|
ANESTH SHOULDER REPLACEMENT
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 01638
|
| Hospital Charge Code |
37000134
|
|
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 SHOULDER REPLACEMENT
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 01638
|
| Hospital Charge Code |
37000134
|
|
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 SHOULDER VEIN SURG
|
Professional
|
Both
|
$5.35
|
|
|
Service Code
|
HCPCS 1670
|
| Hospital Charge Code |
37000261
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Cash Price |
$2.67
|
| Rate for Payer: Multiplan PHCS |
$3.21
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3.75
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
|
|
ANESTH SKIN EXT/PER/ATRUNK
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00400
|
| Hospital Charge Code |
37000020
|
|
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 SKIN EXT/PER/ATRUNK
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 400
|
| Hospital Charge Code |
37000020
|
|
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 SKIN EXT/PER/ATRUNK
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00400
|
| Hospital Charge Code |
37000020
|
|
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 SPINE CORD SURGERY
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 630
|
| Hospital Charge Code |
37000046
|
|
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 SPINE CORD SURGERY
|
Facility
|
IP
|
$2.10
|
|
|
Service Code
|
HCPCS 00620
|
| Hospital Charge Code |
37000275
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Aetna Commercial |
$1.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1.64
|
| Rate for Payer: Cash Price |
$1.05
|
| Rate for Payer: Cigna Commercial |
$1.74
|
| Rate for Payer: First Health Commercial |
$2.00
|
| Rate for Payer: Humana Commercial |
$1.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$0.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$1.85
|
| Rate for Payer: Ohio Health Group HMO |
$1.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.45
|
| Rate for Payer: PHCS Commercial |
$2.02
|
| Rate for Payer: United Healthcare All Payer |
$1.85
|
|
|
ANESTH SPINE CORD SURGERY
|
Professional
|
Both
|
$2.10
|
|
|
Service Code
|
HCPCS 620
|
| Hospital Charge Code |
37000275
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$1.47 |
| Rate for Payer: Cash Price |
$1.05
|
| Rate for Payer: Multiplan PHCS |
$1.26
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1.47
|
| Rate for Payer: UHCCP Medicaid |
$0.74
|
|
|
ANESTH SPINE CORD SURGERY
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00630
|
| Hospital Charge Code |
37000046
|
|
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 SPINE CORD SURGERY
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00630
|
| Hospital Charge Code |
37000046
|
|
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 SPINE CORD SURGERY
|
Facility
|
OP
|
$2.10
|
|
|
Service Code
|
HCPCS 00620
|
| Hospital Charge Code |
37000275
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Aetna Commercial |
$1.62
|
| Rate for Payer: Anthem Medicaid |
$0.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1.64
|
| Rate for Payer: Cash Price |
$1.05
|
| Rate for Payer: Cigna Commercial |
$1.74
|
| Rate for Payer: First Health Commercial |
$2.00
|
| Rate for Payer: Humana Commercial |
$1.78
|
| Rate for Payer: Humana KY Medicaid |
$0.72
|
| Rate for Payer: Kentucky WC Medicaid |
$0.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$0.63
|
| Rate for Payer: Molina Healthcare Medicaid |
$0.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$1.85
|
| Rate for Payer: Ohio Health Group HMO |
$1.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1.45
|
| Rate for Payer: PHCS Commercial |
$2.02
|
| Rate for Payer: United Healthcare All Payer |
$1.85
|
|
|
ANESTH SPINE MANIPULATION
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 640
|
| Hospital Charge Code |
37000048
|
|
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 SPINE MANIPULATION
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00640
|
| Hospital Charge Code |
37000048
|
|
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 SPINE MANIPULATION
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00640
|
| Hospital Charge Code |
37000048
|
|
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 STONE REMOVAL
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00918
|
| Hospital Charge Code |
37000083
|
|
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 STONE REMOVAL
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00918
|
| Hospital Charge Code |
37000083
|
|
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 STONE REMOVAL
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 918
|
| Hospital Charge Code |
37000083
|
|
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 SURGERY FOR OBESITY
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00797
|
| Hospital Charge Code |
37000059
|
|
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 SURGERY FOR OBESITY
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 797
|
| Hospital Charge Code |
37000059
|
|
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 SURGERY FOR OBESITY
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00797
|
| Hospital Charge Code |
37000059
|
|
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 SURGERY OF ABDOMEN
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00860
|
| Hospital Charge Code |
37000071
|
|
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 SURGERY OF ABDOMEN
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 860
|
| Hospital Charge Code |
37000071
|
|
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 SURGERY OF ABDOMEN
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS 00860
|
| Hospital Charge Code |
37000071
|
|
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 SURGERY OF BREAST
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS 00404
|
| Hospital Charge Code |
37000022
|
|
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
|
|
