|
ANESTH COSMET PANNICULECTOM OB
|
Facility
|
IP
|
$430.00
|
|
| Hospital Charge Code |
37000212
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$412.80 |
| Rate for Payer: Aetna Commercial |
$331.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$335.40
|
| Rate for Payer: Cash Price |
$215.00
|
| Rate for Payer: Cigna Commercial |
$356.90
|
| Rate for Payer: First Health Commercial |
$408.50
|
| Rate for Payer: Humana Commercial |
$365.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$352.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$317.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$129.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$378.40
|
| Rate for Payer: Ohio Health Group HMO |
$322.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$344.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$374.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$296.70
|
| Rate for Payer: PHCS Commercial |
$412.80
|
| Rate for Payer: United Healthcare All Payer |
$378.40
|
|
|
ANESTH COSMET PANNICULECTOM OB
|
Facility
|
OP
|
$430.00
|
|
| Hospital Charge Code |
37000212
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$412.80 |
| Rate for Payer: Aetna Commercial |
$331.10
|
| Rate for Payer: Anthem Medicaid |
$147.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$335.40
|
| Rate for Payer: Cash Price |
$215.00
|
| Rate for Payer: Cigna Commercial |
$356.90
|
| Rate for Payer: First Health Commercial |
$408.50
|
| Rate for Payer: Humana Commercial |
$365.50
|
| Rate for Payer: Humana KY Medicaid |
$147.88
|
| Rate for Payer: Kentucky WC Medicaid |
$149.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$352.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$317.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$129.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$150.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$378.40
|
| Rate for Payer: Ohio Health Group HMO |
$322.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$344.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$374.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$296.70
|
| Rate for Payer: PHCS Commercial |
$412.80
|
| Rate for Payer: United Healthcare All Payer |
$378.40
|
|
|
ANESTHCOSM FACENECKWBILUPBLEPH
|
Professional
|
Both
|
$1,380.00
|
|
| Hospital Charge Code |
37000208
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$966.00 |
| Rate for Payer: Cash Price |
$690.00
|
| Rate for Payer: Multiplan PHCS |
$828.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$966.00
|
| Rate for Payer: UHCCP Medicaid |
$483.00
|
|
|
ANESTHCOSM FACENECKWBILUPBLEPH
|
Facility
|
IP
|
$1,380.00
|
|
| Hospital Charge Code |
37000208
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$414.00 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Aetna Commercial |
$1,062.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,076.40
|
| Rate for Payer: Cash Price |
$690.00
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: First Health Commercial |
$1,311.00
|
| Rate for Payer: Humana Commercial |
$1,173.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,131.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,018.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$414.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,214.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,035.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,104.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,200.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$952.20
|
| Rate for Payer: PHCS Commercial |
$1,324.80
|
| Rate for Payer: United Healthcare All Payer |
$1,214.40
|
|
|
ANESTHCOSM FACENECKWBILUPBLEPH
|
Facility
|
OP
|
$1,380.00
|
|
| Hospital Charge Code |
37000208
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$414.00 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Aetna Commercial |
$1,062.60
|
| Rate for Payer: Anthem Medicaid |
$474.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,076.40
|
| Rate for Payer: Cash Price |
$690.00
|
| Rate for Payer: Cigna Commercial |
$1,145.40
|
| Rate for Payer: First Health Commercial |
$1,311.00
|
| Rate for Payer: Humana Commercial |
$1,173.00
|
| Rate for Payer: Humana KY Medicaid |
$474.58
|
| Rate for Payer: Kentucky WC Medicaid |
$479.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,131.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,018.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$414.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$484.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,214.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,035.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,104.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,200.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$952.20
|
| Rate for Payer: PHCS Commercial |
$1,324.80
|
| Rate for Payer: United Healthcare All Payer |
$1,214.40
|
|
|
ANESTHCOSMO90MOR W/OR RPLC IMP
|
Professional
|
Both
|
$310.00
|
|
| Hospital Charge Code |
37000247
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$108.50 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Multiplan PHCS |
$186.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$217.00
|
| Rate for Payer: UHCCP Medicaid |
$108.50
|
|
|
ANESTHCOSMO90MOR W/OR RPLC IMP
|
Facility
|
OP
|
$310.00
|
|
| Hospital Charge Code |
37000247
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$93.00 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$238.70
|
| Rate for Payer: Anthem Medicaid |
$106.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$241.80
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$257.30
|
| Rate for Payer: First Health Commercial |
$294.50
|
| Rate for Payer: Humana Commercial |
$263.50
|
| Rate for Payer: Humana KY Medicaid |
$106.61
|
| Rate for Payer: Kentucky WC Medicaid |
$107.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$254.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$228.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$93.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$108.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$272.80
|
| Rate for Payer: Ohio Health Group HMO |
$232.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$248.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$269.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$213.90
|
| Rate for Payer: PHCS Commercial |
$297.60
|
| Rate for Payer: United Healthcare All Payer |
$272.80
|
|
|
ANESTHCOSMO90MOR W/OR RPLC IMP
|
Facility
|
IP
|
$310.00
|
|
| Hospital Charge Code |
37000247
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$93.00 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$238.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$241.80
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$257.30
|
| Rate for Payer: First Health Commercial |
$294.50
|
| Rate for Payer: Humana Commercial |
$263.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$254.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$228.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$93.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$272.80
|
| Rate for Payer: Ohio Health Group HMO |
$232.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$248.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$269.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$213.90
|
| Rate for Payer: PHCS Commercial |
$297.60
|
| Rate for Payer: United Healthcare All Payer |
$272.80
|
|
|
ANESTH COSMO BIL BRST AUG REV
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
37000222
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$153.60 |
| Rate for Payer: Aetna Commercial |
$123.20
|
| Rate for Payer: Anthem Medicaid |
$55.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$124.80
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna Commercial |
$132.80
|
| Rate for Payer: First Health Commercial |
$152.00
|
| Rate for Payer: Humana Commercial |
$136.00
|
| Rate for Payer: Humana KY Medicaid |
$55.02
|
| Rate for Payer: Kentucky WC Medicaid |
$55.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$131.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$118.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$56.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$140.80
|
| Rate for Payer: Ohio Health Group HMO |
$120.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$128.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$110.40
|
| Rate for Payer: PHCS Commercial |
$153.60
|
| Rate for Payer: United Healthcare All Payer |
$140.80
|
|
|
ANESTH COSMO BIL BRST AUG REV
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
37000222
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$153.60 |
| Rate for Payer: Aetna Commercial |
$123.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$124.80
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna Commercial |
$132.80
|
| Rate for Payer: First Health Commercial |
$152.00
|
| Rate for Payer: Humana Commercial |
$136.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$131.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$118.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$140.80
|
| Rate for Payer: Ohio Health Group HMO |
$120.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$128.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$110.40
|
| Rate for Payer: PHCS Commercial |
$153.60
|
| Rate for Payer: United Healthcare All Payer |
$140.80
|
|
|
ANESTH COSMO BIL BRST AUG REV
|
Professional
|
Both
|
$160.00
|
|
| Hospital Charge Code |
37000222
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$112.00 |
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Multiplan PHCS |
$96.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$112.00
|
| Rate for Payer: UHCCP Medicaid |
$56.00
|
|
|
ANESTH COSMO BRST SURG WSLING
|
Professional
|
Both
|
$210.00
|
|
| Hospital Charge Code |
37000243
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Multiplan PHCS |
$126.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$147.00
|
| Rate for Payer: UHCCP Medicaid |
$73.50
|
|
|
ANESTH COSMO BRST SURG WSLING
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
37000243
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial |
$161.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$163.80
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$174.30
|
| Rate for Payer: First Health Commercial |
$199.50
|
| Rate for Payer: Humana Commercial |
$178.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$172.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$154.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$63.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$184.80
|
| Rate for Payer: Ohio Health Group HMO |
$157.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$168.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$182.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$144.90
|
| Rate for Payer: PHCS Commercial |
$201.60
|
| Rate for Payer: United Healthcare All Payer |
$184.80
|
|
|
ANESTH COSMO BRST SURG WSLING
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
37000243
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial |
$161.70
|
| Rate for Payer: Anthem Medicaid |
$72.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$163.80
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$174.30
|
| Rate for Payer: First Health Commercial |
$199.50
|
| Rate for Payer: Humana Commercial |
$178.50
|
| Rate for Payer: Humana KY Medicaid |
$72.22
|
| Rate for Payer: Kentucky WC Medicaid |
$72.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$172.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$154.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$63.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$73.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$184.80
|
| Rate for Payer: Ohio Health Group HMO |
$157.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$168.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$182.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$144.90
|
| Rate for Payer: PHCS Commercial |
$201.60
|
| Rate for Payer: United Healthcare All Payer |
$184.80
|
|
|
ANESTH COSMO LIPOSUCTION ARMS
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
37000193
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$153.60 |
| Rate for Payer: Aetna Commercial |
$123.20
|
| Rate for Payer: Anthem Medicaid |
$55.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$124.80
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna Commercial |
$132.80
|
| Rate for Payer: First Health Commercial |
$152.00
|
| Rate for Payer: Humana Commercial |
$136.00
|
| Rate for Payer: Humana KY Medicaid |
$55.02
|
| Rate for Payer: Kentucky WC Medicaid |
$55.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$131.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$118.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$56.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$140.80
|
| Rate for Payer: Ohio Health Group HMO |
$120.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$128.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$110.40
|
| Rate for Payer: PHCS Commercial |
$153.60
|
| Rate for Payer: United Healthcare All Payer |
$140.80
|
|
|
ANESTH COSMO LIPOSUCTION ARMS
|
Professional
|
Both
|
$160.00
|
|
| Hospital Charge Code |
37000193
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$112.00 |
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Multiplan PHCS |
$96.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$112.00
|
| Rate for Payer: UHCCP Medicaid |
$56.00
|
|
|
ANESTH COSMO LIPOSUCTION ARMS
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
37000193
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$153.60 |
| Rate for Payer: Aetna Commercial |
$123.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$124.80
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna Commercial |
$132.80
|
| Rate for Payer: First Health Commercial |
$152.00
|
| Rate for Payer: Humana Commercial |
$136.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$131.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$118.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$140.80
|
| Rate for Payer: Ohio Health Group HMO |
$120.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$128.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$110.40
|
| Rate for Payer: PHCS Commercial |
$153.60
|
| Rate for Payer: United Healthcare All Payer |
$140.80
|
|
|
ANESTH COSMO LIPOSUCTION LEGS
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
37000194
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial |
$161.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$163.80
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$174.30
|
| Rate for Payer: First Health Commercial |
$199.50
|
| Rate for Payer: Humana Commercial |
$178.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$172.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$154.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$63.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$184.80
|
| Rate for Payer: Ohio Health Group HMO |
$157.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$168.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$182.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$144.90
|
| Rate for Payer: PHCS Commercial |
$201.60
|
| Rate for Payer: United Healthcare All Payer |
$184.80
|
|
|
ANESTH COSMO LIPOSUCTION LEGS
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
37000194
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial |
$161.70
|
| Rate for Payer: Anthem Medicaid |
$72.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$163.80
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$174.30
|
| Rate for Payer: First Health Commercial |
$199.50
|
| Rate for Payer: Humana Commercial |
$178.50
|
| Rate for Payer: Humana KY Medicaid |
$72.22
|
| Rate for Payer: Kentucky WC Medicaid |
$72.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$172.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$154.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$63.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$73.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$184.80
|
| Rate for Payer: Ohio Health Group HMO |
$157.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$168.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$182.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$144.90
|
| Rate for Payer: PHCS Commercial |
$201.60
|
| Rate for Payer: United Healthcare All Payer |
$184.80
|
|
|
ANESTH COSMO LIPOSUCTION LEGS
|
Professional
|
Both
|
$210.00
|
|
| Hospital Charge Code |
37000194
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Multiplan PHCS |
$126.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$147.00
|
| Rate for Payer: UHCCP Medicaid |
$73.50
|
|
|
ANESTH COSMO LIPOSUCTION NECK
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
37000195
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$153.60 |
| Rate for Payer: Aetna Commercial |
$123.20
|
| Rate for Payer: Anthem Medicaid |
$55.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$124.80
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna Commercial |
$132.80
|
| Rate for Payer: First Health Commercial |
$152.00
|
| Rate for Payer: Humana Commercial |
$136.00
|
| Rate for Payer: Humana KY Medicaid |
$55.02
|
| Rate for Payer: Kentucky WC Medicaid |
$55.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$131.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$118.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$56.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$140.80
|
| Rate for Payer: Ohio Health Group HMO |
$120.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$128.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$110.40
|
| Rate for Payer: PHCS Commercial |
$153.60
|
| Rate for Payer: United Healthcare All Payer |
$140.80
|
|
|
ANESTH COSMO LIPOSUCTION NECK
|
Professional
|
Both
|
$160.00
|
|
| Hospital Charge Code |
37000195
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$112.00 |
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Multiplan PHCS |
$96.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$112.00
|
| Rate for Payer: UHCCP Medicaid |
$56.00
|
|
|
ANESTH COSMO LIPOSUCTION NECK
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
37000195
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$153.60 |
| Rate for Payer: Aetna Commercial |
$123.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$124.80
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna Commercial |
$132.80
|
| Rate for Payer: First Health Commercial |
$152.00
|
| Rate for Payer: Humana Commercial |
$136.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$131.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$118.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$140.80
|
| Rate for Payer: Ohio Health Group HMO |
$120.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$128.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$139.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$110.40
|
| Rate for Payer: PHCS Commercial |
$153.60
|
| Rate for Payer: United Healthcare All Payer |
$140.80
|
|
|
ANESTH COSMO MASTOPEXY - FULL
|
Professional
|
Both
|
$385.00
|
|
| Hospital Charge Code |
37000199
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$134.75 |
| Max. Negotiated Rate |
$269.50 |
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Multiplan PHCS |
$231.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$269.50
|
| Rate for Payer: UHCCP Medicaid |
$134.75
|
|
|
ANESTH COSMO MASTOPEXY - FULL
|
Facility
|
OP
|
$385.00
|
|
| Hospital Charge Code |
37000199
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$115.50 |
| Max. Negotiated Rate |
$369.60 |
| Rate for Payer: Aetna Commercial |
$296.45
|
| Rate for Payer: Anthem Medicaid |
$132.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$300.30
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Cigna Commercial |
$319.55
|
| Rate for Payer: First Health Commercial |
$365.75
|
| Rate for Payer: Humana Commercial |
$327.25
|
| Rate for Payer: Humana KY Medicaid |
$132.40
|
| Rate for Payer: Kentucky WC Medicaid |
$133.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$315.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$284.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$115.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$135.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$338.80
|
| Rate for Payer: Ohio Health Group HMO |
$288.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$308.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$334.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$265.65
|
| Rate for Payer: PHCS Commercial |
$369.60
|
| Rate for Payer: United Healthcare All Payer |
$338.80
|
|
