|
FEMORAL NEXGEN ROT HINGE E-RT
|
Facility
|
IP
|
$37,065.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,818.56 |
| Max. Negotiated Rate |
$35,583.19 |
| Rate for Payer: Aetna Commercial |
$28,540.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,911.34
|
| Rate for Payer: Cash Price |
$18,532.91
|
| Rate for Payer: Cigna Commercial |
$30,764.63
|
| Rate for Payer: First Health Commercial |
$35,212.53
|
| Rate for Payer: Humana Commercial |
$31,505.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,393.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,354.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,119.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,617.92
|
| Rate for Payer: Ohio Health Group HMO |
$27,799.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,413.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,818.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,490.40
|
| Rate for Payer: PHCS Commercial |
$35,583.19
|
| Rate for Payer: United Healthcare All Payer |
$32,617.92
|
|
|
FEMORAL NEXGEN ROT HINGE F-LT
|
Facility
|
IP
|
$37,065.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,818.56 |
| Max. Negotiated Rate |
$35,583.19 |
| Rate for Payer: Aetna Commercial |
$28,540.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,911.34
|
| Rate for Payer: Cash Price |
$18,532.91
|
| Rate for Payer: Cigna Commercial |
$30,764.63
|
| Rate for Payer: First Health Commercial |
$35,212.53
|
| Rate for Payer: Humana Commercial |
$31,505.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,393.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,354.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,119.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,617.92
|
| Rate for Payer: Ohio Health Group HMO |
$27,799.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,413.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,818.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,490.40
|
| Rate for Payer: PHCS Commercial |
$35,583.19
|
| Rate for Payer: United Healthcare All Payer |
$32,617.92
|
|
|
FEMORAL NEXGEN ROT HINGE F-LT
|
Facility
|
OP
|
$37,065.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,818.56 |
| Max. Negotiated Rate |
$35,583.19 |
| Rate for Payer: Aetna Commercial |
$28,540.68
|
| Rate for Payer: Anthem Medicaid |
$12,746.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,911.34
|
| Rate for Payer: Cash Price |
$18,532.91
|
| Rate for Payer: Cigna Commercial |
$30,764.63
|
| Rate for Payer: First Health Commercial |
$35,212.53
|
| Rate for Payer: Humana Commercial |
$31,505.95
|
| Rate for Payer: Humana KY Medicaid |
$12,746.94
|
| Rate for Payer: Kentucky WC Medicaid |
$12,876.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,393.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,354.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,119.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,002.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,617.92
|
| Rate for Payer: Ohio Health Group HMO |
$27,799.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,413.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,818.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,490.40
|
| Rate for Payer: PHCS Commercial |
$35,583.19
|
| Rate for Payer: United Healthcare All Payer |
$32,617.92
|
|
|
FEMORAL NEXGEN ROT HINGE F-RT
|
Facility
|
OP
|
$37,065.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,818.56 |
| Max. Negotiated Rate |
$35,583.19 |
| Rate for Payer: Aetna Commercial |
$28,540.68
|
| Rate for Payer: Anthem Medicaid |
$12,746.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,911.34
|
| Rate for Payer: Cash Price |
$18,532.91
|
| Rate for Payer: Cigna Commercial |
$30,764.63
|
| Rate for Payer: First Health Commercial |
$35,212.53
|
| Rate for Payer: Humana Commercial |
$31,505.95
|
| Rate for Payer: Humana KY Medicaid |
$12,746.94
|
| Rate for Payer: Kentucky WC Medicaid |
$12,876.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,393.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,354.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,119.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,002.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,617.92
|
| Rate for Payer: Ohio Health Group HMO |
$27,799.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,413.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,818.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,490.40
|
| Rate for Payer: PHCS Commercial |
$35,583.19
|
| Rate for Payer: United Healthcare All Payer |
$32,617.92
|
|
|
FEMORAL NEXGEN ROT HINGE F-RT
|
Facility
|
IP
|
$37,065.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,818.56 |
| Max. Negotiated Rate |
$35,583.19 |
| Rate for Payer: Aetna Commercial |
$28,540.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,911.34
|
| Rate for Payer: Cash Price |
$18,532.91
|
| Rate for Payer: Cigna Commercial |
$30,764.63
|
| Rate for Payer: First Health Commercial |
$35,212.53
|
| Rate for Payer: Humana Commercial |
$31,505.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,393.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,354.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,119.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,617.92
|
| Rate for Payer: Ohio Health Group HMO |
$27,799.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,413.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,818.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,490.40
|
| Rate for Payer: PHCS Commercial |
$35,583.19
|
| Rate for Payer: United Healthcare All Payer |
$32,617.92
|
|
|
FEMORAL PEGS FLEX GII LOK
|
Facility
|
OP
|
$3,858.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$501.61 |
| Max. Negotiated Rate |
$3,704.17 |
| Rate for Payer: Aetna Commercial |
$2,971.05
|
| Rate for Payer: Anthem Medicaid |
$1,326.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,009.64
|
| Rate for Payer: Cash Price |
$1,929.26
|
| Rate for Payer: Cigna Commercial |
$3,202.56
|
| Rate for Payer: First Health Commercial |
$3,665.58
|
| Rate for Payer: Humana Commercial |
$3,279.73
|
| Rate for Payer: Humana KY Medicaid |
$1,326.94
|
| Rate for Payer: Kentucky WC Medicaid |
$1,340.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,163.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,847.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,157.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,353.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,395.49
|
| Rate for Payer: Ohio Health Group HMO |
$2,893.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$771.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$501.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,196.14
|
| Rate for Payer: PHCS Commercial |
$3,704.17
|
| Rate for Payer: United Healthcare All Payer |
$3,395.49
|
|
|
FEMORAL PEGS FLEX GII LOK
|
Facility
|
IP
|
$3,858.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$501.61 |
| Max. Negotiated Rate |
$3,704.17 |
| Rate for Payer: Aetna Commercial |
$2,971.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,009.64
|
| Rate for Payer: Cash Price |
$1,929.26
|
| Rate for Payer: Cigna Commercial |
$3,202.56
|
| Rate for Payer: First Health Commercial |
$3,665.58
|
| Rate for Payer: Humana Commercial |
$3,279.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,163.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,847.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,157.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,395.49
|
| Rate for Payer: Ohio Health Group HMO |
$2,893.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$771.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$501.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,196.14
|
| Rate for Payer: PHCS Commercial |
$3,704.17
|
| Rate for Payer: United Healthcare All Payer |
$3,395.49
|
|
|
FEMORAL PROX ADAP MT 4CM*30D R
|
Facility
|
OP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem Medicaid |
$23,664.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Humana KY Medicaid |
$23,664.45
|
| Rate for Payer: Kentucky WC Medicaid |
$23,905.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,139.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX ADAP MT 4CM*30D R
|
Facility
|
IP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN CPS 10CM R
|
Facility
|
IP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN CPS 10CM R
|
Facility
|
OP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem Medicaid |
$23,664.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Humana KY Medicaid |
$23,664.45
|
| Rate for Payer: Kentucky WC Medicaid |
$23,905.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,139.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 7CM L
|
Facility
|
OP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem Medicaid |
$23,664.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Humana KY Medicaid |
$23,664.45
|
| Rate for Payer: Kentucky WC Medicaid |
$23,905.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,139.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 7CM L
|
Facility
|
IP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 7CM R
|
Facility
|
IP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 7CM R
|
Facility
|
OP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem Medicaid |
$23,664.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Humana KY Medicaid |
$23,664.45
|
| Rate for Payer: Kentucky WC Medicaid |
$23,905.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,139.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 8.5CM L
|
Facility
|
OP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem Medicaid |
$23,664.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Humana KY Medicaid |
$23,664.45
|
| Rate for Payer: Kentucky WC Medicaid |
$23,905.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,139.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 8.5CM L
|
Facility
|
IP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 8.5CM R
|
Facility
|
OP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem Medicaid |
$23,664.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Humana KY Medicaid |
$23,664.45
|
| Rate for Payer: Kentucky WC Medicaid |
$23,905.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,139.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL PROX FINN OSS 8.5CM R
|
Facility
|
IP
|
$68,812.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,945.56 |
| Max. Negotiated Rate |
$66,059.52 |
| Rate for Payer: Aetna Commercial |
$52,985.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53,673.36
|
| Rate for Payer: Cash Price |
$34,406.00
|
| Rate for Payer: Cigna Commercial |
$57,113.96
|
| Rate for Payer: First Health Commercial |
$65,371.40
|
| Rate for Payer: Humana Commercial |
$58,490.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$56,425.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50,783.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,643.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$60,554.56
|
| Rate for Payer: Ohio Health Group HMO |
$51,609.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,762.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,945.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,331.72
|
| Rate for Payer: PHCS Commercial |
$66,059.52
|
| Rate for Payer: United Healthcare All Payer |
$60,554.56
|
|
|
FEMORAL RT W/SCREW 67.5MM
|
Facility
|
IP
|
$38,090.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,951.70 |
| Max. Negotiated Rate |
$36,566.41 |
| Rate for Payer: Aetna Commercial |
$29,329.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,710.21
|
| Rate for Payer: Cash Price |
$19,045.00
|
| Rate for Payer: Cigna Commercial |
$31,614.71
|
| Rate for Payer: First Health Commercial |
$36,185.51
|
| Rate for Payer: Humana Commercial |
$32,376.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$31,233.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$28,110.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,427.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,519.21
|
| Rate for Payer: Ohio Health Group HMO |
$28,567.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,618.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,951.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,807.90
|
| Rate for Payer: PHCS Commercial |
$36,566.41
|
| Rate for Payer: United Healthcare All Payer |
$33,519.21
|
|
|
FEMORAL RT W/SCREW 67.5MM
|
Facility
|
OP
|
$38,090.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,951.70 |
| Max. Negotiated Rate |
$36,566.41 |
| Rate for Payer: Aetna Commercial |
$29,329.31
|
| Rate for Payer: Anthem Medicaid |
$13,099.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,710.21
|
| Rate for Payer: Cash Price |
$19,045.00
|
| Rate for Payer: Cigna Commercial |
$31,614.71
|
| Rate for Payer: First Health Commercial |
$36,185.51
|
| Rate for Payer: Humana Commercial |
$32,376.51
|
| Rate for Payer: Humana KY Medicaid |
$13,099.15
|
| Rate for Payer: Kentucky WC Medicaid |
$13,232.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$31,233.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$28,110.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,427.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,361.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,519.21
|
| Rate for Payer: Ohio Health Group HMO |
$28,567.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,618.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,951.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,807.90
|
| Rate for Payer: PHCS Commercial |
$36,566.41
|
| Rate for Payer: United Healthcare All Payer |
$33,519.21
|
|
|
FEMORAL RT W/SCREW 70MM
|
Facility
|
IP
|
$38,090.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,951.70 |
| Max. Negotiated Rate |
$36,566.41 |
| Rate for Payer: Aetna Commercial |
$29,329.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,710.21
|
| Rate for Payer: Cash Price |
$19,045.00
|
| Rate for Payer: Cigna Commercial |
$31,614.71
|
| Rate for Payer: First Health Commercial |
$36,185.51
|
| Rate for Payer: Humana Commercial |
$32,376.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$31,233.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$28,110.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,427.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,519.21
|
| Rate for Payer: Ohio Health Group HMO |
$28,567.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,618.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,951.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,807.90
|
| Rate for Payer: PHCS Commercial |
$36,566.41
|
| Rate for Payer: United Healthcare All Payer |
$33,519.21
|
|
|
FEMORAL RT W/SCREW 70MM
|
Facility
|
OP
|
$38,090.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,951.70 |
| Max. Negotiated Rate |
$36,566.41 |
| Rate for Payer: Aetna Commercial |
$29,329.31
|
| Rate for Payer: Anthem Medicaid |
$13,099.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,710.21
|
| Rate for Payer: Cash Price |
$19,045.00
|
| Rate for Payer: Cigna Commercial |
$31,614.71
|
| Rate for Payer: First Health Commercial |
$36,185.51
|
| Rate for Payer: Humana Commercial |
$32,376.51
|
| Rate for Payer: Humana KY Medicaid |
$13,099.15
|
| Rate for Payer: Kentucky WC Medicaid |
$13,232.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$31,233.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$28,110.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,427.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,361.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,519.21
|
| Rate for Payer: Ohio Health Group HMO |
$28,567.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,618.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,951.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,807.90
|
| Rate for Payer: PHCS Commercial |
$36,566.41
|
| Rate for Payer: United Healthcare All Payer |
$33,519.21
|
|
|
FEMORAL SHAFT SPLIT FD
|
Facility
|
OP
|
$5,612.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$729.62 |
| Max. Negotiated Rate |
$5,388.00 |
| Rate for Payer: Aetna Commercial |
$4,321.62
|
| Rate for Payer: Anthem Medicaid |
$1,930.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,377.75
|
| Rate for Payer: Cash Price |
$2,806.25
|
| Rate for Payer: Cigna Commercial |
$4,658.38
|
| Rate for Payer: First Health Commercial |
$5,331.88
|
| Rate for Payer: Humana Commercial |
$4,770.62
|
| Rate for Payer: Humana KY Medicaid |
$1,930.14
|
| Rate for Payer: Kentucky WC Medicaid |
$1,949.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,602.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,142.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,683.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,968.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,939.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,209.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,122.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$729.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,739.88
|
| Rate for Payer: PHCS Commercial |
$5,388.00
|
| Rate for Payer: United Healthcare All Payer |
$4,939.00
|
|
|
FEMORAL SHAFT SPLIT FD
|
Facility
|
IP
|
$5,612.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$729.62 |
| Max. Negotiated Rate |
$5,388.00 |
| Rate for Payer: Aetna Commercial |
$4,321.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,377.75
|
| Rate for Payer: Cash Price |
$2,806.25
|
| Rate for Payer: Cigna Commercial |
$4,658.38
|
| Rate for Payer: First Health Commercial |
$5,331.88
|
| Rate for Payer: Humana Commercial |
$4,770.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,602.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,142.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,683.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,939.00
|
| Rate for Payer: Ohio Health Group HMO |
$4,209.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,122.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$729.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,739.88
|
| Rate for Payer: PHCS Commercial |
$5,388.00
|
| Rate for Payer: United Healthcare All Payer |
$4,939.00
|
|
