|
KYPHOPLASTY THORACIC (P
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
761P0424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$403.43 |
| Max. Negotiated Rate |
$5,535.46 |
| Rate for Payer: Ambetter Exchange |
$480.52
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$403.43
|
| Rate for Payer: Anthem Medicaid |
$5,426.92
|
| Rate for Payer: Buckeye Individual/Medicaid |
$480.52
|
| Rate for Payer: Buckeye Medicare Advantage |
$480.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$576.62
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cigna Commercial |
$1,022.33
|
| Rate for Payer: Humana Medicaid |
$5,426.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$710.33
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$480.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$480.52
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$5,535.46
|
| Rate for Payer: Molina Healthcare Passport |
$5,426.92
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$624.68
|
| Rate for Payer: UHCCP Medicaid |
$423.60
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$5,481.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$480.52
|
|
|
KYPROLIS 10MG VIAL
|
Facility
|
IP
|
$3,212.94
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
25003885
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$963.88 |
| Max. Negotiated Rate |
$3,084.42 |
| Rate for Payer: Aetna Commercial |
$2,473.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,506.09
|
| Rate for Payer: Cash Price |
$1,606.47
|
| Rate for Payer: Cigna Commercial |
$2,666.74
|
| Rate for Payer: First Health Commercial |
$3,052.29
|
| Rate for Payer: Humana Commercial |
$2,731.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,634.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,371.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$963.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,827.39
|
| Rate for Payer: Ohio Health Group HMO |
$2,409.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,570.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,795.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,216.93
|
| Rate for Payer: PHCS Commercial |
$3,084.42
|
| Rate for Payer: United Healthcare All Payer |
$2,827.39
|
|
|
KYPROLIS 10MG VIAL
|
Facility
|
OP
|
$3,212.94
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
25003885
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.09 |
| Max. Negotiated Rate |
$3,084.42 |
| Rate for Payer: Aetna Commercial |
$2,473.96
|
| Rate for Payer: Anthem Medicaid |
$1,104.93
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$55.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,506.09
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$77.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$74.37
|
| Rate for Payer: Cash Price |
$1,606.47
|
| Rate for Payer: Cash Price |
$1,606.47
|
| Rate for Payer: Cigna Commercial |
$2,666.74
|
| Rate for Payer: First Health Commercial |
$3,052.29
|
| Rate for Payer: Humana Commercial |
$2,731.00
|
| Rate for Payer: Humana KY Medicaid |
$1,104.93
|
| Rate for Payer: Humana Medicare Advantage |
$55.09
|
| Rate for Payer: Kentucky WC Medicaid |
$1,116.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,634.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,371.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$66.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,127.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,827.39
|
| Rate for Payer: Ohio Health Group HMO |
$2,409.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,570.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,795.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,216.93
|
| Rate for Payer: PHCS Commercial |
$3,084.42
|
| Rate for Payer: United Healthcare All Payer |
$2,827.39
|
|
|
KYPROLIS 1MG [60MG VIAL]
|
Facility
|
OP
|
$19,277.69
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
25002580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.09 |
| Max. Negotiated Rate |
$18,506.58 |
| Rate for Payer: Aetna Commercial |
$14,843.82
|
| Rate for Payer: Anthem Medicaid |
$6,629.60
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$55.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,036.60
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$77.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$74.37
|
| Rate for Payer: Cash Price |
$9,638.84
|
| Rate for Payer: Cash Price |
$9,638.84
|
| Rate for Payer: Cigna Commercial |
$16,000.48
|
| Rate for Payer: First Health Commercial |
$18,313.81
|
| Rate for Payer: Humana Commercial |
$16,386.04
|
| Rate for Payer: Humana KY Medicaid |
$6,629.60
|
| Rate for Payer: Humana Medicare Advantage |
$55.09
|
| Rate for Payer: Kentucky WC Medicaid |
$6,697.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,807.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,226.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$66.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,762.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,964.37
|
| Rate for Payer: Ohio Health Group HMO |
$14,458.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,422.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,771.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,301.61
|
| Rate for Payer: PHCS Commercial |
$18,506.58
|
| Rate for Payer: United Healthcare All Payer |
$16,964.37
|
|
|
KYPROLIS 1MG [60MG VIAL]
|
Facility
|
IP
|
$19,277.69
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
25002580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5,783.31 |
| Max. Negotiated Rate |
$18,506.58 |
| Rate for Payer: Aetna Commercial |
$14,843.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,036.60
|
| Rate for Payer: Cash Price |
$9,638.84
|
| Rate for Payer: Cigna Commercial |
$16,000.48
|
| Rate for Payer: First Health Commercial |
$18,313.81
|
| Rate for Payer: Humana Commercial |
$16,386.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,807.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,226.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,783.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,964.37
|
| Rate for Payer: Ohio Health Group HMO |
$14,458.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,422.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,771.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,301.61
|
| Rate for Payer: PHCS Commercial |
$18,506.58
|
| Rate for Payer: United Healthcare All Payer |
$16,964.37
|
|
|
KYPROLIS 30MG VIAL
|
Facility
|
IP
|
$9,638.87
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
25002579
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,891.66 |
| Max. Negotiated Rate |
$9,253.32 |
| Rate for Payer: Aetna Commercial |
$7,421.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,518.32
|
| Rate for Payer: Cash Price |
$4,819.44
|
| Rate for Payer: Cigna Commercial |
$8,000.26
|
| Rate for Payer: First Health Commercial |
$9,156.93
|
| Rate for Payer: Humana Commercial |
$8,193.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,903.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,113.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,891.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,482.21
|
| Rate for Payer: Ohio Health Group HMO |
$7,229.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,711.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,385.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,650.82
|
| Rate for Payer: PHCS Commercial |
$9,253.32
|
| Rate for Payer: United Healthcare All Payer |
$8,482.21
|
|
|
KYPROLIS 30MG VIAL
|
Facility
|
OP
|
$9,638.87
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
25002579
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.09 |
| Max. Negotiated Rate |
$9,253.32 |
| Rate for Payer: Aetna Commercial |
$7,421.93
|
| Rate for Payer: Anthem Medicaid |
$3,314.81
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$55.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,518.32
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$77.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$74.37
|
| Rate for Payer: Cash Price |
$4,819.44
|
| Rate for Payer: Cash Price |
$4,819.44
|
| Rate for Payer: Cigna Commercial |
$8,000.26
|
| Rate for Payer: First Health Commercial |
$9,156.93
|
| Rate for Payer: Humana Commercial |
$8,193.04
|
| Rate for Payer: Humana KY Medicaid |
$3,314.81
|
| Rate for Payer: Humana Medicare Advantage |
$55.09
|
| Rate for Payer: Kentucky WC Medicaid |
$3,348.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,903.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,113.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$66.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,381.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,482.21
|
| Rate for Payer: Ohio Health Group HMO |
$7,229.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,711.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,385.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,650.82
|
| Rate for Payer: PHCS Commercial |
$9,253.32
|
| Rate for Payer: United Healthcare All Payer |
$8,482.21
|
|
|
KYSSE
|
Professional
|
Both
|
$650.00
|
|
| Hospital Charge Code |
22200393
|
|
Hospital Revenue Code
|
222
|
| Min. Negotiated Rate |
$227.50 |
| Max. Negotiated Rate |
$455.00 |
| 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
|
|
|
LABCORP 16+ MARKERS
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
HCPCS 88189
|
| Hospital Charge Code |
30001775
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.70 |
| Max. Negotiated Rate |
$171.84 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: Anthem Medicaid |
$61.56
|
| 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: Humana KY Medicaid |
$61.56
|
| Rate for Payer: Kentucky WC Medicaid |
$62.18
|
| 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 |
$62.79
|
| 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 |
$143.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$155.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$123.51
|
| Rate for Payer: PHCS Commercial |
$171.84
|
| Rate for Payer: United Healthcare All Payer |
$157.52
|
|
|
LABCORP 16+ MARKERS
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
HCPCS 88189
|
| Hospital Charge Code |
30001775
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.70 |
| 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 |
$143.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$155.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$123.51
|
| Rate for Payer: PHCS Commercial |
$171.84
|
| Rate for Payer: United Healthcare All Payer |
$157.52
|
|
|
LABCORP BONE MARROW ASPIRATE
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS 85097
|
| Hospital Charge Code |
30000575
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$1,056.72 |
| Rate for Payer: Aetna Commercial |
$144.76
|
| Rate for Payer: Anthem Medicaid |
$754.80
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$754.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$150.96
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,056.72
|
| Rate for Payer: CareSource Just4Me Medicare |
$754.80
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$156.04
|
| Rate for Payer: First Health Commercial |
$178.60
|
| Rate for Payer: Humana Commercial |
$159.80
|
| Rate for Payer: Humana KY Medicaid |
$754.80
|
| Rate for Payer: Humana Medicare Advantage |
$754.80
|
| Rate for Payer: Kentucky WC Medicaid |
$762.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$154.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$138.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$905.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$769.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$165.44
|
| Rate for Payer: Ohio Health Group HMO |
$141.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$163.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$129.72
|
| Rate for Payer: PHCS Commercial |
$180.48
|
| Rate for Payer: United Healthcare All Payer |
$165.44
|
|
|
LABCORP BONE MARROW ASPIRATE
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
HCPCS 85097
|
| Hospital Charge Code |
30000575
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$180.48 |
| Rate for Payer: Aetna Commercial |
$144.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$150.96
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cigna Commercial |
$156.04
|
| Rate for Payer: First Health Commercial |
$178.60
|
| Rate for Payer: Humana Commercial |
$159.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$154.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$138.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$56.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$165.44
|
| Rate for Payer: Ohio Health Group HMO |
$141.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$163.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$129.72
|
| Rate for Payer: PHCS Commercial |
$180.48
|
| Rate for Payer: United Healthcare All Payer |
$165.44
|
|
|
LABCORP DNA PROBE EACH
|
Facility
|
OP
|
$195.00
|
|
|
Service Code
|
HCPCS 88271
|
| Hospital Charge Code |
30001475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$187.20 |
| Rate for Payer: Aetna Commercial |
$150.15
|
| Rate for Payer: Anthem Medicaid |
$21.42
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$21.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$156.59
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$29.99
|
| Rate for Payer: CareSource Just4Me Medicare |
$21.42
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cigna Commercial |
$161.85
|
| Rate for Payer: First Health Commercial |
$185.25
|
| Rate for Payer: Humana Commercial |
$165.75
|
| 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 |
$159.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$143.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$21.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$171.60
|
| Rate for Payer: Ohio Health Group HMO |
$146.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$156.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$169.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$134.55
|
| Rate for Payer: PHCS Commercial |
$187.20
|
| Rate for Payer: United Healthcare All Payer |
$171.60
|
|
|
LABCORP DNA PROBE EACH
|
Facility
|
IP
|
$195.00
|
|
|
Service Code
|
HCPCS 88271
|
| Hospital Charge Code |
30001475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$187.20 |
| Rate for Payer: Aetna Commercial |
$150.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$156.59
|
| Rate for Payer: Cash Price |
$97.50
|
| Rate for Payer: Cigna Commercial |
$161.85
|
| Rate for Payer: First Health Commercial |
$185.25
|
| Rate for Payer: Humana Commercial |
$165.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$159.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$143.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$58.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$171.60
|
| Rate for Payer: Ohio Health Group HMO |
$146.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$156.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$169.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$134.55
|
| Rate for Payer: PHCS Commercial |
$187.20
|
| Rate for Payer: United Healthcare All Payer |
$171.60
|
|
|
LABCORP EGFR MUTATION ANALYSIS
|
Facility
|
OP
|
$1,954.00
|
|
|
Service Code
|
HCPCS 81235
|
| Hospital Charge Code |
30000185
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$324.58 |
| 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 |
$1,563.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,699.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,348.26
|
| Rate for Payer: PHCS Commercial |
$1,875.84
|
| Rate for Payer: United Healthcare All Payer |
$1,719.52
|
|
|
LABCORP EGFR MUTATION ANALYSIS
|
Facility
|
IP
|
$1,954.00
|
|
|
Service Code
|
HCPCS 81235
|
| Hospital Charge Code |
30000185
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$586.20 |
| 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 |
$1,563.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,699.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,348.26
|
| Rate for Payer: PHCS Commercial |
$1,875.84
|
| Rate for Payer: United Healthcare All Payer |
$1,719.52
|
|
|
LABCORP FIRST FLOW MARKER
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
HCPCS 88184
|
| Hospital Charge Code |
30001428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.89 |
| Max. Negotiated Rate |
$465.32 |
| Rate for Payer: Aetna Commercial |
$62.37
|
| Rate for Payer: Anthem Medicaid |
$332.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$332.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65.04
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$465.32
|
| Rate for Payer: CareSource Just4Me Medicare |
$332.37
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna Commercial |
$67.23
|
| Rate for Payer: First Health Commercial |
$76.95
|
| Rate for Payer: Humana Commercial |
$68.85
|
| Rate for Payer: Humana KY Medicaid |
$332.37
|
| Rate for Payer: Humana Medicare Advantage |
$332.37
|
| Rate for Payer: Kentucky WC Medicaid |
$335.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$66.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$59.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$398.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$339.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$71.28
|
| Rate for Payer: Ohio Health Group HMO |
$60.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$64.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$70.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$55.89
|
| Rate for Payer: PHCS Commercial |
$77.76
|
| Rate for Payer: United Healthcare All Payer |
$71.28
|
|
|
LABCORP FIRST FLOW MARKER
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
HCPCS 88184
|
| Hospital Charge Code |
30001428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.30 |
| Max. Negotiated Rate |
$77.76 |
| Rate for Payer: Aetna Commercial |
$62.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65.04
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna Commercial |
$67.23
|
| Rate for Payer: First Health Commercial |
$76.95
|
| Rate for Payer: Humana Commercial |
$68.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$66.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$59.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$24.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$71.28
|
| Rate for Payer: Ohio Health Group HMO |
$60.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$64.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$70.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$55.89
|
| Rate for Payer: PHCS Commercial |
$77.76
|
| Rate for Payer: United Healthcare All Payer |
$71.28
|
|
|
LABCORP FLOW MARKERS EACH
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001453
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
LABCORP FLOW MARKERS EACH
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001453
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
LABCORP INTERPH SITU HYBR25-99
|
Facility
|
IP
|
$829.00
|
|
|
Service Code
|
HCPCS 88274
|
| Hospital Charge Code |
30001489
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$248.70 |
| 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 |
$663.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$721.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.01
|
| 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 |
$663.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$721.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$572.01
|
| Rate for Payer: PHCS Commercial |
$795.84
|
| Rate for Payer: United Healthcare All Payer |
$729.52
|
|
|
LABCORP TISS CULT CHOMO ANALYS
|
Facility
|
OP
|
$292.00
|
|
|
Service Code
|
HCPCS 88237
|
| Hospital Charge Code |
30001464
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$143.75 |
| Max. Negotiated Rate |
$280.32 |
| Rate for Payer: Aetna Commercial |
$224.84
|
| Rate for Payer: Anthem Medicaid |
$143.75
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$143.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$234.48
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$201.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$143.75
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cigna Commercial |
$242.36
|
| Rate for Payer: First Health Commercial |
$277.40
|
| Rate for Payer: Humana Commercial |
$248.20
|
| 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 |
$239.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$215.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$172.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$146.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$256.96
|
| Rate for Payer: Ohio Health Group HMO |
$219.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$233.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$201.48
|
| Rate for Payer: PHCS Commercial |
$280.32
|
| Rate for Payer: United Healthcare All Payer |
$256.96
|
|
|
LABCORP TISS CULT CHOMO ANALYS
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
HCPCS 88237
|
| Hospital Charge Code |
30001464
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.60 |
| Max. Negotiated Rate |
$280.32 |
| Rate for Payer: Aetna Commercial |
$224.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$234.48
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cigna Commercial |
$242.36
|
| Rate for Payer: First Health Commercial |
$277.40
|
| Rate for Payer: Humana Commercial |
$248.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$239.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$215.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$87.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$256.96
|
| Rate for Payer: Ohio Health Group HMO |
$219.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$233.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$254.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$201.48
|
| Rate for Payer: PHCS Commercial |
$280.32
|
| Rate for Payer: United Healthcare All Payer |
$256.96
|
|
|
Labetalol 100mg/20mL(IV addit)
|
Facility
|
OP
|
$79.96
|
|
|
Service Code
|
NDC 409226720
|
| Hospital Charge Code |
25004044
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.99 |
| 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 |
$63.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$69.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$55.17
|
| Rate for Payer: PHCS Commercial |
$76.76
|
| Rate for Payer: United Healthcare All Payer |
$70.36
|
|
