|
KYSSE
|
Professional
|
Both
|
$650.00
|
|
| Hospital Charge Code |
22200393
|
|
Hospital Revenue Code
|
222
|
| Min. Negotiated Rate |
$227.50 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$650.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Multiplan PHCS |
$390.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$455.00
|
| Rate for Payer: UHCCP Medicaid |
$227.50
|
|
|
KYTRIL EQ 0.1MG (4ML VIAL)
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
HCPCS J1626
|
| Hospital Charge Code |
25002121
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$184.32 |
| Rate for Payer: Aetna Commercial |
$147.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$149.76
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$159.36
|
| Rate for Payer: First Health Commercial |
$182.40
|
| Rate for Payer: Humana Commercial |
$163.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$157.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$141.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$57.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$168.96
|
| Rate for Payer: Ohio Health Group HMO |
$144.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$38.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$24.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$59.52
|
| Rate for Payer: PHCS Commercial |
$184.32
|
| Rate for Payer: United Healthcare All Payer |
$168.96
|
|
|
KYTRIL EQ 0.1MG (4ML VIAL)
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
HCPCS J1626
|
| Hospital Charge Code |
25002121
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$184.32 |
| Rate for Payer: Aetna Commercial |
$147.84
|
| Rate for Payer: Anthem Medicaid |
$66.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$149.76
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cigna Commercial |
$159.36
|
| Rate for Payer: First Health Commercial |
$182.40
|
| Rate for Payer: Humana Commercial |
$163.20
|
| Rate for Payer: Humana KY Medicaid |
$66.03
|
| Rate for Payer: Kentucky WC Medicaid |
$66.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$157.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$141.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$57.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$67.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$168.96
|
| Rate for Payer: Ohio Health Group HMO |
$144.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$38.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$24.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$59.52
|
| Rate for Payer: PHCS Commercial |
$184.32
|
| Rate for Payer: United Healthcare All Payer |
$168.96
|
|
|
LABCORP 16+ MARKERS
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
HCPCS 88189
|
| Hospital Charge Code |
30001775
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$171.84 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$143.74
|
| Rate for Payer: Cash Price |
$89.50
|
| Rate for Payer: Cigna Commercial |
$148.57
|
| Rate for Payer: First Health Commercial |
$170.05
|
| Rate for Payer: Humana Commercial |
$152.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$146.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$132.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$53.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$157.52
|
| Rate for Payer: Ohio Health Group HMO |
$134.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$35.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$55.49
|
| Rate for Payer: PHCS Commercial |
$171.84
|
| Rate for Payer: United Healthcare All Payer |
$157.52
|
|
|
LABCORP 16+ MARKERS
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
HCPCS 88189
|
| Hospital Charge Code |
30001775
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$171.84 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: Anthem Medicaid |
$85.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$143.74
|
| Rate for Payer: Cash Price |
$89.50
|
| Rate for Payer: Cash Price |
$89.50
|
| Rate for Payer: Cigna Commercial |
$148.57
|
| Rate for Payer: First Health Commercial |
$170.05
|
| Rate for Payer: Humana Commercial |
$152.15
|
| Rate for Payer: Humana KY Medicaid |
$85.56
|
| Rate for Payer: Kentucky WC Medicaid |
$86.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$146.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$132.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$53.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$87.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$157.52
|
| Rate for Payer: Ohio Health Group HMO |
$134.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$35.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$55.49
|
| Rate for Payer: PHCS Commercial |
$171.84
|
| Rate for Payer: United Healthcare All Payer |
$157.52
|
|
|
LABCORP BONE MARROW ASPIRATE
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
HCPCS 85097
|
| Hospital Charge Code |
30000575
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$174.72 |
| Rate for Payer: Aetna Commercial |
$140.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$146.15
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cigna Commercial |
$151.06
|
| Rate for Payer: First Health Commercial |
$172.90
|
| Rate for Payer: Humana Commercial |
$154.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$149.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$134.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$54.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$160.16
|
| Rate for Payer: Ohio Health Group HMO |
$136.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$36.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$56.42
|
| Rate for Payer: PHCS Commercial |
$174.72
|
| Rate for Payer: United Healthcare All Payer |
$160.16
|
|
|
LABCORP BONE MARROW ASPIRATE
|
Facility
|
OP
|
$182.00
|
|
|
Service Code
|
HCPCS 85097
|
| Hospital Charge Code |
30000575
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$1,041.03 |
| Rate for Payer: Aetna Commercial |
$140.14
|
| Rate for Payer: Anthem Medicaid |
$66.01
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$743.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$146.15
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,041.03
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,003.85
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cigna Commercial |
$151.06
|
| Rate for Payer: First Health Commercial |
$172.90
|
| Rate for Payer: Humana Commercial |
$154.70
|
| Rate for Payer: Humana KY Medicaid |
$66.01
|
| Rate for Payer: Humana Medicare Advantage |
$743.59
|
| Rate for Payer: Kentucky WC Medicaid |
$66.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$149.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$134.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$67.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$160.16
|
| Rate for Payer: Ohio Health Group HMO |
$136.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$36.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$56.42
|
| Rate for Payer: PHCS Commercial |
$174.72
|
| Rate for Payer: United Healthcare All Payer |
$160.16
|
|
|
LABCORP DNA PROBE EACH
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
HCPCS 88271
|
| Hospital Charge Code |
30001475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$176.64 |
| Rate for Payer: Aetna Commercial |
$141.68
|
| Rate for Payer: Anthem Medicaid |
$21.42
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$21.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$147.75
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$29.99
|
| Rate for Payer: CareSource Just4Me Medicare |
$21.42
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cigna Commercial |
$152.72
|
| Rate for Payer: First Health Commercial |
$174.80
|
| Rate for Payer: Humana Commercial |
$156.40
|
| Rate for Payer: Humana KY Medicaid |
$21.42
|
| Rate for Payer: Humana Medicare Advantage |
$21.42
|
| Rate for Payer: Kentucky WC Medicaid |
$21.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$150.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$135.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$21.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$161.92
|
| Rate for Payer: Ohio Health Group HMO |
$138.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$36.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57.04
|
| Rate for Payer: PHCS Commercial |
$176.64
|
| Rate for Payer: United Healthcare All Payer |
$161.92
|
|
|
LABCORP DNA PROBE EACH
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
HCPCS 88271
|
| Hospital Charge Code |
30001475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$176.64 |
| Rate for Payer: Aetna Commercial |
$141.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$147.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cigna Commercial |
$152.72
|
| Rate for Payer: First Health Commercial |
$174.80
|
| Rate for Payer: Humana Commercial |
$156.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$150.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$135.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$55.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$161.92
|
| Rate for Payer: Ohio Health Group HMO |
$138.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$36.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57.04
|
| Rate for Payer: PHCS Commercial |
$176.64
|
| Rate for Payer: United Healthcare All Payer |
$161.92
|
|
|
LABCORP EGFR MUTATION ANALYSIS
|
Facility
|
IP
|
$1,954.00
|
|
|
Service Code
|
HCPCS 81235
|
| Hospital Charge Code |
30000185
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$254.02 |
| Max. Negotiated Rate |
$1,875.84 |
| Rate for Payer: Aetna Commercial |
$1,504.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,569.06
|
| Rate for Payer: Cash Price |
$977.00
|
| Rate for Payer: Cigna Commercial |
$1,621.82
|
| Rate for Payer: First Health Commercial |
$1,856.30
|
| Rate for Payer: Humana Commercial |
$1,660.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,602.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,442.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$586.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,719.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,465.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$390.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$605.74
|
| Rate for Payer: PHCS Commercial |
$1,875.84
|
| Rate for Payer: United Healthcare All Payer |
$1,719.52
|
|
|
LABCORP EGFR MUTATION ANALYSIS
|
Facility
|
OP
|
$1,954.00
|
|
|
Service Code
|
HCPCS 81235
|
| Hospital Charge Code |
30000185
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$254.02 |
| Max. Negotiated Rate |
$1,875.84 |
| Rate for Payer: Aetna Commercial |
$1,504.58
|
| Rate for Payer: Anthem Medicaid |
$324.58
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$324.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,569.06
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$454.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$324.58
|
| Rate for Payer: Cash Price |
$977.00
|
| Rate for Payer: Cash Price |
$977.00
|
| Rate for Payer: Cigna Commercial |
$1,621.82
|
| Rate for Payer: First Health Commercial |
$1,856.30
|
| Rate for Payer: Humana Commercial |
$1,660.90
|
| Rate for Payer: Humana KY Medicaid |
$324.58
|
| Rate for Payer: Humana Medicare Advantage |
$324.58
|
| Rate for Payer: Kentucky WC Medicaid |
$327.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,602.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,442.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$389.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$331.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,719.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,465.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$390.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$605.74
|
| Rate for Payer: PHCS Commercial |
$1,875.84
|
| Rate for Payer: United Healthcare All Payer |
$1,719.52
|
|
|
LABCORP FIRST FLOW MARKER
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
HCPCS 88184
|
| Hospital Charge Code |
30001428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$74.88 |
| Rate for Payer: Aetna Commercial |
$60.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$62.63
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cigna Commercial |
$64.74
|
| Rate for Payer: First Health Commercial |
$74.10
|
| Rate for Payer: Humana Commercial |
$66.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$63.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$57.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$68.64
|
| Rate for Payer: Ohio Health Group HMO |
$58.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.18
|
| Rate for Payer: PHCS Commercial |
$74.88
|
| Rate for Payer: United Healthcare All Payer |
$68.64
|
|
|
LABCORP FIRST FLOW MARKER
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
HCPCS 88184
|
| Hospital Charge Code |
30001428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$435.16 |
| Rate for Payer: Aetna Commercial |
$60.06
|
| Rate for Payer: Anthem Medicaid |
$34.20
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$310.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$62.63
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$435.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$419.62
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cigna Commercial |
$64.74
|
| Rate for Payer: First Health Commercial |
$74.10
|
| Rate for Payer: Humana Commercial |
$66.30
|
| Rate for Payer: Humana KY Medicaid |
$34.20
|
| Rate for Payer: Humana Medicare Advantage |
$310.83
|
| Rate for Payer: Kentucky WC Medicaid |
$34.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$63.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$57.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$373.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$34.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$68.64
|
| Rate for Payer: Ohio Health Group HMO |
$58.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.18
|
| Rate for Payer: PHCS Commercial |
$74.88
|
| Rate for Payer: United Healthcare All Payer |
$68.64
|
|
|
LABCORP FLOW MARKERS EACH
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001453
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: Aetna Commercial |
$74.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$77.89
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cigna Commercial |
$80.51
|
| Rate for Payer: First Health Commercial |
$92.15
|
| Rate for Payer: Humana Commercial |
$82.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$79.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$71.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$29.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$85.36
|
| Rate for Payer: Ohio Health Group HMO |
$72.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$30.07
|
| Rate for Payer: PHCS Commercial |
$93.12
|
| Rate for Payer: United Healthcare All Payer |
$85.36
|
|
|
LABCORP FLOW MARKERS EACH
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001453
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: Aetna Commercial |
$74.69
|
| Rate for Payer: Anthem Medicaid |
$16.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$77.89
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cigna Commercial |
$80.51
|
| Rate for Payer: First Health Commercial |
$92.15
|
| Rate for Payer: Humana Commercial |
$82.45
|
| Rate for Payer: Humana KY Medicaid |
$16.85
|
| Rate for Payer: Kentucky WC Medicaid |
$17.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$79.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$71.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$29.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$17.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$85.36
|
| Rate for Payer: Ohio Health Group HMO |
$72.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$30.07
|
| Rate for Payer: PHCS Commercial |
$93.12
|
| Rate for Payer: United Healthcare All Payer |
$85.36
|
|
|
LABCORP INTERPH SITU HYBR25-99
|
Facility
|
IP
|
$829.00
|
|
|
Service Code
|
HCPCS 88274
|
| Hospital Charge Code |
30001489
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$107.77 |
| Max. Negotiated Rate |
$795.84 |
| Rate for Payer: Aetna Commercial |
$638.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$665.69
|
| Rate for Payer: Cash Price |
$414.50
|
| Rate for Payer: Cigna Commercial |
$688.07
|
| Rate for Payer: First Health Commercial |
$787.55
|
| Rate for Payer: Humana Commercial |
$704.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$679.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$611.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$248.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$729.52
|
| Rate for Payer: Ohio Health Group HMO |
$621.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$165.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$107.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$256.99
|
| Rate for Payer: PHCS Commercial |
$795.84
|
| Rate for Payer: United Healthcare All Payer |
$729.52
|
|
|
LABCORP INTERPH SITU HYBR25-99
|
Facility
|
OP
|
$829.00
|
|
|
Service Code
|
HCPCS 88274
|
| Hospital Charge Code |
30001489
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.38 |
| Max. Negotiated Rate |
$795.84 |
| Rate for Payer: Aetna Commercial |
$638.33
|
| Rate for Payer: Anthem Medicaid |
$42.38
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$42.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$665.69
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$59.33
|
| Rate for Payer: CareSource Just4Me Medicare |
$42.38
|
| Rate for Payer: Cash Price |
$414.50
|
| Rate for Payer: Cash Price |
$414.50
|
| Rate for Payer: Cigna Commercial |
$688.07
|
| Rate for Payer: First Health Commercial |
$787.55
|
| Rate for Payer: Humana Commercial |
$704.65
|
| Rate for Payer: Humana KY Medicaid |
$42.38
|
| Rate for Payer: Humana Medicare Advantage |
$42.38
|
| Rate for Payer: Kentucky WC Medicaid |
$42.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$679.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$611.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$50.86
|
| Rate for Payer: Molina Healthcare Medicaid |
$43.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$729.52
|
| Rate for Payer: Ohio Health Group HMO |
$621.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$165.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$107.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$256.99
|
| Rate for Payer: PHCS Commercial |
$795.84
|
| Rate for Payer: United Healthcare All Payer |
$729.52
|
|
|
LABCORP TISS CULT CHOMO ANALYS
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
HCPCS 88237
|
| Hospital Charge Code |
30001464
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$263.04 |
| Rate for Payer: Aetna Commercial |
$210.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$220.02
|
| Rate for Payer: Cash Price |
$137.00
|
| Rate for Payer: Cigna Commercial |
$227.42
|
| Rate for Payer: First Health Commercial |
$260.30
|
| Rate for Payer: Humana Commercial |
$232.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$224.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$202.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$82.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$241.12
|
| Rate for Payer: Ohio Health Group HMO |
$205.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$54.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$84.94
|
| Rate for Payer: PHCS Commercial |
$263.04
|
| Rate for Payer: United Healthcare All Payer |
$241.12
|
|
|
LABCORP TISS CULT CHOMO ANALYS
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
HCPCS 88237
|
| Hospital Charge Code |
30001464
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$263.04 |
| Rate for Payer: Aetna Commercial |
$210.98
|
| Rate for Payer: Anthem Medicaid |
$143.75
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$143.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$220.02
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$201.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$143.75
|
| Rate for Payer: Cash Price |
$137.00
|
| Rate for Payer: Cash Price |
$137.00
|
| Rate for Payer: Cigna Commercial |
$227.42
|
| Rate for Payer: First Health Commercial |
$260.30
|
| Rate for Payer: Humana Commercial |
$232.90
|
| Rate for Payer: Humana KY Medicaid |
$143.75
|
| Rate for Payer: Humana Medicare Advantage |
$143.75
|
| Rate for Payer: Kentucky WC Medicaid |
$145.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$224.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$202.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$172.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$146.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$241.12
|
| Rate for Payer: Ohio Health Group HMO |
$205.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$54.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$84.94
|
| Rate for Payer: PHCS Commercial |
$263.04
|
| Rate for Payer: United Healthcare All Payer |
$241.12
|
|
|
Labetalol 100mg/20mL(IV addit)
|
Facility
|
OP
|
$79.96
|
|
|
Service Code
|
NDC 409226720
|
| Hospital Charge Code |
25004044
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.39 |
| Max. Negotiated Rate |
$76.76 |
| Rate for Payer: Aetna Commercial |
$61.57
|
| Rate for Payer: Anthem Medicaid |
$27.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$62.37
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cigna Commercial |
$66.37
|
| Rate for Payer: First Health Commercial |
$75.96
|
| Rate for Payer: Humana Commercial |
$67.97
|
| Rate for Payer: Humana KY Medicaid |
$27.50
|
| Rate for Payer: Kentucky WC Medicaid |
$27.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$65.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$59.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$28.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$70.36
|
| Rate for Payer: Ohio Health Group HMO |
$59.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15.99
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.79
|
| Rate for Payer: PHCS Commercial |
$76.76
|
| Rate for Payer: United Healthcare All Payer |
$70.36
|
|
|
Labetalol 100mg/20mL(IV addit)
|
Facility
|
IP
|
$79.96
|
|
|
Service Code
|
NDC 409226720
|
| Hospital Charge Code |
25004044
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.39 |
| Max. Negotiated Rate |
$76.76 |
| Rate for Payer: Aetna Commercial |
$61.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$62.37
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cigna Commercial |
$66.37
|
| Rate for Payer: First Health Commercial |
$75.96
|
| Rate for Payer: Humana Commercial |
$67.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$65.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$59.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$70.36
|
| Rate for Payer: Ohio Health Group HMO |
$59.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15.99
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.79
|
| Rate for Payer: PHCS Commercial |
$76.76
|
| Rate for Payer: United Healthcare All Payer |
$70.36
|
|
|
LABETALOL 5mg (20mg SDV)
|
Facility
|
IP
|
$80.22
|
|
|
Service Code
|
HCPCS J1920
|
| Hospital Charge Code |
25004306
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$77.01 |
| Rate for Payer: Aetna Commercial |
$61.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$62.57
|
| Rate for Payer: Cash Price |
$40.11
|
| Rate for Payer: Cigna Commercial |
$66.58
|
| Rate for Payer: First Health Commercial |
$76.21
|
| Rate for Payer: Humana Commercial |
$68.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$65.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$59.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$24.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$70.59
|
| Rate for Payer: Ohio Health Group HMO |
$60.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.87
|
| Rate for Payer: PHCS Commercial |
$77.01
|
| Rate for Payer: United Healthcare All Payer |
$70.59
|
|
|
LABETALOL 5mg (20mg SDV)
|
Facility
|
OP
|
$80.22
|
|
|
Service Code
|
HCPCS J1920
|
| Hospital Charge Code |
25004306
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$77.01 |
| Rate for Payer: Aetna Commercial |
$61.77
|
| Rate for Payer: Anthem Medicaid |
$27.59
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$0.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$62.57
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$0.26
|
| Rate for Payer: CareSource Just4Me Medicare |
$0.25
|
| Rate for Payer: Cash Price |
$40.11
|
| Rate for Payer: Cash Price |
$40.11
|
| Rate for Payer: Cigna Commercial |
$66.58
|
| Rate for Payer: First Health Commercial |
$76.21
|
| Rate for Payer: Humana Commercial |
$68.19
|
| Rate for Payer: Humana KY Medicaid |
$27.59
|
| Rate for Payer: Humana Medicare Advantage |
$0.19
|
| Rate for Payer: Kentucky WC Medicaid |
$27.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$65.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$59.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$0.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$28.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$70.59
|
| Rate for Payer: Ohio Health Group HMO |
$60.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.87
|
| Rate for Payer: PHCS Commercial |
$77.01
|
| Rate for Payer: United Healthcare All Payer |
$70.59
|
|
|
LABOR PER HOUR STAGE 1
|
Facility
|
OP
|
$117.00
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$15.21 |
| Max. Negotiated Rate |
$112.32 |
| Rate for Payer: Aetna Commercial |
$90.09
|
| Rate for Payer: Anthem Medicaid |
$40.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$91.26
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cigna Commercial |
$97.11
|
| Rate for Payer: First Health Commercial |
$111.15
|
| Rate for Payer: Humana Commercial |
$99.45
|
| Rate for Payer: Humana KY Medicaid |
$40.24
|
| Rate for Payer: Kentucky WC Medicaid |
$40.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$95.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$86.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$35.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$41.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$102.96
|
| Rate for Payer: Ohio Health Group HMO |
$87.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$36.27
|
| Rate for Payer: PHCS Commercial |
$112.32
|
| Rate for Payer: United Healthcare All Payer |
$102.96
|
|
|
LABOR PER HOUR STAGE 1
|
Facility
|
IP
|
$117.00
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$15.21 |
| Max. Negotiated Rate |
$112.32 |
| Rate for Payer: Aetna Commercial |
$90.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$91.26
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cigna Commercial |
$97.11
|
| Rate for Payer: First Health Commercial |
$111.15
|
| Rate for Payer: Humana Commercial |
$99.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$95.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$86.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$35.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$102.96
|
| Rate for Payer: Ohio Health Group HMO |
$87.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$36.27
|
| Rate for Payer: PHCS Commercial |
$112.32
|
| Rate for Payer: United Healthcare All Payer |
$102.96
|
|
