|
VANGUARD PS+ TIB BRG 20*79/83
|
Facility
|
IP
|
$6,742.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$876.46 |
| Max. Negotiated Rate |
$6,472.32 |
| Rate for Payer: Aetna Commercial |
$5,191.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,258.76
|
| Rate for Payer: Cash Price |
$3,371.00
|
| Rate for Payer: Cigna Commercial |
$5,595.86
|
| Rate for Payer: First Health Commercial |
$6,404.90
|
| Rate for Payer: Humana Commercial |
$5,730.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,528.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,975.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,022.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,932.96
|
| Rate for Payer: Ohio Health Group HMO |
$5,056.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,348.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$876.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,090.02
|
| Rate for Payer: PHCS Commercial |
$6,472.32
|
| Rate for Payer: United Healthcare All Payer |
$5,932.96
|
|
|
VANGUARD PS+ TIB BRG 20*87/91
|
Facility
|
IP
|
$6,742.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$876.46 |
| Max. Negotiated Rate |
$6,472.32 |
| Rate for Payer: Aetna Commercial |
$5,191.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,258.76
|
| Rate for Payer: Cash Price |
$3,371.00
|
| Rate for Payer: Cigna Commercial |
$5,595.86
|
| Rate for Payer: First Health Commercial |
$6,404.90
|
| Rate for Payer: Humana Commercial |
$5,730.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,528.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,975.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,022.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,932.96
|
| Rate for Payer: Ohio Health Group HMO |
$5,056.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,348.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$876.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,090.02
|
| Rate for Payer: PHCS Commercial |
$6,472.32
|
| Rate for Payer: United Healthcare All Payer |
$5,932.96
|
|
|
VANGUARD PS+ TIB BRG 20*87/91
|
Facility
|
OP
|
$6,742.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$876.46 |
| Max. Negotiated Rate |
$6,472.32 |
| Rate for Payer: Aetna Commercial |
$5,191.34
|
| Rate for Payer: Anthem Medicaid |
$2,318.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,258.76
|
| Rate for Payer: Cash Price |
$3,371.00
|
| Rate for Payer: Cigna Commercial |
$5,595.86
|
| Rate for Payer: First Health Commercial |
$6,404.90
|
| Rate for Payer: Humana Commercial |
$5,730.70
|
| Rate for Payer: Humana KY Medicaid |
$2,318.57
|
| Rate for Payer: Kentucky WC Medicaid |
$2,342.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,528.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,975.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,022.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,365.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,932.96
|
| Rate for Payer: Ohio Health Group HMO |
$5,056.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,348.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$876.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,090.02
|
| Rate for Payer: PHCS Commercial |
$6,472.32
|
| Rate for Payer: United Healthcare All Payer |
$5,932.96
|
|
|
VANGUARD SER A PATELLA 34MM
|
Facility
|
OP
|
$3,628.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.64 |
| Max. Negotiated Rate |
$3,482.88 |
| Rate for Payer: Aetna Commercial |
$2,793.56
|
| Rate for Payer: Anthem Medicaid |
$1,247.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,829.84
|
| Rate for Payer: Cash Price |
$1,814.00
|
| Rate for Payer: Cigna Commercial |
$3,011.24
|
| Rate for Payer: First Health Commercial |
$3,446.60
|
| Rate for Payer: Humana Commercial |
$3,083.80
|
| Rate for Payer: Humana KY Medicaid |
$1,247.67
|
| Rate for Payer: Kentucky WC Medicaid |
$1,260.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,974.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,677.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,088.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,272.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,192.64
|
| Rate for Payer: Ohio Health Group HMO |
$2,721.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$725.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$471.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,124.68
|
| Rate for Payer: PHCS Commercial |
$3,482.88
|
| Rate for Payer: United Healthcare All Payer |
$3,192.64
|
|
|
VANGUARD SER A PATELLA 34MM
|
Facility
|
IP
|
$3,628.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.64 |
| Max. Negotiated Rate |
$3,482.88 |
| Rate for Payer: Aetna Commercial |
$2,793.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,829.84
|
| Rate for Payer: Cash Price |
$1,814.00
|
| Rate for Payer: Cigna Commercial |
$3,011.24
|
| Rate for Payer: First Health Commercial |
$3,446.60
|
| Rate for Payer: Humana Commercial |
$3,083.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,974.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,677.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,088.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,192.64
|
| Rate for Payer: Ohio Health Group HMO |
$2,721.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$725.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$471.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,124.68
|
| Rate for Payer: PHCS Commercial |
$3,482.88
|
| Rate for Payer: United Healthcare All Payer |
$3,192.64
|
|
|
VANGUARD SSK PSC TIB BRG 10*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 10*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 12*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 12*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 14*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 14*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 16*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 16*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 18*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 18*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 20*59
|
Facility
|
IP
|
$14,196.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,845.49 |
| Max. Negotiated Rate |
$13,628.21 |
| Rate for Payer: Aetna Commercial |
$10,930.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,072.92
|
| Rate for Payer: Cash Price |
$7,098.03
|
| Rate for Payer: Cigna Commercial |
$11,782.72
|
| Rate for Payer: First Health Commercial |
$13,486.25
|
| Rate for Payer: Humana Commercial |
$12,066.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,640.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,476.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,258.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,492.52
|
| Rate for Payer: Ohio Health Group HMO |
$10,647.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,839.21
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,845.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,400.78
|
| Rate for Payer: PHCS Commercial |
$13,628.21
|
| Rate for Payer: United Healthcare All Payer |
$12,492.52
|
|
|
VANGUARD SSK PSC TIB BRG 20*59
|
Facility
|
OP
|
$14,196.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,845.49 |
| Max. Negotiated Rate |
$13,628.21 |
| Rate for Payer: Aetna Commercial |
$10,930.96
|
| Rate for Payer: Anthem Medicaid |
$4,882.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,072.92
|
| Rate for Payer: Cash Price |
$7,098.03
|
| Rate for Payer: Cigna Commercial |
$11,782.72
|
| Rate for Payer: First Health Commercial |
$13,486.25
|
| Rate for Payer: Humana Commercial |
$12,066.64
|
| Rate for Payer: Humana KY Medicaid |
$4,882.02
|
| Rate for Payer: Kentucky WC Medicaid |
$4,931.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,640.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,476.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,258.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,979.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,492.52
|
| Rate for Payer: Ohio Health Group HMO |
$10,647.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,839.21
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,845.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,400.78
|
| Rate for Payer: PHCS Commercial |
$13,628.21
|
| Rate for Payer: United Healthcare All Payer |
$12,492.52
|
|
|
VANGUARD SSK PSC TIB BRG 22*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 22*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 24*59
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD SSK PSC TIB BRG 24*59
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD TIB BEAR CR 71/75*12
|
Facility
|
OP
|
$8,012.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.59 |
| Max. Negotiated Rate |
$7,691.71 |
| Rate for Payer: Aetna Commercial |
$6,169.39
|
| Rate for Payer: Anthem Medicaid |
$2,755.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,249.52
|
| Rate for Payer: Cash Price |
$4,006.10
|
| Rate for Payer: Cigna Commercial |
$6,650.13
|
| Rate for Payer: First Health Commercial |
$7,611.59
|
| Rate for Payer: Humana Commercial |
$6,810.37
|
| Rate for Payer: Humana KY Medicaid |
$2,755.40
|
| Rate for Payer: Kentucky WC Medicaid |
$2,783.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,570.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,913.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,403.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,810.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,050.74
|
| Rate for Payer: Ohio Health Group HMO |
$6,009.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,602.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,483.78
|
| Rate for Payer: PHCS Commercial |
$7,691.71
|
| Rate for Payer: United Healthcare All Payer |
$7,050.74
|
|
|
VANGUARD TIB BEAR CR 71/75*12
|
Facility
|
IP
|
$8,012.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.59 |
| Max. Negotiated Rate |
$7,691.71 |
| Rate for Payer: Aetna Commercial |
$6,169.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,249.52
|
| Rate for Payer: Cash Price |
$4,006.10
|
| Rate for Payer: Cigna Commercial |
$6,650.13
|
| Rate for Payer: First Health Commercial |
$7,611.59
|
| Rate for Payer: Humana Commercial |
$6,810.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,570.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,913.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,403.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,050.74
|
| Rate for Payer: Ohio Health Group HMO |
$6,009.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,602.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,483.78
|
| Rate for Payer: PHCS Commercial |
$7,691.71
|
| Rate for Payer: United Healthcare All Payer |
$7,050.74
|
|
|
VANGUARD TIB BEARING 79/83X12
|
Facility
|
OP
|
$8,012.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.59 |
| Max. Negotiated Rate |
$7,691.71 |
| Rate for Payer: Aetna Commercial |
$6,169.39
|
| Rate for Payer: Anthem Medicaid |
$2,755.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,249.52
|
| Rate for Payer: Cash Price |
$4,006.10
|
| Rate for Payer: Cigna Commercial |
$6,650.13
|
| Rate for Payer: First Health Commercial |
$7,611.59
|
| Rate for Payer: Humana Commercial |
$6,810.37
|
| Rate for Payer: Humana KY Medicaid |
$2,755.40
|
| Rate for Payer: Kentucky WC Medicaid |
$2,783.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,570.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,913.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,403.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,810.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,050.74
|
| Rate for Payer: Ohio Health Group HMO |
$6,009.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,602.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,483.78
|
| Rate for Payer: PHCS Commercial |
$7,691.71
|
| Rate for Payer: United Healthcare All Payer |
$7,050.74
|
|
|
VANGUARD TIB BEARING 79/83X12
|
Facility
|
IP
|
$8,012.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.59 |
| Max. Negotiated Rate |
$7,691.71 |
| Rate for Payer: Aetna Commercial |
$6,169.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,249.52
|
| Rate for Payer: Cash Price |
$4,006.10
|
| Rate for Payer: Cigna Commercial |
$6,650.13
|
| Rate for Payer: First Health Commercial |
$7,611.59
|
| Rate for Payer: Humana Commercial |
$6,810.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,570.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,913.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,403.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,050.74
|
| Rate for Payer: Ohio Health Group HMO |
$6,009.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,602.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,483.78
|
| Rate for Payer: PHCS Commercial |
$7,691.71
|
| Rate for Payer: United Healthcare All Payer |
$7,050.74
|
|
