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Service Code HCPCS 62320
Hospital Charge Code 45000295
Hospital Revenue Code 450
Min. Negotiated Rate $128.57
Max. Negotiated Rate $949.44
Rate for Payer: Aetna Commercial $761.53
Rate for Payer: Anthem POS/PPO/Traditional $771.42
Rate for Payer: Cash Price $494.50
Rate for Payer: Cigna Commercial $820.87
Rate for Payer: First Health Commercial $939.55
Rate for Payer: Humana Commercial $840.65
Rate for Payer: Medical Mutual Of Ohio HMO $810.98
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $729.88
Rate for Payer: Molina Healthcare Benefit Exchange $296.70
Rate for Payer: Ohio Health Choice Commercial $870.32
Rate for Payer: Ohio Health Group HMO $741.75
Rate for Payer: Ohio Health Group PPO Differential $197.80
Rate for Payer: Ohio Health Group PPO No Differential $128.57
Rate for Payer: Ohio Health Group PPO SOMC Employees $306.59
Rate for Payer: PHCS Commercial $949.44
Rate for Payer: United Healthcare All Payer $870.32
Service Code HCPCS 93567
Hospital Charge Code 761P2490
Hospital Revenue Code 761
Min. Negotiated Rate $26.48
Max. Negotiated Rate $340.00
Rate for Payer: Aetna Commercial $77.98
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $26.48
Rate for Payer: Anthem Medicaid $42.43
Rate for Payer: Buckeye Medicare Advantage $340.00
Rate for Payer: Cash Price $170.00
Rate for Payer: Cash Price $170.00
Rate for Payer: Cigna Commercial $86.36
Rate for Payer: Healthspan PPO $162.28
Rate for Payer: Humana Medicaid $42.43
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $64.92
Rate for Payer: Molina Healthcare CHIP/Medicaid $43.28
Rate for Payer: Molina Healthcare Passport $42.43
Rate for Payer: Multiplan PHCS $204.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $238.00
Rate for Payer: UHCCP Medicaid $27.80
Rate for Payer: Wellcare CHIP/Medicaid $42.85
Service Code HCPCS 93567
Hospital Charge Code 761T2490
Hospital Revenue Code 761
Min. Negotiated Rate $51.35
Max. Negotiated Rate $379.20
Rate for Payer: Aetna Commercial $304.15
Rate for Payer: Anthem Medicaid $135.84
Rate for Payer: Anthem POS/PPO/Traditional $308.10
Rate for Payer: Cash Price $197.50
Rate for Payer: Cigna Commercial $327.85
Rate for Payer: First Health Commercial $375.25
Rate for Payer: Humana Commercial $335.75
Rate for Payer: Humana KY Medicaid $135.84
Rate for Payer: Kentucky WC Medicaid $137.22
Rate for Payer: Medical Mutual Of Ohio HMO $323.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $291.51
Rate for Payer: Molina Healthcare Benefit Exchange $118.50
Rate for Payer: Molina Healthcare Medicaid $138.57
Rate for Payer: Ohio Health Choice Commercial $347.60
Rate for Payer: Ohio Health Group HMO $296.25
Rate for Payer: Ohio Health Group PPO Differential $79.00
Rate for Payer: Ohio Health Group PPO No Differential $51.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $122.45
Rate for Payer: PHCS Commercial $379.20
Rate for Payer: United Healthcare All Payer $347.60
Service Code HCPCS 93567
Hospital Charge Code 761T2490
Hospital Revenue Code 761
Min. Negotiated Rate $51.35
Max. Negotiated Rate $379.20
Rate for Payer: Aetna Commercial $304.15
Rate for Payer: Anthem POS/PPO/Traditional $308.10
Rate for Payer: Cash Price $197.50
Rate for Payer: Cigna Commercial $327.85
Rate for Payer: First Health Commercial $375.25
Rate for Payer: Humana Commercial $335.75
Rate for Payer: Medical Mutual Of Ohio HMO $323.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $291.51
Rate for Payer: Molina Healthcare Benefit Exchange $118.50
Rate for Payer: Ohio Health Choice Commercial $347.60
Rate for Payer: Ohio Health Group HMO $296.25
Rate for Payer: Ohio Health Group PPO Differential $79.00
Rate for Payer: Ohio Health Group PPO No Differential $51.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $122.45
Rate for Payer: PHCS Commercial $379.20
Rate for Payer: United Healthcare All Payer $347.60
Service Code HCPCS 93567
Hospital Charge Code 76102490
Hospital Revenue Code 761
Min. Negotiated Rate $26.48
Max. Negotiated Rate $735.00
Rate for Payer: Aetna Commercial $77.98
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $26.48
Rate for Payer: Anthem Medicaid $42.43
Rate for Payer: Buckeye Medicare Advantage $735.00
Rate for Payer: Cash Price $367.50
Rate for Payer: Cash Price $367.50
Rate for Payer: Cigna Commercial $86.36
Rate for Payer: Healthspan PPO $162.28
Rate for Payer: Humana Medicaid $42.43
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $64.92
Rate for Payer: Molina Healthcare CHIP/Medicaid $43.28
Rate for Payer: Molina Healthcare Passport $42.43
Rate for Payer: Multiplan PHCS $441.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $514.50
Rate for Payer: UHCCP Medicaid $27.80
Rate for Payer: Wellcare CHIP/Medicaid $42.85
Service Code HCPCS 93567
Hospital Charge Code 76102490
Hospital Revenue Code 761
Min. Negotiated Rate $95.55
Max. Negotiated Rate $705.60
Rate for Payer: Aetna Commercial $565.95
Rate for Payer: Anthem POS/PPO/Traditional $573.30
Rate for Payer: Cash Price $367.50
Rate for Payer: Cigna Commercial $610.05
Rate for Payer: First Health Commercial $698.25
Rate for Payer: Humana Commercial $624.75
Rate for Payer: Medical Mutual Of Ohio HMO $602.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $542.43
Rate for Payer: Molina Healthcare Benefit Exchange $220.50
Rate for Payer: Ohio Health Choice Commercial $646.80
Rate for Payer: Ohio Health Group HMO $551.25
Rate for Payer: Ohio Health Group PPO Differential $147.00
Rate for Payer: Ohio Health Group PPO No Differential $95.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $227.85
Rate for Payer: PHCS Commercial $705.60
Rate for Payer: United Healthcare All Payer $646.80
Service Code HCPCS 93567
Hospital Charge Code 48100077
Hospital Revenue Code 481
Min. Negotiated Rate $51.35
Max. Negotiated Rate $379.20
Rate for Payer: Aetna Commercial $304.15
Rate for Payer: Anthem POS/PPO/Traditional $308.10
Rate for Payer: Cash Price $197.50
Rate for Payer: Cigna Commercial $327.85
Rate for Payer: First Health Commercial $375.25
Rate for Payer: Humana Commercial $335.75
Rate for Payer: Medical Mutual Of Ohio HMO $323.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $291.51
Rate for Payer: Molina Healthcare Benefit Exchange $118.50
Rate for Payer: Ohio Health Choice Commercial $347.60
Rate for Payer: Ohio Health Group HMO $296.25
Rate for Payer: Ohio Health Group PPO Differential $79.00
Rate for Payer: Ohio Health Group PPO No Differential $51.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $122.45
Rate for Payer: PHCS Commercial $379.20
Rate for Payer: United Healthcare All Payer $347.60
Service Code HCPCS 93567
Hospital Charge Code 76102490
Hospital Revenue Code 761
Min. Negotiated Rate $95.55
Max. Negotiated Rate $705.60
Rate for Payer: Aetna Commercial $565.95
Rate for Payer: Anthem Medicaid $252.77
Rate for Payer: Anthem POS/PPO/Traditional $573.30
Rate for Payer: Cash Price $367.50
Rate for Payer: Cigna Commercial $610.05
Rate for Payer: First Health Commercial $698.25
Rate for Payer: Humana Commercial $624.75
Rate for Payer: Humana KY Medicaid $252.77
Rate for Payer: Kentucky WC Medicaid $255.34
Rate for Payer: Medical Mutual Of Ohio HMO $602.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $542.43
Rate for Payer: Molina Healthcare Benefit Exchange $220.50
Rate for Payer: Molina Healthcare Medicaid $257.84
Rate for Payer: Ohio Health Choice Commercial $646.80
Rate for Payer: Ohio Health Group HMO $551.25
Rate for Payer: Ohio Health Group PPO Differential $147.00
Rate for Payer: Ohio Health Group PPO No Differential $95.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $227.85
Rate for Payer: PHCS Commercial $705.60
Rate for Payer: United Healthcare All Payer $646.80
Service Code HCPCS 93567
Hospital Charge Code 48100077
Hospital Revenue Code 481
Min. Negotiated Rate $51.35
Max. Negotiated Rate $379.20
Rate for Payer: Aetna Commercial $304.15
Rate for Payer: Anthem Medicaid $135.84
Rate for Payer: Anthem POS/PPO/Traditional $308.10
Rate for Payer: Cash Price $197.50
Rate for Payer: Cigna Commercial $327.85
Rate for Payer: First Health Commercial $375.25
Rate for Payer: Humana Commercial $335.75
Rate for Payer: Humana KY Medicaid $135.84
Rate for Payer: Kentucky WC Medicaid $137.22
Rate for Payer: Medical Mutual Of Ohio HMO $323.90
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $291.51
Rate for Payer: Molina Healthcare Benefit Exchange $118.50
Rate for Payer: Molina Healthcare Medicaid $138.57
Rate for Payer: Ohio Health Choice Commercial $347.60
Rate for Payer: Ohio Health Group HMO $296.25
Rate for Payer: Ohio Health Group PPO Differential $79.00
Rate for Payer: Ohio Health Group PPO No Differential $51.35
Rate for Payer: Ohio Health Group PPO SOMC Employees $122.45
Rate for Payer: PHCS Commercial $379.20
Rate for Payer: United Healthcare All Payer $347.60
Service Code HCPCS 20551
Hospital Charge Code 76100338
Hospital Revenue Code 761
Min. Negotiated Rate $70.33
Max. Negotiated Rate $519.36
Rate for Payer: Aetna Commercial $416.57
Rate for Payer: Anthem POS/PPO/Traditional $421.98
Rate for Payer: Cash Price $270.50
Rate for Payer: Cigna Commercial $449.03
Rate for Payer: First Health Commercial $513.95
Rate for Payer: Humana Commercial $459.85
Rate for Payer: Medical Mutual Of Ohio HMO $443.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $399.26
Rate for Payer: Molina Healthcare Benefit Exchange $162.30
Rate for Payer: Ohio Health Choice Commercial $476.08
Rate for Payer: Ohio Health Group HMO $405.75
Rate for Payer: Ohio Health Group PPO Differential $108.20
Rate for Payer: Ohio Health Group PPO No Differential $70.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $167.71
Rate for Payer: PHCS Commercial $519.36
Rate for Payer: United Healthcare All Payer $476.08
Service Code HCPCS 20551
Hospital Charge Code 76100338
Hospital Revenue Code 761
Min. Negotiated Rate $33.71
Max. Negotiated Rate $541.00
Rate for Payer: Aetna Commercial $65.04
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $33.71
Rate for Payer: Anthem Medicaid $36.32
Rate for Payer: Buckeye Medicare Advantage $541.00
Rate for Payer: Cash Price $270.50
Rate for Payer: Cash Price $270.50
Rate for Payer: Cigna Commercial $91.61
Rate for Payer: Healthspan PPO $75.40
Rate for Payer: Humana Medicaid $36.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $52.67
Rate for Payer: Molina Healthcare CHIP/Medicaid $37.05
Rate for Payer: Molina Healthcare Passport $36.32
Rate for Payer: Multiplan PHCS $324.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $378.70
Rate for Payer: UHCCP Medicaid $35.40
Rate for Payer: Wellcare CHIP/Medicaid $36.68
Service Code HCPCS 20551
Hospital Charge Code 76100338
Hospital Revenue Code 761
Min. Negotiated Rate $70.33
Max. Negotiated Rate $519.36
Rate for Payer: Aetna Commercial $416.57
Rate for Payer: Anthem Medicaid $186.05
Rate for Payer: Anthem Medicare Advantage/PPO $256.12
Rate for Payer: Anthem POS/PPO/Traditional $421.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $358.57
Rate for Payer: CareSource Just4Me Medicare $345.76
Rate for Payer: Cash Price $270.50
Rate for Payer: Cash Price $270.50
Rate for Payer: Cigna Commercial $449.03
Rate for Payer: First Health Commercial $513.95
Rate for Payer: Humana Commercial $459.85
Rate for Payer: Humana KY Medicaid $186.05
Rate for Payer: Humana Medicare Advantage $256.12
Rate for Payer: Kentucky WC Medicaid $187.94
Rate for Payer: Medical Mutual Of Ohio HMO $443.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $399.26
Rate for Payer: Molina Healthcare Benefit Exchange $307.34
Rate for Payer: Molina Healthcare Medicaid $189.78
Rate for Payer: Ohio Health Choice Commercial $476.08
Rate for Payer: Ohio Health Group HMO $405.75
Rate for Payer: Ohio Health Group PPO Differential $108.20
Rate for Payer: Ohio Health Group PPO No Differential $70.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $167.71
Rate for Payer: PHCS Commercial $519.36
Rate for Payer: United Healthcare All Payer $476.08
Service Code HCPCS 20551
Hospital Charge Code 761P0338
Hospital Revenue Code 761
Min. Negotiated Rate $33.71
Max. Negotiated Rate $91.61
Rate for Payer: Aetna Commercial $65.04
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $33.71
Rate for Payer: Anthem Medicaid $36.32
Rate for Payer: Buckeye Medicare Advantage $90.00
Rate for Payer: Cash Price $45.00
Rate for Payer: Cash Price $45.00
Rate for Payer: Cigna Commercial $91.61
Rate for Payer: Healthspan PPO $75.40
Rate for Payer: Humana Medicaid $36.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $52.67
Rate for Payer: Molina Healthcare CHIP/Medicaid $37.05
Rate for Payer: Molina Healthcare Passport $36.32
Rate for Payer: Multiplan PHCS $54.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $63.00
Rate for Payer: UHCCP Medicaid $35.40
Rate for Payer: Wellcare CHIP/Medicaid $36.68
Service Code HCPCS 20551
Hospital Charge Code 761T0338
Hospital Revenue Code 761
Min. Negotiated Rate $58.63
Max. Negotiated Rate $432.96
Rate for Payer: Aetna Commercial $347.27
Rate for Payer: Anthem Medicaid $155.10
Rate for Payer: Anthem Medicare Advantage/PPO $256.12
Rate for Payer: Anthem POS/PPO/Traditional $351.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $358.57
Rate for Payer: CareSource Just4Me Medicare $345.76
Rate for Payer: Cash Price $225.50
Rate for Payer: Cash Price $225.50
Rate for Payer: Cigna Commercial $374.33
Rate for Payer: First Health Commercial $428.45
Rate for Payer: Humana Commercial $383.35
Rate for Payer: Humana KY Medicaid $155.10
Rate for Payer: Humana Medicare Advantage $256.12
Rate for Payer: Kentucky WC Medicaid $156.68
Rate for Payer: Medical Mutual Of Ohio HMO $369.82
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $332.84
Rate for Payer: Molina Healthcare Benefit Exchange $307.34
Rate for Payer: Molina Healthcare Medicaid $158.21
Rate for Payer: Ohio Health Choice Commercial $396.88
Rate for Payer: Ohio Health Group HMO $338.25
Rate for Payer: Ohio Health Group PPO Differential $90.20
Rate for Payer: Ohio Health Group PPO No Differential $58.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $139.81
Rate for Payer: PHCS Commercial $432.96
Rate for Payer: United Healthcare All Payer $396.88
Service Code HCPCS 20551
Hospital Charge Code 761T0338
Hospital Revenue Code 761
Min. Negotiated Rate $58.63
Max. Negotiated Rate $432.96
Rate for Payer: Aetna Commercial $347.27
Rate for Payer: Anthem POS/PPO/Traditional $351.78
Rate for Payer: Cash Price $225.50
Rate for Payer: Cigna Commercial $374.33
Rate for Payer: First Health Commercial $428.45
Rate for Payer: Humana Commercial $383.35
Rate for Payer: Medical Mutual Of Ohio HMO $369.82
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $332.84
Rate for Payer: Molina Healthcare Benefit Exchange $135.30
Rate for Payer: Ohio Health Choice Commercial $396.88
Rate for Payer: Ohio Health Group HMO $338.25
Rate for Payer: Ohio Health Group PPO Differential $90.20
Rate for Payer: Ohio Health Group PPO No Differential $58.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $139.81
Rate for Payer: PHCS Commercial $432.96
Rate for Payer: United Healthcare All Payer $396.88
Service Code HCPCS 20552
Hospital Charge Code 45000088
Hospital Revenue Code 450
Min. Negotiated Rate $50.83
Max. Negotiated Rate $375.36
Rate for Payer: Aetna Commercial $301.07
Rate for Payer: Anthem Medicaid $134.46
Rate for Payer: Anthem Medicare Advantage/PPO $256.12
Rate for Payer: Anthem POS/PPO/Traditional $304.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $358.57
Rate for Payer: CareSource Just4Me Medicare $345.76
Rate for Payer: Cash Price $195.50
Rate for Payer: Cash Price $195.50
Rate for Payer: Cigna Commercial $324.53
Rate for Payer: First Health Commercial $371.45
Rate for Payer: Humana Commercial $332.35
Rate for Payer: Humana KY Medicaid $134.46
Rate for Payer: Humana Medicare Advantage $256.12
Rate for Payer: Kentucky WC Medicaid $135.83
Rate for Payer: Medical Mutual Of Ohio HMO $320.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $288.56
Rate for Payer: Molina Healthcare Benefit Exchange $307.34
Rate for Payer: Molina Healthcare Medicaid $137.16
Rate for Payer: Ohio Health Choice Commercial $344.08
Rate for Payer: Ohio Health Group HMO $293.25
Rate for Payer: Ohio Health Group PPO Differential $78.20
Rate for Payer: Ohio Health Group PPO No Differential $50.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $121.21
Rate for Payer: PHCS Commercial $375.36
Rate for Payer: United Healthcare All Payer $344.08
Service Code HCPCS 20552
Hospital Charge Code 76100339
Hospital Revenue Code 761
Min. Negotiated Rate $63.83
Max. Negotiated Rate $471.36
Rate for Payer: Aetna Commercial $378.07
Rate for Payer: Anthem Medicaid $168.85
Rate for Payer: Anthem Medicare Advantage/PPO $256.12
Rate for Payer: Anthem POS/PPO/Traditional $382.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $358.57
Rate for Payer: CareSource Just4Me Medicare $345.76
Rate for Payer: Cash Price $245.50
Rate for Payer: Cash Price $245.50
Rate for Payer: Cigna Commercial $407.53
Rate for Payer: First Health Commercial $466.45
Rate for Payer: Humana Commercial $417.35
Rate for Payer: Humana KY Medicaid $168.85
Rate for Payer: Humana Medicare Advantage $256.12
Rate for Payer: Kentucky WC Medicaid $170.57
Rate for Payer: Medical Mutual Of Ohio HMO $402.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $362.36
Rate for Payer: Molina Healthcare Benefit Exchange $307.34
Rate for Payer: Molina Healthcare Medicaid $172.24
Rate for Payer: Ohio Health Choice Commercial $432.08
Rate for Payer: Ohio Health Group HMO $368.25
Rate for Payer: Ohio Health Group PPO Differential $98.20
Rate for Payer: Ohio Health Group PPO No Differential $63.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $152.21
Rate for Payer: PHCS Commercial $471.36
Rate for Payer: United Healthcare All Payer $432.08
Service Code HCPCS 20552
Hospital Charge Code 45000088
Hospital Revenue Code 450
Min. Negotiated Rate $50.83
Max. Negotiated Rate $375.36
Rate for Payer: Aetna Commercial $301.07
Rate for Payer: Anthem POS/PPO/Traditional $304.98
Rate for Payer: Cash Price $195.50
Rate for Payer: Cigna Commercial $324.53
Rate for Payer: First Health Commercial $371.45
Rate for Payer: Humana Commercial $332.35
Rate for Payer: Medical Mutual Of Ohio HMO $320.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $288.56
Rate for Payer: Molina Healthcare Benefit Exchange $117.30
Rate for Payer: Ohio Health Choice Commercial $344.08
Rate for Payer: Ohio Health Group HMO $293.25
Rate for Payer: Ohio Health Group PPO Differential $78.20
Rate for Payer: Ohio Health Group PPO No Differential $50.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $121.21
Rate for Payer: PHCS Commercial $375.36
Rate for Payer: United Healthcare All Payer $344.08
Service Code HCPCS 20552
Hospital Charge Code 76100339
Hospital Revenue Code 761
Min. Negotiated Rate $63.83
Max. Negotiated Rate $471.36
Rate for Payer: Aetna Commercial $378.07
Rate for Payer: Anthem POS/PPO/Traditional $382.98
Rate for Payer: Cash Price $245.50
Rate for Payer: Cigna Commercial $407.53
Rate for Payer: First Health Commercial $466.45
Rate for Payer: Humana Commercial $417.35
Rate for Payer: Medical Mutual Of Ohio HMO $402.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $362.36
Rate for Payer: Molina Healthcare Benefit Exchange $147.30
Rate for Payer: Ohio Health Choice Commercial $432.08
Rate for Payer: Ohio Health Group HMO $368.25
Rate for Payer: Ohio Health Group PPO Differential $98.20
Rate for Payer: Ohio Health Group PPO No Differential $63.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $152.21
Rate for Payer: PHCS Commercial $471.36
Rate for Payer: United Healthcare All Payer $432.08
Service Code HCPCS 20552
Hospital Charge Code 76100339
Hospital Revenue Code 761
Min. Negotiated Rate $28.11
Max. Negotiated Rate $491.00
Rate for Payer: Aetna Commercial $54.51
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $28.11
Rate for Payer: Anthem Medicaid $36.32
Rate for Payer: Buckeye Medicare Advantage $491.00
Rate for Payer: Cash Price $245.50
Rate for Payer: Cash Price $245.50
Rate for Payer: Cigna Commercial $85.59
Rate for Payer: Healthspan PPO $67.79
Rate for Payer: Humana Medicaid $36.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $45.89
Rate for Payer: Molina Healthcare CHIP/Medicaid $37.05
Rate for Payer: Molina Healthcare Passport $36.32
Rate for Payer: Multiplan PHCS $294.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $343.70
Rate for Payer: UHCCP Medicaid $29.52
Rate for Payer: Wellcare CHIP/Medicaid $36.68
Service Code HCPCS 20552
Hospital Charge Code 761P0339
Hospital Revenue Code 761
Min. Negotiated Rate $28.11
Max. Negotiated Rate $100.00
Rate for Payer: Aetna Commercial $54.51
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $28.11
Rate for Payer: Anthem Medicaid $36.32
Rate for Payer: Buckeye Medicare Advantage $100.00
Rate for Payer: Cash Price $50.00
Rate for Payer: Cash Price $50.00
Rate for Payer: Cigna Commercial $85.59
Rate for Payer: Healthspan PPO $67.79
Rate for Payer: Humana Medicaid $36.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $45.89
Rate for Payer: Molina Healthcare CHIP/Medicaid $37.05
Rate for Payer: Molina Healthcare Passport $36.32
Rate for Payer: Multiplan PHCS $60.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $70.00
Rate for Payer: UHCCP Medicaid $29.52
Rate for Payer: Wellcare CHIP/Medicaid $36.68
Service Code HCPCS 20552
Hospital Charge Code 761T0339
Hospital Revenue Code 761
Min. Negotiated Rate $50.83
Max. Negotiated Rate $375.36
Rate for Payer: Aetna Commercial $301.07
Rate for Payer: Anthem Medicaid $134.46
Rate for Payer: Anthem Medicare Advantage/PPO $256.12
Rate for Payer: Anthem POS/PPO/Traditional $304.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $358.57
Rate for Payer: CareSource Just4Me Medicare $345.76
Rate for Payer: Cash Price $195.50
Rate for Payer: Cash Price $195.50
Rate for Payer: Cigna Commercial $324.53
Rate for Payer: First Health Commercial $371.45
Rate for Payer: Humana Commercial $332.35
Rate for Payer: Humana KY Medicaid $134.46
Rate for Payer: Humana Medicare Advantage $256.12
Rate for Payer: Kentucky WC Medicaid $135.83
Rate for Payer: Medical Mutual Of Ohio HMO $320.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $288.56
Rate for Payer: Molina Healthcare Benefit Exchange $307.34
Rate for Payer: Molina Healthcare Medicaid $137.16
Rate for Payer: Ohio Health Choice Commercial $344.08
Rate for Payer: Ohio Health Group HMO $293.25
Rate for Payer: Ohio Health Group PPO Differential $78.20
Rate for Payer: Ohio Health Group PPO No Differential $50.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $121.21
Rate for Payer: PHCS Commercial $375.36
Rate for Payer: United Healthcare All Payer $344.08
Service Code HCPCS 20552
Hospital Charge Code 761T0339
Hospital Revenue Code 761
Min. Negotiated Rate $50.83
Max. Negotiated Rate $375.36
Rate for Payer: Aetna Commercial $301.07
Rate for Payer: Anthem POS/PPO/Traditional $304.98
Rate for Payer: Cash Price $195.50
Rate for Payer: Cigna Commercial $324.53
Rate for Payer: First Health Commercial $371.45
Rate for Payer: Humana Commercial $332.35
Rate for Payer: Medical Mutual Of Ohio HMO $320.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $288.56
Rate for Payer: Molina Healthcare Benefit Exchange $117.30
Rate for Payer: Ohio Health Choice Commercial $344.08
Rate for Payer: Ohio Health Group HMO $293.25
Rate for Payer: Ohio Health Group PPO Differential $78.20
Rate for Payer: Ohio Health Group PPO No Differential $50.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $121.21
Rate for Payer: PHCS Commercial $375.36
Rate for Payer: United Healthcare All Payer $344.08
Service Code HCPCS C1876
Hospital Charge Code 27000127
Hospital Revenue Code 278
Min. Negotiated Rate $563.55
Max. Negotiated Rate $4,161.60
Rate for Payer: Aetna Commercial $3,337.95
Rate for Payer: Anthem Medicaid $1,490.81
Rate for Payer: Anthem POS/PPO/Traditional $3,381.30
Rate for Payer: Cash Price $2,167.50
Rate for Payer: Cigna Commercial $3,598.05
Rate for Payer: First Health Commercial $4,118.25
Rate for Payer: Humana Commercial $3,684.75
Rate for Payer: Humana KY Medicaid $1,490.81
Rate for Payer: Kentucky WC Medicaid $1,505.98
Rate for Payer: Medical Mutual Of Ohio HMO $3,554.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,199.23
Rate for Payer: Molina Healthcare Benefit Exchange $1,300.50
Rate for Payer: Molina Healthcare Medicaid $1,520.72
Rate for Payer: Ohio Health Choice Commercial $3,814.80
Rate for Payer: Ohio Health Group HMO $3,251.25
Rate for Payer: Ohio Health Group PPO Differential $867.00
Rate for Payer: Ohio Health Group PPO No Differential $563.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,343.85
Rate for Payer: PHCS Commercial $4,161.60
Rate for Payer: United Healthcare All Payer $3,814.80
Service Code HCPCS C1876
Hospital Charge Code 27000127
Hospital Revenue Code 278
Min. Negotiated Rate $563.55
Max. Negotiated Rate $4,161.60
Rate for Payer: Aetna Commercial $3,337.95
Rate for Payer: Anthem POS/PPO/Traditional $3,381.30
Rate for Payer: Cash Price $2,167.50
Rate for Payer: Cigna Commercial $3,598.05
Rate for Payer: First Health Commercial $4,118.25
Rate for Payer: Humana Commercial $3,684.75
Rate for Payer: Medical Mutual Of Ohio HMO $3,554.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,199.23
Rate for Payer: Molina Healthcare Benefit Exchange $1,300.50
Rate for Payer: Ohio Health Choice Commercial $3,814.80
Rate for Payer: Ohio Health Group HMO $3,251.25
Rate for Payer: Ohio Health Group PPO Differential $867.00
Rate for Payer: Ohio Health Group PPO No Differential $563.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,343.85
Rate for Payer: PHCS Commercial $4,161.60
Rate for Payer: United Healthcare All Payer $3,814.80