OPTIM MEDICAL CENTER - SCREVEN

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
25444	ARTHROPLASTY W/PROSTHETIC REPLACEMENT LU	$290,720	$290,720	$46,408	$208,481	7
IPG KIT 2500	IPG KIT 2500	$202,400	$202,400	$32,309	$145,145	7
IPG KIT	IPG KIT	$184,000	$184,000	$29,372	$131,950	7
INTELLIS MRI COMPATIBLE INS	INTELLIS MRI COMPATIBLE INS	$183,600	$183,600	$29,308	$131,663	7
IPG / CHARGER KIT	IPG / CHARGER KIT	$153,024	$153,024	$24,427	$109,736	7
MODULUS XLW 10X22X45MM 10DEG	MODULUS XLW 10X22X45MM 10DEG	$144,200	$144,200	$23,019	$103,408	7
NUV MAS PLIF 1 W/ INTERBODY & DISPOSABLE	NUV MAS PLIF 1 W/ INTERBODY & DISPOSABLE	$112,000	$112,000	$17,879	$80,317	7
SPHERX PPS 1-LVL PLIF W/COROENT LI NV	SPHERX PPS 1-LVL PLIF W/COROENT LI NV	$112,000	$112,000	$17,879	$80,317	7
MODULUS XL 10X18X55MM 10DEG	MODULUS XL 10X18X55MM 10DEG	$106,400	$106,400	$16,985	$76,301	7
KIT PLIF TLIF LEVEL 1	KIT PLIF TLIF LEVEL 1	$104,000	$104,000	$16,602	$74,580	7
FEMORAL HEMI CONDYLE MEDIAL LEFT FRESH	FEMORAL HEMI CONDYLE MEDIAL LEFT FRESH	$93,360	$93,360	$14,903	$66,950	7
FEMORAL HEMI CONDYLE LATER LEFT FRESH	FEMORAL HEMI CONDYLE LATER LEFT FRESH	$91,400	$91,400	$14,590	$65,545	7
CAGE ELSA 20X50MM 8-15MM 6DEG	CAGE ELSA 20X50MM 8-15MM 6DEG	$89,600	$89,600	$14,303	$64,254	7
TLIF TI OBLIQUE 6X10X30MM 4 DEGREE	TLIF TI OBLIQUE 6X10X30MM 4 DEGREE	$78,536	$78,536	$12,537	$56,320	7
TLIF OBLIQUE TI INTERBODY 8X10X30MM 4DEG	TLIF OBLIQUE TI INTERBODY 8X10X30MM 4DEG	$78,536	$78,536	$12,537	$56,320	7
TLIF OBLIQUE TI INTERBODY10X10X30MM 4DEG	TLIF OBLIQUE TI INTERBODY10X10X30MM 4DEG	$78,536	$78,536	$12,537	$56,320	7
COROENT LARGE MP TI 8X9X28 4 DEGREE	COROENT LARGE MP TI 8X9X28 4 DEGREE	$71,240	$71,240	$11,372	$51,087	7
COROENT LARGE MP TI 10X9X28MM 12 DEGREE	COROENT LARGE MP TI 10X9X28MM 12 DEGREE	$71,240	$71,240	$11,372	$51,087	7
62380	DECOMPRESSION OF SPINAL CORD/ NERVE ROOT	$69,000	$69,000	$11,014	$49,481	7
STEM FEMORAL12/11 AMT CEMENTLESS SZ 15	STEM FEMORAL12/11 AMT CEMENTLESS SZ 15	$65,015	$65,015	$10,378	$46,623	7
IMPLANT PRODISC C MEDIUM 5MM STERILE	IMPLANT PRODISC C MEDIUM 5MM STERILE	$62,216	$62,216	$9,932	$44,616	7
SPACER EXPANDABLE 12X28X08MM-13MM 7DEG	SPACER EXPANDABLE 12X28X08MM-13MM 7DEG	$60,000	$60,000	$9,578	$43,027	7
PLIF / TLIF EACH ADDITIONAL LEVEL	PLIF / TLIF EACH ADDITIONAL LEVEL	$60,000	$60,000	$9,578	$43,027	7
FEMORAL REV COMP SZ 66.5X60.5MM RT F4R	FEMORAL REV COMP SZ 66.5X60.5MM RT F4R	$57,672	$57,672	$9,206	$41,358	7
FEMORAL REV COMP SZ 62.5X56.5MM RT F3R	FEMORAL REV COMP SZ 62.5X56.5MM RT F3R	$57,672	$57,672	$9,206	$41,358	7
CAGE T-PLIF IBF 9MMX27MMX10MM 5DEGREE	CAGE T-PLIF IBF 9MMX27MMX10MM 5DEGREE	$54,800	$54,800	$8,748	$39,298	7
CORENT SM ACR 12X17X14 20DEG TA MARK	CORENT SM ACR 12X17X14 20DEG TA MARK	$54,400	$54,400	$8,684	$39,011	7
CAGE RISE 10X22MM 7-13MM	CAGE RISE 10X22MM 7-13MM	$53,760	$53,760	$8,582	$38,552	7
CAGE RISE 10X30MM 7-14MM	CAGE RISE 10X30MM 7-14MM	$53,760	$53,760	$8,582	$38,552	7
SPACER EXPANDABLE 9X26X9.5-14MM 10 DEG	SPACER EXPANDABLE 9X26X9.5-14MM 10 DEG	$52,000	$52,000	$8,301	$37,290	7
SPACER EXPANDABLE 9X26X7MM 3 DEG	SPACER EXPANDABLE 9X26X7MM 3 DEG	$52,000	$52,000	$8,301	$37,290	7
TIBIAL REV COMP SZ 70MMX45MM T2	TIBIAL REV COMP SZ 70MMX45MM T2	$50,928	$50,928	$8,130	$36,521	7
TIBIAL REV COMP SZ 65MMX43MM T1	TIBIAL REV COMP SZ 65MMX43MM T1	$50,928	$50,928	$8,130	$36,521	7
TIBIAL REV COMP SZ 75MMX52MM T3+	TIBIAL REV COMP SZ 75MMX52MM T3+	$50,928	$50,928	$8,130	$36,521	7
SPACER EXPANDABLE 9X24X9.5-14MM 10 DEG	SPACER EXPANDABLE 9X24X9.5-14MM 10 DEG	$49,200	$49,200	$7,854	$35,282	7
STRYKER NAVIGATION CASE RENTAL	STRYKER NAVIGATION CASE RENTAL	$48,000	$48,000	$7,662	$34,422	7
CAGE INTERBODY LUMBAR LAT ADJ 50MM	CAGE INTERBODY LUMBAR LAT ADJ 50MM	$48,000	$48,000	$7,662	$34,422	7
IMPLANT 14MM LUNA 3D GEN2 12 DEGREE	IMPLANT 14MM LUNA 3D GEN2 12 DEGREE	$47,976	$47,976	$7,658	$34,404	7
IMPLANT 12MM LUNA 3D GEN2 12 DEGREE	IMPLANT 12MM LUNA 3D GEN2 12 DEGREE	$47,976	$47,976	$7,658	$34,404	7
STEM HUMERAL SMALL 12X108MM P2 POR COAT	STEM HUMERAL SMALL 12X108MM P2 POR COAT	$46,498	$46,498	$7,422	$33,344	7
TIBIAL TRAY INFINITY SIZE 4 PLASMA SPRAY	TIBIAL TRAY INFINITY SIZE 4 PLASMA SPRAY	$45,864	$45,864	$7,321	$32,890	7
CEMENTED FEM TC 3 SIZE 4 RIGHT	CEMENTED FEM TC 3 SIZE 4 RIGHT	$45,113	$45,113	$7,201	$32,351	7
FEM TC3 SZ2.5 RIGHT CEM SIGMA	FEM TC3 SZ2.5 RIGHT CEM SIGMA	$45,113	$45,113	$7,201	$32,351	7
SIGMA FEMORAL TC3 CEMENTED SIZE 4 LEFT	SIGMA FEMORAL TC3 CEMENTED SIZE 4 LEFT	$45,113	$45,113	$7,201	$32,351	7
CONE FEMORAL AUGMENT SZ 1&2 RIGHT	CONE FEMORAL AUGMENT SZ 1&2 RIGHT	$43,978	$43,978	$7,020	$31,537	7
COFLEX 8MM REF UQI00008	COFLEX 8MM REF UQI00008	$42,400	$42,400	$6,768	$30,406	7
FEMORAL COMPONENT CEM SZ6 LEFT PS	FEMORAL COMPONENT CEM SZ6 LEFT PS	$41,709	$41,709	$6,658	$29,910	7
PLATE LAPIPLASTY ONE SCREW KIT	PLATE LAPIPLASTY ONE SCREW KIT	$41,560	$41,560	$6,634	$29,803	7
DOME INBONE TALAR SIZE 3 PLASMA SPRAY	DOME INBONE TALAR SIZE 3 PLASMA SPRAY	$39,832	$39,832	$6,358	$28,564	7
DOME TALAR SZ2 SULCUS PLASMA SPRAY	DOME TALAR SZ2 SULCUS PLASMA SPRAY	$39,832	$39,832	$6,358	$28,564	7

Showing top 50 of 2,816 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.