|
GLOBAL ADVANTAGE HUM HD 48*18
|
Facility
|
IP
|
$10,037.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,304.93 |
| Max. Negotiated Rate |
$9,636.43 |
| Rate for Payer: Aetna Commercial |
$7,729.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,829.60
|
| Rate for Payer: Cash Price |
$5,018.98
|
| Rate for Payer: Cigna Commercial |
$8,331.50
|
| Rate for Payer: First Health Commercial |
$9,536.05
|
| Rate for Payer: Humana Commercial |
$8,532.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,231.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,408.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,011.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,833.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,528.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,007.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,304.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,111.76
|
| Rate for Payer: PHCS Commercial |
$9,636.43
|
| Rate for Payer: United Healthcare All Payer |
$8,833.40
|
|
|
GLOBAL ADVANTAGE HUM HD 48*21
|
Facility
|
OP
|
$8,988.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,168.56 |
| Max. Negotiated Rate |
$8,629.38 |
| Rate for Payer: Aetna Commercial |
$6,921.48
|
| Rate for Payer: Anthem Medicaid |
$3,091.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,011.37
|
| Rate for Payer: Cash Price |
$4,494.47
|
| Rate for Payer: Cigna Commercial |
$7,460.82
|
| Rate for Payer: First Health Commercial |
$8,539.49
|
| Rate for Payer: Humana Commercial |
$7,640.60
|
| Rate for Payer: Humana KY Medicaid |
$3,091.30
|
| Rate for Payer: Kentucky WC Medicaid |
$3,122.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,370.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,633.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,696.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,153.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,910.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,741.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,797.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,168.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,786.57
|
| Rate for Payer: PHCS Commercial |
$8,629.38
|
| Rate for Payer: United Healthcare All Payer |
$7,910.27
|
|
|
GLOBAL ADVANTAGE HUM HD 48*21
|
Facility
|
IP
|
$8,988.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,168.56 |
| Max. Negotiated Rate |
$8,629.38 |
| Rate for Payer: Aetna Commercial |
$6,921.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,011.37
|
| Rate for Payer: Cash Price |
$4,494.47
|
| Rate for Payer: Cigna Commercial |
$7,460.82
|
| Rate for Payer: First Health Commercial |
$8,539.49
|
| Rate for Payer: Humana Commercial |
$7,640.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,370.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,633.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,696.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,910.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,741.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,797.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,168.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,786.57
|
| Rate for Payer: PHCS Commercial |
$8,629.38
|
| Rate for Payer: United Healthcare All Payer |
$7,910.27
|
|
|
GLOBAL ADVANTAGE HUM HD 52*15
|
Facility
|
IP
|
$6,538.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$6,276.97 |
| Rate for Payer: Aetna Commercial |
$5,034.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,100.04
|
| Rate for Payer: Cash Price |
$3,269.26
|
| Rate for Payer: Cigna Commercial |
$5,426.96
|
| Rate for Payer: First Health Commercial |
$6,211.58
|
| Rate for Payer: Humana Commercial |
$5,557.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,361.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,825.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,961.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,753.89
|
| Rate for Payer: Ohio Health Group HMO |
$4,903.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,307.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$850.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,026.94
|
| Rate for Payer: PHCS Commercial |
$6,276.97
|
| Rate for Payer: United Healthcare All Payer |
$5,753.89
|
|
|
GLOBAL ADVANTAGE HUM HD 52*15
|
Facility
|
OP
|
$6,538.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$6,276.97 |
| Rate for Payer: Aetna Commercial |
$5,034.65
|
| Rate for Payer: Anthem Medicaid |
$2,248.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,100.04
|
| Rate for Payer: Cash Price |
$3,269.26
|
| Rate for Payer: Cigna Commercial |
$5,426.96
|
| Rate for Payer: First Health Commercial |
$6,211.58
|
| Rate for Payer: Humana Commercial |
$5,557.73
|
| Rate for Payer: Humana KY Medicaid |
$2,248.59
|
| Rate for Payer: Kentucky WC Medicaid |
$2,271.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,361.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,825.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,961.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,293.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,753.89
|
| Rate for Payer: Ohio Health Group HMO |
$4,903.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,307.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$850.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,026.94
|
| Rate for Payer: PHCS Commercial |
$6,276.97
|
| Rate for Payer: United Healthcare All Payer |
$5,753.89
|
|
|
GLOBAL ADVANTAGE HUM HD 52*18
|
Facility
|
IP
|
$13,114.85
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,704.93 |
| Max. Negotiated Rate |
$12,590.26 |
| Rate for Payer: Aetna Commercial |
$10,098.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,229.58
|
| Rate for Payer: Cash Price |
$6,557.42
|
| Rate for Payer: Cigna Commercial |
$10,885.33
|
| Rate for Payer: First Health Commercial |
$12,459.11
|
| Rate for Payer: Humana Commercial |
$11,147.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,754.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,678.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,934.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,541.07
|
| Rate for Payer: Ohio Health Group HMO |
$9,836.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,622.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,704.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,065.60
|
| Rate for Payer: PHCS Commercial |
$12,590.26
|
| Rate for Payer: United Healthcare All Payer |
$11,541.07
|
|
|
GLOBAL ADVANTAGE HUM HD 52*18
|
Facility
|
OP
|
$13,114.85
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,704.93 |
| Max. Negotiated Rate |
$12,590.26 |
| Rate for Payer: Aetna Commercial |
$10,098.43
|
| Rate for Payer: Anthem Medicaid |
$4,510.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,229.58
|
| Rate for Payer: Cash Price |
$6,557.42
|
| Rate for Payer: Cigna Commercial |
$10,885.33
|
| Rate for Payer: First Health Commercial |
$12,459.11
|
| Rate for Payer: Humana Commercial |
$11,147.62
|
| Rate for Payer: Humana KY Medicaid |
$4,510.20
|
| Rate for Payer: Kentucky WC Medicaid |
$4,556.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,754.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,678.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,934.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,600.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,541.07
|
| Rate for Payer: Ohio Health Group HMO |
$9,836.14
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,622.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,704.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,065.60
|
| Rate for Payer: PHCS Commercial |
$12,590.26
|
| Rate for Payer: United Healthcare All Payer |
$11,541.07
|
|
|
GLOBAL ADVANTAGE HUM HD 52*21
|
Facility
|
OP
|
$8,988.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,168.56 |
| Max. Negotiated Rate |
$8,629.38 |
| Rate for Payer: Aetna Commercial |
$6,921.48
|
| Rate for Payer: Anthem Medicaid |
$3,091.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,011.37
|
| Rate for Payer: Cash Price |
$4,494.47
|
| Rate for Payer: Cigna Commercial |
$7,460.82
|
| Rate for Payer: First Health Commercial |
$8,539.49
|
| Rate for Payer: Humana Commercial |
$7,640.60
|
| Rate for Payer: Humana KY Medicaid |
$3,091.30
|
| Rate for Payer: Kentucky WC Medicaid |
$3,122.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,370.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,633.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,696.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,153.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,910.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,741.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,797.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,168.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,786.57
|
| Rate for Payer: PHCS Commercial |
$8,629.38
|
| Rate for Payer: United Healthcare All Payer |
$7,910.27
|
|
|
GLOBAL ADVANTAGE HUM HD 52*21
|
Facility
|
IP
|
$8,988.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,168.56 |
| Max. Negotiated Rate |
$8,629.38 |
| Rate for Payer: Aetna Commercial |
$6,921.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,011.37
|
| Rate for Payer: Cash Price |
$4,494.47
|
| Rate for Payer: Cigna Commercial |
$7,460.82
|
| Rate for Payer: First Health Commercial |
$8,539.49
|
| Rate for Payer: Humana Commercial |
$7,640.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,370.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,633.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,696.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,910.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,741.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,797.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,168.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,786.57
|
| Rate for Payer: PHCS Commercial |
$8,629.38
|
| Rate for Payer: United Healthcare All Payer |
$7,910.27
|
|
|
GLOBAL ADVANTAGE HUM HD 56*15
|
Facility
|
OP
|
$6,538.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$6,276.97 |
| Rate for Payer: Aetna Commercial |
$5,034.65
|
| Rate for Payer: Anthem Medicaid |
$2,248.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,100.04
|
| Rate for Payer: Cash Price |
$3,269.26
|
| Rate for Payer: Cigna Commercial |
$5,426.96
|
| Rate for Payer: First Health Commercial |
$6,211.58
|
| Rate for Payer: Humana Commercial |
$5,557.73
|
| Rate for Payer: Humana KY Medicaid |
$2,248.59
|
| Rate for Payer: Kentucky WC Medicaid |
$2,271.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,361.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,825.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,961.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,293.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,753.89
|
| Rate for Payer: Ohio Health Group HMO |
$4,903.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,307.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$850.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,026.94
|
| Rate for Payer: PHCS Commercial |
$6,276.97
|
| Rate for Payer: United Healthcare All Payer |
$5,753.89
|
|
|
GLOBAL ADVANTAGE HUM HD 56*15
|
Facility
|
IP
|
$6,538.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$6,276.97 |
| Rate for Payer: Aetna Commercial |
$5,034.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,100.04
|
| Rate for Payer: Cash Price |
$3,269.26
|
| Rate for Payer: Cigna Commercial |
$5,426.96
|
| Rate for Payer: First Health Commercial |
$6,211.58
|
| Rate for Payer: Humana Commercial |
$5,557.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,361.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,825.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,961.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,753.89
|
| Rate for Payer: Ohio Health Group HMO |
$4,903.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,307.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$850.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,026.94
|
| Rate for Payer: PHCS Commercial |
$6,276.97
|
| Rate for Payer: United Healthcare All Payer |
$5,753.89
|
|
|
GLOBAL ADVANTAGE HUM HD 56*18
|
Facility
|
IP
|
$6,538.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$6,276.97 |
| Rate for Payer: Aetna Commercial |
$5,034.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,100.04
|
| Rate for Payer: Cash Price |
$3,269.26
|
| Rate for Payer: Cigna Commercial |
$5,426.96
|
| Rate for Payer: First Health Commercial |
$6,211.58
|
| Rate for Payer: Humana Commercial |
$5,557.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,361.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,825.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,961.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,753.89
|
| Rate for Payer: Ohio Health Group HMO |
$4,903.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,307.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$850.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,026.94
|
| Rate for Payer: PHCS Commercial |
$6,276.97
|
| Rate for Payer: United Healthcare All Payer |
$5,753.89
|
|
|
GLOBAL ADVANTAGE HUM HD 56*18
|
Facility
|
OP
|
$6,538.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$6,276.97 |
| Rate for Payer: Aetna Commercial |
$5,034.65
|
| Rate for Payer: Anthem Medicaid |
$2,248.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,100.04
|
| Rate for Payer: Cash Price |
$3,269.26
|
| Rate for Payer: Cigna Commercial |
$5,426.96
|
| Rate for Payer: First Health Commercial |
$6,211.58
|
| Rate for Payer: Humana Commercial |
$5,557.73
|
| Rate for Payer: Humana KY Medicaid |
$2,248.59
|
| Rate for Payer: Kentucky WC Medicaid |
$2,271.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,361.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,825.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,961.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,293.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,753.89
|
| Rate for Payer: Ohio Health Group HMO |
$4,903.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,307.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$850.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,026.94
|
| Rate for Payer: PHCS Commercial |
$6,276.97
|
| Rate for Payer: United Healthcare All Payer |
$5,753.89
|
|
|
GLOBAL ADVANTAGE HUM HD 56*21
|
Facility
|
IP
|
$9,625.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,251.32 |
| Max. Negotiated Rate |
$9,240.48 |
| Rate for Payer: Aetna Commercial |
$7,411.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,507.89
|
| Rate for Payer: Cash Price |
$4,812.75
|
| Rate for Payer: Cigna Commercial |
$7,989.16
|
| Rate for Payer: First Health Commercial |
$9,144.22
|
| Rate for Payer: Humana Commercial |
$8,181.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,892.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,103.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,887.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,470.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,219.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,925.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,251.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,983.90
|
| Rate for Payer: PHCS Commercial |
$9,240.48
|
| Rate for Payer: United Healthcare All Payer |
$8,470.44
|
|
|
GLOBAL ADVANTAGE HUM HD 56*21
|
Facility
|
OP
|
$9,625.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,251.32 |
| Max. Negotiated Rate |
$9,240.48 |
| Rate for Payer: Aetna Commercial |
$7,411.64
|
| Rate for Payer: Anthem Medicaid |
$3,310.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,507.89
|
| Rate for Payer: Cash Price |
$4,812.75
|
| Rate for Payer: Cigna Commercial |
$7,989.16
|
| Rate for Payer: First Health Commercial |
$9,144.22
|
| Rate for Payer: Humana Commercial |
$8,181.68
|
| Rate for Payer: Humana KY Medicaid |
$3,310.21
|
| Rate for Payer: Kentucky WC Medicaid |
$3,343.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,892.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,103.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,887.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,376.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,470.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,219.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,925.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,251.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,983.90
|
| Rate for Payer: PHCS Commercial |
$9,240.48
|
| Rate for Payer: United Healthcare All Payer |
$8,470.44
|
|
|
GLOBAL ADVANTAGE STEM 10 LONG
|
Facility
|
IP
|
$15,032.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.21 |
| Max. Negotiated Rate |
$14,431.10 |
| Rate for Payer: Aetna Commercial |
$11,574.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,725.27
|
| Rate for Payer: Cash Price |
$7,516.20
|
| Rate for Payer: Cigna Commercial |
$12,476.89
|
| Rate for Payer: First Health Commercial |
$14,280.78
|
| Rate for Payer: Humana Commercial |
$12,777.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,326.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,093.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,509.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,228.51
|
| Rate for Payer: Ohio Health Group HMO |
$11,274.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,006.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,954.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,660.04
|
| Rate for Payer: PHCS Commercial |
$14,431.10
|
| Rate for Payer: United Healthcare All Payer |
$13,228.51
|
|
|
GLOBAL ADVANTAGE STEM 10 LONG
|
Facility
|
OP
|
$15,032.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.21 |
| Max. Negotiated Rate |
$14,431.10 |
| Rate for Payer: Aetna Commercial |
$11,574.95
|
| Rate for Payer: Anthem Medicaid |
$5,169.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,725.27
|
| Rate for Payer: Cash Price |
$7,516.20
|
| Rate for Payer: Cigna Commercial |
$12,476.89
|
| Rate for Payer: First Health Commercial |
$14,280.78
|
| Rate for Payer: Humana Commercial |
$12,777.54
|
| Rate for Payer: Humana KY Medicaid |
$5,169.64
|
| Rate for Payer: Kentucky WC Medicaid |
$5,222.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,326.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,093.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,509.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,273.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,228.51
|
| Rate for Payer: Ohio Health Group HMO |
$11,274.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,006.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,954.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,660.04
|
| Rate for Payer: PHCS Commercial |
$14,431.10
|
| Rate for Payer: United Healthcare All Payer |
$13,228.51
|
|
|
GLOBAL ADVANTAGE STEM 10MM
|
Facility
|
IP
|
$24,977.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,247.04 |
| Max. Negotiated Rate |
$23,978.11 |
| Rate for Payer: Aetna Commercial |
$19,232.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,482.22
|
| Rate for Payer: Cash Price |
$12,488.60
|
| Rate for Payer: Cigna Commercial |
$20,731.08
|
| Rate for Payer: First Health Commercial |
$23,728.34
|
| Rate for Payer: Humana Commercial |
$21,230.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,481.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,433.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,493.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,979.94
|
| Rate for Payer: Ohio Health Group HMO |
$18,732.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,995.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,247.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,742.93
|
| Rate for Payer: PHCS Commercial |
$23,978.11
|
| Rate for Payer: United Healthcare All Payer |
$21,979.94
|
|
|
GLOBAL ADVANTAGE STEM 10MM
|
Facility
|
OP
|
$24,977.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,247.04 |
| Max. Negotiated Rate |
$23,978.11 |
| Rate for Payer: Aetna Commercial |
$19,232.44
|
| Rate for Payer: Anthem Medicaid |
$8,589.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,482.22
|
| Rate for Payer: Cash Price |
$12,488.60
|
| Rate for Payer: Cigna Commercial |
$20,731.08
|
| Rate for Payer: First Health Commercial |
$23,728.34
|
| Rate for Payer: Humana Commercial |
$21,230.62
|
| Rate for Payer: Humana KY Medicaid |
$8,589.66
|
| Rate for Payer: Kentucky WC Medicaid |
$8,677.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,481.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,433.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,493.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,762.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,979.94
|
| Rate for Payer: Ohio Health Group HMO |
$18,732.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,995.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,247.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,742.93
|
| Rate for Payer: PHCS Commercial |
$23,978.11
|
| Rate for Payer: United Healthcare All Payer |
$21,979.94
|
|
|
GLOBAL ADVANTAGE STEM 12 LONG
|
Facility
|
IP
|
$15,032.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.21 |
| Max. Negotiated Rate |
$14,431.10 |
| Rate for Payer: Aetna Commercial |
$11,574.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,725.27
|
| Rate for Payer: Cash Price |
$7,516.20
|
| Rate for Payer: Cigna Commercial |
$12,476.89
|
| Rate for Payer: First Health Commercial |
$14,280.78
|
| Rate for Payer: Humana Commercial |
$12,777.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,326.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,093.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,509.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,228.51
|
| Rate for Payer: Ohio Health Group HMO |
$11,274.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,006.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,954.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,660.04
|
| Rate for Payer: PHCS Commercial |
$14,431.10
|
| Rate for Payer: United Healthcare All Payer |
$13,228.51
|
|
|
GLOBAL ADVANTAGE STEM 12 LONG
|
Facility
|
OP
|
$15,032.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.21 |
| Max. Negotiated Rate |
$14,431.10 |
| Rate for Payer: Aetna Commercial |
$11,574.95
|
| Rate for Payer: Anthem Medicaid |
$5,169.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,725.27
|
| Rate for Payer: Cash Price |
$7,516.20
|
| Rate for Payer: Cigna Commercial |
$12,476.89
|
| Rate for Payer: First Health Commercial |
$14,280.78
|
| Rate for Payer: Humana Commercial |
$12,777.54
|
| Rate for Payer: Humana KY Medicaid |
$5,169.64
|
| Rate for Payer: Kentucky WC Medicaid |
$5,222.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,326.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,093.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,509.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,273.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,228.51
|
| Rate for Payer: Ohio Health Group HMO |
$11,274.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,006.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,954.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,660.04
|
| Rate for Payer: PHCS Commercial |
$14,431.10
|
| Rate for Payer: United Healthcare All Payer |
$13,228.51
|
|
|
GLOBAL ADVANTAGE STEM 12MM
|
Facility
|
OP
|
$23,535.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,059.61 |
| Max. Negotiated Rate |
$22,594.03 |
| Rate for Payer: Aetna Commercial |
$18,122.30
|
| Rate for Payer: Anthem Medicaid |
$8,093.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,357.65
|
| Rate for Payer: Cash Price |
$11,767.73
|
| Rate for Payer: Cigna Commercial |
$19,534.42
|
| Rate for Payer: First Health Commercial |
$22,358.68
|
| Rate for Payer: Humana Commercial |
$20,005.13
|
| Rate for Payer: Humana KY Medicaid |
$8,093.84
|
| Rate for Payer: Kentucky WC Medicaid |
$8,176.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,299.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,369.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,060.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,256.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,711.20
|
| Rate for Payer: Ohio Health Group HMO |
$17,651.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,707.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,059.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,295.99
|
| Rate for Payer: PHCS Commercial |
$22,594.03
|
| Rate for Payer: United Healthcare All Payer |
$20,711.20
|
|
|
GLOBAL ADVANTAGE STEM 12MM
|
Facility
|
IP
|
$23,535.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,059.61 |
| Max. Negotiated Rate |
$22,594.03 |
| Rate for Payer: Aetna Commercial |
$18,122.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,357.65
|
| Rate for Payer: Cash Price |
$11,767.73
|
| Rate for Payer: Cigna Commercial |
$19,534.42
|
| Rate for Payer: First Health Commercial |
$22,358.68
|
| Rate for Payer: Humana Commercial |
$20,005.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,299.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,369.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,060.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,711.20
|
| Rate for Payer: Ohio Health Group HMO |
$17,651.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,707.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,059.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,295.99
|
| Rate for Payer: PHCS Commercial |
$22,594.03
|
| Rate for Payer: United Healthcare All Payer |
$20,711.20
|
|
|
GLOBAL ADVANTAGE STEM 14 LONG
|
Facility
|
OP
|
$15,032.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.21 |
| Max. Negotiated Rate |
$14,431.10 |
| Rate for Payer: Aetna Commercial |
$11,574.95
|
| Rate for Payer: Anthem Medicaid |
$5,169.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,725.27
|
| Rate for Payer: Cash Price |
$7,516.20
|
| Rate for Payer: Cigna Commercial |
$12,476.89
|
| Rate for Payer: First Health Commercial |
$14,280.78
|
| Rate for Payer: Humana Commercial |
$12,777.54
|
| Rate for Payer: Humana KY Medicaid |
$5,169.64
|
| Rate for Payer: Kentucky WC Medicaid |
$5,222.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,326.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,093.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,509.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,273.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,228.51
|
| Rate for Payer: Ohio Health Group HMO |
$11,274.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,006.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,954.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,660.04
|
| Rate for Payer: PHCS Commercial |
$14,431.10
|
| Rate for Payer: United Healthcare All Payer |
$13,228.51
|
|
|
GLOBAL ADVANTAGE STEM 14 LONG
|
Facility
|
IP
|
$15,032.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,954.21 |
| Max. Negotiated Rate |
$14,431.10 |
| Rate for Payer: Aetna Commercial |
$11,574.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,725.27
|
| Rate for Payer: Cash Price |
$7,516.20
|
| Rate for Payer: Cigna Commercial |
$12,476.89
|
| Rate for Payer: First Health Commercial |
$14,280.78
|
| Rate for Payer: Humana Commercial |
$12,777.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,326.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,093.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,509.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,228.51
|
| Rate for Payer: Ohio Health Group HMO |
$11,274.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,006.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,954.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,660.04
|
| Rate for Payer: PHCS Commercial |
$14,431.10
|
| Rate for Payer: United Healthcare All Payer |
$13,228.51
|
|
