|
GENI II MIS TIB BS CEM SZ-1 LF
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-1 RT
|
Facility
|
IP
|
$7,827.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,348.14 |
| Max. Negotiated Rate |
$7,514.04 |
| Rate for Payer: Aetna Commercial |
$6,026.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,105.15
|
| Rate for Payer: Cash Price |
$3,913.56
|
| Rate for Payer: Cigna Commercial |
$6,496.51
|
| Rate for Payer: First Health Commercial |
$7,435.76
|
| Rate for Payer: Humana Commercial |
$6,653.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,418.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,776.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,348.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,887.87
|
| Rate for Payer: Ohio Health Group HMO |
$5,870.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,261.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,809.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,400.71
|
| Rate for Payer: PHCS Commercial |
$7,514.04
|
| Rate for Payer: United Healthcare All Payer |
$6,887.87
|
|
|
GENI II MIS TIB BS CEM SZ-1 RT
|
Facility
|
OP
|
$7,827.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,348.14 |
| Max. Negotiated Rate |
$7,514.04 |
| Rate for Payer: Aetna Commercial |
$6,026.88
|
| Rate for Payer: Anthem Medicaid |
$2,691.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,105.15
|
| Rate for Payer: Cash Price |
$3,913.56
|
| Rate for Payer: Cigna Commercial |
$6,496.51
|
| Rate for Payer: First Health Commercial |
$7,435.76
|
| Rate for Payer: Humana Commercial |
$6,653.05
|
| Rate for Payer: Humana KY Medicaid |
$2,691.75
|
| Rate for Payer: Kentucky WC Medicaid |
$2,719.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,418.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,776.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,348.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,745.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,887.87
|
| Rate for Payer: Ohio Health Group HMO |
$5,870.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,261.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,809.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,400.71
|
| Rate for Payer: PHCS Commercial |
$7,514.04
|
| Rate for Payer: United Healthcare All Payer |
$6,887.87
|
|
|
GENI II MIS TIB BS CEM SZ-2 LF
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-2 LF
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-2 RT
|
Facility
|
OP
|
$7,827.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,348.14 |
| Max. Negotiated Rate |
$7,514.04 |
| Rate for Payer: Aetna Commercial |
$6,026.88
|
| Rate for Payer: Anthem Medicaid |
$2,691.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,105.15
|
| Rate for Payer: Cash Price |
$3,913.56
|
| Rate for Payer: Cigna Commercial |
$6,496.51
|
| Rate for Payer: First Health Commercial |
$7,435.76
|
| Rate for Payer: Humana Commercial |
$6,653.05
|
| Rate for Payer: Humana KY Medicaid |
$2,691.75
|
| Rate for Payer: Kentucky WC Medicaid |
$2,719.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,418.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,776.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,348.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,745.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,887.87
|
| Rate for Payer: Ohio Health Group HMO |
$5,870.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,261.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,809.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,400.71
|
| Rate for Payer: PHCS Commercial |
$7,514.04
|
| Rate for Payer: United Healthcare All Payer |
$6,887.87
|
|
|
GENI II MIS TIB BS CEM SZ-2 RT
|
Facility
|
IP
|
$7,827.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,348.14 |
| Max. Negotiated Rate |
$7,514.04 |
| Rate for Payer: Aetna Commercial |
$6,026.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,105.15
|
| Rate for Payer: Cash Price |
$3,913.56
|
| Rate for Payer: Cigna Commercial |
$6,496.51
|
| Rate for Payer: First Health Commercial |
$7,435.76
|
| Rate for Payer: Humana Commercial |
$6,653.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,418.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,776.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,348.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,887.87
|
| Rate for Payer: Ohio Health Group HMO |
$5,870.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,261.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,809.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,400.71
|
| Rate for Payer: PHCS Commercial |
$7,514.04
|
| Rate for Payer: United Healthcare All Payer |
$6,887.87
|
|
|
GENI II MIS TIB BS CEM SZ-3 LF
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-3 LF
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-3 RT
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-3 RT
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-4 LF
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-4 LF
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-4 RT
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-4 RT
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-5 RT
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-5 RT
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-6 RT
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-6 RT
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-7 RT
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-7 RT
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-8 RT
|
Facility
|
OP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem Medicaid |
$2,472.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Humana KY Medicaid |
$2,472.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,497.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,521.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GENI II MIS TIB BS CEM SZ-8 RT
|
Facility
|
IP
|
$7,188.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,156.51 |
| Max. Negotiated Rate |
$6,900.84 |
| Rate for Payer: Aetna Commercial |
$5,535.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,606.94
|
| Rate for Payer: Cash Price |
$3,594.19
|
| Rate for Payer: Cigna Commercial |
$5,966.36
|
| Rate for Payer: First Health Commercial |
$6,828.96
|
| Rate for Payer: Humana Commercial |
$6,110.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,894.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,305.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,156.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,325.77
|
| Rate for Payer: Ohio Health Group HMO |
$5,391.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,750.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,253.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,959.98
|
| Rate for Payer: PHCS Commercial |
$6,900.84
|
| Rate for Payer: United Healthcare All Payer |
$6,325.77
|
|
|
GEN II PS FEMORAL NP SZ 4 RT
|
Facility
|
OP
|
$7,745.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,323.50 |
| Max. Negotiated Rate |
$7,435.20 |
| Rate for Payer: Aetna Commercial |
$5,963.65
|
| Rate for Payer: Anthem Medicaid |
$2,663.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,041.10
|
| Rate for Payer: Cash Price |
$3,872.50
|
| Rate for Payer: Cigna Commercial |
$6,428.35
|
| Rate for Payer: First Health Commercial |
$7,357.75
|
| Rate for Payer: Humana Commercial |
$6,583.25
|
| Rate for Payer: Humana KY Medicaid |
$2,663.51
|
| Rate for Payer: Kentucky WC Medicaid |
$2,690.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,350.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,715.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,323.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,716.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,815.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,808.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,738.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,344.05
|
| Rate for Payer: PHCS Commercial |
$7,435.20
|
| Rate for Payer: United Healthcare All Payer |
$6,815.60
|
|
|
GEN II PS FEMORAL NP SZ 4 RT
|
Facility
|
IP
|
$7,745.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,323.50 |
| Max. Negotiated Rate |
$7,435.20 |
| Rate for Payer: Aetna Commercial |
$5,963.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,041.10
|
| Rate for Payer: Cash Price |
$3,872.50
|
| Rate for Payer: Cigna Commercial |
$6,428.35
|
| Rate for Payer: First Health Commercial |
$7,357.75
|
| Rate for Payer: Humana Commercial |
$6,583.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,350.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,715.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,323.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,815.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,808.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,738.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,344.05
|
| Rate for Payer: PHCS Commercial |
$7,435.20
|
| Rate for Payer: United Healthcare All Payer |
$6,815.60
|
|
