|
ANOSCOPE - EXPLORATION
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
76101925
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$154.64 |
| Rate for Payer: Aetna Commercial |
$92.40
|
| Rate for Payer: Anthem Medicaid |
$41.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$110.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$93.60
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$154.64
|
| Rate for Payer: CareSource Just4Me Medicare |
$149.12
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$99.60
|
| Rate for Payer: First Health Commercial |
$114.00
|
| Rate for Payer: Humana Commercial |
$102.00
|
| Rate for Payer: Humana KY Medicaid |
$41.27
|
| Rate for Payer: Humana Medicare Advantage |
$110.46
|
| Rate for Payer: Kentucky WC Medicaid |
$41.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$98.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$88.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$132.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$42.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$105.60
|
| Rate for Payer: Ohio Health Group HMO |
$90.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$37.20
|
| Rate for Payer: PHCS Commercial |
$115.20
|
| Rate for Payer: United Healthcare All Payer |
$105.60
|
|
|
ANOSCOPE - EXPLORATION
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
76101925
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna Commercial |
$92.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$93.60
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$99.60
|
| Rate for Payer: First Health Commercial |
$114.00
|
| Rate for Payer: Humana Commercial |
$102.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$98.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$88.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$36.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$105.60
|
| Rate for Payer: Ohio Health Group HMO |
$90.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$37.20
|
| Rate for Payer: PHCS Commercial |
$115.20
|
| Rate for Payer: United Healthcare All Payer |
$105.60
|
|
|
ANOSCOPE - EXPLORATION
|
Facility
|
IP
|
$163.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
45000273
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$21.19 |
| Max. Negotiated Rate |
$156.48 |
| Rate for Payer: Aetna Commercial |
$125.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$127.14
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cigna Commercial |
$135.29
|
| Rate for Payer: First Health Commercial |
$154.85
|
| Rate for Payer: Humana Commercial |
$138.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$133.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$120.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$143.44
|
| Rate for Payer: Ohio Health Group HMO |
$122.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.53
|
| Rate for Payer: PHCS Commercial |
$156.48
|
| Rate for Payer: United Healthcare All Payer |
$143.44
|
|
|
ANOSCOPE - EXPLORATION
|
Facility
|
OP
|
$163.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
45000273
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$21.19 |
| Max. Negotiated Rate |
$156.48 |
| Rate for Payer: Aetna Commercial |
$125.51
|
| Rate for Payer: Anthem Medicaid |
$56.06
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$110.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$127.14
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$154.64
|
| Rate for Payer: CareSource Just4Me Medicare |
$149.12
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cigna Commercial |
$135.29
|
| Rate for Payer: First Health Commercial |
$154.85
|
| Rate for Payer: Humana Commercial |
$138.55
|
| Rate for Payer: Humana KY Medicaid |
$56.06
|
| Rate for Payer: Humana Medicare Advantage |
$110.46
|
| Rate for Payer: Kentucky WC Medicaid |
$56.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$133.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$120.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$132.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$57.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$143.44
|
| Rate for Payer: Ohio Health Group HMO |
$122.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.53
|
| Rate for Payer: PHCS Commercial |
$156.48
|
| Rate for Payer: United Healthcare All Payer |
$143.44
|
|
|
ANOSCOPE - EXPLORATION
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
76101925
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$55.12
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$40.40
|
| Rate for Payer: Anthem Medicaid |
$19.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$120.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$113.77
|
| Rate for Payer: Healthspan PPO |
$93.42
|
| Rate for Payer: Humana Medicaid |
$19.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$49.36
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$19.54
|
| Rate for Payer: Molina Healthcare Passport |
$19.16
|
| Rate for Payer: Multiplan PHCS |
$72.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.00
|
| Rate for Payer: UHCCP Medicaid |
$42.42
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$19.35
|
|
|
ANOSCOPE - EXPLORATION(P
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
761P1925
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$55.12
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$40.40
|
| Rate for Payer: Anthem Medicaid |
$19.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$120.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$113.77
|
| Rate for Payer: Healthspan PPO |
$93.42
|
| Rate for Payer: Humana Medicaid |
$19.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$49.36
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$19.54
|
| Rate for Payer: Molina Healthcare Passport |
$19.16
|
| Rate for Payer: Multiplan PHCS |
$72.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.00
|
| Rate for Payer: UHCCP Medicaid |
$42.42
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$19.35
|
|
|
ANOSCOPE SINGLE POLYP
|
Facility
|
OP
|
$360.00
|
|
|
Service Code
|
HCPCS 46611
|
| Hospital Charge Code |
76101929
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$1,106.49 |
| Rate for Payer: Aetna Commercial |
$277.20
|
| Rate for Payer: Anthem Medicaid |
$123.80
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$790.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$280.80
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,106.49
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,066.97
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna Commercial |
$298.80
|
| Rate for Payer: First Health Commercial |
$342.00
|
| Rate for Payer: Humana Commercial |
$306.00
|
| Rate for Payer: Humana KY Medicaid |
$123.80
|
| Rate for Payer: Humana Medicare Advantage |
$790.35
|
| Rate for Payer: Kentucky WC Medicaid |
$125.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$295.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$265.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$126.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$316.80
|
| Rate for Payer: Ohio Health Group HMO |
$270.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$72.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$46.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$111.60
|
| Rate for Payer: PHCS Commercial |
$345.60
|
| Rate for Payer: United Healthcare All Payer |
$316.80
|
|
|
ANOSCOPE SINGLE POLYP
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 46611
|
| Hospital Charge Code |
76101929
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$122.29
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$76.88
|
| Rate for Payer: Anthem Medicaid |
$68.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$360.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna Commercial |
$149.47
|
| Rate for Payer: Healthspan PPO |
$195.66
|
| Rate for Payer: Humana Medicaid |
$68.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$104.05
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$69.52
|
| Rate for Payer: Molina Healthcare Passport |
$68.16
|
| Rate for Payer: Multiplan PHCS |
$216.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$252.00
|
| Rate for Payer: UHCCP Medicaid |
$80.72
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$68.84
|
|
|
ANOSCOPE SINGLE POLYP
|
Facility
|
IP
|
$360.00
|
|
|
Service Code
|
HCPCS 46611
|
| Hospital Charge Code |
76101929
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$345.60 |
| Rate for Payer: Aetna Commercial |
$277.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$280.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna Commercial |
$298.80
|
| Rate for Payer: First Health Commercial |
$342.00
|
| Rate for Payer: Humana Commercial |
$306.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$295.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$265.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$108.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$316.80
|
| Rate for Payer: Ohio Health Group HMO |
$270.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$72.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$46.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$111.60
|
| Rate for Payer: PHCS Commercial |
$345.60
|
| Rate for Payer: United Healthcare All Payer |
$316.80
|
|
|
ANOSCOPE SINGLE POLYP(P
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 46611
|
| Hospital Charge Code |
761P1929
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$122.29
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$76.88
|
| Rate for Payer: Anthem Medicaid |
$68.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$360.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna Commercial |
$149.47
|
| Rate for Payer: Healthspan PPO |
$195.66
|
| Rate for Payer: Humana Medicaid |
$68.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$104.05
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$69.52
|
| Rate for Payer: Molina Healthcare Passport |
$68.16
|
| Rate for Payer: Multiplan PHCS |
$216.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$252.00
|
| Rate for Payer: UHCCP Medicaid |
$80.72
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$68.84
|
|
|
ANOSCOPE WITH DILATION
|
Facility
|
OP
|
$632.00
|
|
|
Service Code
|
HCPCS 46604
|
| Hospital Charge Code |
76101926
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.16 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$486.64
|
| Rate for Payer: Anthem Medicaid |
$217.34
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$492.96
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$524.56
|
| Rate for Payer: First Health Commercial |
$600.40
|
| Rate for Payer: Humana Commercial |
$537.20
|
| Rate for Payer: Humana KY Medicaid |
$217.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$219.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$518.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$466.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$221.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$556.16
|
| Rate for Payer: Ohio Health Group HMO |
$474.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$126.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$82.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$195.92
|
| Rate for Payer: PHCS Commercial |
$606.72
|
| Rate for Payer: United Healthcare All Payer |
$556.16
|
|
|
ANOSCOPE WITH DILATION
|
Facility
|
IP
|
$632.00
|
|
|
Service Code
|
HCPCS 46604
|
| Hospital Charge Code |
76101926
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.16 |
| Max. Negotiated Rate |
$606.72 |
| Rate for Payer: Aetna Commercial |
$486.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$492.96
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$524.56
|
| Rate for Payer: First Health Commercial |
$600.40
|
| Rate for Payer: Humana Commercial |
$537.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$518.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$466.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$189.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$556.16
|
| Rate for Payer: Ohio Health Group HMO |
$474.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$126.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$82.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$195.92
|
| Rate for Payer: PHCS Commercial |
$606.72
|
| Rate for Payer: United Healthcare All Payer |
$556.16
|
|
|
ANOSCOPE WITH DILATION
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 46604
|
| Hospital Charge Code |
76101926
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.99 |
| Max. Negotiated Rate |
$632.00 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$50.11
|
| Rate for Payer: Anthem Medicaid |
$44.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$632.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$626.24
|
| Rate for Payer: Healthspan PPO |
$568.73
|
| Rate for Payer: Humana Medicaid |
$44.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$83.20
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$45.89
|
| Rate for Payer: Molina Healthcare Passport |
$44.99
|
| Rate for Payer: Multiplan PHCS |
$379.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$442.40
|
| Rate for Payer: UHCCP Medicaid |
$52.62
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$45.44
|
|
|
ANOSCOPE WITH DILATION(P
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 46604
|
| Hospital Charge Code |
761P1926
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.99 |
| Max. Negotiated Rate |
$632.00 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$50.11
|
| Rate for Payer: Anthem Medicaid |
$44.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$632.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cigna Commercial |
$626.24
|
| Rate for Payer: Healthspan PPO |
$568.73
|
| Rate for Payer: Humana Medicaid |
$44.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$83.20
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$45.89
|
| Rate for Payer: Molina Healthcare Passport |
$44.99
|
| Rate for Payer: Multiplan PHCS |
$379.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$442.40
|
| Rate for Payer: UHCCP Medicaid |
$52.62
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$45.44
|
|
|
ANOSCOPY
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
HCPCS 46615
|
| Hospital Charge Code |
76101932
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$3,399.27 |
| Rate for Payer: Aetna Commercial |
$227.15
|
| Rate for Payer: Anthem Medicaid |
$101.45
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,428.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$230.10
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,399.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,277.87
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$244.85
|
| Rate for Payer: First Health Commercial |
$280.25
|
| Rate for Payer: Humana Commercial |
$250.75
|
| Rate for Payer: Humana KY Medicaid |
$101.45
|
| Rate for Payer: Humana Medicare Advantage |
$2,428.05
|
| Rate for Payer: Kentucky WC Medicaid |
$102.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$241.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$217.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,913.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$103.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$259.60
|
| Rate for Payer: Ohio Health Group HMO |
$221.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$59.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$38.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$91.45
|
| Rate for Payer: PHCS Commercial |
$283.20
|
| Rate for Payer: United Healthcare All Payer |
$259.60
|
|
|
ANOSCOPY
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
HCPCS 46615
|
| Hospital Charge Code |
76101932
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$283.20 |
| Rate for Payer: Aetna Commercial |
$227.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$230.10
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$244.85
|
| Rate for Payer: First Health Commercial |
$280.25
|
| Rate for Payer: Humana Commercial |
$250.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$241.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$217.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$88.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$259.60
|
| Rate for Payer: Ohio Health Group HMO |
$221.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$59.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$38.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$91.45
|
| Rate for Payer: PHCS Commercial |
$283.20
|
| Rate for Payer: United Healthcare All Payer |
$259.60
|
|
|
ANOSCOPY
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 46615
|
| Hospital Charge Code |
76101932
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.09 |
| Max. Negotiated Rate |
$295.00 |
| Rate for Payer: Aetna Commercial |
$150.75
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$93.09
|
| Rate for Payer: Anthem Medicaid |
$105.50
|
| Rate for Payer: Buckeye Medicare Advantage |
$295.00
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cigna Commercial |
$294.98
|
| Rate for Payer: Healthspan PPO |
$179.04
|
| Rate for Payer: Humana Medicaid |
$105.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$120.93
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$107.61
|
| Rate for Payer: Molina Healthcare Passport |
$105.50
|
| Rate for Payer: Multiplan PHCS |
$177.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$206.50
|
| Rate for Payer: UHCCP Medicaid |
$97.74
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$106.56
|
|
|
ANOSCOPY AND BIOPSY
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
HCPCS 46606
|
| Hospital Charge Code |
76101927
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.35 |
| Max. Negotiated Rate |
$667.20 |
| Rate for Payer: Aetna Commercial |
$535.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$542.10
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cigna Commercial |
$576.85
|
| Rate for Payer: First Health Commercial |
$660.25
|
| Rate for Payer: Humana Commercial |
$590.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$569.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$512.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$208.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$611.60
|
| Rate for Payer: Ohio Health Group HMO |
$521.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$139.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$90.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$215.45
|
| Rate for Payer: PHCS Commercial |
$667.20
|
| Rate for Payer: United Healthcare All Payer |
$611.60
|
|
|
ANOSCOPY AND BIOPSY
|
Professional
|
Both
|
$695.00
|
|
|
Service Code
|
HCPCS 46606
|
| Hospital Charge Code |
76101927
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.05 |
| Max. Negotiated Rate |
$695.00 |
| Rate for Payer: Aetna Commercial |
$105.65
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$38.42
|
| Rate for Payer: Anthem Medicaid |
$30.05
|
| Rate for Payer: Buckeye Medicare Advantage |
$695.00
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cigna Commercial |
$72.46
|
| Rate for Payer: Healthspan PPO |
$237.14
|
| Rate for Payer: Humana Medicaid |
$30.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$96.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$30.65
|
| Rate for Payer: Molina Healthcare Passport |
$30.05
|
| Rate for Payer: Multiplan PHCS |
$417.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$486.50
|
| Rate for Payer: UHCCP Medicaid |
$40.34
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.35
|
|
|
ANOSCOPY AND BIOPSY
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
HCPCS 46606
|
| Hospital Charge Code |
76101927
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.35 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$535.15
|
| Rate for Payer: Anthem Medicaid |
$239.01
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$542.10
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cigna Commercial |
$576.85
|
| Rate for Payer: First Health Commercial |
$660.25
|
| Rate for Payer: Humana Commercial |
$590.75
|
| Rate for Payer: Humana KY Medicaid |
$239.01
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$241.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$569.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$512.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$243.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$611.60
|
| Rate for Payer: Ohio Health Group HMO |
$521.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$139.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$90.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$215.45
|
| Rate for Payer: PHCS Commercial |
$667.20
|
| Rate for Payer: United Healthcare All Payer |
$611.60
|
|
|
ANOSCOPY AND BIOPSY(P
|
Professional
|
Both
|
$695.00
|
|
|
Service Code
|
HCPCS 46606
|
| Hospital Charge Code |
761P1927
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.05 |
| Max. Negotiated Rate |
$695.00 |
| Rate for Payer: Aetna Commercial |
$105.65
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$38.42
|
| Rate for Payer: Anthem Medicaid |
$30.05
|
| Rate for Payer: Buckeye Medicare Advantage |
$695.00
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cash Price |
$347.50
|
| Rate for Payer: Cigna Commercial |
$72.46
|
| Rate for Payer: Healthspan PPO |
$237.14
|
| Rate for Payer: Humana Medicaid |
$30.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$96.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$30.65
|
| Rate for Payer: Molina Healthcare Passport |
$30.05
|
| Rate for Payer: Multiplan PHCS |
$417.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$486.50
|
| Rate for Payer: UHCCP Medicaid |
$40.34
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.35
|
|
|
ANOSCOPY CONTROL BLEEDING
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
HCPCS 46614
|
| Hospital Charge Code |
76101931
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.45 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$204.05
|
| Rate for Payer: Anthem Medicaid |
$91.13
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$206.70
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$219.95
|
| Rate for Payer: First Health Commercial |
$251.75
|
| Rate for Payer: Humana Commercial |
$225.25
|
| Rate for Payer: Humana KY Medicaid |
$91.13
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$92.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$217.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$195.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$92.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$233.20
|
| Rate for Payer: Ohio Health Group HMO |
$198.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$53.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$82.15
|
| Rate for Payer: PHCS Commercial |
$254.40
|
| Rate for Payer: United Healthcare All Payer |
$233.20
|
|
|
ANOSCOPY CONTROL BLEEDING
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 46614
|
| Hospital Charge Code |
76101931
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.37 |
| Max. Negotiated Rate |
$265.00 |
| Rate for Payer: Aetna Commercial |
$104.61
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$64.37
|
| Rate for Payer: Anthem Medicaid |
$85.84
|
| Rate for Payer: Buckeye Medicare Advantage |
$265.00
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$249.44
|
| Rate for Payer: Healthspan PPO |
$151.86
|
| Rate for Payer: Humana Medicaid |
$85.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$82.49
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$87.56
|
| Rate for Payer: Molina Healthcare Passport |
$85.84
|
| Rate for Payer: Multiplan PHCS |
$159.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$185.50
|
| Rate for Payer: UHCCP Medicaid |
$67.59
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$86.70
|
|
|
ANOSCOPY CONTROL BLEEDING
|
Facility
|
IP
|
$265.00
|
|
|
Service Code
|
HCPCS 46614
|
| Hospital Charge Code |
76101931
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.45 |
| Max. Negotiated Rate |
$254.40 |
| Rate for Payer: Aetna Commercial |
$204.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$206.70
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$219.95
|
| Rate for Payer: First Health Commercial |
$251.75
|
| Rate for Payer: Humana Commercial |
$225.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$217.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$195.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$79.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$233.20
|
| Rate for Payer: Ohio Health Group HMO |
$198.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$53.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$82.15
|
| Rate for Payer: PHCS Commercial |
$254.40
|
| Rate for Payer: United Healthcare All Payer |
$233.20
|
|
|
ANOSCOPY CONTROL BLEEDING(P
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 46614
|
| Hospital Charge Code |
761P1931
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.37 |
| Max. Negotiated Rate |
$265.00 |
| Rate for Payer: Aetna Commercial |
$104.61
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$64.37
|
| Rate for Payer: Anthem Medicaid |
$85.84
|
| Rate for Payer: Buckeye Medicare Advantage |
$265.00
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cash Price |
$132.50
|
| Rate for Payer: Cigna Commercial |
$249.44
|
| Rate for Payer: Healthspan PPO |
$151.86
|
| Rate for Payer: Humana Medicaid |
$85.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$82.49
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$87.56
|
| Rate for Payer: Molina Healthcare Passport |
$85.84
|
| Rate for Payer: Multiplan PHCS |
$159.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$185.50
|
| Rate for Payer: UHCCP Medicaid |
$67.59
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$86.70
|
|
