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Service Code HCPCS 44213
Hospital Charge Code 76101832
Hospital Revenue Code 761
Min. Negotiated Rate $146.37
Max. Negotiated Rate $440.00
Rate for Payer: Aetna Commercial $286.90
Rate for Payer: Anthem Medicaid $146.37
Rate for Payer: Buckeye Medicare Advantage $440.00
Rate for Payer: Cash Price $220.00
Rate for Payer: Cash Price $220.00
Rate for Payer: Cigna Commercial $273.79
Rate for Payer: Healthspan PPO $241.95
Rate for Payer: Humana Medicaid $146.37
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $244.59
Rate for Payer: Molina Healthcare CHIP/Medicaid $149.30
Rate for Payer: Molina Healthcare Passport $146.37
Rate for Payer: Multiplan PHCS $264.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $308.00
Rate for Payer: UHCCP Medicaid $154.00
Rate for Payer: Wellcare CHIP/Medicaid $147.83
Service Code HCPCS 43279
Hospital Charge Code 76101763
Hospital Revenue Code 761
Min. Negotiated Rate $196.95
Max. Negotiated Rate $1,454.40
Rate for Payer: Aetna Commercial $1,166.55
Rate for Payer: Anthem POS/PPO/Traditional $1,181.70
Rate for Payer: Cash Price $757.50
Rate for Payer: Cigna Commercial $1,257.45
Rate for Payer: First Health Commercial $1,439.25
Rate for Payer: Humana Commercial $1,287.75
Rate for Payer: Medical Mutual Of Ohio HMO $1,242.30
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,118.07
Rate for Payer: Molina Healthcare Benefit Exchange $454.50
Rate for Payer: Ohio Health Choice Commercial $1,333.20
Rate for Payer: Ohio Health Group HMO $1,136.25
Rate for Payer: Ohio Health Group PPO Differential $303.00
Rate for Payer: Ohio Health Group PPO No Differential $196.95
Rate for Payer: Ohio Health Group PPO SOMC Employees $469.65
Rate for Payer: PHCS Commercial $1,454.40
Rate for Payer: United Healthcare All Payer $1,333.20
Service Code HCPCS 43279
Hospital Charge Code 76101763
Hospital Revenue Code 761
Min. Negotiated Rate $530.25
Max. Negotiated Rate $1,892.35
Rate for Payer: Aetna Commercial $1,888.47
Rate for Payer: Anthem Medicaid $969.91
Rate for Payer: Buckeye Medicare Advantage $1,515.00
Rate for Payer: Cash Price $757.50
Rate for Payer: Cash Price $757.50
Rate for Payer: Cigna Commercial $1,892.35
Rate for Payer: Healthspan PPO $1,592.58
Rate for Payer: Humana Medicaid $969.91
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,666.27
Rate for Payer: Molina Healthcare CHIP/Medicaid $989.31
Rate for Payer: Molina Healthcare Passport $969.91
Rate for Payer: Multiplan PHCS $909.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,060.50
Rate for Payer: UHCCP Medicaid $530.25
Rate for Payer: Wellcare CHIP/Medicaid $979.61
Service Code HCPCS 43279
Hospital Charge Code 76101763
Hospital Revenue Code 761
Min. Negotiated Rate $196.95
Max. Negotiated Rate $1,454.40
Rate for Payer: Aetna Commercial $1,166.55
Rate for Payer: Anthem Medicaid $521.01
Rate for Payer: Anthem POS/PPO/Traditional $1,181.70
Rate for Payer: Cash Price $757.50
Rate for Payer: Cigna Commercial $1,257.45
Rate for Payer: First Health Commercial $1,439.25
Rate for Payer: Humana Commercial $1,287.75
Rate for Payer: Humana KY Medicaid $521.01
Rate for Payer: Kentucky WC Medicaid $526.31
Rate for Payer: Medical Mutual Of Ohio HMO $1,242.30
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,118.07
Rate for Payer: Molina Healthcare Benefit Exchange $454.50
Rate for Payer: Molina Healthcare Medicaid $531.46
Rate for Payer: Ohio Health Choice Commercial $1,333.20
Rate for Payer: Ohio Health Group HMO $1,136.25
Rate for Payer: Ohio Health Group PPO Differential $303.00
Rate for Payer: Ohio Health Group PPO No Differential $196.95
Rate for Payer: Ohio Health Group PPO SOMC Employees $469.65
Rate for Payer: PHCS Commercial $1,454.40
Rate for Payer: United Healthcare All Payer $1,333.20
Service Code HCPCS 43279
Hospital Charge Code 761P1763
Hospital Revenue Code 761
Min. Negotiated Rate $530.25
Max. Negotiated Rate $1,892.35
Rate for Payer: Aetna Commercial $1,888.47
Rate for Payer: Anthem Medicaid $969.91
Rate for Payer: Buckeye Medicare Advantage $1,515.00
Rate for Payer: Cash Price $757.50
Rate for Payer: Cash Price $757.50
Rate for Payer: Cigna Commercial $1,892.35
Rate for Payer: Healthspan PPO $1,592.58
Rate for Payer: Humana Medicaid $969.91
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,666.27
Rate for Payer: Molina Healthcare CHIP/Medicaid $989.31
Rate for Payer: Molina Healthcare Passport $969.91
Rate for Payer: Multiplan PHCS $909.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,060.50
Rate for Payer: UHCCP Medicaid $530.25
Rate for Payer: Wellcare CHIP/Medicaid $979.61
Service Code HCPCS 43281
Hospital Charge Code 76101765
Hospital Revenue Code 761
Min. Negotiated Rate $1,149.87
Max. Negotiated Rate $3,300.00
Rate for Payer: Aetna Commercial $2,457.48
Rate for Payer: Anthem Medicaid $1,149.87
Rate for Payer: Buckeye Medicare Advantage $3,300.00
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cigna Commercial $2,462.79
Rate for Payer: Healthspan PPO $1,632.38
Rate for Payer: Humana Medicaid $1,149.87
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $2,042.93
Rate for Payer: Molina Healthcare CHIP/Medicaid $1,172.87
Rate for Payer: Molina Healthcare Passport $1,149.87
Rate for Payer: Multiplan PHCS $1,980.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,310.00
Rate for Payer: UHCCP Medicaid $1,155.00
Rate for Payer: Wellcare CHIP/Medicaid $1,161.37
Service Code HCPCS 43281
Hospital Charge Code 76101765
Hospital Revenue Code 761
Min. Negotiated Rate $429.00
Max. Negotiated Rate $3,168.00
Rate for Payer: Aetna Commercial $2,541.00
Rate for Payer: Anthem POS/PPO/Traditional $2,574.00
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cigna Commercial $2,739.00
Rate for Payer: First Health Commercial $3,135.00
Rate for Payer: Humana Commercial $2,805.00
Rate for Payer: Medical Mutual Of Ohio HMO $2,706.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,435.40
Rate for Payer: Molina Healthcare Benefit Exchange $990.00
Rate for Payer: Ohio Health Choice Commercial $2,904.00
Rate for Payer: Ohio Health Group HMO $2,475.00
Rate for Payer: Ohio Health Group PPO Differential $660.00
Rate for Payer: Ohio Health Group PPO No Differential $429.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,023.00
Rate for Payer: PHCS Commercial $3,168.00
Rate for Payer: United Healthcare All Payer $2,904.00
Service Code HCPCS 43281
Hospital Charge Code 76101765
Hospital Revenue Code 761
Min. Negotiated Rate $429.00
Max. Negotiated Rate $12,462.13
Rate for Payer: Aetna Commercial $2,541.00
Rate for Payer: Anthem Medicaid $1,134.87
Rate for Payer: Anthem Medicare Advantage/PPO $8,901.52
Rate for Payer: Anthem POS/PPO/Traditional $2,574.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $12,462.13
Rate for Payer: CareSource Just4Me Medicare $12,017.05
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cigna Commercial $2,739.00
Rate for Payer: First Health Commercial $3,135.00
Rate for Payer: Humana Commercial $2,805.00
Rate for Payer: Humana KY Medicaid $1,134.87
Rate for Payer: Humana Medicare Advantage $8,901.52
Rate for Payer: Kentucky WC Medicaid $1,146.42
Rate for Payer: Medical Mutual Of Ohio HMO $2,706.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,435.40
Rate for Payer: Molina Healthcare Benefit Exchange $10,681.82
Rate for Payer: Molina Healthcare Medicaid $1,157.64
Rate for Payer: Ohio Health Choice Commercial $2,904.00
Rate for Payer: Ohio Health Group HMO $2,475.00
Rate for Payer: Ohio Health Group PPO Differential $660.00
Rate for Payer: Ohio Health Group PPO No Differential $429.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,023.00
Rate for Payer: PHCS Commercial $3,168.00
Rate for Payer: United Healthcare All Payer $2,904.00
Service Code HCPCS 43281
Hospital Charge Code 761P1765
Hospital Revenue Code 761
Min. Negotiated Rate $1,149.87
Max. Negotiated Rate $3,300.00
Rate for Payer: Aetna Commercial $2,457.48
Rate for Payer: Anthem Medicaid $1,149.87
Rate for Payer: Buckeye Medicare Advantage $3,300.00
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cash Price $1,650.00
Rate for Payer: Cigna Commercial $2,462.79
Rate for Payer: Healthspan PPO $1,632.38
Rate for Payer: Humana Medicaid $1,149.87
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $2,042.93
Rate for Payer: Molina Healthcare CHIP/Medicaid $1,172.87
Rate for Payer: Molina Healthcare Passport $1,149.87
Rate for Payer: Multiplan PHCS $1,980.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,310.00
Rate for Payer: UHCCP Medicaid $1,155.00
Rate for Payer: Wellcare CHIP/Medicaid $1,161.37
Service Code HCPCS 43282
Hospital Charge Code 76101766
Hospital Revenue Code 761
Min. Negotiated Rate $840.00
Max. Negotiated Rate $2,770.60
Rate for Payer: Aetna Commercial $2,765.05
Rate for Payer: Anthem Medicaid $1,293.66
Rate for Payer: Buckeye Medicare Advantage $2,400.00
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cigna Commercial $2,770.60
Rate for Payer: Healthspan PPO $1,836.90
Rate for Payer: Humana Medicaid $1,293.66
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $2,296.03
Rate for Payer: Molina Healthcare CHIP/Medicaid $1,319.53
Rate for Payer: Molina Healthcare Passport $1,293.66
Rate for Payer: Multiplan PHCS $1,440.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,680.00
Rate for Payer: UHCCP Medicaid $840.00
Rate for Payer: Wellcare CHIP/Medicaid $1,306.60
Service Code HCPCS 43282
Hospital Charge Code 76101766
Hospital Revenue Code 761
Min. Negotiated Rate $312.00
Max. Negotiated Rate $12,462.13
Rate for Payer: Aetna Commercial $1,848.00
Rate for Payer: Anthem Medicaid $825.36
Rate for Payer: Anthem Medicare Advantage/PPO $8,901.52
Rate for Payer: Anthem POS/PPO/Traditional $1,872.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $12,462.13
Rate for Payer: CareSource Just4Me Medicare $12,017.05
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cigna Commercial $1,992.00
Rate for Payer: First Health Commercial $2,280.00
Rate for Payer: Humana Commercial $2,040.00
Rate for Payer: Humana KY Medicaid $825.36
Rate for Payer: Humana Medicare Advantage $8,901.52
Rate for Payer: Kentucky WC Medicaid $833.76
Rate for Payer: Medical Mutual Of Ohio HMO $1,968.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,771.20
Rate for Payer: Molina Healthcare Benefit Exchange $10,681.82
Rate for Payer: Molina Healthcare Medicaid $841.92
Rate for Payer: Ohio Health Choice Commercial $2,112.00
Rate for Payer: Ohio Health Group HMO $1,800.00
Rate for Payer: Ohio Health Group PPO Differential $480.00
Rate for Payer: Ohio Health Group PPO No Differential $312.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $744.00
Rate for Payer: PHCS Commercial $2,304.00
Rate for Payer: United Healthcare All Payer $2,112.00
Service Code HCPCS 43282
Hospital Charge Code 76101766
Hospital Revenue Code 761
Min. Negotiated Rate $312.00
Max. Negotiated Rate $2,304.00
Rate for Payer: Aetna Commercial $1,848.00
Rate for Payer: Anthem POS/PPO/Traditional $1,872.00
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cigna Commercial $1,992.00
Rate for Payer: First Health Commercial $2,280.00
Rate for Payer: Humana Commercial $2,040.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,968.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,771.20
Rate for Payer: Molina Healthcare Benefit Exchange $720.00
Rate for Payer: Ohio Health Choice Commercial $2,112.00
Rate for Payer: Ohio Health Group HMO $1,800.00
Rate for Payer: Ohio Health Group PPO Differential $480.00
Rate for Payer: Ohio Health Group PPO No Differential $312.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $744.00
Rate for Payer: PHCS Commercial $2,304.00
Rate for Payer: United Healthcare All Payer $2,112.00
Service Code HCPCS 43282
Hospital Charge Code 761P1766
Hospital Revenue Code 761
Min. Negotiated Rate $840.00
Max. Negotiated Rate $2,770.60
Rate for Payer: Aetna Commercial $2,765.05
Rate for Payer: Anthem Medicaid $1,293.66
Rate for Payer: Buckeye Medicare Advantage $2,400.00
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cash Price $1,200.00
Rate for Payer: Cigna Commercial $2,770.60
Rate for Payer: Healthspan PPO $1,836.90
Rate for Payer: Humana Medicaid $1,293.66
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $2,296.03
Rate for Payer: Molina Healthcare CHIP/Medicaid $1,319.53
Rate for Payer: Molina Healthcare Passport $1,293.66
Rate for Payer: Multiplan PHCS $1,440.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,680.00
Rate for Payer: UHCCP Medicaid $840.00
Rate for Payer: Wellcare CHIP/Medicaid $1,306.60
Service Code HCPCS 44238
Hospital Charge Code 76102687
Hospital Revenue Code 360
Min. Negotiated Rate $0.60
Max. Negotiated Rate $2,527.03
Rate for Payer: Buckeye Medicare Advantage $1,155.00
Rate for Payer: Cash Price $577.50
Rate for Payer: Cash Price $577.50
Rate for Payer: Healthspan PPO $0.60
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $2,527.03
Rate for Payer: Multiplan PHCS $693.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $808.50
Rate for Payer: UHCCP Medicaid $404.25
Service Code HCPCS 49651
Hospital Charge Code 76102033
Hospital Revenue Code 761
Min. Negotiated Rate $169.00
Max. Negotiated Rate $1,248.00
Rate for Payer: Aetna Commercial $1,001.00
Rate for Payer: Anthem POS/PPO/Traditional $1,014.00
Rate for Payer: Cash Price $650.00
Rate for Payer: Cigna Commercial $1,079.00
Rate for Payer: First Health Commercial $1,235.00
Rate for Payer: Humana Commercial $1,105.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,066.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $959.40
Rate for Payer: Molina Healthcare Benefit Exchange $390.00
Rate for Payer: Ohio Health Choice Commercial $1,144.00
Rate for Payer: Ohio Health Group HMO $975.00
Rate for Payer: Ohio Health Group PPO Differential $260.00
Rate for Payer: Ohio Health Group PPO No Differential $169.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $403.00
Rate for Payer: PHCS Commercial $1,248.00
Rate for Payer: United Healthcare All Payer $1,144.00
Service Code HCPCS 49651
Hospital Charge Code 76102033
Hospital Revenue Code 761
Min. Negotiated Rate $169.00
Max. Negotiated Rate $6,985.45
Rate for Payer: Aetna Commercial $1,001.00
Rate for Payer: Anthem Medicaid $447.07
Rate for Payer: Anthem Medicare Advantage/PPO $4,989.61
Rate for Payer: Anthem POS/PPO/Traditional $1,014.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $6,985.45
Rate for Payer: CareSource Just4Me Medicare $6,735.97
Rate for Payer: Cash Price $650.00
Rate for Payer: Cash Price $650.00
Rate for Payer: Cigna Commercial $1,079.00
Rate for Payer: First Health Commercial $1,235.00
Rate for Payer: Humana Commercial $1,105.00
Rate for Payer: Humana KY Medicaid $447.07
Rate for Payer: Humana Medicare Advantage $4,989.61
Rate for Payer: Kentucky WC Medicaid $451.62
Rate for Payer: Medical Mutual Of Ohio HMO $1,066.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $959.40
Rate for Payer: Molina Healthcare Benefit Exchange $5,987.53
Rate for Payer: Molina Healthcare Medicaid $456.04
Rate for Payer: Ohio Health Choice Commercial $1,144.00
Rate for Payer: Ohio Health Group HMO $975.00
Rate for Payer: Ohio Health Group PPO Differential $260.00
Rate for Payer: Ohio Health Group PPO No Differential $169.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $403.00
Rate for Payer: PHCS Commercial $1,248.00
Rate for Payer: United Healthcare All Payer $1,144.00
Service Code HCPCS 49651
Hospital Charge Code 76102033
Hospital Revenue Code 761
Min. Negotiated Rate $387.99
Max. Negotiated Rate $1,300.00
Rate for Payer: Aetna Commercial $787.19
Rate for Payer: Anthem Medicaid $387.99
Rate for Payer: Buckeye Medicare Advantage $1,300.00
Rate for Payer: Cash Price $650.00
Rate for Payer: Cash Price $650.00
Rate for Payer: Cigna Commercial $730.58
Rate for Payer: Healthspan PPO $663.85
Rate for Payer: Humana Medicaid $387.99
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $699.60
Rate for Payer: Molina Healthcare CHIP/Medicaid $395.75
Rate for Payer: Molina Healthcare Passport $387.99
Rate for Payer: Multiplan PHCS $780.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $910.00
Rate for Payer: UHCCP Medicaid $455.00
Rate for Payer: Wellcare CHIP/Medicaid $391.87
Service Code HCPCS 49651
Hospital Charge Code 761P2033
Hospital Revenue Code 761
Min. Negotiated Rate $387.99
Max. Negotiated Rate $1,300.00
Rate for Payer: Aetna Commercial $787.19
Rate for Payer: Anthem Medicaid $387.99
Rate for Payer: Buckeye Medicare Advantage $1,300.00
Rate for Payer: Cash Price $650.00
Rate for Payer: Cash Price $650.00
Rate for Payer: Cigna Commercial $730.58
Rate for Payer: Healthspan PPO $663.85
Rate for Payer: Humana Medicaid $387.99
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $699.60
Rate for Payer: Molina Healthcare CHIP/Medicaid $395.75
Rate for Payer: Molina Healthcare Passport $387.99
Rate for Payer: Multiplan PHCS $780.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $910.00
Rate for Payer: UHCCP Medicaid $455.00
Rate for Payer: Wellcare CHIP/Medicaid $391.87
Service Code HCPCS 43659
Hospital Charge Code 76102732
Hospital Revenue Code 761
Min. Negotiated Rate $0.60
Max. Negotiated Rate $1,023.36
Rate for Payer: Buckeye Medicare Advantage $1,023.36
Rate for Payer: Cash Price $511.68
Rate for Payer: Cash Price $511.68
Rate for Payer: Healthspan PPO $0.60
Rate for Payer: Multiplan PHCS $614.02
Rate for Payer: Ohio Health Choice Preferred Health Choice $716.35
Rate for Payer: UHCCP Medicaid $358.18
Service Code HCPCS 44203
Hospital Charge Code 51000298
Hospital Revenue Code 510
Min. Negotiated Rate $180.61
Max. Negotiated Rate $554.00
Rate for Payer: Aetna Commercial $364.33
Rate for Payer: Anthem Medicaid $180.61
Rate for Payer: Buckeye Medicare Advantage $554.00
Rate for Payer: Cash Price $277.00
Rate for Payer: Cash Price $277.00
Rate for Payer: Cigna Commercial $345.63
Rate for Payer: Healthspan PPO $307.25
Rate for Payer: Humana Medicaid $180.61
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $314.22
Rate for Payer: Molina Healthcare CHIP/Medicaid $184.22
Rate for Payer: Molina Healthcare Passport $180.61
Rate for Payer: Multiplan PHCS $332.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $387.80
Rate for Payer: UHCCP Medicaid $193.90
Rate for Payer: Wellcare CHIP/Medicaid $182.42
Service Code HCPCS 43771
Hospital Charge Code 76101794
Hospital Revenue Code 761
Min. Negotiated Rate $208.00
Max. Negotiated Rate $1,536.00
Rate for Payer: Aetna Commercial $1,232.00
Rate for Payer: Anthem POS/PPO/Traditional $1,248.00
Rate for Payer: Cash Price $800.00
Rate for Payer: Cigna Commercial $1,328.00
Rate for Payer: First Health Commercial $1,520.00
Rate for Payer: Humana Commercial $1,360.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,312.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,180.80
Rate for Payer: Molina Healthcare Benefit Exchange $480.00
Rate for Payer: Ohio Health Choice Commercial $1,408.00
Rate for Payer: Ohio Health Group HMO $1,200.00
Rate for Payer: Ohio Health Group PPO Differential $320.00
Rate for Payer: Ohio Health Group PPO No Differential $208.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $496.00
Rate for Payer: PHCS Commercial $1,536.00
Rate for Payer: United Healthcare All Payer $1,408.00
Service Code HCPCS 43771
Hospital Charge Code 76101794
Hospital Revenue Code 761
Min. Negotiated Rate $560.00
Max. Negotiated Rate $1,826.92
Rate for Payer: Aetna Commercial $1,826.92
Rate for Payer: Anthem Medicaid $864.05
Rate for Payer: Buckeye Medicare Advantage $1,600.00
Rate for Payer: Cash Price $800.00
Rate for Payer: Cash Price $800.00
Rate for Payer: Cigna Commercial $1,707.92
Rate for Payer: Healthspan PPO $1,540.67
Rate for Payer: Humana Medicaid $864.05
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,620.89
Rate for Payer: Molina Healthcare CHIP/Medicaid $881.33
Rate for Payer: Molina Healthcare Passport $864.05
Rate for Payer: Multiplan PHCS $960.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,120.00
Rate for Payer: UHCCP Medicaid $560.00
Rate for Payer: Wellcare CHIP/Medicaid $872.69
Service Code HCPCS 43771
Hospital Charge Code 76101794
Hospital Revenue Code 761
Min. Negotiated Rate $208.00
Max. Negotiated Rate $1,536.00
Rate for Payer: Aetna Commercial $1,232.00
Rate for Payer: Anthem Medicaid $550.24
Rate for Payer: Anthem POS/PPO/Traditional $1,248.00
Rate for Payer: Cash Price $800.00
Rate for Payer: Cigna Commercial $1,328.00
Rate for Payer: First Health Commercial $1,520.00
Rate for Payer: Humana Commercial $1,360.00
Rate for Payer: Humana KY Medicaid $550.24
Rate for Payer: Kentucky WC Medicaid $555.84
Rate for Payer: Medical Mutual Of Ohio HMO $1,312.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,180.80
Rate for Payer: Molina Healthcare Benefit Exchange $480.00
Rate for Payer: Molina Healthcare Medicaid $561.28
Rate for Payer: Ohio Health Choice Commercial $1,408.00
Rate for Payer: Ohio Health Group HMO $1,200.00
Rate for Payer: Ohio Health Group PPO Differential $320.00
Rate for Payer: Ohio Health Group PPO No Differential $208.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $496.00
Rate for Payer: PHCS Commercial $1,536.00
Rate for Payer: United Healthcare All Payer $1,408.00
Service Code HCPCS 43771
Hospital Charge Code 761P1794
Hospital Revenue Code 761
Min. Negotiated Rate $560.00
Max. Negotiated Rate $1,826.92
Rate for Payer: Aetna Commercial $1,826.92
Rate for Payer: Anthem Medicaid $864.05
Rate for Payer: Buckeye Medicare Advantage $1,600.00
Rate for Payer: Cash Price $800.00
Rate for Payer: Cash Price $800.00
Rate for Payer: Cigna Commercial $1,707.92
Rate for Payer: Healthspan PPO $1,540.67
Rate for Payer: Humana Medicaid $864.05
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,620.89
Rate for Payer: Molina Healthcare CHIP/Medicaid $881.33
Rate for Payer: Molina Healthcare Passport $864.05
Rate for Payer: Multiplan PHCS $960.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,120.00
Rate for Payer: UHCCP Medicaid $560.00
Rate for Payer: Wellcare CHIP/Medicaid $872.69
Service Code HCPCS 55559
Hospital Charge Code 76102898
Hospital Revenue Code 761
Min. Negotiated Rate $0.60
Max. Negotiated Rate $1,000.00
Rate for Payer: Buckeye Medicare Advantage $1,000.00
Rate for Payer: Cash Price $500.00
Rate for Payer: Cash Price $500.00
Rate for Payer: Healthspan PPO $0.60
Rate for Payer: Multiplan PHCS $600.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $700.00
Rate for Payer: UHCCP Medicaid $350.00