ANESTH CABG W/O PUMP
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 566
|
Hospital Charge Code |
37000044
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CABG W/PUMP
|
Facility
|
IP
|
$5.50
|
|
Service Code
|
HCPCS 567
|
Hospital Charge Code |
37000045
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$0.72 |
Max. Negotiated Rate |
$5.28 |
Rate for Payer: Aetna Commercial |
$4.24
|
Rate for Payer: Anthem POS/PPO/Traditional |
$4.29
|
Rate for Payer: Cash Price |
$2.75
|
Rate for Payer: Cigna Commercial |
$4.56
|
Rate for Payer: First Health Commercial |
$5.22
|
Rate for Payer: Humana Commercial |
$4.68
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$4.51
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4.06
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$1.65
|
Rate for Payer: Ohio Health Choice Commercial |
$4.84
|
Rate for Payer: Ohio Health Group HMO |
$4.12
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.10
|
Rate for Payer: Ohio Health Group PPO No Differential |
$0.72
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.70
|
Rate for Payer: PHCS Commercial |
$5.28
|
Rate for Payer: United Healthcare All Payer |
$4.84
|
|
ANESTH CABG W/PUMP
|
Facility
|
OP
|
$5.50
|
|
Service Code
|
HCPCS 567
|
Hospital Charge Code |
37000045
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$0.72 |
Max. Negotiated Rate |
$5.28 |
Rate for Payer: Aetna Commercial |
$4.24
|
Rate for Payer: Anthem Medicaid |
$1.89
|
Rate for Payer: Anthem POS/PPO/Traditional |
$4.29
|
Rate for Payer: Cash Price |
$2.75
|
Rate for Payer: Cigna Commercial |
$4.56
|
Rate for Payer: First Health Commercial |
$5.22
|
Rate for Payer: Humana Commercial |
$4.68
|
Rate for Payer: Humana KY Medicaid |
$1.89
|
Rate for Payer: Kentucky WC Medicaid |
$1.91
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$4.51
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4.06
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$1.65
|
Rate for Payer: Molina Healthcare Medicaid |
$1.93
|
Rate for Payer: Ohio Health Choice Commercial |
$4.84
|
Rate for Payer: Ohio Health Group HMO |
$4.12
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.10
|
Rate for Payer: Ohio Health Group PPO No Differential |
$0.72
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.70
|
Rate for Payer: PHCS Commercial |
$5.28
|
Rate for Payer: United Healthcare All Payer |
$4.84
|
|
ANESTH CABG W/PUMP
|
Professional
|
Both
|
$5.50
|
|
Service Code
|
HCPCS 00567
|
Hospital Charge Code |
37000045
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.92 |
Max. Negotiated Rate |
$5.50 |
Rate for Payer: Buckeye Medicare Advantage |
$5.50
|
Rate for Payer: Cash Price |
$2.75
|
Rate for Payer: Multiplan PHCS |
$3.30
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3.85
|
Rate for Payer: UHCCP Medicaid |
$1.92
|
|
ANESTH CARDIAC ELECTROPHYS
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 537
|
Hospital Charge Code |
37000037
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CARDIAC ELECTROPHYS
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 537
|
Hospital Charge Code |
37000037
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CARDIAC ELECTROPHYS
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 00537
|
Hospital Charge Code |
37000037
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CARDIOVERTER/DEFIB
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 534
|
Hospital Charge Code |
37000036
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CARDIOVERTER/DEFIB
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 534
|
Hospital Charge Code |
37000036
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CARDIOVERTER/DEFIB
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 00534
|
Hospital Charge Code |
37000036
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CATHETERIZE HEART
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 1920
|
Hospital Charge Code |
37000158
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CATHETERIZE HEART
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 01920
|
Hospital Charge Code |
37000158
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CATHETERIZE HEART
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 1920
|
Hospital Charge Code |
37000158
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CAT OR MRI SCAN
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 1922
|
Hospital Charge Code |
37000159
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CAT OR MRI SCAN
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 01922
|
Hospital Charge Code |
37000159
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CAT OR MRI SCAN
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 1922
|
Hospital Charge Code |
37000159
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CHEST DRAINAGE
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 00524
|
Hospital Charge Code |
37000031
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CHEST DRAINAGE
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 524
|
Hospital Charge Code |
37000031
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CHEST DRAINAGE
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 524
|
Hospital Charge Code |
37000031
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CHEST LINING BIOPSY
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 522
|
Hospital Charge Code |
37000030
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CHEST LINING BIOPSY
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 00522
|
Hospital Charge Code |
37000030
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CHEST LINING BIOPSY
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 522
|
Hospital Charge Code |
37000030
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CHEST PROCEDURE
|
Facility
|
IP
|
$8.00
|
|
Service Code
|
HCPCS 520
|
Hospital Charge Code |
37000029
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|
ANESTH CHEST PROCEDURE
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 00520
|
Hospital Charge Code |
37000029
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: Buckeye Medicare Advantage |
$8.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Multiplan PHCS |
$4.80
|
Rate for Payer: Ohio Health Choice Preferred Health Choice |
$5.60
|
Rate for Payer: UHCCP Medicaid |
$2.80
|
|
ANESTH CHEST PROCEDURE
|
Facility
|
OP
|
$8.00
|
|
Service Code
|
HCPCS 520
|
Hospital Charge Code |
37000029
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.04 |
Max. Negotiated Rate |
$7.68 |
Rate for Payer: Aetna Commercial |
$6.16
|
Rate for Payer: Anthem Medicaid |
$2.75
|
Rate for Payer: Anthem POS/PPO/Traditional |
$6.24
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Cigna Commercial |
$6.64
|
Rate for Payer: First Health Commercial |
$7.60
|
Rate for Payer: Humana Commercial |
$6.80
|
Rate for Payer: Humana KY Medicaid |
$2.75
|
Rate for Payer: Kentucky WC Medicaid |
$2.78
|
Rate for Payer: Medical Mutual Of Ohio HMO |
$6.56
|
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5.90
|
Rate for Payer: Molina Healthcare Benefit Exchange |
$2.40
|
Rate for Payer: Molina Healthcare Medicaid |
$2.81
|
Rate for Payer: Ohio Health Choice Commercial |
$7.04
|
Rate for Payer: Ohio Health Group HMO |
$6.00
|
Rate for Payer: Ohio Health Group PPO Differential |
$1.60
|
Rate for Payer: Ohio Health Group PPO No Differential |
$1.04
|
Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.48
|
Rate for Payer: PHCS Commercial |
$7.68
|
Rate for Payer: United Healthcare All Payer |
$7.04
|
|