|
GLOBAL ADVANTAGE HUM HD 52*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 56*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 56*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 56*18
|
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 56*18
|
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 56*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 56*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 STEM 10 LONG
|
Facility
|
OP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem Medicaid |
$5,341.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Humana KY Medicaid |
$5,341.90
|
| Rate for Payer: Kentucky WC Medicaid |
$5,396.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,449.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 10 LONG
|
Facility
|
IP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 10MM
|
Facility
|
IP
|
$25,730.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,719.00 |
| Max. Negotiated Rate |
$24,700.80 |
| Rate for Payer: Aetna Commercial |
$19,812.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,069.40
|
| Rate for Payer: Cash Price |
$12,865.00
|
| Rate for Payer: Cigna Commercial |
$21,355.90
|
| Rate for Payer: First Health Commercial |
$24,443.50
|
| Rate for Payer: Humana Commercial |
$21,870.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,098.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,988.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,719.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,642.40
|
| Rate for Payer: Ohio Health Group HMO |
$19,297.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$20,584.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,385.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,753.70
|
| Rate for Payer: PHCS Commercial |
$24,700.80
|
| Rate for Payer: United Healthcare All Payer |
$22,642.40
|
|
|
GLOBAL ADVANTAGE STEM 10MM
|
Facility
|
OP
|
$25,730.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,719.00 |
| Max. Negotiated Rate |
$24,700.80 |
| Rate for Payer: Aetna Commercial |
$19,812.10
|
| Rate for Payer: Anthem Medicaid |
$8,848.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,069.40
|
| Rate for Payer: Cash Price |
$12,865.00
|
| Rate for Payer: Cigna Commercial |
$21,355.90
|
| Rate for Payer: First Health Commercial |
$24,443.50
|
| Rate for Payer: Humana Commercial |
$21,870.50
|
| Rate for Payer: Humana KY Medicaid |
$8,848.55
|
| Rate for Payer: Kentucky WC Medicaid |
$8,938.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,098.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,988.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,719.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,026.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,642.40
|
| Rate for Payer: Ohio Health Group HMO |
$19,297.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$20,584.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,385.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,753.70
|
| Rate for Payer: PHCS Commercial |
$24,700.80
|
| Rate for Payer: United Healthcare All Payer |
$22,642.40
|
|
|
GLOBAL ADVANTAGE STEM 12 LONG
|
Facility
|
IP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 12 LONG
|
Facility
|
OP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem Medicaid |
$5,341.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Humana KY Medicaid |
$5,341.90
|
| Rate for Payer: Kentucky WC Medicaid |
$5,396.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,449.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 12MM
|
Facility
|
IP
|
$24,248.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,274.62 |
| Max. Negotiated Rate |
$23,278.80 |
| Rate for Payer: Aetna Commercial |
$18,671.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,914.03
|
| Rate for Payer: Cash Price |
$12,124.38
|
| Rate for Payer: Cigna Commercial |
$20,126.46
|
| Rate for Payer: First Health Commercial |
$23,036.31
|
| Rate for Payer: Humana Commercial |
$20,611.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,883.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,895.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,274.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,338.90
|
| Rate for Payer: Ohio Health Group HMO |
$18,186.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,399.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,096.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,731.64
|
| Rate for Payer: PHCS Commercial |
$23,278.80
|
| Rate for Payer: United Healthcare All Payer |
$21,338.90
|
|
|
GLOBAL ADVANTAGE STEM 12MM
|
Facility
|
OP
|
$24,248.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,274.62 |
| Max. Negotiated Rate |
$23,278.80 |
| Rate for Payer: Aetna Commercial |
$18,671.54
|
| Rate for Payer: Anthem Medicaid |
$8,339.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,914.03
|
| Rate for Payer: Cash Price |
$12,124.38
|
| Rate for Payer: Cigna Commercial |
$20,126.46
|
| Rate for Payer: First Health Commercial |
$23,036.31
|
| Rate for Payer: Humana Commercial |
$20,611.44
|
| Rate for Payer: Humana KY Medicaid |
$8,339.15
|
| Rate for Payer: Kentucky WC Medicaid |
$8,424.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,883.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,895.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,274.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,506.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,338.90
|
| Rate for Payer: Ohio Health Group HMO |
$18,186.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,399.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,096.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,731.64
|
| Rate for Payer: PHCS Commercial |
$23,278.80
|
| Rate for Payer: United Healthcare All Payer |
$21,338.90
|
|
|
GLOBAL ADVANTAGE STEM 14 LONG
|
Facility
|
OP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem Medicaid |
$5,341.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Humana KY Medicaid |
$5,341.90
|
| Rate for Payer: Kentucky WC Medicaid |
$5,396.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,449.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 14 LONG
|
Facility
|
IP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 14MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| 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 |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| 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 |
$6.90 |
| 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 |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| 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 |
$6.90 |
| 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 |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| 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 |
$6.90 |
| 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 |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
GLOBAL ADVANTAGE STEM 6MM
|
Facility
|
OP
|
$26,352.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,905.75 |
| Max. Negotiated Rate |
$25,298.40 |
| Rate for Payer: Aetna Commercial |
$20,291.42
|
| Rate for Payer: Anthem Medicaid |
$9,062.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,554.95
|
| Rate for Payer: Cash Price |
$13,176.25
|
| Rate for Payer: Cigna Commercial |
$21,872.58
|
| Rate for Payer: First Health Commercial |
$25,034.88
|
| Rate for Payer: Humana Commercial |
$22,399.62
|
| Rate for Payer: Humana KY Medicaid |
$9,062.62
|
| Rate for Payer: Kentucky WC Medicaid |
$9,154.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,609.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,448.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,905.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,244.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,190.20
|
| Rate for Payer: Ohio Health Group HMO |
$19,764.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,082.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,926.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,183.22
|
| Rate for Payer: PHCS Commercial |
$25,298.40
|
| Rate for Payer: United Healthcare All Payer |
$23,190.20
|
|
|
GLOBAL ADVANTAGE STEM 6MM
|
Facility
|
IP
|
$26,352.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,905.75 |
| Max. Negotiated Rate |
$25,298.40 |
| Rate for Payer: Aetna Commercial |
$20,291.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,554.95
|
| Rate for Payer: Cash Price |
$13,176.25
|
| Rate for Payer: Cigna Commercial |
$21,872.58
|
| Rate for Payer: First Health Commercial |
$25,034.88
|
| Rate for Payer: Humana Commercial |
$22,399.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,609.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,448.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,905.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,190.20
|
| Rate for Payer: Ohio Health Group HMO |
$19,764.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,082.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,926.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,183.22
|
| Rate for Payer: PHCS Commercial |
$25,298.40
|
| Rate for Payer: United Healthcare All Payer |
$23,190.20
|
|
|
GLOBAL ADVANTAGE STEM 8 LONG
|
Facility
|
OP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem Medicaid |
$5,341.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Humana KY Medicaid |
$5,341.90
|
| Rate for Payer: Kentucky WC Medicaid |
$5,396.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,449.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
|
GLOBAL ADVANTAGE STEM 8 LONG
|
Facility
|
IP
|
$15,533.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,659.99 |
| Max. Negotiated Rate |
$14,911.97 |
| Rate for Payer: Aetna Commercial |
$11,960.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,115.97
|
| Rate for Payer: Cash Price |
$7,766.65
|
| Rate for Payer: Cigna Commercial |
$12,892.64
|
| Rate for Payer: First Health Commercial |
$14,756.64
|
| Rate for Payer: Humana Commercial |
$13,203.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,737.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,463.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,659.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$11,649.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,426.64
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,513.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,717.98
|
| Rate for Payer: PHCS Commercial |
$14,911.97
|
| Rate for Payer: United Healthcare All Payer |
$13,669.30
|
|
