|
INSERT TUN IP CATH PERC(T
|
Facility
|
OP
|
$6,423.41
|
|
|
Service Code
|
HCPCS 49418
|
| Hospital Charge Code |
761T1999
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,209.01 |
| Max. Negotiated Rate |
$6,166.47 |
| Rate for Payer: Aetna Commercial |
$4,946.03
|
| Rate for Payer: Anthem Medicaid |
$2,209.01
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,260.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,010.26
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,565.09
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,402.05
|
| Rate for Payer: Cash Price |
$3,211.70
|
| Rate for Payer: Cash Price |
$3,211.70
|
| Rate for Payer: Cigna Commercial |
$5,331.43
|
| Rate for Payer: First Health Commercial |
$6,102.24
|
| Rate for Payer: Humana Commercial |
$5,459.90
|
| Rate for Payer: Humana KY Medicaid |
$2,209.01
|
| Rate for Payer: Humana Medicare Advantage |
$3,260.78
|
| Rate for Payer: Kentucky WC Medicaid |
$2,231.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,267.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,740.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,912.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,253.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,652.60
|
| Rate for Payer: Ohio Health Group HMO |
$4,817.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,138.73
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,588.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,432.15
|
| Rate for Payer: PHCS Commercial |
$6,166.47
|
| Rate for Payer: United Healthcare All Payer |
$5,652.60
|
|
|
INSERT TUNNELED CENTRAL ACCESS
|
Facility
|
OP
|
$7,345.00
|
|
|
Service Code
|
HCPCS 36560
|
| Hospital Charge Code |
761T1475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,525.95 |
| Max. Negotiated Rate |
$7,051.20 |
| Rate for Payer: Aetna Commercial |
$5,655.65
|
| Rate for Payer: Anthem Medicaid |
$2,525.95
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,729.10
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$3,672.50
|
| Rate for Payer: Cash Price |
$3,672.50
|
| Rate for Payer: Cigna Commercial |
$6,096.35
|
| Rate for Payer: First Health Commercial |
$6,977.75
|
| Rate for Payer: Humana Commercial |
$6,243.25
|
| Rate for Payer: Humana KY Medicaid |
$2,525.95
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,551.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,022.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,420.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,576.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,463.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,508.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,876.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,390.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,068.05
|
| Rate for Payer: PHCS Commercial |
$7,051.20
|
| Rate for Payer: United Healthcare All Payer |
$6,463.60
|
|
|
INSERT TUNNELED CENTRAL ACCESS
|
Professional
|
Both
|
$9,345.00
|
|
|
Service Code
|
HCPCS 36560
|
| Hospital Charge Code |
76101475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$250.01 |
| Max. Negotiated Rate |
$5,607.00 |
| Rate for Payer: Aetna Commercial |
$556.11
|
| Rate for Payer: Ambetter Exchange |
$363.86
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$250.01
|
| Rate for Payer: Anthem Medicaid |
$948.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$363.86
|
| Rate for Payer: Buckeye Medicare Advantage |
$363.86
|
| Rate for Payer: CareSource Just4Me Medicare |
$436.63
|
| Rate for Payer: Cash Price |
$4,672.50
|
| Rate for Payer: Cash Price |
$4,672.50
|
| Rate for Payer: Cigna Commercial |
$524.61
|
| Rate for Payer: Healthspan PPO |
$1,345.50
|
| Rate for Payer: Humana Medicaid |
$948.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$453.11
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$363.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$363.86
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$967.92
|
| Rate for Payer: Molina Healthcare Passport |
$948.94
|
| Rate for Payer: Multiplan PHCS |
$5,607.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$473.02
|
| Rate for Payer: UHCCP Medicaid |
$262.51
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$958.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$363.86
|
|
|
INSERT TUNNELED CENTRAL ACCESS
|
Facility
|
IP
|
$7,345.00
|
|
|
Service Code
|
HCPCS 36560
|
| Hospital Charge Code |
761T1475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,203.50 |
| Max. Negotiated Rate |
$7,051.20 |
| Rate for Payer: Aetna Commercial |
$5,655.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,729.10
|
| Rate for Payer: Cash Price |
$3,672.50
|
| Rate for Payer: Cigna Commercial |
$6,096.35
|
| Rate for Payer: First Health Commercial |
$6,977.75
|
| Rate for Payer: Humana Commercial |
$6,243.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,022.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,420.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,203.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,463.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,508.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,876.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,390.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,068.05
|
| Rate for Payer: PHCS Commercial |
$7,051.20
|
| Rate for Payer: United Healthcare All Payer |
$6,463.60
|
|
|
INSERT TUNNELED CENTRAL ACCESS
|
Facility
|
IP
|
$9,345.00
|
|
|
Service Code
|
HCPCS 36560
|
| Hospital Charge Code |
76101475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,803.50 |
| Max. Negotiated Rate |
$8,971.20 |
| Rate for Payer: Aetna Commercial |
$7,195.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,289.10
|
| Rate for Payer: Cash Price |
$4,672.50
|
| Rate for Payer: Cigna Commercial |
$7,756.35
|
| Rate for Payer: First Health Commercial |
$8,877.75
|
| Rate for Payer: Humana Commercial |
$7,943.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,662.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,896.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,803.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,223.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,008.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,476.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,130.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,448.05
|
| Rate for Payer: PHCS Commercial |
$8,971.20
|
| Rate for Payer: United Healthcare All Payer |
$8,223.60
|
|
|
INSERT TUNNELED CENTRAL ACCESS
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 36560
|
| Hospital Charge Code |
761P1475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$250.01 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Aetna Commercial |
$556.11
|
| Rate for Payer: Ambetter Exchange |
$363.86
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$250.01
|
| Rate for Payer: Anthem Medicaid |
$948.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$363.86
|
| Rate for Payer: Buckeye Medicare Advantage |
$363.86
|
| Rate for Payer: CareSource Just4Me Medicare |
$436.63
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$524.61
|
| Rate for Payer: Healthspan PPO |
$1,345.50
|
| Rate for Payer: Humana Medicaid |
$948.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$453.11
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$363.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$363.86
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$967.92
|
| Rate for Payer: Molina Healthcare Passport |
$948.94
|
| Rate for Payer: Multiplan PHCS |
$1,200.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$473.02
|
| Rate for Payer: UHCCP Medicaid |
$262.51
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$958.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$363.86
|
|
|
INSERT TUNNELED CENTRAL ACCESS
|
Facility
|
OP
|
$9,345.00
|
|
|
Service Code
|
HCPCS 36560
|
| Hospital Charge Code |
76101475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,908.23 |
| Max. Negotiated Rate |
$8,971.20 |
| Rate for Payer: Aetna Commercial |
$7,195.65
|
| Rate for Payer: Anthem Medicaid |
$3,213.75
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,289.10
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$4,672.50
|
| Rate for Payer: Cash Price |
$4,672.50
|
| Rate for Payer: Cigna Commercial |
$7,756.35
|
| Rate for Payer: First Health Commercial |
$8,877.75
|
| Rate for Payer: Humana Commercial |
$7,943.25
|
| Rate for Payer: Humana KY Medicaid |
$3,213.75
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$3,246.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,662.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,896.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,278.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,223.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,008.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,476.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,130.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,448.05
|
| Rate for Payer: PHCS Commercial |
$8,971.20
|
| Rate for Payer: United Healthcare All Payer |
$8,223.60
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
IP
|
$8,464.00
|
|
|
Service Code
|
HCPCS 36563
|
| Hospital Charge Code |
76101477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,539.20 |
| Max. Negotiated Rate |
$8,125.44 |
| Rate for Payer: Aetna Commercial |
$6,517.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,601.92
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cigna Commercial |
$7,025.12
|
| Rate for Payer: First Health Commercial |
$8,040.80
|
| Rate for Payer: Humana Commercial |
$7,194.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,940.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,246.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,539.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,448.32
|
| Rate for Payer: Ohio Health Group HMO |
$6,348.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,771.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,363.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,840.16
|
| Rate for Payer: PHCS Commercial |
$8,125.44
|
| Rate for Payer: United Healthcare All Payer |
$7,448.32
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
OP
|
$7,294.00
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
76101473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,508.41 |
| Max. Negotiated Rate |
$7,002.24 |
| Rate for Payer: Aetna Commercial |
$5,616.38
|
| Rate for Payer: Anthem Medicaid |
$2,508.41
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,994.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,689.32
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,992.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,742.93
|
| Rate for Payer: Cash Price |
$3,647.00
|
| Rate for Payer: Cash Price |
$3,647.00
|
| Rate for Payer: Cigna Commercial |
$6,054.02
|
| Rate for Payer: First Health Commercial |
$6,929.30
|
| Rate for Payer: Humana Commercial |
$6,199.90
|
| Rate for Payer: Humana KY Medicaid |
$2,508.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,994.76
|
| Rate for Payer: Kentucky WC Medicaid |
$2,533.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,981.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,382.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,993.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,558.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,418.72
|
| Rate for Payer: Ohio Health Group HMO |
$5,470.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,835.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,345.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,032.86
|
| Rate for Payer: PHCS Commercial |
$7,002.24
|
| Rate for Payer: United Healthcare All Payer |
$6,418.72
|
|
|
INSERT TUNNELED CV CATH
|
Professional
|
Both
|
$4,275.00
|
|
|
Service Code
|
HCPCS 36566
|
| Hospital Charge Code |
76102770
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.58 |
| Max. Negotiated Rate |
$4,127.18 |
| Rate for Payer: Aetna Commercial |
$567.33
|
| Rate for Payer: Ambetter Exchange |
$334.55
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$251.58
|
| Rate for Payer: Anthem Medicaid |
$795.03
|
| Rate for Payer: Buckeye Individual/Medicaid |
$334.55
|
| Rate for Payer: Buckeye Medicare Advantage |
$334.55
|
| Rate for Payer: CareSource Just4Me Medicare |
$401.46
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cigna Commercial |
$543.16
|
| Rate for Payer: Healthspan PPO |
$4,127.18
|
| Rate for Payer: Humana Medicaid |
$795.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$489.38
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$334.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$334.55
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$810.93
|
| Rate for Payer: Molina Healthcare Passport |
$795.03
|
| Rate for Payer: Multiplan PHCS |
$2,565.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$434.92
|
| Rate for Payer: UHCCP Medicaid |
$264.16
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$802.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$334.55
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
IP
|
$7,294.00
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
76101473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,188.20 |
| Max. Negotiated Rate |
$7,002.24 |
| Rate for Payer: Aetna Commercial |
$5,616.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,689.32
|
| Rate for Payer: Cash Price |
$3,647.00
|
| Rate for Payer: Cigna Commercial |
$6,054.02
|
| Rate for Payer: First Health Commercial |
$6,929.30
|
| Rate for Payer: Humana Commercial |
$6,199.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,981.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,382.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,188.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,418.72
|
| Rate for Payer: Ohio Health Group HMO |
$5,470.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,835.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,345.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,032.86
|
| Rate for Payer: PHCS Commercial |
$7,002.24
|
| Rate for Payer: United Healthcare All Payer |
$6,418.72
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
IP
|
$4,275.00
|
|
|
Service Code
|
HCPCS 36566
|
| Hospital Charge Code |
76102770
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,282.50 |
| Max. Negotiated Rate |
$4,104.00 |
| Rate for Payer: Aetna Commercial |
$3,291.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,334.50
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cigna Commercial |
$3,548.25
|
| Rate for Payer: First Health Commercial |
$4,061.25
|
| Rate for Payer: Humana Commercial |
$3,633.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,505.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,154.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,282.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,762.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,206.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,719.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,949.75
|
| Rate for Payer: PHCS Commercial |
$4,104.00
|
| Rate for Payer: United Healthcare All Payer |
$3,762.00
|
|
|
INSERT TUNNELED CV CATH
|
Professional
|
Both
|
$8,464.00
|
|
|
Service Code
|
HCPCS 36563
|
| Hospital Charge Code |
76101477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.03 |
| Max. Negotiated Rate |
$5,078.40 |
| Rate for Payer: Aetna Commercial |
$567.62
|
| Rate for Payer: Ambetter Exchange |
$340.88
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$253.03
|
| Rate for Payer: Anthem Medicaid |
$882.00
|
| Rate for Payer: Buckeye Individual/Medicaid |
$340.88
|
| Rate for Payer: Buckeye Medicare Advantage |
$340.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$409.06
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cigna Commercial |
$537.01
|
| Rate for Payer: Healthspan PPO |
$1,353.42
|
| Rate for Payer: Humana Medicaid |
$882.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$481.20
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$340.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$340.88
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$899.64
|
| Rate for Payer: Molina Healthcare Passport |
$882.00
|
| Rate for Payer: Multiplan PHCS |
$5,078.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$443.14
|
| Rate for Payer: UHCCP Medicaid |
$265.68
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$890.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$340.88
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
OP
|
$8,464.00
|
|
|
Service Code
|
HCPCS 36563
|
| Hospital Charge Code |
76101477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,910.77 |
| Max. Negotiated Rate |
$8,125.44 |
| Rate for Payer: Aetna Commercial |
$6,517.28
|
| Rate for Payer: Anthem Medicaid |
$2,910.77
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,994.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,601.92
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,992.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,742.93
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cigna Commercial |
$7,025.12
|
| Rate for Payer: First Health Commercial |
$8,040.80
|
| Rate for Payer: Humana Commercial |
$7,194.40
|
| Rate for Payer: Humana KY Medicaid |
$2,910.77
|
| Rate for Payer: Humana Medicare Advantage |
$4,994.76
|
| Rate for Payer: Kentucky WC Medicaid |
$2,940.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,940.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,246.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,993.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,969.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,448.32
|
| Rate for Payer: Ohio Health Group HMO |
$6,348.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,771.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,363.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,840.16
|
| Rate for Payer: PHCS Commercial |
$8,125.44
|
| Rate for Payer: United Healthcare All Payer |
$7,448.32
|
|
|
INSERT TUNNELED CV CATH
|
Professional
|
Both
|
$7,294.00
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
76101473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.16 |
| Max. Negotiated Rate |
$4,376.40 |
| Rate for Payer: Aetna Commercial |
$472.59
|
| Rate for Payer: Ambetter Exchange |
$304.30
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$213.16
|
| Rate for Payer: Anthem Medicaid |
$511.70
|
| Rate for Payer: Buckeye Individual/Medicaid |
$304.30
|
| Rate for Payer: Buckeye Medicare Advantage |
$304.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$365.16
|
| Rate for Payer: Cash Price |
$3,647.00
|
| Rate for Payer: Cash Price |
$3,647.00
|
| Rate for Payer: Cigna Commercial |
$444.51
|
| Rate for Payer: Healthspan PPO |
$986.00
|
| Rate for Payer: Humana Medicaid |
$511.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$411.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$304.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$304.30
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$521.93
|
| Rate for Payer: Molina Healthcare Passport |
$511.70
|
| Rate for Payer: Multiplan PHCS |
$4,376.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$395.59
|
| Rate for Payer: UHCCP Medicaid |
$223.82
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$516.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$304.30
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
OP
|
$4,275.00
|
|
|
Service Code
|
HCPCS 36566
|
| Hospital Charge Code |
76102770
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,470.17 |
| Max. Negotiated Rate |
$6,992.66 |
| Rate for Payer: Aetna Commercial |
$3,291.75
|
| Rate for Payer: Anthem Medicaid |
$1,470.17
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,994.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,334.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,992.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,742.93
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cigna Commercial |
$3,548.25
|
| Rate for Payer: First Health Commercial |
$4,061.25
|
| Rate for Payer: Humana Commercial |
$3,633.75
|
| Rate for Payer: Humana KY Medicaid |
$1,470.17
|
| Rate for Payer: Humana Medicare Advantage |
$4,994.76
|
| Rate for Payer: Kentucky WC Medicaid |
$1,485.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,505.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,154.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,993.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,499.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,762.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,206.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,719.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,949.75
|
| Rate for Payer: PHCS Commercial |
$4,104.00
|
| Rate for Payer: United Healthcare All Payer |
$3,762.00
|
|
|
INSERT TUNNELED CV CATH (P
|
Professional
|
Both
|
$4,275.00
|
|
|
Service Code
|
HCPCS 36566
|
| Hospital Charge Code |
761P2770
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.58 |
| Max. Negotiated Rate |
$4,127.18 |
| Rate for Payer: Aetna Commercial |
$567.33
|
| Rate for Payer: Ambetter Exchange |
$334.55
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$251.58
|
| Rate for Payer: Anthem Medicaid |
$795.03
|
| Rate for Payer: Buckeye Individual/Medicaid |
$334.55
|
| Rate for Payer: Buckeye Medicare Advantage |
$334.55
|
| Rate for Payer: CareSource Just4Me Medicare |
$401.46
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cigna Commercial |
$543.16
|
| Rate for Payer: Healthspan PPO |
$4,127.18
|
| Rate for Payer: Humana Medicaid |
$795.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$489.38
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$334.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$334.55
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$810.93
|
| Rate for Payer: Molina Healthcare Passport |
$795.03
|
| Rate for Payer: Multiplan PHCS |
$2,565.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$434.92
|
| Rate for Payer: UHCCP Medicaid |
$264.16
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$802.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$334.55
|
|
|
INSERT TUNNELED CV CATH(P
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 36563
|
| Hospital Charge Code |
761P1477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.03 |
| Max. Negotiated Rate |
$1,353.42 |
| Rate for Payer: Aetna Commercial |
$567.62
|
| Rate for Payer: Ambetter Exchange |
$340.88
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$253.03
|
| Rate for Payer: Anthem Medicaid |
$882.00
|
| Rate for Payer: Buckeye Individual/Medicaid |
$340.88
|
| Rate for Payer: Buckeye Medicare Advantage |
$340.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$409.06
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cigna Commercial |
$537.01
|
| Rate for Payer: Healthspan PPO |
$1,353.42
|
| Rate for Payer: Humana Medicaid |
$882.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$481.20
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$340.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$340.88
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$899.64
|
| Rate for Payer: Molina Healthcare Passport |
$882.00
|
| Rate for Payer: Multiplan PHCS |
$960.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$443.14
|
| Rate for Payer: UHCCP Medicaid |
$265.68
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$890.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$340.88
|
|
|
INSERT TUNNELED CV CATH(P
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
761P1473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.16 |
| Max. Negotiated Rate |
$986.00 |
| Rate for Payer: Aetna Commercial |
$472.59
|
| Rate for Payer: Ambetter Exchange |
$304.30
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$213.16
|
| Rate for Payer: Anthem Medicaid |
$511.70
|
| Rate for Payer: Buckeye Individual/Medicaid |
$304.30
|
| Rate for Payer: Buckeye Medicare Advantage |
$304.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$365.16
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cigna Commercial |
$444.51
|
| Rate for Payer: Healthspan PPO |
$986.00
|
| Rate for Payer: Humana Medicaid |
$511.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$411.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$304.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$304.30
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$521.93
|
| Rate for Payer: Molina Healthcare Passport |
$511.70
|
| Rate for Payer: Multiplan PHCS |
$312.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$395.59
|
| Rate for Payer: UHCCP Medicaid |
$223.82
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$516.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$304.30
|
|
|
INSERT TUNNELED CV CATH(T
|
Facility
|
IP
|
$6,774.00
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
761T1473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,032.20 |
| Max. Negotiated Rate |
$6,503.04 |
| Rate for Payer: Aetna Commercial |
$5,215.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,283.72
|
| Rate for Payer: Cash Price |
$3,387.00
|
| Rate for Payer: Cigna Commercial |
$5,622.42
|
| Rate for Payer: First Health Commercial |
$6,435.30
|
| Rate for Payer: Humana Commercial |
$5,757.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,554.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,999.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,032.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,961.12
|
| Rate for Payer: Ohio Health Group HMO |
$5,080.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,419.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,893.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,674.06
|
| Rate for Payer: PHCS Commercial |
$6,503.04
|
| Rate for Payer: United Healthcare All Payer |
$5,961.12
|
|
|
INSERT TUNNELED CV CATH(T
|
Facility
|
OP
|
$6,774.00
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
761T1473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,329.58 |
| Max. Negotiated Rate |
$6,992.66 |
| Rate for Payer: Aetna Commercial |
$5,215.98
|
| Rate for Payer: Anthem Medicaid |
$2,329.58
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,994.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,283.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,992.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,742.93
|
| Rate for Payer: Cash Price |
$3,387.00
|
| Rate for Payer: Cash Price |
$3,387.00
|
| Rate for Payer: Cigna Commercial |
$5,622.42
|
| Rate for Payer: First Health Commercial |
$6,435.30
|
| Rate for Payer: Humana Commercial |
$5,757.90
|
| Rate for Payer: Humana KY Medicaid |
$2,329.58
|
| Rate for Payer: Humana Medicare Advantage |
$4,994.76
|
| Rate for Payer: Kentucky WC Medicaid |
$2,353.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,554.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,999.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,993.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,376.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,961.12
|
| Rate for Payer: Ohio Health Group HMO |
$5,080.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,419.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,893.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,674.06
|
| Rate for Payer: PHCS Commercial |
$6,503.04
|
| Rate for Payer: United Healthcare All Payer |
$5,961.12
|
|
|
INSERT TUNNELED CV CATH(T
|
Facility
|
OP
|
$6,864.00
|
|
|
Service Code
|
HCPCS 36563
|
| Hospital Charge Code |
761T1477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,360.53 |
| Max. Negotiated Rate |
$6,992.66 |
| Rate for Payer: Aetna Commercial |
$5,285.28
|
| Rate for Payer: Anthem Medicaid |
$2,360.53
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,994.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,353.92
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,992.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,742.93
|
| Rate for Payer: Cash Price |
$3,432.00
|
| Rate for Payer: Cash Price |
$3,432.00
|
| Rate for Payer: Cigna Commercial |
$5,697.12
|
| Rate for Payer: First Health Commercial |
$6,520.80
|
| Rate for Payer: Humana Commercial |
$5,834.40
|
| Rate for Payer: Humana KY Medicaid |
$2,360.53
|
| Rate for Payer: Humana Medicare Advantage |
$4,994.76
|
| Rate for Payer: Kentucky WC Medicaid |
$2,384.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,628.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,065.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,993.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,407.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,040.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,148.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,491.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,971.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,736.16
|
| Rate for Payer: PHCS Commercial |
$6,589.44
|
| Rate for Payer: United Healthcare All Payer |
$6,040.32
|
|
|
INSERT TUNNELED CV CATH(T
|
Facility
|
IP
|
$6,864.00
|
|
|
Service Code
|
HCPCS 36563
|
| Hospital Charge Code |
761T1477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,059.20 |
| Max. Negotiated Rate |
$6,589.44 |
| Rate for Payer: Aetna Commercial |
$5,285.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,353.92
|
| Rate for Payer: Cash Price |
$3,432.00
|
| Rate for Payer: Cigna Commercial |
$5,697.12
|
| Rate for Payer: First Health Commercial |
$6,520.80
|
| Rate for Payer: Humana Commercial |
$5,834.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,628.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,065.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,059.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,040.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,148.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,491.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,971.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,736.16
|
| Rate for Payer: PHCS Commercial |
$6,589.44
|
| Rate for Payer: United Healthcare All Payer |
$6,040.32
|
|
|
INSERT W/JRNY FLXHI LK 3-4 11
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,500.00 |
| Max. Negotiated Rate |
$4,800.00 |
| Rate for Payer: Aetna Commercial |
$3,850.00
|
| Rate for Payer: Anthem Medicaid |
$1,719.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,900.00
|
| Rate for Payer: Cash Price |
$2,500.00
|
| Rate for Payer: Cigna Commercial |
$4,150.00
|
| Rate for Payer: First Health Commercial |
$4,750.00
|
| Rate for Payer: Humana Commercial |
$4,250.00
|
| Rate for Payer: Humana KY Medicaid |
$1,719.50
|
| Rate for Payer: Kentucky WC Medicaid |
$1,737.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,100.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,690.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,500.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,754.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,400.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,750.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,350.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,450.00
|
| Rate for Payer: PHCS Commercial |
$4,800.00
|
| Rate for Payer: United Healthcare All Payer |
$4,400.00
|
|
|
INSERT W/JRNY FLXHI LK 3-4 11
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,500.00 |
| Max. Negotiated Rate |
$4,800.00 |
| Rate for Payer: Aetna Commercial |
$3,850.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,900.00
|
| Rate for Payer: Cash Price |
$2,500.00
|
| Rate for Payer: Cigna Commercial |
$4,150.00
|
| Rate for Payer: First Health Commercial |
$4,750.00
|
| Rate for Payer: Humana Commercial |
$4,250.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,100.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,690.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,500.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,400.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,750.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,350.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,450.00
|
| Rate for Payer: PHCS Commercial |
$4,800.00
|
| Rate for Payer: United Healthcare All Payer |
$4,400.00
|
|
