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Service Code HCPCS 90636
Hospital Charge Code 77000013
Hospital Revenue Code 636
Min. Negotiated Rate $47.72
Max. Negotiated Rate $352.42
Rate for Payer: Aetna Commercial $282.67
Rate for Payer: Anthem Medicaid $126.25
Rate for Payer: Anthem POS/PPO/Traditional $286.34
Rate for Payer: Cash Price $183.55
Rate for Payer: Cigna Commercial $304.69
Rate for Payer: First Health Commercial $348.74
Rate for Payer: Humana Commercial $312.04
Rate for Payer: Humana KY Medicaid $126.25
Rate for Payer: Kentucky WC Medicaid $127.53
Rate for Payer: Medical Mutual Of Ohio HMO $301.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $270.92
Rate for Payer: Molina Healthcare Benefit Exchange $110.13
Rate for Payer: Molina Healthcare Medicaid $128.78
Rate for Payer: Ohio Health Choice Commercial $323.05
Rate for Payer: Ohio Health Group HMO $275.32
Rate for Payer: Ohio Health Group PPO Differential $73.42
Rate for Payer: Ohio Health Group PPO No Differential $47.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $113.80
Rate for Payer: PHCS Commercial $352.42
Rate for Payer: United Healthcare All Payer $323.05
Service Code HCPCS 90636
Hospital Charge Code 77000013
Hospital Revenue Code 636
Min. Negotiated Rate $97.92
Max. Negotiated Rate $367.10
Rate for Payer: Buckeye Medicare Advantage $367.10
Rate for Payer: Cash Price $183.55
Rate for Payer: Cash Price $183.55
Rate for Payer: Healthspan PPO $97.92
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $184.34
Rate for Payer: Multiplan PHCS $220.26
Rate for Payer: Ohio Health Choice Preferred Health Choice $256.97
Rate for Payer: UHCCP Medicaid $128.48
Service Code HCPCS 90636
Hospital Charge Code 770T0013
Hospital Revenue Code 636
Min. Negotiated Rate $47.72
Max. Negotiated Rate $352.42
Rate for Payer: Aetna Commercial $282.67
Rate for Payer: Anthem POS/PPO/Traditional $286.34
Rate for Payer: Cash Price $183.55
Rate for Payer: Cigna Commercial $304.69
Rate for Payer: First Health Commercial $348.74
Rate for Payer: Humana Commercial $312.04
Rate for Payer: Medical Mutual Of Ohio HMO $301.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $270.92
Rate for Payer: Molina Healthcare Benefit Exchange $110.13
Rate for Payer: Ohio Health Choice Commercial $323.05
Rate for Payer: Ohio Health Group HMO $275.32
Rate for Payer: Ohio Health Group PPO Differential $73.42
Rate for Payer: Ohio Health Group PPO No Differential $47.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $113.80
Rate for Payer: PHCS Commercial $352.42
Rate for Payer: United Healthcare All Payer $323.05
Service Code HCPCS 90636
Hospital Charge Code 770T0013
Hospital Revenue Code 636
Min. Negotiated Rate $47.72
Max. Negotiated Rate $352.42
Rate for Payer: Aetna Commercial $282.67
Rate for Payer: Anthem Medicaid $126.25
Rate for Payer: Anthem POS/PPO/Traditional $286.34
Rate for Payer: Cash Price $183.55
Rate for Payer: Cigna Commercial $304.69
Rate for Payer: First Health Commercial $348.74
Rate for Payer: Humana Commercial $312.04
Rate for Payer: Humana KY Medicaid $126.25
Rate for Payer: Kentucky WC Medicaid $127.53
Rate for Payer: Medical Mutual Of Ohio HMO $301.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $270.92
Rate for Payer: Molina Healthcare Benefit Exchange $110.13
Rate for Payer: Molina Healthcare Medicaid $128.78
Rate for Payer: Ohio Health Choice Commercial $323.05
Rate for Payer: Ohio Health Group HMO $275.32
Rate for Payer: Ohio Health Group PPO Differential $73.42
Rate for Payer: Ohio Health Group PPO No Differential $47.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $113.80
Rate for Payer: PHCS Commercial $352.42
Rate for Payer: United Healthcare All Payer $323.05
Service Code HCPCS J1644
Hospital Charge Code 25002135
Hospital Revenue Code 636
Min. Negotiated Rate $14.90
Max. Negotiated Rate $110.02
Rate for Payer: Aetna Commercial $88.24
Rate for Payer: Anthem Medicaid $39.41
Rate for Payer: Anthem POS/PPO/Traditional $89.39
Rate for Payer: Cash Price $57.30
Rate for Payer: Cigna Commercial $95.12
Rate for Payer: First Health Commercial $108.87
Rate for Payer: Humana Commercial $97.41
Rate for Payer: Humana KY Medicaid $39.41
Rate for Payer: Kentucky WC Medicaid $39.81
Rate for Payer: Medical Mutual Of Ohio HMO $93.97
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $84.57
Rate for Payer: Molina Healthcare Benefit Exchange $34.38
Rate for Payer: Molina Healthcare Medicaid $40.20
Rate for Payer: Ohio Health Choice Commercial $100.85
Rate for Payer: Ohio Health Group HMO $85.95
Rate for Payer: Ohio Health Group PPO Differential $22.92
Rate for Payer: Ohio Health Group PPO No Differential $14.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $35.53
Rate for Payer: PHCS Commercial $110.02
Rate for Payer: United Healthcare All Payer $100.85
Service Code HCPCS J1644
Hospital Charge Code 25002135
Hospital Revenue Code 636
Min. Negotiated Rate $14.90
Max. Negotiated Rate $110.02
Rate for Payer: Aetna Commercial $88.24
Rate for Payer: Anthem POS/PPO/Traditional $89.39
Rate for Payer: Cash Price $57.30
Rate for Payer: Cigna Commercial $95.12
Rate for Payer: First Health Commercial $108.87
Rate for Payer: Humana Commercial $97.41
Rate for Payer: Medical Mutual Of Ohio HMO $93.97
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $84.57
Rate for Payer: Molina Healthcare Benefit Exchange $34.38
Rate for Payer: Ohio Health Choice Commercial $100.85
Rate for Payer: Ohio Health Group HMO $85.95
Rate for Payer: Ohio Health Group PPO Differential $22.92
Rate for Payer: Ohio Health Group PPO No Differential $14.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $35.53
Rate for Payer: PHCS Commercial $110.02
Rate for Payer: United Healthcare All Payer $100.85
Service Code HCPCS J1644
Hospital Charge Code 25002136
Hospital Revenue Code 636
Min. Negotiated Rate $14.21
Max. Negotiated Rate $104.90
Rate for Payer: Aetna Commercial $84.14
Rate for Payer: Anthem POS/PPO/Traditional $85.23
Rate for Payer: Cash Price $54.63
Rate for Payer: Cigna Commercial $90.69
Rate for Payer: First Health Commercial $103.81
Rate for Payer: Humana Commercial $92.88
Rate for Payer: Medical Mutual Of Ohio HMO $89.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $80.64
Rate for Payer: Molina Healthcare Benefit Exchange $32.78
Rate for Payer: Ohio Health Choice Commercial $96.16
Rate for Payer: Ohio Health Group HMO $81.95
Rate for Payer: Ohio Health Group PPO Differential $21.85
Rate for Payer: Ohio Health Group PPO No Differential $14.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $33.87
Rate for Payer: PHCS Commercial $104.90
Rate for Payer: United Healthcare All Payer $96.16
Service Code HCPCS J1644
Hospital Charge Code 25002136
Hospital Revenue Code 636
Min. Negotiated Rate $14.21
Max. Negotiated Rate $104.90
Rate for Payer: Aetna Commercial $84.14
Rate for Payer: Anthem Medicaid $37.58
Rate for Payer: Anthem POS/PPO/Traditional $85.23
Rate for Payer: Cash Price $54.63
Rate for Payer: Cigna Commercial $90.69
Rate for Payer: First Health Commercial $103.81
Rate for Payer: Humana Commercial $92.88
Rate for Payer: Humana KY Medicaid $37.58
Rate for Payer: Kentucky WC Medicaid $37.96
Rate for Payer: Medical Mutual Of Ohio HMO $89.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $80.64
Rate for Payer: Molina Healthcare Benefit Exchange $32.78
Rate for Payer: Molina Healthcare Medicaid $38.33
Rate for Payer: Ohio Health Choice Commercial $96.16
Rate for Payer: Ohio Health Group HMO $81.95
Rate for Payer: Ohio Health Group PPO Differential $21.85
Rate for Payer: Ohio Health Group PPO No Differential $14.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $33.87
Rate for Payer: PHCS Commercial $104.90
Rate for Payer: United Healthcare All Payer $96.16
Service Code HCPCS J1644
Hospital Charge Code 25002131
Hospital Revenue Code 636
Min. Negotiated Rate $2.33
Max. Negotiated Rate $17.21
Rate for Payer: Aetna Commercial $13.81
Rate for Payer: Anthem POS/PPO/Traditional $13.99
Rate for Payer: Cash Price $8.96
Rate for Payer: Cigna Commercial $14.88
Rate for Payer: First Health Commercial $17.03
Rate for Payer: Humana Commercial $15.24
Rate for Payer: Medical Mutual Of Ohio HMO $14.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $13.23
Rate for Payer: Molina Healthcare Benefit Exchange $5.38
Rate for Payer: Ohio Health Choice Commercial $15.78
Rate for Payer: Ohio Health Group HMO $13.45
Rate for Payer: Ohio Health Group PPO Differential $3.59
Rate for Payer: Ohio Health Group PPO No Differential $2.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $5.56
Rate for Payer: PHCS Commercial $17.21
Rate for Payer: United Healthcare All Payer $15.78
Service Code HCPCS J1644
Hospital Charge Code 25002131
Hospital Revenue Code 636
Min. Negotiated Rate $2.33
Max. Negotiated Rate $17.21
Rate for Payer: Aetna Commercial $13.81
Rate for Payer: Anthem Medicaid $6.17
Rate for Payer: Anthem POS/PPO/Traditional $13.99
Rate for Payer: Cash Price $8.96
Rate for Payer: Cigna Commercial $14.88
Rate for Payer: First Health Commercial $17.03
Rate for Payer: Humana Commercial $15.24
Rate for Payer: Humana KY Medicaid $6.17
Rate for Payer: Kentucky WC Medicaid $6.23
Rate for Payer: Medical Mutual Of Ohio HMO $14.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $13.23
Rate for Payer: Molina Healthcare Benefit Exchange $5.38
Rate for Payer: Molina Healthcare Medicaid $6.29
Rate for Payer: Ohio Health Choice Commercial $15.78
Rate for Payer: Ohio Health Group HMO $13.45
Rate for Payer: Ohio Health Group PPO Differential $3.59
Rate for Payer: Ohio Health Group PPO No Differential $2.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $5.56
Rate for Payer: PHCS Commercial $17.21
Rate for Payer: United Healthcare All Payer $15.78
Service Code HCPCS J1644
Hospital Charge Code 25003099
Hospital Revenue Code 636
Min. Negotiated Rate $14.18
Max. Negotiated Rate $104.70
Rate for Payer: Aetna Commercial $83.98
Rate for Payer: Aetna Commercial $87.83
Rate for Payer: Anthem Medicaid $37.51
Rate for Payer: Anthem Medicaid $39.23
Rate for Payer: Anthem POS/PPO/Traditional $85.07
Rate for Payer: Anthem POS/PPO/Traditional $88.97
Rate for Payer: Cash Price $54.53
Rate for Payer: Cash Price $57.03
Rate for Payer: Cigna Commercial $94.67
Rate for Payer: Cigna Commercial $90.52
Rate for Payer: First Health Commercial $108.36
Rate for Payer: First Health Commercial $103.61
Rate for Payer: Humana Commercial $92.70
Rate for Payer: Humana Commercial $96.95
Rate for Payer: Humana KY Medicaid $37.51
Rate for Payer: Humana KY Medicaid $39.23
Rate for Payer: Kentucky WC Medicaid $39.62
Rate for Payer: Kentucky WC Medicaid $37.89
Rate for Payer: Medical Mutual Of Ohio HMO $89.43
Rate for Payer: Medical Mutual Of Ohio HMO $93.53
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $84.18
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $80.49
Rate for Payer: Molina Healthcare Benefit Exchange $34.22
Rate for Payer: Molina Healthcare Benefit Exchange $32.72
Rate for Payer: Molina Healthcare Medicaid $38.26
Rate for Payer: Molina Healthcare Medicaid $40.01
Rate for Payer: Ohio Health Choice Commercial $95.97
Rate for Payer: Ohio Health Choice Commercial $100.37
Rate for Payer: Ohio Health Group HMO $81.80
Rate for Payer: Ohio Health Group HMO $85.54
Rate for Payer: Ohio Health Group PPO Differential $21.81
Rate for Payer: Ohio Health Group PPO Differential $22.81
Rate for Payer: Ohio Health Group PPO No Differential $14.18
Rate for Payer: Ohio Health Group PPO No Differential $14.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $33.81
Rate for Payer: Ohio Health Group PPO SOMC Employees $35.36
Rate for Payer: PHCS Commercial $109.50
Rate for Payer: PHCS Commercial $104.70
Rate for Payer: United Healthcare All Payer $100.37
Rate for Payer: United Healthcare All Payer $95.97
Service Code HCPCS J1644
Hospital Charge Code 25003099
Hospital Revenue Code 636
Min. Negotiated Rate $14.18
Max. Negotiated Rate $104.70
Rate for Payer: Aetna Commercial $83.98
Rate for Payer: Aetna Commercial $87.83
Rate for Payer: Anthem POS/PPO/Traditional $85.07
Rate for Payer: Anthem POS/PPO/Traditional $88.97
Rate for Payer: Cash Price $54.53
Rate for Payer: Cash Price $57.03
Rate for Payer: Cigna Commercial $90.52
Rate for Payer: Cigna Commercial $94.67
Rate for Payer: First Health Commercial $108.36
Rate for Payer: First Health Commercial $103.61
Rate for Payer: Humana Commercial $96.95
Rate for Payer: Humana Commercial $92.70
Rate for Payer: Medical Mutual Of Ohio HMO $89.43
Rate for Payer: Medical Mutual Of Ohio HMO $93.53
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $80.49
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $84.18
Rate for Payer: Molina Healthcare Benefit Exchange $34.22
Rate for Payer: Molina Healthcare Benefit Exchange $32.72
Rate for Payer: Ohio Health Choice Commercial $95.97
Rate for Payer: Ohio Health Choice Commercial $100.37
Rate for Payer: Ohio Health Group HMO $81.80
Rate for Payer: Ohio Health Group HMO $85.54
Rate for Payer: Ohio Health Group PPO Differential $21.81
Rate for Payer: Ohio Health Group PPO Differential $22.81
Rate for Payer: Ohio Health Group PPO No Differential $14.18
Rate for Payer: Ohio Health Group PPO No Differential $14.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $35.36
Rate for Payer: Ohio Health Group PPO SOMC Employees $33.81
Rate for Payer: PHCS Commercial $104.70
Rate for Payer: PHCS Commercial $109.50
Rate for Payer: United Healthcare All Payer $95.97
Rate for Payer: United Healthcare All Payer $100.37
Service Code HCPCS J1644
Hospital Charge Code 25002134
Hospital Revenue Code 636
Min. Negotiated Rate $1.28
Max. Negotiated Rate $9.42
Rate for Payer: Aetna Commercial $7.55
Rate for Payer: Anthem POS/PPO/Traditional $7.65
Rate for Payer: Cash Price $4.90
Rate for Payer: Cigna Commercial $8.14
Rate for Payer: First Health Commercial $9.32
Rate for Payer: Humana Commercial $8.34
Rate for Payer: Medical Mutual Of Ohio HMO $8.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.24
Rate for Payer: Molina Healthcare Benefit Exchange $2.94
Rate for Payer: Ohio Health Choice Commercial $8.63
Rate for Payer: Ohio Health Group HMO $7.36
Rate for Payer: Ohio Health Group PPO Differential $1.96
Rate for Payer: Ohio Health Group PPO No Differential $1.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.04
Rate for Payer: PHCS Commercial $9.42
Rate for Payer: United Healthcare All Payer $8.63
Service Code HCPCS J1644
Hospital Charge Code 25002134
Hospital Revenue Code 636
Min. Negotiated Rate $1.28
Max. Negotiated Rate $9.42
Rate for Payer: Aetna Commercial $7.55
Rate for Payer: Anthem Medicaid $3.37
Rate for Payer: Anthem POS/PPO/Traditional $7.65
Rate for Payer: Cash Price $4.90
Rate for Payer: Cigna Commercial $8.14
Rate for Payer: First Health Commercial $9.32
Rate for Payer: Humana Commercial $8.34
Rate for Payer: Humana KY Medicaid $3.37
Rate for Payer: Kentucky WC Medicaid $3.41
Rate for Payer: Medical Mutual Of Ohio HMO $8.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.24
Rate for Payer: Molina Healthcare Benefit Exchange $2.94
Rate for Payer: Molina Healthcare Medicaid $3.44
Rate for Payer: Ohio Health Choice Commercial $8.63
Rate for Payer: Ohio Health Group HMO $7.36
Rate for Payer: Ohio Health Group PPO Differential $1.96
Rate for Payer: Ohio Health Group PPO No Differential $1.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.04
Rate for Payer: PHCS Commercial $9.42
Rate for Payer: United Healthcare All Payer $8.63
Service Code HCPCS J1642
Hospital Charge Code 25002125
Hospital Revenue Code 636
Min. Negotiated Rate $8.30
Max. Negotiated Rate $61.28
Rate for Payer: Aetna Commercial $49.15
Rate for Payer: Anthem Medicaid $21.95
Rate for Payer: Anthem POS/PPO/Traditional $49.79
Rate for Payer: Cash Price $31.91
Rate for Payer: Cigna Commercial $52.98
Rate for Payer: First Health Commercial $60.64
Rate for Payer: Humana Commercial $54.26
Rate for Payer: Humana KY Medicaid $21.95
Rate for Payer: Kentucky WC Medicaid $22.17
Rate for Payer: Medical Mutual Of Ohio HMO $52.34
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.11
Rate for Payer: Molina Healthcare Benefit Exchange $19.15
Rate for Payer: Molina Healthcare Medicaid $22.39
Rate for Payer: Ohio Health Choice Commercial $56.17
Rate for Payer: Ohio Health Group HMO $47.87
Rate for Payer: Ohio Health Group PPO Differential $12.77
Rate for Payer: Ohio Health Group PPO No Differential $8.30
Rate for Payer: Ohio Health Group PPO SOMC Employees $19.79
Rate for Payer: PHCS Commercial $61.28
Rate for Payer: United Healthcare All Payer $56.17
Service Code HCPCS J1642
Hospital Charge Code 25002125
Hospital Revenue Code 636
Min. Negotiated Rate $8.30
Max. Negotiated Rate $61.28
Rate for Payer: Aetna Commercial $49.15
Rate for Payer: Anthem POS/PPO/Traditional $49.79
Rate for Payer: Cash Price $31.91
Rate for Payer: Cigna Commercial $52.98
Rate for Payer: First Health Commercial $60.64
Rate for Payer: Humana Commercial $54.26
Rate for Payer: Medical Mutual Of Ohio HMO $52.34
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.11
Rate for Payer: Molina Healthcare Benefit Exchange $19.15
Rate for Payer: Ohio Health Choice Commercial $56.17
Rate for Payer: Ohio Health Group HMO $47.87
Rate for Payer: Ohio Health Group PPO Differential $12.77
Rate for Payer: Ohio Health Group PPO No Differential $8.30
Rate for Payer: Ohio Health Group PPO SOMC Employees $19.79
Rate for Payer: PHCS Commercial $61.28
Rate for Payer: United Healthcare All Payer $56.17
Service Code HCPCS J1644
Hospital Charge Code 25003098
Hospital Revenue Code 636
Min. Negotiated Rate $15.51
Max. Negotiated Rate $114.54
Rate for Payer: Aetna Commercial $91.87
Rate for Payer: Anthem POS/PPO/Traditional $93.06
Rate for Payer: Cash Price $59.66
Rate for Payer: Cigna Commercial $99.03
Rate for Payer: First Health Commercial $113.34
Rate for Payer: Humana Commercial $101.41
Rate for Payer: Medical Mutual Of Ohio HMO $97.83
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $88.05
Rate for Payer: Molina Healthcare Benefit Exchange $35.79
Rate for Payer: Ohio Health Choice Commercial $104.99
Rate for Payer: Ohio Health Group HMO $89.48
Rate for Payer: Ohio Health Group PPO Differential $23.86
Rate for Payer: Ohio Health Group PPO No Differential $15.51
Rate for Payer: Ohio Health Group PPO SOMC Employees $36.99
Rate for Payer: PHCS Commercial $114.54
Rate for Payer: United Healthcare All Payer $104.99
Service Code HCPCS J1644
Hospital Charge Code 25003098
Hospital Revenue Code 636
Min. Negotiated Rate $15.51
Max. Negotiated Rate $114.54
Rate for Payer: Aetna Commercial $91.87
Rate for Payer: Anthem Medicaid $41.03
Rate for Payer: Anthem POS/PPO/Traditional $93.06
Rate for Payer: Cash Price $59.66
Rate for Payer: Cigna Commercial $99.03
Rate for Payer: First Health Commercial $113.34
Rate for Payer: Humana Commercial $101.41
Rate for Payer: Humana KY Medicaid $41.03
Rate for Payer: Kentucky WC Medicaid $41.45
Rate for Payer: Medical Mutual Of Ohio HMO $97.83
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $88.05
Rate for Payer: Molina Healthcare Benefit Exchange $35.79
Rate for Payer: Molina Healthcare Medicaid $41.85
Rate for Payer: Ohio Health Choice Commercial $104.99
Rate for Payer: Ohio Health Group HMO $89.48
Rate for Payer: Ohio Health Group PPO Differential $23.86
Rate for Payer: Ohio Health Group PPO No Differential $15.51
Rate for Payer: Ohio Health Group PPO SOMC Employees $36.99
Rate for Payer: PHCS Commercial $114.54
Rate for Payer: United Healthcare All Payer $104.99
Service Code HCPCS J1644
Hospital Charge Code 25003099
Hospital Revenue Code 636
Min. Negotiated Rate $2.99
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 $4.60
Rate for Payer: Ohio Health Group PPO No Differential $2.99
Rate for Payer: Ohio Health Group PPO SOMC Employees $7.13
Rate for Payer: PHCS Commercial $22.08
Rate for Payer: United Healthcare All Payer $20.24
Service Code HCPCS J1644
Hospital Charge Code 25003099
Hospital Revenue Code 636
Min. Negotiated Rate $2.99
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 $4.60
Rate for Payer: Ohio Health Group PPO No Differential $2.99
Rate for Payer: Ohio Health Group PPO SOMC Employees $7.13
Rate for Payer: PHCS Commercial $22.08
Rate for Payer: United Healthcare All Payer $20.24
Service Code CPT 85520
Hospital Revenue Code 360
Min. Negotiated Rate $13.09
Max. Negotiated Rate $18.33
Rate for Payer: Anthem Medicaid $13.09
Rate for Payer: Anthem Medicare Advantage/PPO $13.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $18.33
Rate for Payer: CareSource Just4Me Medicare $13.09
Rate for Payer: Humana KY Medicaid $13.09
Rate for Payer: Humana Medicare Advantage $13.09
Rate for Payer: Kentucky WC Medicaid $13.22
Rate for Payer: Molina Healthcare Benefit Exchange $15.71
Rate for Payer: Molina Healthcare Medicaid $13.35
Service Code HCPCS J1644
Hospital Charge Code 25003100
Hospital Revenue Code 636
Min. Negotiated Rate $16.04
Max. Negotiated Rate $118.47
Rate for Payer: Aetna Commercial $95.03
Rate for Payer: Anthem Medicaid $42.44
Rate for Payer: Anthem POS/PPO/Traditional $96.26
Rate for Payer: Cash Price $61.70
Rate for Payer: Cigna Commercial $102.43
Rate for Payer: First Health Commercial $117.24
Rate for Payer: Humana Commercial $104.90
Rate for Payer: Humana KY Medicaid $42.44
Rate for Payer: Kentucky WC Medicaid $42.87
Rate for Payer: Medical Mutual Of Ohio HMO $101.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $91.08
Rate for Payer: Molina Healthcare Benefit Exchange $37.02
Rate for Payer: Molina Healthcare Medicaid $43.29
Rate for Payer: Ohio Health Choice Commercial $108.60
Rate for Payer: Ohio Health Group HMO $92.56
Rate for Payer: Ohio Health Group PPO Differential $24.68
Rate for Payer: Ohio Health Group PPO No Differential $16.04
Rate for Payer: Ohio Health Group PPO SOMC Employees $38.26
Rate for Payer: PHCS Commercial $118.47
Rate for Payer: United Healthcare All Payer $108.60
Service Code HCPCS J1644
Hospital Charge Code 25003100
Hospital Revenue Code 636
Min. Negotiated Rate $16.04
Max. Negotiated Rate $118.47
Rate for Payer: Aetna Commercial $95.03
Rate for Payer: Anthem POS/PPO/Traditional $96.26
Rate for Payer: Cash Price $61.70
Rate for Payer: Cigna Commercial $102.43
Rate for Payer: First Health Commercial $117.24
Rate for Payer: Humana Commercial $104.90
Rate for Payer: Medical Mutual Of Ohio HMO $101.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $91.08
Rate for Payer: Molina Healthcare Benefit Exchange $37.02
Rate for Payer: Ohio Health Choice Commercial $108.60
Rate for Payer: Ohio Health Group HMO $92.56
Rate for Payer: Ohio Health Group PPO Differential $24.68
Rate for Payer: Ohio Health Group PPO No Differential $16.04
Rate for Payer: Ohio Health Group PPO SOMC Employees $38.26
Rate for Payer: PHCS Commercial $118.47
Rate for Payer: United Healthcare All Payer $108.60
Service Code HCPCS J1642
Hospital Charge Code 25003750
Hospital Revenue Code 636
Min. Negotiated Rate $10.01
Max. Negotiated Rate $73.92
Rate for Payer: Aetna Commercial $59.29
Rate for Payer: Anthem Medicaid $26.48
Rate for Payer: Anthem POS/PPO/Traditional $60.06
Rate for Payer: Cash Price $38.50
Rate for Payer: Cigna Commercial $63.91
Rate for Payer: First Health Commercial $73.15
Rate for Payer: Humana Commercial $65.45
Rate for Payer: Humana KY Medicaid $26.48
Rate for Payer: Kentucky WC Medicaid $26.75
Rate for Payer: Medical Mutual Of Ohio HMO $63.14
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $56.83
Rate for Payer: Molina Healthcare Benefit Exchange $23.10
Rate for Payer: Molina Healthcare Medicaid $27.01
Rate for Payer: Ohio Health Choice Commercial $67.76
Rate for Payer: Ohio Health Group HMO $57.75
Rate for Payer: Ohio Health Group PPO Differential $15.40
Rate for Payer: Ohio Health Group PPO No Differential $10.01
Rate for Payer: Ohio Health Group PPO SOMC Employees $23.87
Rate for Payer: PHCS Commercial $73.92
Rate for Payer: United Healthcare All Payer $67.76
Service Code HCPCS J1642
Hospital Charge Code 25003750
Hospital Revenue Code 636
Min. Negotiated Rate $10.01
Max. Negotiated Rate $73.92
Rate for Payer: Aetna Commercial $59.29
Rate for Payer: Anthem POS/PPO/Traditional $60.06
Rate for Payer: Cash Price $38.50
Rate for Payer: Cigna Commercial $63.91
Rate for Payer: First Health Commercial $73.15
Rate for Payer: Humana Commercial $65.45
Rate for Payer: Medical Mutual Of Ohio HMO $63.14
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $56.83
Rate for Payer: Molina Healthcare Benefit Exchange $23.10
Rate for Payer: Ohio Health Choice Commercial $67.76
Rate for Payer: Ohio Health Group HMO $57.75
Rate for Payer: Ohio Health Group PPO Differential $15.40
Rate for Payer: Ohio Health Group PPO No Differential $10.01
Rate for Payer: Ohio Health Group PPO SOMC Employees $23.87
Rate for Payer: PHCS Commercial $73.92
Rate for Payer: United Healthcare All Payer $67.76