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Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $66.04
Max. Negotiated Rate $487.68
Rate for Payer: Aetna Commercial $391.16
Rate for Payer: Anthem Medicaid $174.70
Rate for Payer: Anthem POS/PPO/Traditional $396.24
Rate for Payer: Cash Price $254.00
Rate for Payer: Cigna Commercial $421.64
Rate for Payer: First Health Commercial $482.60
Rate for Payer: Humana Commercial $431.80
Rate for Payer: Humana KY Medicaid $174.70
Rate for Payer: Kentucky WC Medicaid $176.48
Rate for Payer: Medical Mutual Of Ohio HMO $416.56
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $374.90
Rate for Payer: Molina Healthcare Benefit Exchange $152.40
Rate for Payer: Molina Healthcare Medicaid $178.21
Rate for Payer: Ohio Health Choice Commercial $447.04
Rate for Payer: Ohio Health Group HMO $381.00
Rate for Payer: Ohio Health Group PPO Differential $101.60
Rate for Payer: Ohio Health Group PPO No Differential $66.04
Rate for Payer: Ohio Health Group PPO SOMC Employees $157.48
Rate for Payer: PHCS Commercial $487.68
Rate for Payer: United Healthcare All Payer $447.04
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $66.04
Max. Negotiated Rate $487.68
Rate for Payer: Aetna Commercial $391.16
Rate for Payer: Anthem POS/PPO/Traditional $396.24
Rate for Payer: Cash Price $254.00
Rate for Payer: Cigna Commercial $421.64
Rate for Payer: First Health Commercial $482.60
Rate for Payer: Humana Commercial $431.80
Rate for Payer: Medical Mutual Of Ohio HMO $416.56
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $374.90
Rate for Payer: Molina Healthcare Benefit Exchange $152.40
Rate for Payer: Ohio Health Choice Commercial $447.04
Rate for Payer: Ohio Health Group HMO $381.00
Rate for Payer: Ohio Health Group PPO Differential $101.60
Rate for Payer: Ohio Health Group PPO No Differential $66.04
Rate for Payer: Ohio Health Group PPO SOMC Employees $157.48
Rate for Payer: PHCS Commercial $487.68
Rate for Payer: United Healthcare All Payer $447.04
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $19.77
Max. Negotiated Rate $146.02
Rate for Payer: Aetna Commercial $117.12
Rate for Payer: Anthem Medicaid $52.31
Rate for Payer: Anthem POS/PPO/Traditional $118.64
Rate for Payer: Cash Price $76.05
Rate for Payer: Cigna Commercial $126.24
Rate for Payer: First Health Commercial $144.50
Rate for Payer: Humana Commercial $129.28
Rate for Payer: Humana KY Medicaid $52.31
Rate for Payer: Kentucky WC Medicaid $52.84
Rate for Payer: Medical Mutual Of Ohio HMO $124.72
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $112.25
Rate for Payer: Molina Healthcare Benefit Exchange $45.63
Rate for Payer: Molina Healthcare Medicaid $53.36
Rate for Payer: Ohio Health Choice Commercial $133.85
Rate for Payer: Ohio Health Group HMO $114.08
Rate for Payer: Ohio Health Group PPO Differential $30.42
Rate for Payer: Ohio Health Group PPO No Differential $19.77
Rate for Payer: Ohio Health Group PPO SOMC Employees $47.15
Rate for Payer: PHCS Commercial $146.02
Rate for Payer: United Healthcare All Payer $133.85
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $19.77
Max. Negotiated Rate $146.02
Rate for Payer: Aetna Commercial $117.12
Rate for Payer: Anthem POS/PPO/Traditional $118.64
Rate for Payer: Cash Price $76.05
Rate for Payer: Cigna Commercial $126.24
Rate for Payer: First Health Commercial $144.50
Rate for Payer: Humana Commercial $129.28
Rate for Payer: Medical Mutual Of Ohio HMO $124.72
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $112.25
Rate for Payer: Molina Healthcare Benefit Exchange $45.63
Rate for Payer: Ohio Health Choice Commercial $133.85
Rate for Payer: Ohio Health Group HMO $114.08
Rate for Payer: Ohio Health Group PPO Differential $30.42
Rate for Payer: Ohio Health Group PPO No Differential $19.77
Rate for Payer: Ohio Health Group PPO SOMC Employees $47.15
Rate for Payer: PHCS Commercial $146.02
Rate for Payer: United Healthcare All Payer $133.85
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $64.35
Max. Negotiated Rate $475.20
Rate for Payer: Aetna Commercial $381.15
Rate for Payer: Anthem POS/PPO/Traditional $386.10
Rate for Payer: Cash Price $247.50
Rate for Payer: Cigna Commercial $410.85
Rate for Payer: First Health Commercial $470.25
Rate for Payer: Humana Commercial $420.75
Rate for Payer: Medical Mutual Of Ohio HMO $405.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $365.31
Rate for Payer: Molina Healthcare Benefit Exchange $148.50
Rate for Payer: Ohio Health Choice Commercial $435.60
Rate for Payer: Ohio Health Group HMO $371.25
Rate for Payer: Ohio Health Group PPO Differential $99.00
Rate for Payer: Ohio Health Group PPO No Differential $64.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $153.45
Rate for Payer: PHCS Commercial $475.20
Rate for Payer: United Healthcare All Payer $435.60
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $64.35
Max. Negotiated Rate $475.20
Rate for Payer: Aetna Commercial $381.15
Rate for Payer: Anthem Medicaid $170.23
Rate for Payer: Anthem POS/PPO/Traditional $386.10
Rate for Payer: Cash Price $247.50
Rate for Payer: Cigna Commercial $410.85
Rate for Payer: First Health Commercial $470.25
Rate for Payer: Humana Commercial $420.75
Rate for Payer: Humana KY Medicaid $170.23
Rate for Payer: Kentucky WC Medicaid $171.96
Rate for Payer: Medical Mutual Of Ohio HMO $405.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $365.31
Rate for Payer: Molina Healthcare Benefit Exchange $148.50
Rate for Payer: Molina Healthcare Medicaid $173.65
Rate for Payer: Ohio Health Choice Commercial $435.60
Rate for Payer: Ohio Health Group HMO $371.25
Rate for Payer: Ohio Health Group PPO Differential $99.00
Rate for Payer: Ohio Health Group PPO No Differential $64.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $153.45
Rate for Payer: PHCS Commercial $475.20
Rate for Payer: United Healthcare All Payer $435.60
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $97.59
Max. Negotiated Rate $720.63
Rate for Payer: Aetna Commercial $578.01
Rate for Payer: Anthem POS/PPO/Traditional $585.51
Rate for Payer: Cash Price $375.33
Rate for Payer: Cigna Commercial $623.05
Rate for Payer: First Health Commercial $713.13
Rate for Payer: Humana Commercial $638.06
Rate for Payer: Medical Mutual Of Ohio HMO $615.54
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $553.99
Rate for Payer: Molina Healthcare Benefit Exchange $225.20
Rate for Payer: Ohio Health Choice Commercial $660.58
Rate for Payer: Ohio Health Group HMO $563.00
Rate for Payer: Ohio Health Group PPO Differential $150.13
Rate for Payer: Ohio Health Group PPO No Differential $97.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $232.70
Rate for Payer: PHCS Commercial $720.63
Rate for Payer: United Healthcare All Payer $660.58
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $97.59
Max. Negotiated Rate $720.63
Rate for Payer: Aetna Commercial $578.01
Rate for Payer: Anthem Medicaid $258.15
Rate for Payer: Anthem POS/PPO/Traditional $585.51
Rate for Payer: Cash Price $375.33
Rate for Payer: Cigna Commercial $623.05
Rate for Payer: First Health Commercial $713.13
Rate for Payer: Humana Commercial $638.06
Rate for Payer: Humana KY Medicaid $258.15
Rate for Payer: Kentucky WC Medicaid $260.78
Rate for Payer: Medical Mutual Of Ohio HMO $615.54
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $553.99
Rate for Payer: Molina Healthcare Benefit Exchange $225.20
Rate for Payer: Molina Healthcare Medicaid $263.33
Rate for Payer: Ohio Health Choice Commercial $660.58
Rate for Payer: Ohio Health Group HMO $563.00
Rate for Payer: Ohio Health Group PPO Differential $150.13
Rate for Payer: Ohio Health Group PPO No Differential $97.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $232.70
Rate for Payer: PHCS Commercial $720.63
Rate for Payer: United Healthcare All Payer $660.58
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $141.80
Max. Negotiated Rate $1,047.17
Rate for Payer: Aetna Commercial $839.92
Rate for Payer: Anthem POS/PPO/Traditional $850.82
Rate for Payer: Cash Price $545.40
Rate for Payer: Cigna Commercial $905.36
Rate for Payer: First Health Commercial $1,036.26
Rate for Payer: Humana Commercial $927.18
Rate for Payer: Medical Mutual Of Ohio HMO $894.46
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $805.01
Rate for Payer: Molina Healthcare Benefit Exchange $327.24
Rate for Payer: Ohio Health Choice Commercial $959.90
Rate for Payer: Ohio Health Group HMO $818.10
Rate for Payer: Ohio Health Group PPO Differential $218.16
Rate for Payer: Ohio Health Group PPO No Differential $141.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $338.15
Rate for Payer: PHCS Commercial $1,047.17
Rate for Payer: United Healthcare All Payer $959.90
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $141.80
Max. Negotiated Rate $1,047.17
Rate for Payer: Aetna Commercial $839.92
Rate for Payer: Anthem Medicaid $375.13
Rate for Payer: Anthem POS/PPO/Traditional $850.82
Rate for Payer: Cash Price $545.40
Rate for Payer: Cigna Commercial $905.36
Rate for Payer: First Health Commercial $1,036.26
Rate for Payer: Humana Commercial $927.18
Rate for Payer: Humana KY Medicaid $375.13
Rate for Payer: Kentucky WC Medicaid $378.94
Rate for Payer: Medical Mutual Of Ohio HMO $894.46
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $805.01
Rate for Payer: Molina Healthcare Benefit Exchange $327.24
Rate for Payer: Molina Healthcare Medicaid $382.65
Rate for Payer: Ohio Health Choice Commercial $959.90
Rate for Payer: Ohio Health Group HMO $818.10
Rate for Payer: Ohio Health Group PPO Differential $218.16
Rate for Payer: Ohio Health Group PPO No Differential $141.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $338.15
Rate for Payer: PHCS Commercial $1,047.17
Rate for Payer: United Healthcare All Payer $959.90
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $67.90
Max. Negotiated Rate $501.41
Rate for Payer: Aetna Commercial $402.17
Rate for Payer: Anthem POS/PPO/Traditional $407.39
Rate for Payer: Cash Price $261.15
Rate for Payer: Cigna Commercial $433.51
Rate for Payer: First Health Commercial $496.18
Rate for Payer: Humana Commercial $443.96
Rate for Payer: Medical Mutual Of Ohio HMO $428.29
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $385.46
Rate for Payer: Molina Healthcare Benefit Exchange $156.69
Rate for Payer: Ohio Health Choice Commercial $459.62
Rate for Payer: Ohio Health Group HMO $391.72
Rate for Payer: Ohio Health Group PPO Differential $104.46
Rate for Payer: Ohio Health Group PPO No Differential $67.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $161.91
Rate for Payer: PHCS Commercial $501.41
Rate for Payer: United Healthcare All Payer $459.62
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $67.90
Max. Negotiated Rate $501.41
Rate for Payer: Aetna Commercial $402.17
Rate for Payer: Anthem Medicaid $179.62
Rate for Payer: Anthem POS/PPO/Traditional $407.39
Rate for Payer: Cash Price $261.15
Rate for Payer: Cigna Commercial $433.51
Rate for Payer: First Health Commercial $496.18
Rate for Payer: Humana Commercial $443.96
Rate for Payer: Humana KY Medicaid $179.62
Rate for Payer: Kentucky WC Medicaid $181.45
Rate for Payer: Medical Mutual Of Ohio HMO $428.29
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $385.46
Rate for Payer: Molina Healthcare Benefit Exchange $156.69
Rate for Payer: Molina Healthcare Medicaid $183.22
Rate for Payer: Ohio Health Choice Commercial $459.62
Rate for Payer: Ohio Health Group HMO $391.72
Rate for Payer: Ohio Health Group PPO Differential $104.46
Rate for Payer: Ohio Health Group PPO No Differential $67.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $161.91
Rate for Payer: PHCS Commercial $501.41
Rate for Payer: United Healthcare All Payer $459.62
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $64.35
Max. Negotiated Rate $475.20
Rate for Payer: Aetna Commercial $381.15
Rate for Payer: Anthem Medicaid $170.23
Rate for Payer: Anthem POS/PPO/Traditional $386.10
Rate for Payer: Cash Price $247.50
Rate for Payer: Cigna Commercial $410.85
Rate for Payer: First Health Commercial $470.25
Rate for Payer: Humana Commercial $420.75
Rate for Payer: Humana KY Medicaid $170.23
Rate for Payer: Kentucky WC Medicaid $171.96
Rate for Payer: Medical Mutual Of Ohio HMO $405.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $365.31
Rate for Payer: Molina Healthcare Benefit Exchange $148.50
Rate for Payer: Molina Healthcare Medicaid $173.65
Rate for Payer: Ohio Health Choice Commercial $435.60
Rate for Payer: Ohio Health Group HMO $371.25
Rate for Payer: Ohio Health Group PPO Differential $99.00
Rate for Payer: Ohio Health Group PPO No Differential $64.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $153.45
Rate for Payer: PHCS Commercial $475.20
Rate for Payer: United Healthcare All Payer $435.60
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $64.35
Max. Negotiated Rate $475.20
Rate for Payer: Ohio Health Choice Commercial $435.60
Rate for Payer: Ohio Health Group HMO $371.25
Rate for Payer: Ohio Health Group PPO Differential $99.00
Rate for Payer: Ohio Health Group PPO No Differential $64.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $153.45
Rate for Payer: PHCS Commercial $475.20
Rate for Payer: United Healthcare All Payer $435.60
Rate for Payer: Aetna Commercial $381.15
Rate for Payer: Anthem POS/PPO/Traditional $386.10
Rate for Payer: Cash Price $247.50
Rate for Payer: Cigna Commercial $410.85
Rate for Payer: First Health Commercial $470.25
Rate for Payer: Humana Commercial $420.75
Rate for Payer: Medical Mutual Of Ohio HMO $405.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $365.31
Rate for Payer: Molina Healthcare Benefit Exchange $148.50
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $60.76
Max. Negotiated Rate $448.68
Rate for Payer: Aetna Commercial $359.88
Rate for Payer: Anthem Medicaid $160.73
Rate for Payer: Anthem POS/PPO/Traditional $364.56
Rate for Payer: Cash Price $233.69
Rate for Payer: Cigna Commercial $387.93
Rate for Payer: First Health Commercial $444.01
Rate for Payer: Humana Commercial $397.27
Rate for Payer: Humana KY Medicaid $160.73
Rate for Payer: Kentucky WC Medicaid $162.37
Rate for Payer: Medical Mutual Of Ohio HMO $383.25
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $344.93
Rate for Payer: Molina Healthcare Benefit Exchange $140.21
Rate for Payer: Molina Healthcare Medicaid $163.96
Rate for Payer: Ohio Health Choice Commercial $411.29
Rate for Payer: Ohio Health Group HMO $350.54
Rate for Payer: Ohio Health Group PPO Differential $93.48
Rate for Payer: Ohio Health Group PPO No Differential $60.76
Rate for Payer: Ohio Health Group PPO SOMC Employees $144.89
Rate for Payer: PHCS Commercial $448.68
Rate for Payer: United Healthcare All Payer $411.29
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $60.76
Max. Negotiated Rate $448.68
Rate for Payer: Aetna Commercial $359.88
Rate for Payer: Anthem POS/PPO/Traditional $364.56
Rate for Payer: Cash Price $233.69
Rate for Payer: Cigna Commercial $387.93
Rate for Payer: First Health Commercial $444.01
Rate for Payer: Humana Commercial $397.27
Rate for Payer: Medical Mutual Of Ohio HMO $383.25
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $344.93
Rate for Payer: Molina Healthcare Benefit Exchange $140.21
Rate for Payer: Ohio Health Choice Commercial $411.29
Rate for Payer: Ohio Health Group HMO $350.54
Rate for Payer: Ohio Health Group PPO Differential $93.48
Rate for Payer: Ohio Health Group PPO No Differential $60.76
Rate for Payer: Ohio Health Group PPO SOMC Employees $144.89
Rate for Payer: PHCS Commercial $448.68
Rate for Payer: United Healthcare All Payer $411.29
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $202.08
Max. Negotiated Rate $1,492.32
Rate for Payer: Aetna Commercial $1,196.96
Rate for Payer: Anthem Medicaid $534.59
Rate for Payer: Anthem POS/PPO/Traditional $1,212.51
Rate for Payer: Cash Price $777.25
Rate for Payer: Cigna Commercial $1,290.24
Rate for Payer: First Health Commercial $1,476.78
Rate for Payer: Humana Commercial $1,321.32
Rate for Payer: Humana KY Medicaid $534.59
Rate for Payer: Kentucky WC Medicaid $540.03
Rate for Payer: Medical Mutual Of Ohio HMO $1,274.69
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,147.22
Rate for Payer: Molina Healthcare Benefit Exchange $466.35
Rate for Payer: Molina Healthcare Medicaid $545.32
Rate for Payer: Ohio Health Choice Commercial $1,367.96
Rate for Payer: Ohio Health Group HMO $1,165.88
Rate for Payer: Ohio Health Group PPO Differential $310.90
Rate for Payer: Ohio Health Group PPO No Differential $202.08
Rate for Payer: Ohio Health Group PPO SOMC Employees $481.90
Rate for Payer: PHCS Commercial $1,492.32
Rate for Payer: United Healthcare All Payer $1,367.96
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $202.08
Max. Negotiated Rate $1,492.32
Rate for Payer: Aetna Commercial $1,196.96
Rate for Payer: Anthem POS/PPO/Traditional $1,212.51
Rate for Payer: Cash Price $777.25
Rate for Payer: Cigna Commercial $1,290.24
Rate for Payer: First Health Commercial $1,476.78
Rate for Payer: Humana Commercial $1,321.32
Rate for Payer: Medical Mutual Of Ohio HMO $1,274.69
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,147.22
Rate for Payer: Molina Healthcare Benefit Exchange $466.35
Rate for Payer: Ohio Health Choice Commercial $1,367.96
Rate for Payer: Ohio Health Group HMO $1,165.88
Rate for Payer: Ohio Health Group PPO Differential $310.90
Rate for Payer: Ohio Health Group PPO No Differential $202.08
Rate for Payer: Ohio Health Group PPO SOMC Employees $481.90
Rate for Payer: PHCS Commercial $1,492.32
Rate for Payer: United Healthcare All Payer $1,367.96
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $95.55
Max. Negotiated Rate $705.60
Rate for Payer: Aetna Commercial $565.95
Rate for Payer: Anthem Medicaid $252.77
Rate for Payer: Anthem POS/PPO/Traditional $573.30
Rate for Payer: Cash Price $367.50
Rate for Payer: Cigna Commercial $610.05
Rate for Payer: First Health Commercial $698.25
Rate for Payer: Humana Commercial $624.75
Rate for Payer: Humana KY Medicaid $252.77
Rate for Payer: Kentucky WC Medicaid $255.34
Rate for Payer: Medical Mutual Of Ohio HMO $602.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $542.43
Rate for Payer: Molina Healthcare Benefit Exchange $220.50
Rate for Payer: Molina Healthcare Medicaid $257.84
Rate for Payer: Ohio Health Choice Commercial $646.80
Rate for Payer: Ohio Health Group HMO $551.25
Rate for Payer: Ohio Health Group PPO Differential $147.00
Rate for Payer: Ohio Health Group PPO No Differential $95.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $227.85
Rate for Payer: PHCS Commercial $705.60
Rate for Payer: United Healthcare All Payer $646.80
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $95.55
Max. Negotiated Rate $705.60
Rate for Payer: Aetna Commercial $565.95
Rate for Payer: Anthem POS/PPO/Traditional $573.30
Rate for Payer: Cash Price $367.50
Rate for Payer: Cigna Commercial $610.05
Rate for Payer: First Health Commercial $698.25
Rate for Payer: Humana Commercial $624.75
Rate for Payer: Medical Mutual Of Ohio HMO $602.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $542.43
Rate for Payer: Molina Healthcare Benefit Exchange $220.50
Rate for Payer: Ohio Health Choice Commercial $646.80
Rate for Payer: Ohio Health Group HMO $551.25
Rate for Payer: Ohio Health Group PPO Differential $147.00
Rate for Payer: Ohio Health Group PPO No Differential $95.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $227.85
Rate for Payer: PHCS Commercial $705.60
Rate for Payer: United Healthcare All Payer $646.80
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $201.14
Max. Negotiated Rate $1,485.33
Rate for Payer: Aetna Commercial $1,191.36
Rate for Payer: Anthem POS/PPO/Traditional $1,206.83
Rate for Payer: Cash Price $773.61
Rate for Payer: Cigna Commercial $1,284.19
Rate for Payer: First Health Commercial $1,469.86
Rate for Payer: Humana Commercial $1,315.14
Rate for Payer: Medical Mutual Of Ohio HMO $1,268.72
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,141.85
Rate for Payer: Molina Healthcare Benefit Exchange $464.17
Rate for Payer: Ohio Health Choice Commercial $1,361.55
Rate for Payer: Ohio Health Group HMO $1,160.42
Rate for Payer: Ohio Health Group PPO Differential $309.44
Rate for Payer: Ohio Health Group PPO No Differential $201.14
Rate for Payer: Ohio Health Group PPO SOMC Employees $479.64
Rate for Payer: PHCS Commercial $1,485.33
Rate for Payer: United Healthcare All Payer $1,361.55
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $201.14
Max. Negotiated Rate $1,485.33
Rate for Payer: Aetna Commercial $1,191.36
Rate for Payer: Anthem Medicaid $532.09
Rate for Payer: Anthem POS/PPO/Traditional $1,206.83
Rate for Payer: Cash Price $773.61
Rate for Payer: Cigna Commercial $1,284.19
Rate for Payer: First Health Commercial $1,469.86
Rate for Payer: Humana Commercial $1,315.14
Rate for Payer: Humana KY Medicaid $532.09
Rate for Payer: Kentucky WC Medicaid $537.50
Rate for Payer: Medical Mutual Of Ohio HMO $1,268.72
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,141.85
Rate for Payer: Molina Healthcare Benefit Exchange $464.17
Rate for Payer: Molina Healthcare Medicaid $542.76
Rate for Payer: Ohio Health Choice Commercial $1,361.55
Rate for Payer: Ohio Health Group HMO $1,160.42
Rate for Payer: Ohio Health Group PPO Differential $309.44
Rate for Payer: Ohio Health Group PPO No Differential $201.14
Rate for Payer: Ohio Health Group PPO SOMC Employees $479.64
Rate for Payer: PHCS Commercial $1,485.33
Rate for Payer: United Healthcare All Payer $1,361.55
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $100.37
Max. Negotiated Rate $741.20
Rate for Payer: Aetna Commercial $594.50
Rate for Payer: Anthem Medicaid $265.52
Rate for Payer: Anthem POS/PPO/Traditional $602.22
Rate for Payer: Cash Price $386.04
Rate for Payer: Cigna Commercial $640.83
Rate for Payer: First Health Commercial $733.48
Rate for Payer: Humana Commercial $656.27
Rate for Payer: Humana KY Medicaid $265.52
Rate for Payer: Kentucky WC Medicaid $268.22
Rate for Payer: Medical Mutual Of Ohio HMO $633.11
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $569.80
Rate for Payer: Molina Healthcare Benefit Exchange $231.62
Rate for Payer: Molina Healthcare Medicaid $270.85
Rate for Payer: Ohio Health Choice Commercial $679.43
Rate for Payer: Ohio Health Group HMO $579.06
Rate for Payer: Ohio Health Group PPO Differential $154.42
Rate for Payer: Ohio Health Group PPO No Differential $100.37
Rate for Payer: Ohio Health Group PPO SOMC Employees $239.34
Rate for Payer: PHCS Commercial $741.20
Rate for Payer: United Healthcare All Payer $679.43
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $100.37
Max. Negotiated Rate $741.20
Rate for Payer: Aetna Commercial $594.50
Rate for Payer: Anthem POS/PPO/Traditional $602.22
Rate for Payer: Cash Price $386.04
Rate for Payer: Cigna Commercial $640.83
Rate for Payer: First Health Commercial $733.48
Rate for Payer: Humana Commercial $656.27
Rate for Payer: Medical Mutual Of Ohio HMO $633.11
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $569.80
Rate for Payer: Molina Healthcare Benefit Exchange $231.62
Rate for Payer: Ohio Health Choice Commercial $679.43
Rate for Payer: Ohio Health Group HMO $579.06
Rate for Payer: Ohio Health Group PPO Differential $154.42
Rate for Payer: Ohio Health Group PPO No Differential $100.37
Rate for Payer: Ohio Health Group PPO SOMC Employees $239.34
Rate for Payer: PHCS Commercial $741.20
Rate for Payer: United Healthcare All Payer $679.43
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $55.90
Max. Negotiated Rate $412.80
Rate for Payer: Aetna Commercial $331.10
Rate for Payer: Anthem Medicaid $147.88
Rate for Payer: Anthem POS/PPO/Traditional $335.40
Rate for Payer: Cash Price $215.00
Rate for Payer: Cigna Commercial $356.90
Rate for Payer: First Health Commercial $408.50
Rate for Payer: Humana Commercial $365.50
Rate for Payer: Humana KY Medicaid $147.88
Rate for Payer: Kentucky WC Medicaid $149.38
Rate for Payer: Medical Mutual Of Ohio HMO $352.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $317.34
Rate for Payer: Molina Healthcare Benefit Exchange $129.00
Rate for Payer: Molina Healthcare Medicaid $150.84
Rate for Payer: Ohio Health Choice Commercial $378.40
Rate for Payer: Ohio Health Group HMO $322.50
Rate for Payer: Ohio Health Group PPO Differential $86.00
Rate for Payer: Ohio Health Group PPO No Differential $55.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $133.30
Rate for Payer: PHCS Commercial $412.80
Rate for Payer: United Healthcare All Payer $378.40