|
LARYNGOSCOP FLEX AIRWAY(T
|
Facility
|
IP
|
$492.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
761T1165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.96 |
| Max. Negotiated Rate |
$472.32 |
| Rate for Payer: Aetna Commercial |
$378.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$383.76
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$408.36
|
| Rate for Payer: First Health Commercial |
$467.40
|
| Rate for Payer: Humana Commercial |
$418.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$403.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$363.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$147.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$432.96
|
| Rate for Payer: Ohio Health Group HMO |
$369.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$98.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$152.52
|
| Rate for Payer: PHCS Commercial |
$472.32
|
| Rate for Payer: United Healthcare All Payer |
$432.96
|
|
|
LARYNGOSCOPY
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 31511
|
| Hospital Charge Code |
41000016
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.14 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$195.49
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$67.14
|
| Rate for Payer: Anthem Medicaid |
$91.56
|
| Rate for Payer: Buckeye Medicare Advantage |
$750.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$186.84
|
| Rate for Payer: Healthspan PPO |
$251.52
|
| Rate for Payer: Humana Medicaid |
$91.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$166.87
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$93.39
|
| Rate for Payer: Molina Healthcare Passport |
$91.56
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$525.00
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$92.48
|
|
|
LARYNGOSCOPY
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31540
|
| Hospital Charge Code |
41000023
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$277.90 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$370.00
|
| Rate for Payer: Anthem Medicaid |
$277.90
|
| Rate for Payer: Buckeye Medicare Advantage |
$850.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$374.09
|
| Rate for Payer: Healthspan PPO |
$312.03
|
| Rate for Payer: Humana Medicaid |
$277.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$319.01
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$283.46
|
| Rate for Payer: Molina Healthcare Passport |
$277.90
|
| Rate for Payer: Multiplan PHCS |
$510.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$595.00
|
| Rate for Payer: UHCCP Medicaid |
$297.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$280.68
|
|
|
LARYNGOSCOPY AND DILATION
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
HCPCS 31528
|
| Hospital Charge Code |
76102928
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$336.00 |
| Rate for Payer: Aetna Commercial |
$269.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$273.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cigna Commercial |
$290.50
|
| Rate for Payer: First Health Commercial |
$332.50
|
| Rate for Payer: Humana Commercial |
$297.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$287.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$258.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$105.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$308.00
|
| Rate for Payer: Ohio Health Group HMO |
$262.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$70.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$45.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$108.50
|
| Rate for Payer: PHCS Commercial |
$336.00
|
| Rate for Payer: United Healthcare All Payer |
$308.00
|
|
|
LARYNGOSCOPY AND DILATION
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 31528
|
| Hospital Charge Code |
76102928
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.50 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$217.79
|
| Rate for Payer: Anthem Medicaid |
$148.18
|
| Rate for Payer: Buckeye Medicare Advantage |
$350.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cigna Commercial |
$215.91
|
| Rate for Payer: Healthspan PPO |
$183.67
|
| Rate for Payer: Humana Medicaid |
$148.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$189.30
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$151.14
|
| Rate for Payer: Molina Healthcare Passport |
$148.18
|
| Rate for Payer: Multiplan PHCS |
$210.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$245.00
|
| Rate for Payer: UHCCP Medicaid |
$122.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$149.66
|
|
|
LARYNGOSCOPY AND DILATION
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
HCPCS 31528
|
| Hospital Charge Code |
76102928
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$4,533.70 |
| Rate for Payer: Aetna Commercial |
$269.50
|
| Rate for Payer: Anthem Medicaid |
$120.36
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,238.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$273.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,533.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,371.79
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cigna Commercial |
$290.50
|
| Rate for Payer: First Health Commercial |
$332.50
|
| Rate for Payer: Humana Commercial |
$297.50
|
| Rate for Payer: Humana KY Medicaid |
$120.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,238.36
|
| Rate for Payer: Kentucky WC Medicaid |
$121.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$287.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$258.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,886.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$122.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$308.00
|
| Rate for Payer: Ohio Health Group HMO |
$262.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$70.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$45.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$108.50
|
| Rate for Payer: PHCS Commercial |
$336.00
|
| Rate for Payer: United Healthcare All Payer |
$308.00
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$1,250.00
|
|
|
Service Code
|
HCPCS 31536
|
| Hospital Charge Code |
41000022
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$216.25 |
| Max. Negotiated Rate |
$1,250.00 |
| Rate for Payer: Aetna Commercial |
$321.92
|
| Rate for Payer: Anthem Medicaid |
$216.25
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,250.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cigna Commercial |
$325.55
|
| Rate for Payer: Healthspan PPO |
$271.48
|
| Rate for Payer: Humana Medicaid |
$216.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$277.53
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$220.58
|
| Rate for Payer: Molina Healthcare Passport |
$216.25
|
| Rate for Payer: Multiplan PHCS |
$750.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$875.00
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$218.41
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31535
|
| Hospital Charge Code |
41000021
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$211.22 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$288.18
|
| Rate for Payer: Anthem Medicaid |
$211.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$850.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$290.13
|
| Rate for Payer: Healthspan PPO |
$243.03
|
| Rate for Payer: Humana Medicaid |
$211.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$248.90
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$215.44
|
| Rate for Payer: Molina Healthcare Passport |
$211.22
|
| Rate for Payer: Multiplan PHCS |
$510.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$595.00
|
| Rate for Payer: UHCCP Medicaid |
$297.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$213.33
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$4,199.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
76101163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$545.95 |
| Max. Negotiated Rate |
$4,031.60 |
| Rate for Payer: Aetna Commercial |
$3,233.68
|
| Rate for Payer: Anthem Medicaid |
$1,444.24
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,467.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,275.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,054.81
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,981.42
|
| Rate for Payer: Cash Price |
$2,099.79
|
| Rate for Payer: Cash Price |
$2,099.79
|
| Rate for Payer: Cigna Commercial |
$3,485.65
|
| Rate for Payer: First Health Commercial |
$3,989.60
|
| Rate for Payer: Humana Commercial |
$3,569.64
|
| Rate for Payer: Humana KY Medicaid |
$1,444.24
|
| Rate for Payer: Humana Medicare Advantage |
$1,467.72
|
| Rate for Payer: Kentucky WC Medicaid |
$1,458.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,443.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,099.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,761.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,473.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,695.63
|
| Rate for Payer: Ohio Health Group HMO |
$3,149.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$839.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$545.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,301.87
|
| Rate for Payer: PHCS Commercial |
$4,031.60
|
| Rate for Payer: United Healthcare All Payer |
$3,695.63
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 31515
|
| Hospital Charge Code |
41000018
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$165.27
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$56.58
|
| Rate for Payer: Anthem Medicaid |
$86.53
|
| Rate for Payer: Buckeye Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$163.42
|
| Rate for Payer: Healthspan PPO |
$245.44
|
| Rate for Payer: Humana Medicaid |
$86.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$142.52
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$88.26
|
| Rate for Payer: Molina Healthcare Passport |
$86.53
|
| Rate for Payer: Multiplan PHCS |
$180.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$210.00
|
| Rate for Payer: UHCCP Medicaid |
$59.41
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$87.40
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$4,199.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
76101163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$545.95 |
| Max. Negotiated Rate |
$4,031.60 |
| Rate for Payer: Aetna Commercial |
$3,233.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,275.67
|
| Rate for Payer: Cash Price |
$2,099.79
|
| Rate for Payer: Cigna Commercial |
$3,485.65
|
| Rate for Payer: First Health Commercial |
$3,989.60
|
| Rate for Payer: Humana Commercial |
$3,569.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,443.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,099.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,259.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,695.63
|
| Rate for Payer: Ohio Health Group HMO |
$3,149.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$839.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$545.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,301.87
|
| Rate for Payer: PHCS Commercial |
$4,031.60
|
| Rate for Payer: United Healthcare All Payer |
$3,695.63
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$2,228.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
45000214
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.64 |
| Max. Negotiated Rate |
$2,138.88 |
| Rate for Payer: Aetna Commercial |
$1,715.56
|
| Rate for Payer: Anthem Medicaid |
$766.21
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,467.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,737.84
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,054.81
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,981.42
|
| Rate for Payer: Cash Price |
$1,114.00
|
| Rate for Payer: Cash Price |
$1,114.00
|
| Rate for Payer: Cigna Commercial |
$1,849.24
|
| Rate for Payer: First Health Commercial |
$2,116.60
|
| Rate for Payer: Humana Commercial |
$1,893.80
|
| Rate for Payer: Humana KY Medicaid |
$766.21
|
| Rate for Payer: Humana Medicare Advantage |
$1,467.72
|
| Rate for Payer: Kentucky WC Medicaid |
$774.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,826.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,644.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,761.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$781.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,960.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,671.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$445.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$289.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$690.68
|
| Rate for Payer: PHCS Commercial |
$2,138.88
|
| Rate for Payer: United Healthcare All Payer |
$1,960.64
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 31541
|
| Hospital Charge Code |
41000024
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$244.99 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: Aetna Commercial |
$405.04
|
| Rate for Payer: Anthem Medicaid |
$244.99
|
| 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 |
$410.10
|
| Rate for Payer: Healthspan PPO |
$341.58
|
| Rate for Payer: Humana Medicaid |
$244.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$348.74
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$249.89
|
| Rate for Payer: Molina Healthcare Passport |
$244.99
|
| 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 |
$247.44
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$2,228.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
45000214
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.64 |
| Max. Negotiated Rate |
$2,138.88 |
| Rate for Payer: Aetna Commercial |
$1,715.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,737.84
|
| Rate for Payer: Cash Price |
$1,114.00
|
| Rate for Payer: Cigna Commercial |
$1,849.24
|
| Rate for Payer: First Health Commercial |
$2,116.60
|
| Rate for Payer: Humana Commercial |
$1,893.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,826.96
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,644.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$668.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,960.64
|
| Rate for Payer: Ohio Health Group HMO |
$1,671.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$445.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$289.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$690.68
|
| Rate for Payer: PHCS Commercial |
$2,138.88
|
| Rate for Payer: United Healthcare All Payer |
$1,960.64
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 31546
|
| Hospital Charge Code |
41000025
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$837.23
|
| Rate for Payer: Anthem Medicaid |
$435.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cigna Commercial |
$839.66
|
| Rate for Payer: Healthspan PPO |
$706.05
|
| Rate for Payer: Humana Medicaid |
$435.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$723.62
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$444.42
|
| Rate for Payer: Molina Healthcare Passport |
$435.71
|
| Rate for Payer: Multiplan PHCS |
$540.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$630.00
|
| Rate for Payer: UHCCP Medicaid |
$315.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$440.07
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$4,199.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
76101163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$4,199.58 |
| Rate for Payer: Aetna Commercial |
$240.64
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$81.15
|
| Rate for Payer: Anthem Medicaid |
$112.27
|
| Rate for Payer: Buckeye Medicare Advantage |
$4,199.58
|
| Rate for Payer: Cash Price |
$2,099.79
|
| Rate for Payer: Cash Price |
$2,099.79
|
| Rate for Payer: Cigna Commercial |
$356.09
|
| Rate for Payer: Healthspan PPO |
$298.17
|
| Rate for Payer: Humana Medicaid |
$112.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$208.02
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$114.52
|
| Rate for Payer: Molina Healthcare Passport |
$112.27
|
| Rate for Payer: Multiplan PHCS |
$2,519.75
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,939.71
|
| Rate for Payer: UHCCP Medicaid |
$85.21
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$113.39
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY;
|
Facility
|
OP
|
$4,533.70
|
|
|
Service Code
|
CPT 31535
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,238.36 |
| Max. Negotiated Rate |
$4,533.70 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,238.36
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,533.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,371.79
|
| Rate for Payer: Humana Medicare Advantage |
$3,238.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,886.03
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$4,533.70
|
|
|
Service Code
|
CPT 31536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,238.36 |
| Max. Negotiated Rate |
$4,533.70 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,238.36
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,533.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,371.79
|
| Rate for Payer: Humana Medicare Advantage |
$3,238.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,886.03
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$4,533.70
|
|
|
Service Code
|
CPT 31541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,238.36 |
| Max. Negotiated Rate |
$4,533.70 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,238.36
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,533.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,371.79
|
| Rate for Payer: Humana Medicare Advantage |
$3,238.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,886.03
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
761P1163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$550.00 |
| Rate for Payer: Aetna Commercial |
$240.64
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$81.15
|
| Rate for Payer: Anthem Medicaid |
$112.27
|
| Rate for Payer: Buckeye Medicare Advantage |
$550.00
|
| Rate for Payer: Cash Price |
$275.00
|
| Rate for Payer: Cash Price |
$275.00
|
| Rate for Payer: Cigna Commercial |
$356.09
|
| Rate for Payer: Healthspan PPO |
$298.17
|
| Rate for Payer: Humana Medicaid |
$112.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$208.02
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$114.52
|
| Rate for Payer: Molina Healthcare Passport |
$112.27
|
| Rate for Payer: Multiplan PHCS |
$330.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$385.00
|
| Rate for Payer: UHCCP Medicaid |
$85.21
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$113.39
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31535
|
| Hospital Charge Code |
410P0021
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$211.22 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$288.18
|
| Rate for Payer: Anthem Medicaid |
$211.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$850.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$290.13
|
| Rate for Payer: Healthspan PPO |
$243.03
|
| Rate for Payer: Humana Medicaid |
$211.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$248.90
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$215.44
|
| Rate for Payer: Molina Healthcare Passport |
$211.22
|
| Rate for Payer: Multiplan PHCS |
$510.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$595.00
|
| Rate for Payer: UHCCP Medicaid |
$297.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$213.33
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 31515
|
| Hospital Charge Code |
410P0018
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$165.27
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$56.58
|
| Rate for Payer: Anthem Medicaid |
$86.53
|
| Rate for Payer: Buckeye Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$163.42
|
| Rate for Payer: Healthspan PPO |
$245.44
|
| Rate for Payer: Humana Medicaid |
$86.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$142.52
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$88.26
|
| Rate for Payer: Molina Healthcare Passport |
$86.53
|
| Rate for Payer: Multiplan PHCS |
$180.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$210.00
|
| Rate for Payer: UHCCP Medicaid |
$59.41
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$87.40
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 31541
|
| Hospital Charge Code |
410P0024
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$244.99 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: Aetna Commercial |
$405.04
|
| Rate for Payer: Anthem Medicaid |
$244.99
|
| 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 |
$410.10
|
| Rate for Payer: Healthspan PPO |
$341.58
|
| Rate for Payer: Humana Medicaid |
$244.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$348.74
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$249.89
|
| Rate for Payer: Molina Healthcare Passport |
$244.99
|
| 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 |
$247.44
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 31546
|
| Hospital Charge Code |
410P0025
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$837.23
|
| Rate for Payer: Anthem Medicaid |
$435.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cigna Commercial |
$839.66
|
| Rate for Payer: Healthspan PPO |
$706.05
|
| Rate for Payer: Humana Medicaid |
$435.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$723.62
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$444.42
|
| Rate for Payer: Molina Healthcare Passport |
$435.71
|
| Rate for Payer: Multiplan PHCS |
$540.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$630.00
|
| Rate for Payer: UHCCP Medicaid |
$315.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$440.07
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$1,250.00
|
|
|
Service Code
|
HCPCS 31536
|
| Hospital Charge Code |
410P0022
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$216.25 |
| Max. Negotiated Rate |
$1,250.00 |
| Rate for Payer: Aetna Commercial |
$321.92
|
| Rate for Payer: Anthem Medicaid |
$216.25
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,250.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cigna Commercial |
$325.55
|
| Rate for Payer: Healthspan PPO |
$271.48
|
| Rate for Payer: Humana Medicaid |
$216.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$277.53
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$220.58
|
| Rate for Payer: Molina Healthcare Passport |
$216.25
|
| Rate for Payer: Multiplan PHCS |
$750.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$875.00
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$218.41
|
|
