|
STEM APEX HUMERAL 11 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 12 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 12 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 13 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 13 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 14 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 14 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 15 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 15 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 5 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 5 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 6 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 6 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 7 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 7 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 8 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 8 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 9 MINI
|
Facility
|
IP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 9 MINI
|
Facility
|
OP
|
$13,762.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,789.15 |
| Max. Negotiated Rate |
$13,212.22 |
| Rate for Payer: Aetna Commercial |
$10,597.30
|
| Rate for Payer: Anthem Medicaid |
$4,733.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,734.93
|
| Rate for Payer: Cash Price |
$6,881.36
|
| Rate for Payer: Cigna Commercial |
$11,423.07
|
| Rate for Payer: First Health Commercial |
$13,074.59
|
| Rate for Payer: Humana Commercial |
$11,698.32
|
| Rate for Payer: Humana KY Medicaid |
$4,733.00
|
| Rate for Payer: Kentucky WC Medicaid |
$4,781.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,285.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,156.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,128.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,827.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,111.20
|
| Rate for Payer: Ohio Health Group HMO |
$10,322.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,752.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,789.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,266.45
|
| Rate for Payer: PHCS Commercial |
$13,212.22
|
| Rate for Payer: United Healthcare All Payer |
$12,111.20
|
|
|
STEM APEX HUMERAL 9MM
|
Facility
|
IP
|
$20,038.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,605.04 |
| Max. Negotiated Rate |
$19,237.20 |
| Rate for Payer: Aetna Commercial |
$15,429.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,630.22
|
| Rate for Payer: Cash Price |
$10,019.38
|
| Rate for Payer: Cigna Commercial |
$16,632.16
|
| Rate for Payer: First Health Commercial |
$19,036.81
|
| Rate for Payer: Humana Commercial |
$17,032.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,431.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,788.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,011.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,634.10
|
| Rate for Payer: Ohio Health Group HMO |
$15,029.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,007.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,605.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,212.01
|
| Rate for Payer: PHCS Commercial |
$19,237.20
|
| Rate for Payer: United Healthcare All Payer |
$17,634.10
|
|
|
STEM APEX HUMERAL 9MM
|
Facility
|
OP
|
$20,038.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,605.04 |
| Max. Negotiated Rate |
$19,237.20 |
| Rate for Payer: Aetna Commercial |
$15,429.84
|
| Rate for Payer: Anthem Medicaid |
$6,891.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,630.22
|
| Rate for Payer: Cash Price |
$10,019.38
|
| Rate for Payer: Cigna Commercial |
$16,632.16
|
| Rate for Payer: First Health Commercial |
$19,036.81
|
| Rate for Payer: Humana Commercial |
$17,032.94
|
| Rate for Payer: Humana KY Medicaid |
$6,891.33
|
| Rate for Payer: Kentucky WC Medicaid |
$6,961.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,431.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,788.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,011.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,029.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,634.10
|
| Rate for Payer: Ohio Health Group HMO |
$15,029.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,007.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,605.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,212.01
|
| Rate for Payer: PHCS Commercial |
$19,237.20
|
| Rate for Payer: United Healthcare All Payer |
$17,634.10
|
|
|
STEM APEX REVERS HUM SZ 10
|
Facility
|
IP
|
$14,195.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,845.38 |
| Max. Negotiated Rate |
$13,627.44 |
| Rate for Payer: Aetna Commercial |
$10,930.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,072.30
|
| Rate for Payer: Cash Price |
$7,097.62
|
| Rate for Payer: Cigna Commercial |
$11,782.06
|
| Rate for Payer: First Health Commercial |
$13,485.49
|
| Rate for Payer: Humana Commercial |
$12,065.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,640.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,476.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,258.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,491.82
|
| Rate for Payer: Ohio Health Group HMO |
$10,646.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,839.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,845.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,400.53
|
| Rate for Payer: PHCS Commercial |
$13,627.44
|
| Rate for Payer: United Healthcare All Payer |
$12,491.82
|
|
|
STEM APEX REVERS HUM SZ 10
|
Facility
|
OP
|
$14,195.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,845.38 |
| Max. Negotiated Rate |
$13,627.44 |
| Rate for Payer: Aetna Commercial |
$10,930.34
|
| Rate for Payer: Anthem Medicaid |
$4,881.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,072.30
|
| Rate for Payer: Cash Price |
$7,097.62
|
| Rate for Payer: Cigna Commercial |
$11,782.06
|
| Rate for Payer: First Health Commercial |
$13,485.49
|
| Rate for Payer: Humana Commercial |
$12,065.96
|
| Rate for Payer: Humana KY Medicaid |
$4,881.75
|
| Rate for Payer: Kentucky WC Medicaid |
$4,931.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,640.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,476.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,258.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,979.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,491.82
|
| Rate for Payer: Ohio Health Group HMO |
$10,646.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,839.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,845.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,400.53
|
| Rate for Payer: PHCS Commercial |
$13,627.44
|
| Rate for Payer: United Healthcare All Payer |
$12,491.82
|
|
|
STEM ARCOS 12X115MM CYL DIST
|
Facility
|
IP
|
$22,508.34
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,926.08 |
| Max. Negotiated Rate |
$21,608.01 |
| Rate for Payer: Aetna Commercial |
$17,331.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,556.51
|
| Rate for Payer: Cash Price |
$11,254.17
|
| Rate for Payer: Cigna Commercial |
$18,681.92
|
| Rate for Payer: First Health Commercial |
$21,382.92
|
| Rate for Payer: Humana Commercial |
$19,132.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,456.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,611.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,752.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,807.34
|
| Rate for Payer: Ohio Health Group HMO |
$16,881.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,501.67
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,926.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,977.59
|
| Rate for Payer: PHCS Commercial |
$21,608.01
|
| Rate for Payer: United Healthcare All Payer |
$19,807.34
|
|
|
STEM ARCOS 12X115MM CYL DIST
|
Facility
|
OP
|
$22,508.34
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,926.08 |
| Max. Negotiated Rate |
$21,608.01 |
| Rate for Payer: Aetna Commercial |
$17,331.42
|
| Rate for Payer: Anthem Medicaid |
$7,740.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,556.51
|
| Rate for Payer: Cash Price |
$11,254.17
|
| Rate for Payer: Cigna Commercial |
$18,681.92
|
| Rate for Payer: First Health Commercial |
$21,382.92
|
| Rate for Payer: Humana Commercial |
$19,132.09
|
| Rate for Payer: Humana KY Medicaid |
$7,740.62
|
| Rate for Payer: Kentucky WC Medicaid |
$7,819.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,456.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,611.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,752.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,895.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,807.34
|
| Rate for Payer: Ohio Health Group HMO |
$16,881.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,501.67
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,926.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,977.59
|
| Rate for Payer: PHCS Commercial |
$21,608.01
|
| Rate for Payer: United Healthcare All Payer |
$19,807.34
|
|
