|
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC
|
Facility
|
IP
|
$23,431.51
|
|
|
Service Code
|
MSDRG 064
|
| Min. Negotiated Rate |
$15,899.95 |
| Max. Negotiated Rate |
$23,431.51 |
| Rate for Payer: Anthem Medicaid |
$15,899.95
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$16,736.79
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$23,431.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$22,594.67
|
| Rate for Payer: Humana KY Medicaid |
$15,899.95
|
| Rate for Payer: Humana Medicare Advantage |
$16,736.79
|
| Rate for Payer: Kentucky WC Medicaid |
$16,058.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$20,084.15
|
| Rate for Payer: Molina Healthcare Medicaid |
$16,217.95
|
|
|
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC
|
Facility
|
IP
|
$8,042.52
|
|
|
Service Code
|
MSDRG 066
|
| Min. Negotiated Rate |
$5,457.43 |
| Max. Negotiated Rate |
$8,042.52 |
| Rate for Payer: Anthem Medicaid |
$5,457.43
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,744.66
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$8,042.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,755.29
|
| Rate for Payer: Humana KY Medicaid |
$5,457.43
|
| Rate for Payer: Humana Medicare Advantage |
$5,744.66
|
| Rate for Payer: Kentucky WC Medicaid |
$5,512.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,893.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,566.58
|
|
|
INTRACRANIAL STUDY
|
Professional
|
Both
|
$1,057.00
|
|
|
Service Code
|
HCPCS 93888
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.62 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$145.48
|
| Rate for Payer: Anthem Medicaid |
$105.85
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,057.00
|
| Rate for Payer: Cash Price |
$528.50
|
| Rate for Payer: Cash Price |
$528.50
|
| Rate for Payer: Cigna Commercial |
$253.58
|
| Rate for Payer: Healthspan PPO |
$155.40
|
| Rate for Payer: Humana Medicaid |
$105.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$41.62
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$107.97
|
| Rate for Payer: Molina Healthcare Passport |
$105.85
|
| Rate for Payer: Multiplan PHCS |
$634.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$739.90
|
| Rate for Payer: UHCCP Medicaid |
$369.95
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$106.91
|
|
|
INTRACRANIAL STUDY
|
Facility
|
IP
|
$1,057.00
|
|
|
Service Code
|
HCPCS 93888
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.41 |
| Max. Negotiated Rate |
$1,014.72 |
| Rate for Payer: Aetna Commercial |
$813.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$824.46
|
| Rate for Payer: Cash Price |
$528.50
|
| Rate for Payer: Cigna Commercial |
$877.31
|
| Rate for Payer: First Health Commercial |
$1,004.15
|
| Rate for Payer: Humana Commercial |
$898.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$866.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$780.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$317.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$930.16
|
| Rate for Payer: Ohio Health Group HMO |
$792.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$211.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$327.67
|
| Rate for Payer: PHCS Commercial |
$1,014.72
|
| Rate for Payer: United Healthcare All Payer |
$930.16
|
|
|
INTRACRANIAL STUDY
|
Professional
|
Both
|
$1,654.00
|
|
|
Service Code
|
HCPCS 93886
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$1,654.00 |
| Rate for Payer: Wellcare CHIP/Medicaid |
$160.41
|
| Rate for Payer: Aetna Commercial |
$306.83
|
| Rate for Payer: Anthem Medicaid |
$158.82
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,654.00
|
| Rate for Payer: Cash Price |
$827.00
|
| Rate for Payer: Cash Price |
$827.00
|
| Rate for Payer: Cigna Commercial |
$390.43
|
| Rate for Payer: Healthspan PPO |
$327.76
|
| Rate for Payer: Humana Medicaid |
$158.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$62.20
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$162.00
|
| Rate for Payer: Molina Healthcare Passport |
$158.82
|
| Rate for Payer: Multiplan PHCS |
$992.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,157.80
|
| Rate for Payer: UHCCP Medicaid |
$578.90
|
|
|
INTRACRANIAL STUDY
|
Facility
|
OP
|
$1,654.00
|
|
|
Service Code
|
HCPCS 93886
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.90 |
| Max. Negotiated Rate |
$1,587.84 |
| Rate for Payer: Aetna Commercial |
$1,273.58
|
| Rate for Payer: Anthem Medicaid |
$568.81
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$211.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,290.12
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$296.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$286.06
|
| Rate for Payer: Cash Price |
$827.00
|
| Rate for Payer: Cash Price |
$827.00
|
| Rate for Payer: Cigna Commercial |
$1,372.82
|
| Rate for Payer: First Health Commercial |
$1,571.30
|
| Rate for Payer: Humana Commercial |
$1,405.90
|
| Rate for Payer: Humana KY Medicaid |
$568.81
|
| Rate for Payer: Humana Medicare Advantage |
$211.90
|
| Rate for Payer: Kentucky WC Medicaid |
$574.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,356.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,220.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$254.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$580.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,455.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,240.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$330.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$215.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$512.74
|
| Rate for Payer: PHCS Commercial |
$1,587.84
|
| Rate for Payer: United Healthcare All Payer |
$1,455.52
|
|
|
INTRACRANIAL STUDY
|
Facility
|
IP
|
$1,654.00
|
|
|
Service Code
|
HCPCS 93886
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$215.02 |
| Max. Negotiated Rate |
$1,587.84 |
| Rate for Payer: Aetna Commercial |
$1,273.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,290.12
|
| Rate for Payer: Cash Price |
$827.00
|
| Rate for Payer: Cigna Commercial |
$1,372.82
|
| Rate for Payer: First Health Commercial |
$1,571.30
|
| Rate for Payer: Humana Commercial |
$1,405.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,356.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,220.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$496.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,455.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,240.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$330.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$215.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$512.74
|
| Rate for Payer: PHCS Commercial |
$1,587.84
|
| Rate for Payer: United Healthcare All Payer |
$1,455.52
|
|
|
INTRACRANIAL STUDY
|
Facility
|
OP
|
$1,057.00
|
|
|
Service Code
|
HCPCS 93888
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.07 |
| Max. Negotiated Rate |
$1,014.72 |
| Rate for Payer: Aetna Commercial |
$813.89
|
| Rate for Payer: Anthem Medicaid |
$363.50
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$95.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$824.46
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$133.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$128.34
|
| Rate for Payer: Cash Price |
$528.50
|
| Rate for Payer: Cash Price |
$528.50
|
| Rate for Payer: Cigna Commercial |
$877.31
|
| Rate for Payer: First Health Commercial |
$1,004.15
|
| Rate for Payer: Humana Commercial |
$898.45
|
| Rate for Payer: Humana KY Medicaid |
$363.50
|
| Rate for Payer: Humana Medicare Advantage |
$95.07
|
| Rate for Payer: Kentucky WC Medicaid |
$367.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$866.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$780.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$370.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$930.16
|
| Rate for Payer: Ohio Health Group HMO |
$792.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$211.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$327.67
|
| Rate for Payer: PHCS Commercial |
$1,014.72
|
| Rate for Payer: United Healthcare All Payer |
$930.16
|
|
|
INTRACRANIAL STUDY(P
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 93886
|
| Hospital Charge Code |
320P0296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$390.43 |
| Rate for Payer: Aetna Commercial |
$306.83
|
| Rate for Payer: Anthem Medicaid |
$158.82
|
| Rate for Payer: Buckeye Medicare Advantage |
$375.00
|
| Rate for Payer: Cash Price |
$187.50
|
| Rate for Payer: Cash Price |
$187.50
|
| Rate for Payer: Cigna Commercial |
$390.43
|
| Rate for Payer: Healthspan PPO |
$327.76
|
| Rate for Payer: Humana Medicaid |
$158.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$62.20
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$162.00
|
| Rate for Payer: Molina Healthcare Passport |
$158.82
|
| Rate for Payer: Multiplan PHCS |
$225.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$262.50
|
| Rate for Payer: UHCCP Medicaid |
$131.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$160.41
|
|
|
INTRACRANIAL STUDY(P
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 93888
|
| Hospital Charge Code |
320P0297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.62 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$145.48
|
| Rate for Payer: Anthem Medicaid |
$105.85
|
| Rate for Payer: Buckeye Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$253.58
|
| Rate for Payer: Healthspan PPO |
$155.40
|
| Rate for Payer: Humana Medicaid |
$105.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$41.62
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$107.97
|
| Rate for Payer: Molina Healthcare Passport |
$105.85
|
| 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
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$106.91
|
|
|
INTRACRANIAL STUDY(T
|
Facility
|
IP
|
$757.00
|
|
|
Service Code
|
HCPCS 93888
|
| Hospital Charge Code |
320T0297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$726.72 |
| Rate for Payer: Aetna Commercial |
$582.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$590.46
|
| Rate for Payer: Cash Price |
$378.50
|
| Rate for Payer: Cigna Commercial |
$628.31
|
| Rate for Payer: First Health Commercial |
$719.15
|
| Rate for Payer: Humana Commercial |
$643.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$620.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$558.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$227.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$666.16
|
| Rate for Payer: Ohio Health Group HMO |
$567.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$151.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$98.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$234.67
|
| Rate for Payer: PHCS Commercial |
$726.72
|
| Rate for Payer: United Healthcare All Payer |
$666.16
|
|
|
INTRACRANIAL STUDY(T
|
Facility
|
OP
|
$1,279.00
|
|
|
Service Code
|
HCPCS 93886
|
| Hospital Charge Code |
320T0296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.27 |
| Max. Negotiated Rate |
$1,227.84 |
| Rate for Payer: Aetna Commercial |
$984.83
|
| Rate for Payer: Anthem Medicaid |
$439.85
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$211.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$997.62
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$296.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$286.06
|
| Rate for Payer: Cash Price |
$639.50
|
| Rate for Payer: Cash Price |
$639.50
|
| Rate for Payer: Cigna Commercial |
$1,061.57
|
| Rate for Payer: First Health Commercial |
$1,215.05
|
| Rate for Payer: Humana Commercial |
$1,087.15
|
| Rate for Payer: Humana KY Medicaid |
$439.85
|
| Rate for Payer: Humana Medicare Advantage |
$211.90
|
| Rate for Payer: Kentucky WC Medicaid |
$444.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,048.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$943.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$254.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$448.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,125.52
|
| Rate for Payer: Ohio Health Group HMO |
$959.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$255.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$166.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$396.49
|
| Rate for Payer: PHCS Commercial |
$1,227.84
|
| Rate for Payer: United Healthcare All Payer |
$1,125.52
|
|
|
INTRACRANIAL STUDY(T
|
Facility
|
IP
|
$1,279.00
|
|
|
Service Code
|
HCPCS 93886
|
| Hospital Charge Code |
320T0296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.27 |
| Max. Negotiated Rate |
$1,227.84 |
| Rate for Payer: Aetna Commercial |
$984.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$997.62
|
| Rate for Payer: Cash Price |
$639.50
|
| Rate for Payer: Cigna Commercial |
$1,061.57
|
| Rate for Payer: First Health Commercial |
$1,215.05
|
| Rate for Payer: Humana Commercial |
$1,087.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,048.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$943.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$383.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,125.52
|
| Rate for Payer: Ohio Health Group HMO |
$959.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$255.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$166.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$396.49
|
| Rate for Payer: PHCS Commercial |
$1,227.84
|
| Rate for Payer: United Healthcare All Payer |
$1,125.52
|
|
|
INTRACRANIAL STUDY(T
|
Facility
|
OP
|
$757.00
|
|
|
Service Code
|
HCPCS 93888
|
| Hospital Charge Code |
320T0297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.07 |
| Max. Negotiated Rate |
$726.72 |
| Rate for Payer: Aetna Commercial |
$582.89
|
| Rate for Payer: Anthem Medicaid |
$260.33
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$95.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$590.46
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$133.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$128.34
|
| Rate for Payer: Cash Price |
$378.50
|
| Rate for Payer: Cash Price |
$378.50
|
| Rate for Payer: Cigna Commercial |
$628.31
|
| Rate for Payer: First Health Commercial |
$719.15
|
| Rate for Payer: Humana Commercial |
$643.45
|
| Rate for Payer: Humana KY Medicaid |
$260.33
|
| Rate for Payer: Humana Medicare Advantage |
$95.07
|
| Rate for Payer: Kentucky WC Medicaid |
$262.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$620.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$558.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$265.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$666.16
|
| Rate for Payer: Ohio Health Group HMO |
$567.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$151.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$98.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$234.67
|
| Rate for Payer: PHCS Commercial |
$726.72
|
| Rate for Payer: United Healthcare All Payer |
$666.16
|
|
|
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC
|
Facility
|
IP
|
$71,843.34
|
|
|
Service Code
|
MSDRG 021
|
| Min. Negotiated Rate |
$48,750.84 |
| Max. Negotiated Rate |
$71,843.34 |
| Rate for Payer: Anthem Medicaid |
$48,750.84
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$51,316.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$71,843.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$69,277.50
|
| Rate for Payer: Humana KY Medicaid |
$48,750.84
|
| Rate for Payer: Humana Medicare Advantage |
$51,316.67
|
| Rate for Payer: Kentucky WC Medicaid |
$49,238.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$61,580.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$49,725.85
|
|
|
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC
|
Facility
|
IP
|
$98,877.91
|
|
|
Service Code
|
MSDRG 020
|
| Min. Negotiated Rate |
$67,095.73 |
| Max. Negotiated Rate |
$98,877.91 |
| Rate for Payer: Anthem Medicaid |
$67,095.73
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$70,627.08
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$98,877.91
|
| Rate for Payer: CareSource Just4Me Medicare |
$95,346.56
|
| Rate for Payer: Humana KY Medicaid |
$67,095.73
|
| Rate for Payer: Humana Medicare Advantage |
$70,627.08
|
| Rate for Payer: Kentucky WC Medicaid |
$67,766.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$84,752.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$68,437.64
|
|
|
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC
|
Facility
|
IP
|
$45,888.56
|
|
|
Service Code
|
MSDRG 022
|
| Min. Negotiated Rate |
$31,138.66 |
| Max. Negotiated Rate |
$45,888.56 |
| Rate for Payer: Anthem Medicaid |
$31,138.66
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$32,777.54
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$45,888.56
|
| Rate for Payer: CareSource Just4Me Medicare |
$44,249.68
|
| Rate for Payer: Humana KY Medicaid |
$31,138.66
|
| Rate for Payer: Humana Medicare Advantage |
$32,777.54
|
| Rate for Payer: Kentucky WC Medicaid |
$31,450.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$39,333.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$31,761.44
|
|
|
INTRACUANEOUS TEST SEQ & INCRE
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 95027
|
| Hospital Charge Code |
410T0107
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$38.40 |
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Anthem Medicaid |
$13.76
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$25.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31.20
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$36.05
|
| Rate for Payer: CareSource Just4Me Medicare |
$34.76
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cigna Commercial |
$33.20
|
| Rate for Payer: First Health Commercial |
$38.00
|
| Rate for Payer: Humana Commercial |
$34.00
|
| Rate for Payer: Humana KY Medicaid |
$13.76
|
| Rate for Payer: Humana Medicare Advantage |
$25.75
|
| Rate for Payer: Kentucky WC Medicaid |
$13.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$14.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$35.20
|
| Rate for Payer: Ohio Health Group HMO |
$30.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12.40
|
| Rate for Payer: PHCS Commercial |
$38.40
|
| Rate for Payer: United Healthcare All Payer |
$35.20
|
|
|
INTRACUANEOUS TEST SEQ & INCRE
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 95027
|
| Hospital Charge Code |
41000107
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$6.10
|
| Rate for Payer: Anthem Medicaid |
$4.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$115.00
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cigna Commercial |
$9.96
|
| Rate for Payer: Healthspan PPO |
$8.20
|
| Rate for Payer: Humana Medicaid |
$4.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$5.63
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$4.08
|
| Rate for Payer: Molina Healthcare Passport |
$4.00
|
| Rate for Payer: Multiplan PHCS |
$69.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$80.50
|
| Rate for Payer: UHCCP Medicaid |
$40.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$4.04
|
|
|
INTRACUANEOUS TEST SEQ & INCRE
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
HCPCS 95027
|
| Hospital Charge Code |
41000107
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Aetna Commercial |
$88.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$89.70
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cigna Commercial |
$95.45
|
| Rate for Payer: First Health Commercial |
$109.25
|
| Rate for Payer: Humana Commercial |
$97.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$94.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$84.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$34.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$101.20
|
| Rate for Payer: Ohio Health Group HMO |
$86.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$35.65
|
| Rate for Payer: PHCS Commercial |
$110.40
|
| Rate for Payer: United Healthcare All Payer |
$101.20
|
|
|
INTRACUANEOUS TEST SEQ & INCRE
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 95027
|
| Hospital Charge Code |
410T0107
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$38.40 |
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31.20
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cigna Commercial |
$33.20
|
| Rate for Payer: First Health Commercial |
$38.00
|
| Rate for Payer: Humana Commercial |
$34.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$35.20
|
| Rate for Payer: Ohio Health Group HMO |
$30.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12.40
|
| Rate for Payer: PHCS Commercial |
$38.40
|
| Rate for Payer: United Healthcare All Payer |
$35.20
|
|
|
INTRACUANEOUS TEST SEQ & INCRE
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 95027
|
| Hospital Charge Code |
410P0107
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$6.10
|
| Rate for Payer: Anthem Medicaid |
$4.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$9.96
|
| Rate for Payer: Healthspan PPO |
$8.20
|
| Rate for Payer: Humana Medicaid |
$4.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$5.63
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$4.08
|
| Rate for Payer: Molina Healthcare Passport |
$4.00
|
| 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
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$4.04
|
|
|
INTRACUANEOUS TEST SEQ & INCRE
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
HCPCS 95027
|
| Hospital Charge Code |
41000107
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Aetna Commercial |
$88.55
|
| Rate for Payer: Anthem Medicaid |
$39.55
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$25.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$89.70
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$36.05
|
| Rate for Payer: CareSource Just4Me Medicare |
$34.76
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cigna Commercial |
$95.45
|
| Rate for Payer: First Health Commercial |
$109.25
|
| Rate for Payer: Humana Commercial |
$97.75
|
| Rate for Payer: Humana KY Medicaid |
$39.55
|
| Rate for Payer: Humana Medicare Advantage |
$25.75
|
| Rate for Payer: Kentucky WC Medicaid |
$39.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$94.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$84.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$40.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$101.20
|
| Rate for Payer: Ohio Health Group HMO |
$86.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$35.65
|
| Rate for Payer: PHCS Commercial |
$110.40
|
| Rate for Payer: United Healthcare All Payer |
$101.20
|
|
|
INTRACUANEOU TEST W/ALLERGENIC
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
HCPCS 95024
|
| Hospital Charge Code |
410T0106
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$78.72 |
| Rate for Payer: Aetna Commercial |
$63.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$63.96
|
| Rate for Payer: Cash Price |
$41.00
|
| Rate for Payer: Cigna Commercial |
$68.06
|
| Rate for Payer: First Health Commercial |
$77.90
|
| Rate for Payer: Humana Commercial |
$69.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$67.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$60.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$24.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$72.16
|
| Rate for Payer: Ohio Health Group HMO |
$61.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25.42
|
| Rate for Payer: PHCS Commercial |
$78.72
|
| Rate for Payer: United Healthcare All Payer |
$72.16
|
|
|
INTRACUANEOU TEST W/ALLERGENIC
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 95024
|
| Hospital Charge Code |
41000106
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$94.00 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$0.86
|
| Rate for Payer: Anthem Medicaid |
$4.10
|
| Rate for Payer: Buckeye Medicare Advantage |
$94.00
|
| Rate for Payer: Cash Price |
$47.00
|
| Rate for Payer: Cash Price |
$47.00
|
| Rate for Payer: Cigna Commercial |
$9.96
|
| Rate for Payer: Healthspan PPO |
$11.88
|
| Rate for Payer: Humana Medicaid |
$4.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$8.78
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$4.18
|
| Rate for Payer: Molina Healthcare Passport |
$4.10
|
| Rate for Payer: Multiplan PHCS |
$56.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$65.80
|
| Rate for Payer: UHCCP Medicaid |
$0.90
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$4.14
|
|
