|
ECH STR FEM REAMER SZ 19.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 19.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 19.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 19.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 20.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 20.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 20.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 20.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 21.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 21.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 21.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 21.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 22.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 22.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 8.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 8.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 8.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 8.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 9.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 9.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 9.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 9.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECLIPSE CAGE SCREW 30MM
|
Facility
|
OP
|
$18,537.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,409.81 |
| Max. Negotiated Rate |
$17,795.52 |
| Rate for Payer: Aetna Commercial |
$14,273.49
|
| Rate for Payer: Anthem Medicaid |
$6,374.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,458.86
|
| Rate for Payer: Cash Price |
$9,268.50
|
| Rate for Payer: Cigna Commercial |
$15,385.71
|
| Rate for Payer: First Health Commercial |
$17,610.15
|
| Rate for Payer: Humana Commercial |
$15,756.45
|
| Rate for Payer: Humana KY Medicaid |
$6,374.87
|
| Rate for Payer: Kentucky WC Medicaid |
$6,439.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,200.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,680.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,561.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,502.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,312.56
|
| Rate for Payer: Ohio Health Group HMO |
$13,902.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,707.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,409.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,746.47
|
| Rate for Payer: PHCS Commercial |
$17,795.52
|
| Rate for Payer: United Healthcare All Payer |
$16,312.56
|
|
|
ECLIPSE CAGE SCREW 30MM
|
Facility
|
IP
|
$18,537.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,409.81 |
| Max. Negotiated Rate |
$17,795.52 |
| Rate for Payer: Aetna Commercial |
$14,273.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,458.86
|
| Rate for Payer: Cash Price |
$9,268.50
|
| Rate for Payer: Cigna Commercial |
$15,385.71
|
| Rate for Payer: First Health Commercial |
$17,610.15
|
| Rate for Payer: Humana Commercial |
$15,756.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,200.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,680.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,561.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,312.56
|
| Rate for Payer: Ohio Health Group HMO |
$13,902.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,707.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,409.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,746.47
|
| Rate for Payer: PHCS Commercial |
$17,795.52
|
| Rate for Payer: United Healthcare All Payer |
$16,312.56
|
|
|
ECLIPSE CAGE SCREW 35MM
|
Facility
|
OP
|
$20,951.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,723.66 |
| Max. Negotiated Rate |
$20,113.20 |
| Rate for Payer: Aetna Commercial |
$16,132.46
|
| Rate for Payer: Anthem Medicaid |
$7,205.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,341.98
|
| Rate for Payer: Cash Price |
$10,475.62
|
| Rate for Payer: Cigna Commercial |
$17,389.54
|
| Rate for Payer: First Health Commercial |
$19,903.69
|
| Rate for Payer: Humana Commercial |
$17,808.56
|
| Rate for Payer: Humana KY Medicaid |
$7,205.13
|
| Rate for Payer: Kentucky WC Medicaid |
$7,278.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,180.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,462.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,285.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,349.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,437.10
|
| Rate for Payer: Ohio Health Group HMO |
$15,713.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,190.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,723.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,494.89
|
| Rate for Payer: PHCS Commercial |
$20,113.20
|
| Rate for Payer: United Healthcare All Payer |
$18,437.10
|
|
