|
GLOBAL ADVANTAGE ECC HD 56*21
|
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
|
|
|
GLOBAL ADVANTAGE ECC HD 56*21
|
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
|
|
|
GLOBAL ADVANTAGE HUM HD 40*15
|
Facility
|
OP
|
$10,237.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,071.39 |
| Max. Negotiated Rate |
$9,828.43 |
| Rate for Payer: Aetna Commercial |
$7,883.22
|
| Rate for Payer: Anthem Medicaid |
$3,520.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,985.60
|
| Rate for Payer: Cash Price |
$5,118.98
|
| Rate for Payer: Cigna Commercial |
$8,497.50
|
| Rate for Payer: First Health Commercial |
$9,726.05
|
| Rate for Payer: Humana Commercial |
$8,702.26
|
| Rate for Payer: Humana KY Medicaid |
$3,520.83
|
| Rate for Payer: Kentucky WC Medicaid |
$3,556.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,395.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,555.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,071.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,591.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,009.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,678.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,190.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,907.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,064.19
|
| Rate for Payer: PHCS Commercial |
$9,828.43
|
| Rate for Payer: United Healthcare All Payer |
$9,009.40
|
|
|
GLOBAL ADVANTAGE HUM HD 40*15
|
Facility
|
IP
|
$10,237.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,071.39 |
| Max. Negotiated Rate |
$9,828.43 |
| Rate for Payer: Aetna Commercial |
$7,883.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,985.60
|
| Rate for Payer: Cash Price |
$5,118.98
|
| Rate for Payer: Cigna Commercial |
$8,497.50
|
| Rate for Payer: First Health Commercial |
$9,726.05
|
| Rate for Payer: Humana Commercial |
$8,702.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,395.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,555.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,071.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,009.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,678.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,190.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,907.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,064.19
|
| Rate for Payer: PHCS Commercial |
$9,828.43
|
| Rate for Payer: United Healthcare All Payer |
$9,009.40
|
|
|
GLOBAL ADVANTAGE HUM HD 40*18
|
Facility
|
OP
|
$14,447.61
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,334.28 |
| Max. Negotiated Rate |
$13,869.71 |
| Rate for Payer: Aetna Commercial |
$11,124.66
|
| Rate for Payer: Anthem Medicaid |
$4,968.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,269.14
|
| Rate for Payer: Cash Price |
$7,223.80
|
| Rate for Payer: Cigna Commercial |
$11,991.52
|
| Rate for Payer: First Health Commercial |
$13,725.23
|
| Rate for Payer: Humana Commercial |
$12,280.47
|
| Rate for Payer: Humana KY Medicaid |
$4,968.53
|
| Rate for Payer: Kentucky WC Medicaid |
$5,019.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,847.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,662.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,334.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,068.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,713.90
|
| Rate for Payer: Ohio Health Group HMO |
$10,835.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,558.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,569.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,968.85
|
| Rate for Payer: PHCS Commercial |
$13,869.71
|
| Rate for Payer: United Healthcare All Payer |
$12,713.90
|
|
|
GLOBAL ADVANTAGE HUM HD 40*18
|
Facility
|
IP
|
$14,447.61
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,334.28 |
| Max. Negotiated Rate |
$13,869.71 |
| Rate for Payer: Aetna Commercial |
$11,124.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,269.14
|
| Rate for Payer: Cash Price |
$7,223.80
|
| Rate for Payer: Cigna Commercial |
$11,991.52
|
| Rate for Payer: First Health Commercial |
$13,725.23
|
| Rate for Payer: Humana Commercial |
$12,280.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,847.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,662.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,334.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,713.90
|
| Rate for Payer: Ohio Health Group HMO |
$10,835.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,558.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,569.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,968.85
|
| Rate for Payer: PHCS Commercial |
$13,869.71
|
| Rate for Payer: United Healthcare All Payer |
$12,713.90
|
|
|
GLOBAL ADVANTAGE HUM HD 40*21
|
Facility
|
OP
|
$13,820.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,146.01 |
| Max. Negotiated Rate |
$13,267.24 |
| Rate for Payer: Aetna Commercial |
$10,641.43
|
| Rate for Payer: Anthem Medicaid |
$4,752.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,779.63
|
| Rate for Payer: Cash Price |
$6,910.02
|
| Rate for Payer: Cigna Commercial |
$11,470.63
|
| Rate for Payer: First Health Commercial |
$13,129.04
|
| Rate for Payer: Humana Commercial |
$11,747.03
|
| Rate for Payer: Humana KY Medicaid |
$4,752.71
|
| Rate for Payer: Kentucky WC Medicaid |
$4,801.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,332.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,199.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,146.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,848.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,161.64
|
| Rate for Payer: Ohio Health Group HMO |
$10,365.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,056.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,023.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,535.83
|
| Rate for Payer: PHCS Commercial |
$13,267.24
|
| Rate for Payer: United Healthcare All Payer |
$12,161.64
|
|
|
GLOBAL ADVANTAGE HUM HD 40*21
|
Facility
|
IP
|
$13,820.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,146.01 |
| Max. Negotiated Rate |
$13,267.24 |
| Rate for Payer: Aetna Commercial |
$10,641.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,779.63
|
| Rate for Payer: Cash Price |
$6,910.02
|
| Rate for Payer: Cigna Commercial |
$11,470.63
|
| Rate for Payer: First Health Commercial |
$13,129.04
|
| Rate for Payer: Humana Commercial |
$11,747.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,332.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,199.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,146.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,161.64
|
| Rate for Payer: Ohio Health Group HMO |
$10,365.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,056.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,023.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,535.83
|
| Rate for Payer: PHCS Commercial |
$13,267.24
|
| Rate for Payer: United Healthcare All Payer |
$12,161.64
|
|
|
GLOBAL ADVANTAGE HUM HD 44*15
|
Facility
|
IP
|
$9,825.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,947.65 |
| Max. Negotiated Rate |
$9,432.48 |
| Rate for Payer: Aetna Commercial |
$7,565.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,663.89
|
| Rate for Payer: Cash Price |
$4,912.75
|
| Rate for Payer: Cigna Commercial |
$8,155.16
|
| Rate for Payer: First Health Commercial |
$9,334.23
|
| Rate for Payer: Humana Commercial |
$8,351.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,056.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,251.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,947.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,646.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,369.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,860.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,548.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,779.60
|
| Rate for Payer: PHCS Commercial |
$9,432.48
|
| Rate for Payer: United Healthcare All Payer |
$8,646.44
|
|
|
GLOBAL ADVANTAGE HUM HD 44*15
|
Facility
|
OP
|
$9,825.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,947.65 |
| Max. Negotiated Rate |
$9,432.48 |
| Rate for Payer: Aetna Commercial |
$7,565.64
|
| Rate for Payer: Anthem Medicaid |
$3,378.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,663.89
|
| Rate for Payer: Cash Price |
$4,912.75
|
| Rate for Payer: Cigna Commercial |
$8,155.16
|
| Rate for Payer: First Health Commercial |
$9,334.23
|
| Rate for Payer: Humana Commercial |
$8,351.67
|
| Rate for Payer: Humana KY Medicaid |
$3,378.99
|
| Rate for Payer: Kentucky WC Medicaid |
$3,413.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,056.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,251.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,947.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,446.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,646.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,369.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,860.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,548.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,779.60
|
| Rate for Payer: PHCS Commercial |
$9,432.48
|
| Rate for Payer: United Healthcare All Payer |
$8,646.44
|
|
|
GLOBAL ADVANTAGE HUM HD 44*18
|
Facility
|
OP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem Medicaid |
$2,657.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Humana KY Medicaid |
$2,657.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,684.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,710.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
GLOBAL ADVANTAGE HUM HD 44*18
|
Facility
|
IP
|
$7,726.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,318.03 |
| Max. Negotiated Rate |
$7,417.68 |
| Rate for Payer: Aetna Commercial |
$5,949.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,026.86
|
| Rate for Payer: Cash Price |
$3,863.38
|
| Rate for Payer: Cigna Commercial |
$6,413.20
|
| Rate for Payer: First Health Commercial |
$7,340.41
|
| Rate for Payer: Humana Commercial |
$6,567.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,335.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,702.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,318.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,799.54
|
| Rate for Payer: Ohio Health Group HMO |
$5,795.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,181.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,722.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,331.46
|
| Rate for Payer: PHCS Commercial |
$7,417.68
|
| Rate for Payer: United Healthcare All Payer |
$6,799.54
|
|
|
GLOBAL ADVANTAGE HUM HD 44*21
|
Facility
|
IP
|
$9,825.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,947.65 |
| Max. Negotiated Rate |
$9,432.48 |
| Rate for Payer: Aetna Commercial |
$7,565.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,663.89
|
| Rate for Payer: Cash Price |
$4,912.75
|
| Rate for Payer: Cigna Commercial |
$8,155.16
|
| Rate for Payer: First Health Commercial |
$9,334.23
|
| Rate for Payer: Humana Commercial |
$8,351.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,056.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,251.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,947.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,646.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,369.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,860.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,548.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,779.60
|
| Rate for Payer: PHCS Commercial |
$9,432.48
|
| Rate for Payer: United Healthcare All Payer |
$8,646.44
|
|
|
GLOBAL ADVANTAGE HUM HD 44*21
|
Facility
|
OP
|
$9,825.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,947.65 |
| Max. Negotiated Rate |
$9,432.48 |
| Rate for Payer: Aetna Commercial |
$7,565.64
|
| Rate for Payer: Anthem Medicaid |
$3,378.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,663.89
|
| Rate for Payer: Cash Price |
$4,912.75
|
| Rate for Payer: Cigna Commercial |
$8,155.16
|
| Rate for Payer: First Health Commercial |
$9,334.23
|
| Rate for Payer: Humana Commercial |
$8,351.67
|
| Rate for Payer: Humana KY Medicaid |
$3,378.99
|
| Rate for Payer: Kentucky WC Medicaid |
$3,413.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,056.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,251.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,947.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,446.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,646.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,369.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,860.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,548.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,779.60
|
| Rate for Payer: PHCS Commercial |
$9,432.48
|
| Rate for Payer: United Healthcare All Payer |
$8,646.44
|
|
|
GLOBAL ADVANTAGE HUM HD 48*15
|
Facility
|
IP
|
$6,738.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.55 |
| Max. Negotiated Rate |
$6,468.97 |
| Rate for Payer: Aetna Commercial |
$5,188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,256.04
|
| Rate for Payer: Cash Price |
$3,369.26
|
| Rate for Payer: Cigna Commercial |
$5,592.96
|
| Rate for Payer: First Health Commercial |
$6,401.58
|
| Rate for Payer: Humana Commercial |
$5,727.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,525.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,973.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,021.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,929.89
|
| Rate for Payer: Ohio Health Group HMO |
$5,053.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,390.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,862.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,649.57
|
| Rate for Payer: PHCS Commercial |
$6,468.97
|
| Rate for Payer: United Healthcare All Payer |
$5,929.89
|
|
|
GLOBAL ADVANTAGE HUM HD 48*15
|
Facility
|
OP
|
$6,738.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.55 |
| Max. Negotiated Rate |
$6,468.97 |
| Rate for Payer: Aetna Commercial |
$5,188.65
|
| Rate for Payer: Anthem Medicaid |
$2,317.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,256.04
|
| Rate for Payer: Cash Price |
$3,369.26
|
| Rate for Payer: Cigna Commercial |
$5,592.96
|
| Rate for Payer: First Health Commercial |
$6,401.58
|
| Rate for Payer: Humana Commercial |
$5,727.73
|
| Rate for Payer: Humana KY Medicaid |
$2,317.37
|
| Rate for Payer: Kentucky WC Medicaid |
$2,340.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,525.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,973.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,021.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,363.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,929.89
|
| Rate for Payer: Ohio Health Group HMO |
$5,053.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,390.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,862.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,649.57
|
| Rate for Payer: PHCS Commercial |
$6,468.97
|
| Rate for Payer: United Healthcare All Payer |
$5,929.89
|
|
|
GLOBAL ADVANTAGE HUM HD 48*18
|
Facility
|
IP
|
$10,237.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,071.39 |
| Max. Negotiated Rate |
$9,828.43 |
| Rate for Payer: Aetna Commercial |
$7,883.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,985.60
|
| Rate for Payer: Cash Price |
$5,118.98
|
| Rate for Payer: Cigna Commercial |
$8,497.50
|
| Rate for Payer: First Health Commercial |
$9,726.05
|
| Rate for Payer: Humana Commercial |
$8,702.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,395.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,555.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,071.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,009.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,678.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,190.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,907.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,064.19
|
| Rate for Payer: PHCS Commercial |
$9,828.43
|
| Rate for Payer: United Healthcare All Payer |
$9,009.40
|
|
|
GLOBAL ADVANTAGE HUM HD 48*18
|
Facility
|
OP
|
$10,237.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,071.39 |
| Max. Negotiated Rate |
$9,828.43 |
| Rate for Payer: Aetna Commercial |
$7,883.22
|
| Rate for Payer: Anthem Medicaid |
$3,520.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,985.60
|
| Rate for Payer: Cash Price |
$5,118.98
|
| Rate for Payer: Cigna Commercial |
$8,497.50
|
| Rate for Payer: First Health Commercial |
$9,726.05
|
| Rate for Payer: Humana Commercial |
$8,702.26
|
| Rate for Payer: Humana KY Medicaid |
$3,520.83
|
| Rate for Payer: Kentucky WC Medicaid |
$3,556.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,395.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,555.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,071.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,591.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,009.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,678.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,190.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,907.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,064.19
|
| Rate for Payer: PHCS Commercial |
$9,828.43
|
| Rate for Payer: United Healthcare All Payer |
$9,009.40
|
|
|
GLOBAL ADVANTAGE HUM HD 48*21
|
Facility
|
IP
|
$9,188.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,756.68 |
| Max. Negotiated Rate |
$8,821.38 |
| Rate for Payer: Aetna Commercial |
$7,075.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,167.37
|
| Rate for Payer: Cash Price |
$4,594.47
|
| Rate for Payer: Cigna Commercial |
$7,626.82
|
| Rate for Payer: First Health Commercial |
$8,729.49
|
| Rate for Payer: Humana Commercial |
$7,810.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,534.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,781.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,756.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,086.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,891.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,351.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,994.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,340.37
|
| Rate for Payer: PHCS Commercial |
$8,821.38
|
| Rate for Payer: United Healthcare All Payer |
$8,086.27
|
|
|
GLOBAL ADVANTAGE HUM HD 48*21
|
Facility
|
OP
|
$9,188.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,756.68 |
| Max. Negotiated Rate |
$8,821.38 |
| Rate for Payer: Aetna Commercial |
$7,075.48
|
| Rate for Payer: Anthem Medicaid |
$3,160.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,167.37
|
| Rate for Payer: Cash Price |
$4,594.47
|
| Rate for Payer: Cigna Commercial |
$7,626.82
|
| Rate for Payer: First Health Commercial |
$8,729.49
|
| Rate for Payer: Humana Commercial |
$7,810.60
|
| Rate for Payer: Humana KY Medicaid |
$3,160.08
|
| Rate for Payer: Kentucky WC Medicaid |
$3,192.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,534.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,781.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,756.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,223.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,086.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,891.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,351.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,994.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,340.37
|
| Rate for Payer: PHCS Commercial |
$8,821.38
|
| Rate for Payer: United Healthcare All Payer |
$8,086.27
|
|
|
GLOBAL ADVANTAGE HUM HD 52*15
|
Facility
|
IP
|
$6,738.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.55 |
| Max. Negotiated Rate |
$6,468.97 |
| Rate for Payer: Aetna Commercial |
$5,188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,256.04
|
| Rate for Payer: Cash Price |
$3,369.26
|
| Rate for Payer: Cigna Commercial |
$5,592.96
|
| Rate for Payer: First Health Commercial |
$6,401.58
|
| Rate for Payer: Humana Commercial |
$5,727.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,525.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,973.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,021.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,929.89
|
| Rate for Payer: Ohio Health Group HMO |
$5,053.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,390.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,862.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,649.57
|
| Rate for Payer: PHCS Commercial |
$6,468.97
|
| Rate for Payer: United Healthcare All Payer |
$5,929.89
|
|
|
GLOBAL ADVANTAGE HUM HD 52*15
|
Facility
|
OP
|
$6,738.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.55 |
| Max. Negotiated Rate |
$6,468.97 |
| Rate for Payer: Aetna Commercial |
$5,188.65
|
| Rate for Payer: Anthem Medicaid |
$2,317.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,256.04
|
| Rate for Payer: Cash Price |
$3,369.26
|
| Rate for Payer: Cigna Commercial |
$5,592.96
|
| Rate for Payer: First Health Commercial |
$6,401.58
|
| Rate for Payer: Humana Commercial |
$5,727.73
|
| Rate for Payer: Humana KY Medicaid |
$2,317.37
|
| Rate for Payer: Kentucky WC Medicaid |
$2,340.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,525.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,973.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,021.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,363.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,929.89
|
| Rate for Payer: Ohio Health Group HMO |
$5,053.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,390.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,862.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,649.57
|
| Rate for Payer: PHCS Commercial |
$6,468.97
|
| Rate for Payer: United Healthcare All Payer |
$5,929.89
|
|
|
GLOBAL ADVANTAGE HUM HD 52*18
|
Facility
|
IP
|
$13,368.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,010.59 |
| Max. Negotiated Rate |
$12,833.88 |
| Rate for Payer: Aetna Commercial |
$10,293.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,427.53
|
| Rate for Payer: Cash Price |
$6,684.31
|
| Rate for Payer: Cigna Commercial |
$11,095.96
|
| Rate for Payer: First Health Commercial |
$12,700.20
|
| Rate for Payer: Humana Commercial |
$11,363.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,962.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,866.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,010.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,764.39
|
| Rate for Payer: Ohio Health Group HMO |
$10,026.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,694.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,630.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,224.35
|
| Rate for Payer: PHCS Commercial |
$12,833.88
|
| Rate for Payer: United Healthcare All Payer |
$11,764.39
|
|
|
GLOBAL ADVANTAGE HUM HD 52*18
|
Facility
|
OP
|
$13,368.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,010.59 |
| Max. Negotiated Rate |
$12,833.88 |
| Rate for Payer: Aetna Commercial |
$10,293.85
|
| Rate for Payer: Anthem Medicaid |
$4,597.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,427.53
|
| Rate for Payer: Cash Price |
$6,684.31
|
| Rate for Payer: Cigna Commercial |
$11,095.96
|
| Rate for Payer: First Health Commercial |
$12,700.20
|
| Rate for Payer: Humana Commercial |
$11,363.34
|
| Rate for Payer: Humana KY Medicaid |
$4,597.47
|
| Rate for Payer: Kentucky WC Medicaid |
$4,644.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,962.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,866.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,010.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,689.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,764.39
|
| Rate for Payer: Ohio Health Group HMO |
$10,026.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,694.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,630.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,224.35
|
| Rate for Payer: PHCS Commercial |
$12,833.88
|
| Rate for Payer: United Healthcare All Payer |
$11,764.39
|
|
|
GLOBAL ADVANTAGE HUM HD 52*21
|
Facility
|
OP
|
$9,188.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,756.68 |
| Max. Negotiated Rate |
$8,821.38 |
| Rate for Payer: Aetna Commercial |
$7,075.48
|
| Rate for Payer: Anthem Medicaid |
$3,160.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,167.37
|
| Rate for Payer: Cash Price |
$4,594.47
|
| Rate for Payer: Cigna Commercial |
$7,626.82
|
| Rate for Payer: First Health Commercial |
$8,729.49
|
| Rate for Payer: Humana Commercial |
$7,810.60
|
| Rate for Payer: Humana KY Medicaid |
$3,160.08
|
| Rate for Payer: Kentucky WC Medicaid |
$3,192.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,534.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,781.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,756.68
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,223.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,086.27
|
| Rate for Payer: Ohio Health Group HMO |
$6,891.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,351.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,994.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,340.37
|
| Rate for Payer: PHCS Commercial |
$8,821.38
|
| Rate for Payer: United Healthcare All Payer |
$8,086.27
|
|
