|
TIBIAL JIG HEAD LEFT MD
|
Facility
|
IP
|
$11,830.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,549.27 |
| Max. Negotiated Rate |
$11,357.66 |
| Rate for Payer: Aetna Commercial |
$9,109.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,228.10
|
| Rate for Payer: Cash Price |
$5,915.45
|
| Rate for Payer: Cigna Commercial |
$9,819.65
|
| Rate for Payer: First Health Commercial |
$11,239.35
|
| Rate for Payer: Humana Commercial |
$10,056.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,701.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,731.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,549.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,411.19
|
| Rate for Payer: Ohio Health Group HMO |
$8,873.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,464.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,292.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,163.32
|
| Rate for Payer: PHCS Commercial |
$11,357.66
|
| Rate for Payer: United Healthcare All Payer |
$10,411.19
|
|
|
TIBIAL JIG HEAD RIGHT MD
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
TIBIAL JIG HEAD RIGHT MD
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
TIBIAL JIG TAIL LEFT MD
|
Facility
|
IP
|
$4,925.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,477.50 |
| Max. Negotiated Rate |
$4,728.00 |
| Rate for Payer: Aetna Commercial |
$3,792.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,841.50
|
| Rate for Payer: Cash Price |
$2,462.50
|
| Rate for Payer: Cigna Commercial |
$4,087.75
|
| Rate for Payer: First Health Commercial |
$4,678.75
|
| Rate for Payer: Humana Commercial |
$4,186.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,038.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,634.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,477.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,334.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,693.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,940.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,284.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,398.25
|
| Rate for Payer: PHCS Commercial |
$4,728.00
|
| Rate for Payer: United Healthcare All Payer |
$4,334.00
|
|
|
TIBIAL JIG TAIL LEFT MD
|
Facility
|
OP
|
$4,925.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,477.50 |
| Max. Negotiated Rate |
$4,728.00 |
| Rate for Payer: Aetna Commercial |
$3,792.25
|
| Rate for Payer: Anthem Medicaid |
$1,693.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,841.50
|
| Rate for Payer: Cash Price |
$2,462.50
|
| Rate for Payer: Cigna Commercial |
$4,087.75
|
| Rate for Payer: First Health Commercial |
$4,678.75
|
| Rate for Payer: Humana Commercial |
$4,186.25
|
| Rate for Payer: Humana KY Medicaid |
$1,693.71
|
| Rate for Payer: Kentucky WC Medicaid |
$1,710.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,038.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,634.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,477.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,727.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,334.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,693.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,940.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,284.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,398.25
|
| Rate for Payer: PHCS Commercial |
$4,728.00
|
| Rate for Payer: United Healthcare All Payer |
$4,334.00
|
|
|
TIBIAL JIG TAIL RIGHT MD
|
Facility
|
IP
|
$5,675.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,702.50 |
| Max. Negotiated Rate |
$5,448.00 |
| Rate for Payer: Aetna Commercial |
$4,369.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,426.50
|
| Rate for Payer: Cash Price |
$2,837.50
|
| Rate for Payer: Cigna Commercial |
$4,710.25
|
| Rate for Payer: First Health Commercial |
$5,391.25
|
| Rate for Payer: Humana Commercial |
$4,823.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,653.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,188.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,702.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,994.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,256.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,540.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,937.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,915.75
|
| Rate for Payer: PHCS Commercial |
$5,448.00
|
| Rate for Payer: United Healthcare All Payer |
$4,994.00
|
|
|
TIBIAL JIG TAIL RIGHT MD
|
Facility
|
OP
|
$5,675.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,702.50 |
| Max. Negotiated Rate |
$5,448.00 |
| Rate for Payer: Aetna Commercial |
$4,369.75
|
| Rate for Payer: Anthem Medicaid |
$1,951.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,426.50
|
| Rate for Payer: Cash Price |
$2,837.50
|
| Rate for Payer: Cigna Commercial |
$4,710.25
|
| Rate for Payer: First Health Commercial |
$5,391.25
|
| Rate for Payer: Humana Commercial |
$4,823.75
|
| Rate for Payer: Humana KY Medicaid |
$1,951.63
|
| Rate for Payer: Kentucky WC Medicaid |
$1,971.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,653.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,188.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,702.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,990.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,994.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,256.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,540.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,937.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,915.75
|
| Rate for Payer: PHCS Commercial |
$5,448.00
|
| Rate for Payer: United Healthcare All Payer |
$4,994.00
|
|
|
TIBIAL MAX PRDCM BRNG 10*71/75
|
Facility
|
OP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem Medicaid |
$1,918.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Humana KY Medicaid |
$1,918.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,937.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,956.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 10*71/75
|
Facility
|
IP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 12*71/75
|
Facility
|
IP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 12*71/75
|
Facility
|
OP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem Medicaid |
$1,918.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Humana KY Medicaid |
$1,918.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,937.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,956.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 14*63/67
|
Facility
|
OP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem Medicaid |
$1,918.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Humana KY Medicaid |
$1,918.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,937.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,956.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 14*63/67
|
Facility
|
IP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 16*71/75
|
Facility
|
IP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 16*71/75
|
Facility
|
OP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem Medicaid |
$1,918.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Humana KY Medicaid |
$1,918.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,937.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,956.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 18*71/75
|
Facility
|
OP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem Medicaid |
$1,918.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Humana KY Medicaid |
$1,918.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,937.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,956.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MAX PRDCM BRNG 18*71/75
|
Facility
|
IP
|
$5,577.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,673.25 |
| Max. Negotiated Rate |
$5,354.40 |
| Rate for Payer: Aetna Commercial |
$4,294.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,350.45
|
| Rate for Payer: Cash Price |
$2,788.75
|
| Rate for Payer: Cigna Commercial |
$4,629.32
|
| Rate for Payer: First Health Commercial |
$5,298.62
|
| Rate for Payer: Humana Commercial |
$4,740.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,573.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,116.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,673.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,908.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,183.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,462.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,852.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,848.47
|
| Rate for Payer: PHCS Commercial |
$5,354.40
|
| Rate for Payer: United Healthcare All Payer |
$4,908.20
|
|
|
TIBIAL MBT CEMT SZ 3
|
Facility
|
OP
|
$13,042.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,912.60 |
| Max. Negotiated Rate |
$12,520.32 |
| Rate for Payer: Aetna Commercial |
$10,042.34
|
| Rate for Payer: Anthem Medicaid |
$4,485.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,172.76
|
| Rate for Payer: Cash Price |
$6,521.00
|
| Rate for Payer: Cigna Commercial |
$10,824.86
|
| Rate for Payer: First Health Commercial |
$12,389.90
|
| Rate for Payer: Humana Commercial |
$11,085.70
|
| Rate for Payer: Humana KY Medicaid |
$4,485.14
|
| Rate for Payer: Kentucky WC Medicaid |
$4,530.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,694.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,625.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,912.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,575.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,476.96
|
| Rate for Payer: Ohio Health Group HMO |
$9,781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,433.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,346.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,998.98
|
| Rate for Payer: PHCS Commercial |
$12,520.32
|
| Rate for Payer: United Healthcare All Payer |
$11,476.96
|
|
|
TIBIAL MBT CEMT SZ 3
|
Facility
|
IP
|
$13,042.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,912.60 |
| Max. Negotiated Rate |
$12,520.32 |
| Rate for Payer: Aetna Commercial |
$10,042.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,172.76
|
| Rate for Payer: Cash Price |
$6,521.00
|
| Rate for Payer: Cigna Commercial |
$10,824.86
|
| Rate for Payer: First Health Commercial |
$12,389.90
|
| Rate for Payer: Humana Commercial |
$11,085.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,694.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,625.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,912.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,476.96
|
| Rate for Payer: Ohio Health Group HMO |
$9,781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,433.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,346.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,998.98
|
| Rate for Payer: PHCS Commercial |
$12,520.32
|
| Rate for Payer: United Healthcare All Payer |
$11,476.96
|
|
|
TIBIAL MBTTHK TRY REV CEM 3*15
|
Facility
|
IP
|
$83,756.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25,126.92 |
| Max. Negotiated Rate |
$80,406.14 |
| Rate for Payer: Aetna Commercial |
$64,492.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,329.99
|
| Rate for Payer: Cash Price |
$41,878.20
|
| Rate for Payer: Cigna Commercial |
$69,517.81
|
| Rate for Payer: First Health Commercial |
$79,568.58
|
| Rate for Payer: Humana Commercial |
$71,192.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,680.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,812.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,126.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,705.63
|
| Rate for Payer: Ohio Health Group HMO |
$62,817.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$67,005.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$72,868.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57,791.92
|
| Rate for Payer: PHCS Commercial |
$80,406.14
|
| Rate for Payer: United Healthcare All Payer |
$73,705.63
|
|
|
TIBIAL MBTTHK TRY REV CEM 3*15
|
Facility
|
OP
|
$83,756.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25,126.92 |
| Max. Negotiated Rate |
$80,406.14 |
| Rate for Payer: Aetna Commercial |
$64,492.43
|
| Rate for Payer: Anthem Medicaid |
$28,803.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,329.99
|
| Rate for Payer: Cash Price |
$41,878.20
|
| Rate for Payer: Cigna Commercial |
$69,517.81
|
| Rate for Payer: First Health Commercial |
$79,568.58
|
| Rate for Payer: Humana Commercial |
$71,192.94
|
| Rate for Payer: Humana KY Medicaid |
$28,803.83
|
| Rate for Payer: Kentucky WC Medicaid |
$29,096.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,680.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,812.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,126.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,381.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,705.63
|
| Rate for Payer: Ohio Health Group HMO |
$62,817.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$67,005.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$72,868.07
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57,791.92
|
| Rate for Payer: PHCS Commercial |
$80,406.14
|
| Rate for Payer: United Healthcare All Payer |
$73,705.63
|
|
|
TIBIAL MBT THKTRY REV CEM 4*15
|
Facility
|
OP
|
$83,752.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25,125.78 |
| Max. Negotiated Rate |
$80,402.50 |
| Rate for Payer: Aetna Commercial |
$64,489.50
|
| Rate for Payer: Anthem Medicaid |
$28,802.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,327.03
|
| Rate for Payer: Cash Price |
$41,876.30
|
| Rate for Payer: Cigna Commercial |
$69,514.66
|
| Rate for Payer: First Health Commercial |
$79,564.97
|
| Rate for Payer: Humana Commercial |
$71,189.71
|
| Rate for Payer: Humana KY Medicaid |
$28,802.52
|
| Rate for Payer: Kentucky WC Medicaid |
$29,095.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,677.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,809.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,125.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,380.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,702.29
|
| Rate for Payer: Ohio Health Group HMO |
$62,814.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$67,002.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$72,864.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57,789.29
|
| Rate for Payer: PHCS Commercial |
$80,402.50
|
| Rate for Payer: United Healthcare All Payer |
$73,702.29
|
|
|
TIBIAL MBT THKTRY REV CEM 4*15
|
Facility
|
IP
|
$83,752.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25,125.78 |
| Max. Negotiated Rate |
$80,402.50 |
| Rate for Payer: Aetna Commercial |
$64,489.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,327.03
|
| Rate for Payer: Cash Price |
$41,876.30
|
| Rate for Payer: Cigna Commercial |
$69,514.66
|
| Rate for Payer: First Health Commercial |
$79,564.97
|
| Rate for Payer: Humana Commercial |
$71,189.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,677.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,809.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,125.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,702.29
|
| Rate for Payer: Ohio Health Group HMO |
$62,814.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$67,002.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$72,864.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57,789.29
|
| Rate for Payer: PHCS Commercial |
$80,402.50
|
| Rate for Payer: United Healthcare All Payer |
$73,702.29
|
|
|
TIBIAL PROXOSS 1 PC 5CM 9*150
|
Facility
|
OP
|
$78,232.72
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23,469.82 |
| Max. Negotiated Rate |
$75,103.41 |
| Rate for Payer: Aetna Commercial |
$60,239.19
|
| Rate for Payer: Anthem Medicaid |
$26,904.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$61,021.52
|
| Rate for Payer: Cash Price |
$39,116.36
|
| Rate for Payer: Cigna Commercial |
$64,933.16
|
| Rate for Payer: First Health Commercial |
$74,321.08
|
| Rate for Payer: Humana Commercial |
$66,497.81
|
| Rate for Payer: Humana KY Medicaid |
$26,904.23
|
| Rate for Payer: Kentucky WC Medicaid |
$27,178.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$64,150.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$57,735.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23,469.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$27,444.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$68,844.79
|
| Rate for Payer: Ohio Health Group HMO |
$58,674.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$62,586.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$68,062.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$53,980.58
|
| Rate for Payer: PHCS Commercial |
$75,103.41
|
| Rate for Payer: United Healthcare All Payer |
$68,844.79
|
|
|
TIBIAL PROXOSS 1 PC 5CM 9*150
|
Facility
|
IP
|
$78,232.72
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23,469.82 |
| Max. Negotiated Rate |
$75,103.41 |
| Rate for Payer: Aetna Commercial |
$60,239.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$61,021.52
|
| Rate for Payer: Cash Price |
$39,116.36
|
| Rate for Payer: Cigna Commercial |
$64,933.16
|
| Rate for Payer: First Health Commercial |
$74,321.08
|
| Rate for Payer: Humana Commercial |
$66,497.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$64,150.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$57,735.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23,469.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$68,844.79
|
| Rate for Payer: Ohio Health Group HMO |
$58,674.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$62,586.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$68,062.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$53,980.58
|
| Rate for Payer: PHCS Commercial |
$75,103.41
|
| Rate for Payer: United Healthcare All Payer |
$68,844.79
|
|
