372.16
|
| Rate for Payer: United Healthcare All Payer |
$15,924.48
|
|
|
SOLAR HUMERAL STEM SHLD 9*200
|
Facility
|
OP
|
$16,330.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,122.97 |
| Max. Negotiated Rate |
$15,677.34 |
| Rate for Payer: Aetna Commercial |
$12,574.53
|
| Rate for Payer: Anthem Medicaid |
$5,616.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,737.84
|
| Rate for Payer: Cash Price |
$8,165.28
|
| Rate for Payer: Cigna Commercial |
$13,554.36
|
| Rate for Payer: First Health Commercial |
$15,514.03
|
| Rate for Payer: Humana Commercial |
$13,880.98
|
| Rate for Payer: Humana KY Medicaid |
$5,616.08
|
| Rate for Payer: Kentucky WC Medicaid |
$5,673.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,391.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,051.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,899.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,728.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,370.89
|
| Rate for Payer: Ohio Health Group HMO |
$12,247.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,266.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,122.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,062.47
|
| Rate for Payer: PHCS Commercial |
$15,677.34
|
| Rate for Payer: United Healthcare All Payer |
$14,370.89
|
|
|
SOLAR HUMERAL STEM SHLD 9*200
|
Facility
|
IP
|
$16,330.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,122.97 |
| Max. Negotiated Rate |
$15,677.34 |
| Rate for Payer: Aetna Commercial |
$12,574.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,737.84
|
| Rate for Payer: Cash Price |
$8,165.28
|
| Rate for Payer: Cigna Commercial |
$13,554.36
|
| Rate for Payer: First Health Commercial |
$15,514.03
|
| Rate for Payer: Humana Commercial |
$13,880.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,391.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,051.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,899.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,370.89
|
| Rate for Payer: Ohio Health Group HMO |
$12,247.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,266.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,122.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,062.47
|
| Rate for Payer: PHCS Commercial |
$15,677.34
|
| Rate for Payer: United Healthcare All Payer |
$14,370.89
|
|
|
SOLAR HUMERAL STEM SHLDR 10MM
|
Facility
|
IP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 10MM
|
Facility
|
OP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem Medicaid |
$4,520.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Humana KY Medicaid |
$4,520.99
|
| Rate for Payer: Kentucky WC Medicaid |
$4,567.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,611.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 11MM
|
Facility
|
IP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 11MM
|
Facility
|
OP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem Medicaid |
$4,520.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Humana KY Medicaid |
$4,520.99
|
| Rate for Payer: Kentucky WC Medicaid |
$4,567.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,611.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 12MM
|
Facility
|
OP
|
$12,749.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.39 |
| Max. Negotiated Rate |
$12,239.16 |
| Rate for Payer: Aetna Commercial |
$9,816.82
|
| Rate for Payer: Anthem Medicaid |
$4,384.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,944.31
|
| Rate for Payer: Cash Price |
$6,374.56
|
| Rate for Payer: Cigna Commercial |
$10,581.77
|
| Rate for Payer: First Health Commercial |
$12,111.66
|
| Rate for Payer: Humana Commercial |
$10,836.75
|
| Rate for Payer: Humana KY Medicaid |
$4,384.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,429.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,454.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,408.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,824.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,472.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,219.23
|
| Rate for Payer: Ohio Health Group HMO |
$9,561.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,549.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,657.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,952.23
|
| Rate for Payer: PHCS Commercial |
$12,239.16
|
| Rate for Payer: United Healthcare All Payer |
$11,219.23
|
|
|
SOLAR HUMERAL STEM SHLDR 12MM
|
Facility
|
IP
|
$12,749.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.39 |
| Max. Negotiated Rate |
$12,239.16 |
| Rate for Payer: Aetna Commercial |
$9,816.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,944.31
|
| Rate for Payer: Cash Price |
$6,374.56
|
| Rate for Payer: Cigna Commercial |
$10,581.77
|
| Rate for Payer: First Health Commercial |
$12,111.66
|
| Rate for Payer: Humana Commercial |
$10,836.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,454.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,408.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,824.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,219.23
|
| Rate for Payer: Ohio Health Group HMO |
$9,561.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,549.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,657.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,952.23
|
| Rate for Payer: PHCS Commercial |
$12,239.16
|
| Rate for Payer: United Healthcare All Payer |
$11,219.23
|
|
|
SOLAR HUMERAL STEM SHLDR 13MM
|
Facility
|
IP
|
$12,474.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,621.70 |
| Max. Negotiated Rate |
$11,975.65 |
| Rate for Payer: Aetna Commercial |
$9,605.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,730.22
|
| Rate for Payer: Cash Price |
$6,237.32
|
| Rate for Payer: Cigna Commercial |
$10,353.95
|
| Rate for Payer: First Health Commercial |
$11,850.91
|
| Rate for Payer: Humana Commercial |
$10,603.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,229.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,206.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,742.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,977.68
|
| Rate for Payer: Ohio Health Group HMO |
$9,355.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,494.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,621.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,867.14
|
| Rate for Payer: PHCS Commercial |
$11,975.65
|
| Rate for Payer: United Healthcare All Payer |
$10,977.68
|
|
|
SOLAR HUMERAL STEM SHLDR 13MM
|
Facility
|
OP
|
$12,474.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,621.70 |
| Max. Negotiated Rate |
$11,975.65 |
| Rate for Payer: Aetna Commercial |
$9,605.47
|
| Rate for Payer: Anthem Medicaid |
$4,290.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,730.22
|
| Rate for Payer: Cash Price |
$6,237.32
|
| Rate for Payer: Cigna Commercial |
$10,353.95
|
| Rate for Payer: First Health Commercial |
$11,850.91
|
| Rate for Payer: Humana Commercial |
$10,603.44
|
| Rate for Payer: Humana KY Medicaid |
$4,290.03
|
| Rate for Payer: Kentucky WC Medicaid |
$4,333.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,229.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,206.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,742.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,376.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,977.68
|
| Rate for Payer: Ohio Health Group HMO |
$9,355.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,494.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,621.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,867.14
|
| Rate for Payer: PHCS Commercial |
$11,975.65
|
| Rate for Payer: United Healthcare All Payer |
$10,977.68
|
|
|
SOLAR HUMERAL STEM SHLDR 14MM
|
Facility
|
IP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 14MM
|
Facility
|
OP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem Medicaid |
$4,520.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Humana KY Medicaid |
$4,520.99
|
| Rate for Payer: Kentucky WC Medicaid |
$4,567.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,611.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 15MM
|
Facility
|
OP
|
$11,794.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,533.26 |
| Max. Negotiated Rate |
$11,322.51 |
| Rate for Payer: Aetna Commercial |
$9,081.60
|
| Rate for Payer: Anthem Medicaid |
$4,056.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,199.54
|
| Rate for Payer: Cash Price |
$5,897.14
|
| Rate for Payer: Cigna Commercial |
$9,789.25
|
| Rate for Payer: First Health Commercial |
$11,204.57
|
| Rate for Payer: Humana Commercial |
$10,025.14
|
| Rate for Payer: Humana KY Medicaid |
$4,056.05
|
| Rate for Payer: Kentucky WC Medicaid |
$4,097.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,671.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,704.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,538.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,137.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,378.97
|
| Rate for Payer: Ohio Health Group HMO |
$8,845.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,358.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,533.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,656.23
|
| Rate for Payer: PHCS Commercial |
$11,322.51
|
| Rate for Payer: United Healthcare All Payer |
$10,378.97
|
|
|
SOLAR HUMERAL STEM SHLDR 15MM
|
Facility
|
IP
|
$11,794.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,533.26 |
| Max. Negotiated Rate |
$11,322.51 |
| Rate for Payer: Aetna Commercial |
$9,081.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,199.54
|
| Rate for Payer: Cash Price |
$5,897.14
|
| Rate for Payer: Cigna Commercial |
$9,789.25
|
| Rate for Payer: First Health Commercial |
$11,204.57
|
| Rate for Payer: Humana Commercial |
$10,025.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,671.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,704.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,538.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,378.97
|
| Rate for Payer: Ohio Health Group HMO |
$8,845.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,358.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,533.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,656.23
|
| Rate for Payer: PHCS Commercial |
$11,322.51
|
| Rate for Payer: United Healthcare All Payer |
$10,378.97
|
|
|
SOLAR HUMERAL STEM SHLDR 16MM
|
Facility
|
OP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem Medicaid |
$4,520.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Humana KY Medicaid |
$4,520.99
|
| Rate for Payer: Kentucky WC Medicaid |
$4,567.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,611.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 16MM
|
Facility
|
IP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 17MM
|
Facility
|
IP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 17MM
|
Facility
|
OP
|
$13,146.24
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.01 |
| Max. Negotiated Rate |
$12,620.39 |
| Rate for Payer: Aetna Commercial |
$10,122.60
|
| Rate for Payer: Anthem Medicaid |
$4,520.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,254.07
|
| Rate for Payer: Cash Price |
$6,573.12
|
| Rate for Payer: Cigna Commercial |
$10,911.38
|
| Rate for Payer: First Health Commercial |
$12,488.93
|
| Rate for Payer: Humana Commercial |
$11,174.30
|
| Rate for Payer: Humana KY Medicaid |
$4,520.99
|
| Rate for Payer: Kentucky WC Medicaid |
$4,567.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,779.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,701.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,943.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,611.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,568.69
|
| Rate for Payer: Ohio Health Group HMO |
$9,859.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,629.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,709.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,075.33
|
| Rate for Payer: PHCS Commercial |
$12,620.39
|
| Rate for Payer: United Healthcare All Payer |
$11,568.69
|
|
|
SOLAR HUMERAL STEM SHLDR 7MM
|
Facility
|
IP
|
$11,794.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,533.26 |
| Max. Negotiated Rate |
$11,322.51 |
| Rate for Payer: Aetna Commercial |
$9,081.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,199.54
|
| Rate for Payer: Cash Price |
$5,897.14
|
| Rate for Payer: Cigna Commercial |
$9,789.25
|
| Rate for Payer: First Health Commercial |
$11,204.57
|
| Rate for Payer: Humana Commercial |
$10,025.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,671.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,704.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,538.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,378.97
|
| Rate for Payer: Ohio Health Group HMO |
$8,845.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,358.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,533.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,656.23
|
| Rate for Payer: PHCS Commercial |
$11,322.51
|
| Rate for Payer: United Healthcare All Payer |
$10,378.97
|
|
|
SOLAR HUMERAL STEM SHLDR 7MM
|
Facility
|
OP
|
$11,794.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,533.26 |
| Max. Negotiated Rate |
$11,322.51 |
| Rate for Payer: Aetna Commercial |
$9,081.60
|
| Rate for Payer: Anthem Medicaid |
$4,056.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,199.54
|
| Rate for Payer: Cash Price |
$5,897.14
|
| Rate for Payer: Cigna Commercial |
$9,789.25
|
| Rate for Payer: First Health Commercial |
$11,204.57
|
| Rate for Payer: Humana Commercial |
$10,025.14
|
| Rate for Payer: Humana KY Medicaid |
$4,056.05
|
| Rate for Payer: Kentucky WC Medicaid |
$4,097.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,671.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,704.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,538.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,137.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,378.97
|
| Rate for Payer: Ohio Health Group HMO |
$8,845.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,358.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,533.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,656.23
|
| Rate for Payer: PHCS Commercial |
$11,322.51
|
| Rate for Payer: United Healthcare All Payer |
$10,378.97
|
|
|
SOLAR HUMERAL STEM SHLDR 8MM
|
Facility
|
OP
|
$12,749.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.39 |
| Max. Negotiated Rate |
$12,239.16 |
| Rate for Payer: Aetna Commercial |
$9,816.82
|
| Rate for Payer: Anthem Medicaid |
$4,384.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,944.31
|
| Rate for Payer: Cash Price |
$6,374.56
|
| Rate for Payer: Cigna Commercial |
$10,581.77
|
| Rate for Payer: First Health Commercial |
$12,111.66
|
| Rate for Payer: Humana Commercial |
$10,836.75
|
| Rate for Payer: Humana KY Medicaid |
$4,384.42
|
| Rate for Payer: Kentucky WC Medicaid |
$4,429.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,454.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,408.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,824.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,472.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,219.23
|
| Rate for Payer: Ohio Health Group HMO |
$9,561.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,549.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,657.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,952.23
|
| Rate for Payer: PHCS Commercial |
$12,239.16
|
| Rate for Payer: United Healthcare All Payer |
$11,219.23
|
|
|
SOLAR HUMERAL STEM SHLDR 8MM
|
Facility
|
IP
|
$12,749.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.39 |
| Max. Negotiated Rate |
$12,239.16 |
| Rate for Payer: Aetna Commercial |
$9,816.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,944.31
|
| Rate for Payer: Cash Price |
$6,374.56
|
| Rate for Payer: Cigna Commercial |
$10,581.77
|
| Rate for Payer: First Health Commercial |
$12,111.66
|
| Rate for Payer: Humana Commercial |
$10,836.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,454.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,408.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,824.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,219.23
|
| Rate for Payer: Ohio Health Group HMO |
$9,561.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,549.82
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,657.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,952.23
|
| Rate for Payer: PHCS Commercial |
$12,239.16
|
| Rate for Payer: United Healthcare All Payer |
$11,219.23
|
|
