|
SOLAR HUMERAL HEAD 55*34
|
Facility
|
IP
|
$7,251.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,175.46 |
| Max. Negotiated Rate |
$6,961.46 |
| Rate for Payer: Aetna Commercial |
$5,583.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,656.19
|
| Rate for Payer: Cash Price |
$3,625.76
|
| Rate for Payer: Cigna Commercial |
$6,018.76
|
| Rate for Payer: First Health Commercial |
$6,888.94
|
| Rate for Payer: Humana Commercial |
$6,163.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,946.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,351.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,175.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,381.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,438.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,801.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,308.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,003.55
|
| Rate for Payer: PHCS Commercial |
$6,961.46
|
| Rate for Payer: United Healthcare All Payer |
$6,381.34
|
|
|
SOLAR HUMERAL STEM PUREFIX
|
Facility
|
IP
|
$18,682.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,604.60 |
| Max. Negotiated Rate |
$17,934.72 |
| Rate for Payer: Aetna Commercial |
$14,385.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,571.96
|
| Rate for Payer: Cash Price |
$9,341.00
|
| Rate for Payer: Cigna Commercial |
$15,506.06
|
| Rate for Payer: First Health Commercial |
$17,747.90
|
| Rate for Payer: Humana Commercial |
$15,879.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,319.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,787.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,604.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,440.16
|
| Rate for Payer: Ohio Health Group HMO |
$14,011.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$14,945.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,253.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,890.58
|
| Rate for Payer: PHCS Commercial |
$17,934.72
|
| Rate for Payer: United Healthcare All Payer |
$16,440.16
|
|
|
SOLAR HUMERAL STEM PUREFIX
|
Facility
|
OP
|
$18,682.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,604.60 |
| Max. Negotiated Rate |
$17,934.72 |
| Rate for Payer: Aetna Commercial |
$14,385.14
|
| Rate for Payer: Anthem Medicaid |
$6,424.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,571.96
|
| Rate for Payer: Cash Price |
$9,341.00
|
| Rate for Payer: Cigna Commercial |
$15,506.06
|
| Rate for Payer: First Health Commercial |
$17,747.90
|
| Rate for Payer: Humana Commercial |
$15,879.70
|
| Rate for Payer: Humana KY Medicaid |
$6,424.74
|
| Rate for Payer: Kentucky WC Medicaid |
$6,490.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,319.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,787.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,604.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,553.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,440.16
|
| Rate for Payer: Ohio Health Group HMO |
$14,011.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$14,945.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,253.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,890.58
|
| Rate for Payer: PHCS Commercial |
$17,934.72
|
| Rate for Payer: United Healthcare All Payer |
$16,440.16
|
|
|
SOLAR HUMERAL STEM SHLD 9*200
|
Facility
|
OP
|
$16,867.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,060.26 |
| Max. Negotiated Rate |
$16,192.82 |
| Rate for Payer: Aetna Commercial |
$12,987.99
|
| Rate for Payer: Anthem Medicaid |
$5,800.74
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,156.67
|
| Rate for Payer: Cash Price |
$8,433.76
|
| Rate for Payer: Cigna Commercial |
$14,000.04
|
| Rate for Payer: First Health Commercial |
$16,024.14
|
| Rate for Payer: Humana Commercial |
$14,337.39
|
| Rate for Payer: Humana KY Medicaid |
$5,800.74
|
| Rate for Payer: Kentucky WC Medicaid |
$5,859.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,831.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,448.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,060.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,917.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,843.42
|
| Rate for Payer: Ohio Health Group HMO |
$12,650.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,494.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,674.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,638.59
|
| Rate for Payer: PHCS Commercial |
$16,192.82
|
| Rate for Payer: United Healthcare All Payer |
$14,843.42
|
|
|
SOLAR HUMERAL STEM SHLD 9*200
|
Facility
|
IP
|
$16,867.52
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,060.26 |
| Max. Negotiated Rate |
$16,192.82 |
| Rate for Payer: Aetna Commercial |
$12,987.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,156.67
|
| Rate for Payer: Cash Price |
$8,433.76
|
| Rate for Payer: Cigna Commercial |
$14,000.04
|
| Rate for Payer: First Health Commercial |
$16,024.14
|
| Rate for Payer: Humana Commercial |
$14,337.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,831.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,448.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,060.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,843.42
|
| Rate for Payer: Ohio Health Group HMO |
$12,650.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,494.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,674.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,638.59
|
| Rate for Payer: PHCS Commercial |
$16,192.82
|
| Rate for Payer: United Healthcare All Payer |
$14,843.42
|
|
|
SOLAR HUMERAL STEM SHLDR 10MM
|
Facility
|
IP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 10MM
|
Facility
|
OP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem Medicaid |
$4,608.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Humana KY Medicaid |
$4,608.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,655.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,700.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 11MM
|
Facility
|
IP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 11MM
|
Facility
|
OP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem Medicaid |
$4,608.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Humana KY Medicaid |
$4,608.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,655.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,700.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 12MM
|
Facility
|
OP
|
$13,000.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,900.27 |
| Max. Negotiated Rate |
$12,480.86 |
| Rate for Payer: Aetna Commercial |
$10,010.69
|
| Rate for Payer: Anthem Medicaid |
$4,471.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,140.70
|
| Rate for Payer: Cash Price |
$6,500.45
|
| Rate for Payer: Cigna Commercial |
$10,790.75
|
| Rate for Payer: First Health Commercial |
$12,350.85
|
| Rate for Payer: Humana Commercial |
$11,050.76
|
| Rate for Payer: Humana KY Medicaid |
$4,471.01
|
| Rate for Payer: Kentucky WC Medicaid |
$4,516.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,660.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,594.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,900.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,560.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,440.79
|
| Rate for Payer: Ohio Health Group HMO |
$9,750.67
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,400.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,310.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,970.62
|
| Rate for Payer: PHCS Commercial |
$12,480.86
|
| Rate for Payer: United Healthcare All Payer |
$11,440.79
|
|
|
SOLAR HUMERAL STEM SHLDR 12MM
|
Facility
|
IP
|
$13,000.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,900.27 |
| Max. Negotiated Rate |
$12,480.86 |
| Rate for Payer: Aetna Commercial |
$10,010.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,140.70
|
| Rate for Payer: Cash Price |
$6,500.45
|
| Rate for Payer: Cigna Commercial |
$10,790.75
|
| Rate for Payer: First Health Commercial |
$12,350.85
|
| Rate for Payer: Humana Commercial |
$11,050.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,660.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,594.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,900.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,440.79
|
| Rate for Payer: Ohio Health Group HMO |
$9,750.67
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,400.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,310.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,970.62
|
| Rate for Payer: PHCS Commercial |
$12,480.86
|
| Rate for Payer: United Healthcare All Payer |
$11,440.79
|
|
|
SOLAR HUMERAL STEM SHLDR 13MM
|
Facility
|
IP
|
$12,724.91
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,817.47 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$9,798.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,925.43
|
| Rate for Payer: Cash Price |
$6,362.46
|
| Rate for Payer: Cigna Commercial |
$10,561.68
|
| Rate for Payer: First Health Commercial |
$12,088.66
|
| Rate for Payer: Humana Commercial |
$10,816.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,434.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,390.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,817.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,197.92
|
| Rate for Payer: Ohio Health Group HMO |
$9,543.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,179.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,070.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,780.19
|
| Rate for Payer: PHCS Commercial |
$12,215.91
|
| Rate for Payer: United Healthcare All Payer |
$11,197.92
|
|
|
SOLAR HUMERAL STEM SHLDR 13MM
|
Facility
|
OP
|
$12,724.91
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,817.47 |
| Max. Negotiated Rate |
$12,215.91 |
| Rate for Payer: Aetna Commercial |
$9,798.18
|
| Rate for Payer: Anthem Medicaid |
$4,376.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,925.43
|
| Rate for Payer: Cash Price |
$6,362.46
|
| Rate for Payer: Cigna Commercial |
$10,561.68
|
| Rate for Payer: First Health Commercial |
$12,088.66
|
| Rate for Payer: Humana Commercial |
$10,816.17
|
| Rate for Payer: Humana KY Medicaid |
$4,376.10
|
| Rate for Payer: Kentucky WC Medicaid |
$4,420.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,434.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,390.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,817.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,463.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,197.92
|
| Rate for Payer: Ohio Health Group HMO |
$9,543.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,179.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,070.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,780.19
|
| Rate for Payer: PHCS Commercial |
$12,215.91
|
| Rate for Payer: United Healthcare All Payer |
$11,197.92
|
|
|
SOLAR HUMERAL STEM SHLDR 14MM
|
Facility
|
OP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem Medicaid |
$4,608.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Humana KY Medicaid |
$4,608.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,655.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,700.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 14MM
|
Facility
|
IP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 15MM
|
Facility
|
IP
|
$12,040.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,612.25 |
| Max. Negotiated Rate |
$11,559.19 |
| Rate for Payer: Aetna Commercial |
$9,271.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,391.84
|
| Rate for Payer: Cash Price |
$6,020.41
|
| Rate for Payer: Cigna Commercial |
$9,993.88
|
| Rate for Payer: First Health Commercial |
$11,438.78
|
| Rate for Payer: Humana Commercial |
$10,234.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,873.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,886.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,612.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,595.92
|
| Rate for Payer: Ohio Health Group HMO |
$9,030.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,632.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,475.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,308.17
|
| Rate for Payer: PHCS Commercial |
$11,559.19
|
| Rate for Payer: United Healthcare All Payer |
$10,595.92
|
|
|
SOLAR HUMERAL STEM SHLDR 15MM
|
Facility
|
OP
|
$12,040.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,612.25 |
| Max. Negotiated Rate |
$11,559.19 |
| Rate for Payer: Aetna Commercial |
$9,271.43
|
| Rate for Payer: Anthem Medicaid |
$4,140.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,391.84
|
| Rate for Payer: Cash Price |
$6,020.41
|
| Rate for Payer: Cigna Commercial |
$9,993.88
|
| Rate for Payer: First Health Commercial |
$11,438.78
|
| Rate for Payer: Humana Commercial |
$10,234.70
|
| Rate for Payer: Humana KY Medicaid |
$4,140.84
|
| Rate for Payer: Kentucky WC Medicaid |
$4,182.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,873.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,886.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,612.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,223.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,595.92
|
| Rate for Payer: Ohio Health Group HMO |
$9,030.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,632.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,475.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,308.17
|
| Rate for Payer: PHCS Commercial |
$11,559.19
|
| Rate for Payer: United Healthcare All Payer |
$10,595.92
|
|
|
SOLAR HUMERAL STEM SHLDR 16MM
|
Facility
|
IP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 16MM
|
Facility
|
OP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem Medicaid |
$4,608.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Humana KY Medicaid |
$4,608.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,655.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,700.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 17MM
|
Facility
|
OP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem Medicaid |
$4,608.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Humana KY Medicaid |
$4,608.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,655.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,700.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 17MM
|
Facility
|
IP
|
$13,400.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,020.06 |
| Max. Negotiated Rate |
$12,864.18 |
| Rate for Payer: Aetna Commercial |
$10,318.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,452.15
|
| Rate for Payer: Cash Price |
$6,700.10
|
| Rate for Payer: Cigna Commercial |
$11,122.16
|
| Rate for Payer: First Health Commercial |
$12,730.18
|
| Rate for Payer: Humana Commercial |
$11,390.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,988.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,889.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,020.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,792.17
|
| Rate for Payer: Ohio Health Group HMO |
$10,050.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,720.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,658.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,246.13
|
| Rate for Payer: PHCS Commercial |
$12,864.18
|
| Rate for Payer: United Healthcare All Payer |
$11,792.17
|
|
|
SOLAR HUMERAL STEM SHLDR 7MM
|
Facility
|
IP
|
$12,040.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,612.25 |
| Max. Negotiated Rate |
$11,559.19 |
| Rate for Payer: Aetna Commercial |
$9,271.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,391.84
|
| Rate for Payer: Cash Price |
$6,020.41
|
| Rate for Payer: Cigna Commercial |
$9,993.88
|
| Rate for Payer: First Health Commercial |
$11,438.78
|
| Rate for Payer: Humana Commercial |
$10,234.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,873.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,886.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,612.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,595.92
|
| Rate for Payer: Ohio Health Group HMO |
$9,030.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,632.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,475.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,308.17
|
| Rate for Payer: PHCS Commercial |
$11,559.19
|
| Rate for Payer: United Healthcare All Payer |
$10,595.92
|
|
|
SOLAR HUMERAL STEM SHLDR 7MM
|
Facility
|
OP
|
$12,040.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,612.25 |
| Max. Negotiated Rate |
$11,559.19 |
| Rate for Payer: Aetna Commercial |
$9,271.43
|
| Rate for Payer: Anthem Medicaid |
$4,140.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,391.84
|
| Rate for Payer: Cash Price |
$6,020.41
|
| Rate for Payer: Cigna Commercial |
$9,993.88
|
| Rate for Payer: First Health Commercial |
$11,438.78
|
| Rate for Payer: Humana Commercial |
$10,234.70
|
| Rate for Payer: Humana KY Medicaid |
$4,140.84
|
| Rate for Payer: Kentucky WC Medicaid |
$4,182.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,873.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,886.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,612.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,223.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,595.92
|
| Rate for Payer: Ohio Health Group HMO |
$9,030.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,632.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,475.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,308.17
|
| Rate for Payer: PHCS Commercial |
$11,559.19
|
| Rate for Payer: United Healthcare All Payer |
$10,595.92
|
|
|
SOLAR HUMERAL STEM SHLDR 8MM
|
Facility
|
IP
|
$13,000.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,900.27 |
| Max. Negotiated Rate |
$12,480.86 |
| Rate for Payer: Aetna Commercial |
$10,010.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,140.70
|
| Rate for Payer: Cash Price |
$6,500.45
|
| Rate for Payer: Cigna Commercial |
$10,790.75
|
| Rate for Payer: First Health Commercial |
$12,350.85
|
| Rate for Payer: Humana Commercial |
$11,050.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,660.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,594.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,900.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,440.79
|
| Rate for Payer: Ohio Health Group HMO |
$9,750.67
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,400.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,310.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,970.62
|
| Rate for Payer: PHCS Commercial |
$12,480.86
|
| Rate for Payer: United Healthcare All Payer |
$11,440.79
|
|
|
SOLAR HUMERAL STEM SHLDR 8MM
|
Facility
|
OP
|
$13,000.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,900.27 |
| Max. Negotiated Rate |
$12,480.86 |
| Rate for Payer: Aetna Commercial |
$10,010.69
|
| Rate for Payer: Anthem Medicaid |
$4,471.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,140.70
|
| Rate for Payer: Cash Price |
$6,500.45
|
| Rate for Payer: Cigna Commercial |
$10,790.75
|
| Rate for Payer: First Health Commercial |
$12,350.85
|
| Rate for Payer: Humana Commercial |
$11,050.76
|
| Rate for Payer: Humana KY Medicaid |
$4,471.01
|
| Rate for Payer: Kentucky WC Medicaid |
$4,516.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,660.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,594.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,900.27
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,560.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,440.79
|
| Rate for Payer: Ohio Health Group HMO |
$9,750.67
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,400.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,310.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,970.62
|
| Rate for Payer: PHCS Commercial |
$12,480.86
|
| Rate for Payer: United Healthcare All Payer |
$11,440.79
|
|
