|
ANESTHESIA COSM LIPO ANY W/OTH
|
Facility
|
OP
|
$105.00
|
|
| Hospital Charge Code |
37000235
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial |
$80.85
|
| Rate for Payer: Anthem Medicaid |
$36.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$81.90
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$87.15
|
| Rate for Payer: First Health Commercial |
$99.75
|
| Rate for Payer: Humana Commercial |
$89.25
|
| Rate for Payer: Humana KY Medicaid |
$36.11
|
| Rate for Payer: Kentucky WC Medicaid |
$36.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$86.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$77.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$31.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$92.40
|
| Rate for Payer: Ohio Health Group HMO |
$78.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$84.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$91.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$72.45
|
| Rate for Payer: PHCS Commercial |
$100.80
|
| Rate for Payer: United Healthcare All Payer |
$92.40
|
|
|
ANESTHESIA COSMO 30 MINUTES
|
Professional
|
Both
|
$105.00
|
|
| Hospital Charge Code |
37000249
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Multiplan PHCS |
$63.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$73.50
|
| Rate for Payer: UHCCP Medicaid |
$36.75
|
|
|
ANESTHESIA COSMO 30 MINUTES
|
Facility
|
OP
|
$105.00
|
|
| Hospital Charge Code |
37000249
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial |
$80.85
|
| Rate for Payer: Anthem Medicaid |
$36.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$81.90
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$87.15
|
| Rate for Payer: First Health Commercial |
$99.75
|
| Rate for Payer: Humana Commercial |
$89.25
|
| Rate for Payer: Humana KY Medicaid |
$36.11
|
| Rate for Payer: Kentucky WC Medicaid |
$36.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$86.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$77.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$31.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$92.40
|
| Rate for Payer: Ohio Health Group HMO |
$78.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$84.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$91.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$72.45
|
| Rate for Payer: PHCS Commercial |
$100.80
|
| Rate for Payer: United Healthcare All Payer |
$92.40
|
|
|
ANESTHESIA COSMO 30 MINUTES
|
Facility
|
IP
|
$105.00
|
|
| Hospital Charge Code |
37000249
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial |
$80.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$81.90
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$87.15
|
| Rate for Payer: First Health Commercial |
$99.75
|
| Rate for Payer: Humana Commercial |
$89.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$86.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$77.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$31.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$92.40
|
| Rate for Payer: Ohio Health Group HMO |
$78.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$84.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$91.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$72.45
|
| Rate for Payer: PHCS Commercial |
$100.80
|
| Rate for Payer: United Healthcare All Payer |
$92.40
|
|
|
ANESTHESIA FOR; ANORECTAL PROC
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 902
|
| Hospital Charge Code |
37000078
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.60 |
| 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
|
|
|
ANESTHESIA FOR; ANORECTAL PROC
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00902
|
| Hospital Charge Code |
37000078
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTHESIA FOR; ANORECTAL PROC
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00902
|
| Hospital Charge Code |
37000078
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTHESIA REMOVAL PLEURA
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00542
|
| Hospital Charge Code |
37000040
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTHESIA REMOVAL PLEURA
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 542
|
| Hospital Charge Code |
37000040
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.60 |
| 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
|
|
|
ANESTHESIA REMOVAL PLEURA
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00542
|
| Hospital Charge Code |
37000040
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH ESOPHAGEAL SURGERY
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 500
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.60 |
| 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 ESOPHAGEAL SURGERY
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00500
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH ESOPHAGEAL SURGERY
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00500
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH FACE/SKULL BONE SURG
|
Facility
|
OP
|
$4.80
|
|
|
Service Code
|
HCPCS 00190
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$4.61 |
| Rate for Payer: Aetna Commercial |
$3.70
|
| Rate for Payer: Anthem Medicaid |
$1.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.74
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$3.98
|
| Rate for Payer: First Health Commercial |
$4.56
|
| Rate for Payer: Humana Commercial |
$4.08
|
| Rate for Payer: Humana KY Medicaid |
$1.65
|
| Rate for Payer: Kentucky WC Medicaid |
$1.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$4.22
|
| Rate for Payer: Ohio Health Group HMO |
$3.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3.31
|
| Rate for Payer: PHCS Commercial |
$4.61
|
| Rate for Payer: United Healthcare All Payer |
$4.22
|
|
|
ANESTH FACE/SKULL BONE SURG
|
Professional
|
Both
|
$4.80
|
|
|
Service Code
|
HCPCS 190
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$3.36 |
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan PHCS |
$2.88
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3.36
|
| Rate for Payer: UHCCP Medicaid |
$1.68
|
|
|
ANESTH FACE/SKULL BONE SURG
|
Facility
|
IP
|
$4.80
|
|
|
Service Code
|
HCPCS 00190
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$4.61 |
| Rate for Payer: Aetna Commercial |
$3.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.74
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna Commercial |
$3.98
|
| Rate for Payer: First Health Commercial |
$4.56
|
| Rate for Payer: Humana Commercial |
$4.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$4.22
|
| Rate for Payer: Ohio Health Group HMO |
$3.60
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3.31
|
| Rate for Payer: PHCS Commercial |
$4.61
|
| Rate for Payer: United Healthcare All Payer |
$4.22
|
|
|
ANESTH FACIAL BONE SURGERY
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00192
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH FACIAL BONE SURGERY
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 192
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.60 |
| 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 FACIAL BONE SURGERY
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00192
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH FAT LAYER REMOVAL
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00802
|
| Hospital Charge Code |
37000061
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH FAT LAYER REMOVAL
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00802
|
| Hospital Charge Code |
37000061
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.40 |
| 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 |
$6.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.52
|
| Rate for Payer: PHCS Commercial |
$7.68
|
| Rate for Payer: United Healthcare All Payer |
$7.04
|
|
|
ANESTH FAT LAYER REMOVAL
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 802
|
| Hospital Charge Code |
37000061
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.60 |
| 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 FATTOFACE W/FCLFT/OTH
|
Facility
|
IP
|
$158.00
|
|
| Hospital Charge Code |
37000227
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$151.68 |
| Rate for Payer: Aetna Commercial |
$121.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$123.24
|
| Rate for Payer: Cash Price |
$79.00
|
| Rate for Payer: Cigna Commercial |
$131.14
|
| Rate for Payer: First Health Commercial |
$150.10
|
| Rate for Payer: Humana Commercial |
$134.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$129.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$116.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$47.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$139.04
|
| Rate for Payer: Ohio Health Group HMO |
$118.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$126.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$109.02
|
| Rate for Payer: PHCS Commercial |
$151.68
|
| Rate for Payer: United Healthcare All Payer |
$139.04
|
|
|
ANESTH FATTOFACE W/FCLFT/OTH
|
Professional
|
Both
|
$158.00
|
|
| Hospital Charge Code |
37000227
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$55.30 |
| Max. Negotiated Rate |
$110.60 |
| Rate for Payer: Cash Price |
$79.00
|
| Rate for Payer: Multiplan PHCS |
$94.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$110.60
|
| Rate for Payer: UHCCP Medicaid |
$55.30
|
|
|
ANESTH FATTOFACE W/FCLFT/OTH
|
Facility
|
OP
|
$158.00
|
|
| Hospital Charge Code |
37000227
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$151.68 |
| Rate for Payer: Aetna Commercial |
$121.66
|
| Rate for Payer: Anthem Medicaid |
$54.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$123.24
|
| Rate for Payer: Cash Price |
$79.00
|
| Rate for Payer: Cigna Commercial |
$131.14
|
| Rate for Payer: First Health Commercial |
$150.10
|
| Rate for Payer: Humana Commercial |
$134.30
|
| Rate for Payer: Humana KY Medicaid |
$54.34
|
| Rate for Payer: Kentucky WC Medicaid |
$54.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$129.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$116.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$47.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$55.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$139.04
|
| Rate for Payer: Ohio Health Group HMO |
$118.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$126.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$109.02
|
| Rate for Payer: PHCS Commercial |
$151.68
|
| Rate for Payer: United Healthcare All Payer |
$139.04
|
|
