|
GLOBAL ADVANTAGE STEM 14MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
GLOBAL ADVANTAGE STEM 14MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
GLOBAL ADVANTAGE STEM 16MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
GLOBAL ADVANTAGE STEM 16MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
GLOBAL ADVANTAGE STEM 6MM
|
Facility
|
OP
|
$25,583.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,325.80 |
| Max. Negotiated Rate |
$24,559.78 |
| Rate for Payer: Aetna Commercial |
$19,698.99
|
| Rate for Payer: Anthem Medicaid |
$8,798.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,954.82
|
| Rate for Payer: Cash Price |
$12,791.55
|
| Rate for Payer: Cigna Commercial |
$21,233.97
|
| Rate for Payer: First Health Commercial |
$24,303.94
|
| Rate for Payer: Humana Commercial |
$21,745.64
|
| Rate for Payer: Humana KY Medicaid |
$8,798.03
|
| Rate for Payer: Kentucky WC Medicaid |
$8,887.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,978.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,880.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,674.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,974.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,513.13
|
| Rate for Payer: Ohio Health Group HMO |
$19,187.32
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,116.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,325.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,930.76
|
| Rate for Payer: PHCS Commercial |
$24,559.78
|
| Rate for Payer: United Healthcare All Payer |
$22,513.13
|
|
|
GLOBAL ADVANTAGE STEM 6MM
|
Facility
|
IP
|
$25,583.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,325.80 |
| Max. Negotiated Rate |
$24,559.78 |
| Rate for Payer: Aetna Commercial |
$19,698.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,954.82
|
| Rate for Payer: Cash Price |
$12,791.55
|
| Rate for Payer: Cigna Commercial |
$21,233.97
|
| Rate for Payer: First Health Commercial |
$24,303.94
|
| Rate for Payer: Humana Commercial |
$21,745.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,978.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,880.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,674.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,513.13
|
| Rate for Payer: Ohio Health Group HMO |
$19,187.32
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,116.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,325.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,930.76
|
| Rate for Payer: PHCS Commercial |
$24,559.78
|
| Rate for Payer: United Healthcare All Payer |
$22,513.13
|
|
|
GLOBAL ADVANTAGE STEM 8 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 8 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 8MM
|
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 8MM
|
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 P/C 12MM
|
Facility
|
OP
|
$30,328.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,942.65 |
| Max. Negotiated Rate |
$29,114.98 |
| Rate for Payer: Aetna Commercial |
$23,352.64
|
| Rate for Payer: Anthem Medicaid |
$10,429.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,655.92
|
| Rate for Payer: Cash Price |
$15,164.05
|
| Rate for Payer: Cigna Commercial |
$25,172.32
|
| Rate for Payer: First Health Commercial |
$28,811.70
|
| Rate for Payer: Humana Commercial |
$25,778.88
|
| Rate for Payer: Humana KY Medicaid |
$10,429.83
|
| Rate for Payer: Kentucky WC Medicaid |
$10,535.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,869.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,382.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,098.43
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,639.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,688.73
|
| Rate for Payer: Ohio Health Group HMO |
$22,746.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,065.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,942.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,401.71
|
| Rate for Payer: PHCS Commercial |
$29,114.98
|
| Rate for Payer: United Healthcare All Payer |
$26,688.73
|
|
|
GLOBAL ADVANTAGE STEM P/C 12MM
|
Facility
|
IP
|
$30,328.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,942.65 |
| Max. Negotiated Rate |
$29,114.98 |
| Rate for Payer: Aetna Commercial |
$23,352.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,655.92
|
| Rate for Payer: Cash Price |
$15,164.05
|
| Rate for Payer: Cigna Commercial |
$25,172.32
|
| Rate for Payer: First Health Commercial |
$28,811.70
|
| Rate for Payer: Humana Commercial |
$25,778.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,869.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,382.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,098.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,688.73
|
| Rate for Payer: Ohio Health Group HMO |
$22,746.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,065.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,942.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,401.71
|
| Rate for Payer: PHCS Commercial |
$29,114.98
|
| Rate for Payer: United Healthcare All Payer |
$26,688.73
|
|
|
GLOBAL ADVANTAGE STEM P/C 14MM
|
Facility
|
IP
|
$21,400.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,782.03 |
| Max. Negotiated Rate |
$20,544.19 |
| Rate for Payer: Aetna Commercial |
$16,478.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,692.16
|
| Rate for Payer: Cash Price |
$10,700.10
|
| Rate for Payer: Cigna Commercial |
$17,762.17
|
| Rate for Payer: First Health Commercial |
$20,330.19
|
| Rate for Payer: Humana Commercial |
$18,190.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,548.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,793.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,420.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,832.18
|
| Rate for Payer: Ohio Health Group HMO |
$16,050.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,280.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,782.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,634.06
|
| Rate for Payer: PHCS Commercial |
$20,544.19
|
| Rate for Payer: United Healthcare All Payer |
$18,832.18
|
|
|
GLOBAL ADVANTAGE STEM P/C 14MM
|
Facility
|
OP
|
$21,400.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,782.03 |
| Max. Negotiated Rate |
$20,544.19 |
| Rate for Payer: Aetna Commercial |
$16,478.15
|
| Rate for Payer: Anthem Medicaid |
$7,359.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,692.16
|
| Rate for Payer: Cash Price |
$10,700.10
|
| Rate for Payer: Cigna Commercial |
$17,762.17
|
| Rate for Payer: First Health Commercial |
$20,330.19
|
| Rate for Payer: Humana Commercial |
$18,190.17
|
| Rate for Payer: Humana KY Medicaid |
$7,359.53
|
| Rate for Payer: Kentucky WC Medicaid |
$7,434.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,548.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,793.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,420.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,507.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,832.18
|
| Rate for Payer: Ohio Health Group HMO |
$16,050.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,280.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,782.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,634.06
|
| Rate for Payer: PHCS Commercial |
$20,544.19
|
| Rate for Payer: United Healthcare All Payer |
$18,832.18
|
|
|
GLOBAL ADVANTAGE STEM P/C 8MM
|
Facility
|
IP
|
$28,860.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,751.90 |
| Max. Negotiated Rate |
$27,706.37 |
| Rate for Payer: Aetna Commercial |
$22,222.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,511.42
|
| Rate for Payer: Cash Price |
$14,430.40
|
| Rate for Payer: Cigna Commercial |
$23,954.46
|
| Rate for Payer: First Health Commercial |
$27,417.76
|
| Rate for Payer: Humana Commercial |
$24,531.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,665.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,299.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,658.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,397.50
|
| Rate for Payer: Ohio Health Group HMO |
$21,645.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,772.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,751.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,946.85
|
| Rate for Payer: PHCS Commercial |
$27,706.37
|
| Rate for Payer: United Healthcare All Payer |
$25,397.50
|
|
|
GLOBAL ADVANTAGE STEM P/C 8MM
|
Facility
|
OP
|
$28,860.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,751.90 |
| Max. Negotiated Rate |
$27,706.37 |
| Rate for Payer: Aetna Commercial |
$22,222.82
|
| Rate for Payer: Anthem Medicaid |
$9,925.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,511.42
|
| Rate for Payer: Cash Price |
$14,430.40
|
| Rate for Payer: Cigna Commercial |
$23,954.46
|
| Rate for Payer: First Health Commercial |
$27,417.76
|
| Rate for Payer: Humana Commercial |
$24,531.68
|
| Rate for Payer: Humana KY Medicaid |
$9,925.23
|
| Rate for Payer: Kentucky WC Medicaid |
$10,026.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,665.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,299.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,658.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,124.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,397.50
|
| Rate for Payer: Ohio Health Group HMO |
$21,645.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,772.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,751.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,946.85
|
| Rate for Payer: PHCS Commercial |
$27,706.37
|
| Rate for Payer: United Healthcare All Payer |
$25,397.50
|
|
|
GLOBAL ADV. HUM STEM P/C 16MM
|
Facility
|
OP
|
$20,312.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,640.62 |
| Max. Negotiated Rate |
$19,500.00 |
| Rate for Payer: Aetna Commercial |
$15,640.62
|
| Rate for Payer: Anthem Medicaid |
$6,985.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,843.75
|
| Rate for Payer: Cash Price |
$10,156.25
|
| Rate for Payer: Cigna Commercial |
$16,859.38
|
| Rate for Payer: First Health Commercial |
$19,296.88
|
| Rate for Payer: Humana Commercial |
$17,265.62
|
| Rate for Payer: Humana KY Medicaid |
$6,985.47
|
| Rate for Payer: Kentucky WC Medicaid |
$7,056.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,656.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,990.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,093.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,125.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,875.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,234.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,062.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,640.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,296.88
|
| Rate for Payer: PHCS Commercial |
$19,500.00
|
| Rate for Payer: United Healthcare All Payer |
$17,875.00
|
|
|
GLOBAL ADV. HUM STEM P/C 16MM
|
Facility
|
IP
|
$20,312.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,640.62 |
| Max. Negotiated Rate |
$19,500.00 |
| Rate for Payer: Aetna Commercial |
$15,640.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,843.75
|
| Rate for Payer: Cash Price |
$10,156.25
|
| Rate for Payer: Cigna Commercial |
$16,859.38
|
| Rate for Payer: First Health Commercial |
$19,296.88
|
| Rate for Payer: Humana Commercial |
$17,265.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,656.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,990.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,093.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,875.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,234.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,062.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,640.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,296.88
|
| Rate for Payer: PHCS Commercial |
$19,500.00
|
| Rate for Payer: United Healthcare All Payer |
$17,875.00
|
|
|
GLOBAL CAP CTA DUOFIX 40*15
|
Facility
|
IP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
|
GLOBAL CAP CTA DUOFIX 40*15
|
Facility
|
OP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem Medicaid |
$10,299.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Humana KY Medicaid |
$10,299.29
|
| Rate for Payer: Kentucky WC Medicaid |
$10,404.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,505.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
|
GLOBAL CAP CTA DUOFIX 40*18
|
Facility
|
IP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
|
GLOBAL CAP CTA DUOFIX 40*18
|
Facility
|
OP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem Medicaid |
$10,299.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Humana KY Medicaid |
$10,299.29
|
| Rate for Payer: Kentucky WC Medicaid |
$10,404.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,505.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
|
GLOBAL CAP CTA DUOFIX 44*15
|
Facility
|
OP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem Medicaid |
$10,299.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Humana KY Medicaid |
$10,299.29
|
| Rate for Payer: Kentucky WC Medicaid |
$10,404.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,505.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
|
GLOBAL CAP CTA DUOFIX 44*15
|
Facility
|
IP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
|
GLOBAL CAP CTA DUOFIX 44*18
|
Facility
|
OP
|
$29,948.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,893.30 |
| Max. Negotiated Rate |
$28,750.56 |
| Rate for Payer: Aetna Commercial |
$23,060.34
|
| Rate for Payer: Anthem Medicaid |
$10,299.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,359.83
|
| Rate for Payer: Cash Price |
$14,974.25
|
| Rate for Payer: Cigna Commercial |
$24,857.26
|
| Rate for Payer: First Health Commercial |
$28,451.08
|
| Rate for Payer: Humana Commercial |
$25,456.22
|
| Rate for Payer: Humana KY Medicaid |
$10,299.29
|
| Rate for Payer: Kentucky WC Medicaid |
$10,404.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,557.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,101.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,984.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,505.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,354.68
|
| Rate for Payer: Ohio Health Group HMO |
$22,461.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,989.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,893.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,284.04
|
| Rate for Payer: PHCS Commercial |
$28,750.56
|
| Rate for Payer: United Healthcare All Payer |
$26,354.68
|
|
