Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

HEAR-AID DIG MON ITE PREMIUM

Facility

$3,900.00

Service Code	HCPCS V5256
Hospital Charge Code	47000076
Hospital Revenue Code	270
Min. Negotiated Rate	$1,170.00
Max. Negotiated Rate	$3,744.00
Rate for Payer: Aetna Commercial	$3,003.00
Rate for Payer: Anthem POS/PPO/Traditional	$3,042.00
Rate for Payer: Cash Price	$1,950.00
Rate for Payer: Cigna Commercial	$3,237.00
Rate for Payer: First Health Commercial	$3,705.00
Rate for Payer: Humana Commercial	$3,315.00
Rate for Payer: Medical Mutual Of Ohio HMO	$3,198.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$2,878.20
Rate for Payer: Molina Healthcare Benefit Exchange	$1,170.00
Rate for Payer: Ohio Health Choice Commercial	$3,432.00
Rate for Payer: Ohio Health Group HMO	$2,925.00
Rate for Payer: Ohio Health Group PPO Differential	$3,120.00
Rate for Payer: Ohio Health Group PPO No Differential	$3,393.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$2,691.00
Rate for Payer: PHCS Commercial	$3,744.00
Rate for Payer: United Healthcare All Payer	$3,432.00

HEAR-AID DIG MON ITE PREMIUM

Facility

$3,900.00

Service Code	HCPCS V5256
Hospital Charge Code	47000076
Hospital Revenue Code	270
Min. Negotiated Rate	$1,170.00
Max. Negotiated Rate	$3,744.00
Rate for Payer: Aetna Commercial	$3,003.00
Rate for Payer: Anthem Medicaid	$1,341.21
Rate for Payer: Anthem POS/PPO/Traditional	$3,042.00
Rate for Payer: Cash Price	$1,950.00
Rate for Payer: Cigna Commercial	$3,237.00
Rate for Payer: First Health Commercial	$3,705.00
Rate for Payer: Humana Commercial	$3,315.00
Rate for Payer: Humana KY Medicaid	$1,341.21
Rate for Payer: Kentucky WC Medicaid	$1,354.86
Rate for Payer: Medical Mutual Of Ohio HMO	$3,198.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$2,878.20
Rate for Payer: Molina Healthcare Benefit Exchange	$1,170.00
Rate for Payer: Molina Healthcare Medicaid	$1,368.12
Rate for Payer: Ohio Health Choice Commercial	$3,432.00
Rate for Payer: Ohio Health Group HMO	$2,925.00
Rate for Payer: Ohio Health Group PPO Differential	$3,120.00
Rate for Payer: Ohio Health Group PPO No Differential	$3,393.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$2,691.00
Rate for Payer: PHCS Commercial	$3,744.00
Rate for Payer: United Healthcare All Payer	$3,432.00

HEAR-AID DIG MON ITE PRM SP

Professional

Both

$3,900.00

Hospital Charge Code	47000089
Hospital Revenue Code	222
Min. Negotiated Rate	$1,365.00
Max. Negotiated Rate	$2,730.00
Rate for Payer: Cash Price	$1,950.00
Rate for Payer: Multiplan PHCS	$2,340.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$2,730.00
Rate for Payer: UHCCP Medicaid	$1,365.00

HEAR-AID DIG MON ITE STANDARD

Facility

$1,700.00

Service Code	HCPCS V5256
Hospital Charge Code	47000074
Hospital Revenue Code	270
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$1,632.00
Rate for Payer: Aetna Commercial	$1,309.00
Rate for Payer: Anthem POS/PPO/Traditional	$1,326.00
Rate for Payer: Cash Price	$850.00
Rate for Payer: Cigna Commercial	$1,411.00
Rate for Payer: First Health Commercial	$1,615.00
Rate for Payer: Humana Commercial	$1,445.00
Rate for Payer: Medical Mutual Of Ohio HMO	$1,394.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$1,254.60
Rate for Payer: Molina Healthcare Benefit Exchange	$510.00
Rate for Payer: Ohio Health Choice Commercial	$1,496.00
Rate for Payer: Ohio Health Group HMO	$1,275.00
Rate for Payer: Ohio Health Group PPO Differential	$1,360.00
Rate for Payer: Ohio Health Group PPO No Differential	$1,479.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$1,173.00
Rate for Payer: PHCS Commercial	$1,632.00
Rate for Payer: United Healthcare All Payer	$1,496.00

HEAR-AID DIG MON ITE STANDARD

Facility

$1,700.00

Service Code	HCPCS V5256
Hospital Charge Code	47000074
Hospital Revenue Code	270
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$1,632.00
Rate for Payer: Aetna Commercial	$1,309.00
Rate for Payer: Anthem Medicaid	$584.63
Rate for Payer: Anthem POS/PPO/Traditional	$1,326.00
Rate for Payer: Cash Price	$850.00
Rate for Payer: Cigna Commercial	$1,411.00
Rate for Payer: First Health Commercial	$1,615.00
Rate for Payer: Humana Commercial	$1,445.00
Rate for Payer: Humana KY Medicaid	$584.63
Rate for Payer: Kentucky WC Medicaid	$590.58
Rate for Payer: Medical Mutual Of Ohio HMO	$1,394.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$1,254.60
Rate for Payer: Molina Healthcare Benefit Exchange	$510.00
Rate for Payer: Molina Healthcare Medicaid	$596.36
Rate for Payer: Ohio Health Choice Commercial	$1,496.00
Rate for Payer: Ohio Health Group HMO	$1,275.00
Rate for Payer: Ohio Health Group PPO Differential	$1,360.00
Rate for Payer: Ohio Health Group PPO No Differential	$1,479.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$1,173.00
Rate for Payer: PHCS Commercial	$1,632.00
Rate for Payer: United Healthcare All Payer	$1,496.00

HEAR-AID DIG MON ITE STD SP

Professional

Both

$1,700.00

Hospital Charge Code	47000087
Hospital Revenue Code	222
Min. Negotiated Rate	$595.00
Max. Negotiated Rate	$1,190.00
Rate for Payer: Cash Price	$850.00
Rate for Payer: Multiplan PHCS	$1,020.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$1,190.00
Rate for Payer: UHCCP Medicaid	$595.00

HEAR-AID REPAIR $225 MINOR SP

Professional

Both

$225.00

Hospital Charge Code	47000111
Hospital Revenue Code	222
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$157.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Multiplan PHCS	$135.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$157.50
Rate for Payer: UHCCP Medicaid	$78.75

HEAR-AID REPAIR $250 MINOR SP

Professional

Both

$250.00

Hospital Charge Code	47000112
Hospital Revenue Code	222
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$175.00
Rate for Payer: Cash Price	$125.00
Rate for Payer: Multiplan PHCS	$150.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$175.00
Rate for Payer: UHCCP Medicaid	$87.50

HEAR-AID REPAIR $300 MINOR SP

Professional

Both

$300.00

Hospital Charge Code	47000113
Hospital Revenue Code	222
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$210.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Multiplan PHCS	$180.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$210.00
Rate for Payer: UHCCP Medicaid	$105.00

HEAR-AID REPAIR $350 MINOR SP

Professional

Both

$350.00

Hospital Charge Code	47000108
Hospital Revenue Code	222
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$245.00
Rate for Payer: Cash Price	$175.00
Rate for Payer: Multiplan PHCS	$210.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$245.00
Rate for Payer: UHCCP Medicaid	$122.50

HEAR-AID RPR OFFICE MINOR SP

Professional

Both

$25.00

Hospital Charge Code	47000109
Hospital Revenue Code	222
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$17.50
Rate for Payer: Cash Price	$12.50
Rate for Payer: Multiplan PHCS	$15.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$17.50
Rate for Payer: UHCCP Medicaid	$8.75

HEAR-AID RPR PARTS MINOR SP

Professional

Both

$75.00

Hospital Charge Code	47000110
Hospital Revenue Code	222
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$52.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Multiplan PHCS	$45.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$52.50
Rate for Payer: UHCCP Medicaid	$26.25

HEARING AID ACCESSORIES

Facility

$250.00

Service Code	HCPCS V5267
Hospital Charge Code	47000049
Hospital Revenue Code	290
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$192.50
Rate for Payer: Anthem Medicaid	$85.97
Rate for Payer: Anthem POS/PPO/Traditional	$195.00
Rate for Payer: Cash Price	$125.00
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: First Health Commercial	$237.50
Rate for Payer: Humana Commercial	$212.50
Rate for Payer: Humana KY Medicaid	$85.97
Rate for Payer: Kentucky WC Medicaid	$86.85
Rate for Payer: Medical Mutual Of Ohio HMO	$205.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$184.50
Rate for Payer: Molina Healthcare Benefit Exchange	$75.00
Rate for Payer: Molina Healthcare Medicaid	$87.70
Rate for Payer: Ohio Health Choice Commercial	$220.00
Rate for Payer: Ohio Health Group HMO	$187.50
Rate for Payer: Ohio Health Group PPO Differential	$200.00
Rate for Payer: Ohio Health Group PPO No Differential	$217.50
Rate for Payer: Ohio Health Group PPO SOMC Employees	$172.50
Rate for Payer: PHCS Commercial	$240.00
Rate for Payer: United Healthcare All Payer	$220.00

HEARING AID ACCESSORIES

Facility

$250.00

Service Code	HCPCS V5267
Hospital Charge Code	47000049
Hospital Revenue Code	290
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$192.50
Rate for Payer: Anthem POS/PPO/Traditional	$195.00
Rate for Payer: Cash Price	$125.00
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: First Health Commercial	$237.50
Rate for Payer: Humana Commercial	$212.50
Rate for Payer: Medical Mutual Of Ohio HMO	$205.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$184.50
Rate for Payer: Molina Healthcare Benefit Exchange	$75.00
Rate for Payer: Ohio Health Choice Commercial	$220.00
Rate for Payer: Ohio Health Group HMO	$187.50
Rate for Payer: Ohio Health Group PPO Differential	$200.00
Rate for Payer: Ohio Health Group PPO No Differential	$217.50
Rate for Payer: Ohio Health Group PPO SOMC Employees	$172.50
Rate for Payer: PHCS Commercial	$240.00
Rate for Payer: United Healthcare All Payer	$220.00

HEARING AID ACCESSORIES SP

Professional

Both

$250.00

Hospital Charge Code	47000104
Hospital Revenue Code	222
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$175.00
Rate for Payer: Cash Price	$125.00
Rate for Payer: Multiplan PHCS	$150.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$175.00
Rate for Payer: UHCCP Medicaid	$87.50

HEARING AID/CANAL

Facility

$1,100.00

Hospital Charge Code	47000028
Hospital Revenue Code	292
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$1,056.00
Rate for Payer: Aetna Commercial	$847.00
Rate for Payer: Anthem POS/PPO/Traditional	$858.00
Rate for Payer: Cash Price	$550.00
Rate for Payer: Cigna Commercial	$913.00
Rate for Payer: First Health Commercial	$1,045.00
Rate for Payer: Humana Commercial	$935.00
Rate for Payer: Medical Mutual Of Ohio HMO	$902.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$811.80
Rate for Payer: Molina Healthcare Benefit Exchange	$330.00
Rate for Payer: Ohio Health Choice Commercial	$968.00
Rate for Payer: Ohio Health Group HMO	$825.00
Rate for Payer: Ohio Health Group PPO Differential	$880.00
Rate for Payer: Ohio Health Group PPO No Differential	$957.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$759.00
Rate for Payer: PHCS Commercial	$1,056.00
Rate for Payer: United Healthcare All Payer	$968.00

HEARING AID/CANAL

Facility

$1,100.00

Hospital Charge Code	47000028
Hospital Revenue Code	292
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$1,056.00
Rate for Payer: Aetna Commercial	$847.00
Rate for Payer: Anthem Medicaid	$378.29
Rate for Payer: Anthem POS/PPO/Traditional	$858.00
Rate for Payer: Cash Price	$550.00
Rate for Payer: Cigna Commercial	$913.00
Rate for Payer: First Health Commercial	$1,045.00
Rate for Payer: Humana Commercial	$935.00
Rate for Payer: Humana KY Medicaid	$378.29
Rate for Payer: Kentucky WC Medicaid	$382.14
Rate for Payer: Medical Mutual Of Ohio HMO	$902.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$811.80
Rate for Payer: Molina Healthcare Benefit Exchange	$330.00
Rate for Payer: Molina Healthcare Medicaid	$385.88
Rate for Payer: Ohio Health Choice Commercial	$968.00
Rate for Payer: Ohio Health Group HMO	$825.00
Rate for Payer: Ohio Health Group PPO Differential	$880.00
Rate for Payer: Ohio Health Group PPO No Differential	$957.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$759.00
Rate for Payer: PHCS Commercial	$1,056.00
Rate for Payer: United Healthcare All Payer	$968.00

HEARING AID CONSULTATION

Facility

$62.00

Service Code	HCPCS 92594
Hospital Charge Code	47000020
Hospital Revenue Code	470
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$59.52
Rate for Payer: Aetna Commercial	$47.74
Rate for Payer: Anthem Medicaid	$21.32
Rate for Payer: Anthem POS/PPO/Traditional	$48.36
Rate for Payer: Cash Price	$31.00
Rate for Payer: Cigna Commercial	$51.46
Rate for Payer: First Health Commercial	$58.90
Rate for Payer: Humana Commercial	$52.70
Rate for Payer: Humana KY Medicaid	$21.32
Rate for Payer: Kentucky WC Medicaid	$21.54
Rate for Payer: Medical Mutual Of Ohio HMO	$50.84
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$45.76
Rate for Payer: Molina Healthcare Benefit Exchange	$18.60
Rate for Payer: Molina Healthcare Medicaid	$21.75
Rate for Payer: Ohio Health Choice Commercial	$54.56
Rate for Payer: Ohio Health Group HMO	$46.50
Rate for Payer: Ohio Health Group PPO Differential	$49.60
Rate for Payer: Ohio Health Group PPO No Differential	$53.94
Rate for Payer: Ohio Health Group PPO SOMC Employees	$42.78
Rate for Payer: PHCS Commercial	$59.52
Rate for Payer: United Healthcare All Payer	$54.56

HEARING AID CONSULTATION

Facility

$62.00

Service Code	HCPCS 92594
Hospital Charge Code	47000020
Hospital Revenue Code	470
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$59.52
Rate for Payer: Aetna Commercial	$47.74
Rate for Payer: Anthem POS/PPO/Traditional	$48.36
Rate for Payer: Cash Price	$31.00
Rate for Payer: Cigna Commercial	$51.46
Rate for Payer: First Health Commercial	$58.90
Rate for Payer: Humana Commercial	$52.70
Rate for Payer: Medical Mutual Of Ohio HMO	$50.84
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$45.76
Rate for Payer: Molina Healthcare Benefit Exchange	$18.60
Rate for Payer: Ohio Health Choice Commercial	$54.56
Rate for Payer: Ohio Health Group HMO	$46.50
Rate for Payer: Ohio Health Group PPO Differential	$49.60
Rate for Payer: Ohio Health Group PPO No Differential	$53.94
Rate for Payer: Ohio Health Group PPO SOMC Employees	$42.78
Rate for Payer: PHCS Commercial	$59.52
Rate for Payer: United Healthcare All Payer	$54.56

HEARING AID REPAIR/MAJOR

Facility

$158.00

Service Code	HCPCS V5014
Hospital Charge Code	47000023
Hospital Revenue Code	292
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

HEARING AID REPAIR/MAJOR

Facility

$158.00

Service Code	HCPCS V5014
Hospital Charge Code	47000023
Hospital Revenue Code	292
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

HEARING AID REPAIR MAJOR SP

Professional

Both

$250.00

Hospital Charge Code	47000115
Hospital Revenue Code	222
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$175.00
Rate for Payer: Cash Price	$125.00
Rate for Payer: Multiplan PHCS	$150.00
Rate for Payer: Ohio Health Choice Preferred Health Choice	$175.00
Rate for Payer: UHCCP Medicaid	$87.50

HEARING AID REPAIR MINOR

Facility

$300.00

Hospital Charge Code	47000054
Hospital Revenue Code	470
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$231.00
Rate for Payer: Anthem Medicaid	$103.17
Rate for Payer: Anthem POS/PPO/Traditional	$234.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Cigna Commercial	$249.00
Rate for Payer: First Health Commercial	$285.00
Rate for Payer: Humana Commercial	$255.00
Rate for Payer: Humana KY Medicaid	$103.17
Rate for Payer: Kentucky WC Medicaid	$104.22
Rate for Payer: Medical Mutual Of Ohio HMO	$246.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$221.40
Rate for Payer: Molina Healthcare Benefit Exchange	$90.00
Rate for Payer: Molina Healthcare Medicaid	$105.24
Rate for Payer: Ohio Health Choice Commercial	$264.00
Rate for Payer: Ohio Health Group HMO	$225.00
Rate for Payer: Ohio Health Group PPO Differential	$240.00
Rate for Payer: Ohio Health Group PPO No Differential	$261.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$207.00
Rate for Payer: PHCS Commercial	$288.00
Rate for Payer: United Healthcare All Payer	$264.00

HEARING AID REPAIR MINOR

Facility

$300.00

Hospital Charge Code	47000054
Hospital Revenue Code	470
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$231.00
Rate for Payer: Anthem POS/PPO/Traditional	$234.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Cigna Commercial	$249.00
Rate for Payer: First Health Commercial	$285.00
Rate for Payer: Humana Commercial	$255.00
Rate for Payer: Medical Mutual Of Ohio HMO	$246.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$221.40
Rate for Payer: Molina Healthcare Benefit Exchange	$90.00
Rate for Payer: Ohio Health Choice Commercial	$264.00
Rate for Payer: Ohio Health Group HMO	$225.00
Rate for Payer: Ohio Health Group PPO Differential	$240.00
Rate for Payer: Ohio Health Group PPO No Differential	$261.00
Rate for Payer: Ohio Health Group PPO SOMC Employees	$207.00
Rate for Payer: PHCS Commercial	$288.00
Rate for Payer: United Healthcare All Payer	$264.00

HEARING AID REPAIR MINOR

Facility

$225.00

Hospital Charge Code	47000052
Hospital Revenue Code	470
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$216.00
Rate for Payer: Aetna Commercial	$173.25
Rate for Payer: Anthem Medicaid	$77.38
Rate for Payer: Anthem POS/PPO/Traditional	$175.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Cigna Commercial	$186.75
Rate for Payer: First Health Commercial	$213.75
Rate for Payer: Humana Commercial	$191.25
Rate for Payer: Humana KY Medicaid	$77.38
Rate for Payer: Kentucky WC Medicaid	$78.17
Rate for Payer: Medical Mutual Of Ohio HMO	$184.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional	$166.05
Rate for Payer: Molina Healthcare Benefit Exchange	$67.50
Rate for Payer: Molina Healthcare Medicaid	$78.93
Rate for Payer: Ohio Health Choice Commercial	$198.00
Rate for Payer: Ohio Health Group HMO	$168.75
Rate for Payer: Ohio Health Group PPO Differential	$180.00
Rate for Payer: Ohio Health Group PPO No Differential	$195.75
Rate for Payer: Ohio Health Group PPO SOMC Employees	$155.25
Rate for Payer: PHCS Commercial	$216.00
Rate for Payer: United Healthcare All Payer	$198.00

Know your out-of-pocket cost for care.

All Charges