|
LAP CLOSE ENTEROSTOMY
|
Facility
|
OP
|
$3,700.00
|
|
|
Service Code
|
HCPCS 44227
|
| Hospital Charge Code |
76101833
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,110.00 |
| Max. Negotiated Rate |
$3,552.00 |
| Rate for Payer: Aetna Commercial |
$2,849.00
|
| Rate for Payer: Anthem Medicaid |
$1,272.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,886.00
|
| Rate for Payer: Cash Price |
$1,850.00
|
| Rate for Payer: Cigna Commercial |
$3,071.00
|
| Rate for Payer: First Health Commercial |
$3,515.00
|
| Rate for Payer: Humana Commercial |
$3,145.00
|
| Rate for Payer: Humana KY Medicaid |
$1,272.43
|
| Rate for Payer: Kentucky WC Medicaid |
$1,285.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,034.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,730.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,110.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,297.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,256.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,775.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,960.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,219.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,553.00
|
| Rate for Payer: PHCS Commercial |
$3,552.00
|
| Rate for Payer: United Healthcare All Payer |
$3,256.00
|
|
|
LAP CLOSE ENTEROSTOMY
|
Facility
|
IP
|
$3,700.00
|
|
|
Service Code
|
HCPCS 44227
|
| Hospital Charge Code |
76101833
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,110.00 |
| Max. Negotiated Rate |
$3,552.00 |
| Rate for Payer: Aetna Commercial |
$2,849.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,886.00
|
| Rate for Payer: Cash Price |
$1,850.00
|
| Rate for Payer: Cigna Commercial |
$3,071.00
|
| Rate for Payer: First Health Commercial |
$3,515.00
|
| Rate for Payer: Humana Commercial |
$3,145.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,034.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,730.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,110.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,256.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,775.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,960.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,219.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,553.00
|
| Rate for Payer: PHCS Commercial |
$3,552.00
|
| Rate for Payer: United Healthcare All Payer |
$3,256.00
|
|
|
LAP CLOSE ENTEROSTOMY
|
Professional
|
Both
|
$3,700.00
|
|
|
Service Code
|
HCPCS 44227
|
| Hospital Charge Code |
76101833
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,145.29 |
| Max. Negotiated Rate |
$2,433.39 |
| Rate for Payer: Aetna Commercial |
$2,433.39
|
| Rate for Payer: Ambetter Exchange |
$1,567.08
|
| Rate for Payer: Anthem Medicaid |
$1,145.29
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,567.08
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,567.08
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,880.50
|
| Rate for Payer: Cash Price |
$1,850.00
|
| Rate for Payer: Cash Price |
$1,850.00
|
| Rate for Payer: Cigna Commercial |
$2,275.44
|
| Rate for Payer: Healthspan PPO |
$2,052.12
|
| Rate for Payer: Humana Medicaid |
$1,145.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,139.28
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,567.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,567.08
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,168.20
|
| Rate for Payer: Molina Healthcare Passport |
$1,145.29
|
| Rate for Payer: Multiplan PHCS |
$2,220.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,037.20
|
| Rate for Payer: UHCCP Medicaid |
$1,295.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,156.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,567.08
|
|
|
LAP CLOSE ENTEROSTOMY(P
|
Professional
|
Both
|
$3,700.00
|
|
|
Service Code
|
HCPCS 44227
|
| Hospital Charge Code |
761P1833
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,145.29 |
| Max. Negotiated Rate |
$2,433.39 |
| Rate for Payer: Aetna Commercial |
$2,433.39
|
| Rate for Payer: Ambetter Exchange |
$1,567.08
|
| Rate for Payer: Anthem Medicaid |
$1,145.29
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,567.08
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,567.08
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,880.50
|
| Rate for Payer: Cash Price |
$1,850.00
|
| Rate for Payer: Cash Price |
$1,850.00
|
| Rate for Payer: Cigna Commercial |
$2,275.44
|
| Rate for Payer: Healthspan PPO |
$2,052.12
|
| Rate for Payer: Humana Medicaid |
$1,145.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,139.28
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,567.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,567.08
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,168.20
|
| Rate for Payer: Molina Healthcare Passport |
$1,145.29
|
| Rate for Payer: Multiplan PHCS |
$2,220.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,037.20
|
| Rate for Payer: UHCCP Medicaid |
$1,295.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,156.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,567.08
|
|
|
LAP COLECTOMY PARTIAL
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 44205
|
| Hospital Charge Code |
76101829
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Aetna Commercial |
$2,310.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,340.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,490.00
|
| Rate for Payer: First Health Commercial |
$2,850.00
|
| Rate for Payer: Humana Commercial |
$2,550.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,460.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,214.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$900.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,640.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,610.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,070.00
|
| Rate for Payer: PHCS Commercial |
$2,880.00
|
| Rate for Payer: United Healthcare All Payer |
$2,640.00
|
|
|
LAP COLECTOMY PARTIAL
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 44205
|
| Hospital Charge Code |
76101829
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Aetna Commercial |
$2,310.00
|
| Rate for Payer: Anthem Medicaid |
$1,031.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,340.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,490.00
|
| Rate for Payer: First Health Commercial |
$2,850.00
|
| Rate for Payer: Humana Commercial |
$2,550.00
|
| Rate for Payer: Humana KY Medicaid |
$1,031.70
|
| Rate for Payer: Kentucky WC Medicaid |
$1,042.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,460.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,214.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$900.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,052.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,640.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,610.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,070.00
|
| Rate for Payer: PHCS Commercial |
$2,880.00
|
| Rate for Payer: United Healthcare All Payer |
$2,640.00
|
|
|
LAP COLECTOMY PARTIAL
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 44205
|
| Hospital Charge Code |
76101829
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$918.82 |
| Max. Negotiated Rate |
$1,962.89 |
| Rate for Payer: Aetna Commercial |
$1,962.89
|
| Rate for Payer: Ambetter Exchange |
$1,262.01
|
| Rate for Payer: Anthem Medicaid |
$918.82
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,262.01
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,262.01
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,514.41
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$1,843.93
|
| Rate for Payer: Healthspan PPO |
$1,655.34
|
| Rate for Payer: Humana Medicaid |
$918.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,714.01
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,262.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,262.01
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$937.20
|
| Rate for Payer: Molina Healthcare Passport |
$918.82
|
| Rate for Payer: Multiplan PHCS |
$1,800.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,640.61
|
| Rate for Payer: UHCCP Medicaid |
$1,050.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$928.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,262.01
|
|
|
LAP COLECTOMY PARTIAL(P
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 44205
|
| Hospital Charge Code |
761P1829
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$918.82 |
| Max. Negotiated Rate |
$1,962.89 |
| Rate for Payer: Aetna Commercial |
$1,962.89
|
| Rate for Payer: Ambetter Exchange |
$1,262.01
|
| Rate for Payer: Anthem Medicaid |
$918.82
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,262.01
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,262.01
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,514.41
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$1,843.93
|
| Rate for Payer: Healthspan PPO |
$1,655.34
|
| Rate for Payer: Humana Medicaid |
$918.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,714.01
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,262.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,262.01
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$937.20
|
| Rate for Payer: Molina Healthcare Passport |
$918.82
|
| Rate for Payer: Multiplan PHCS |
$1,800.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,640.61
|
| Rate for Payer: UHCCP Medicaid |
$1,050.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$928.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,262.01
|
|
|
LAP COLECTOMY PART W/ANAST
|
Professional
|
Both
|
$4,000.00
|
|
|
Service Code
|
HCPCS 44207
|
| Hospital Charge Code |
76101831
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,224.87 |
| Max. Negotiated Rate |
$2,678.25 |
| Rate for Payer: Aetna Commercial |
$2,678.25
|
| Rate for Payer: Ambetter Exchange |
$1,708.73
|
| Rate for Payer: Anthem Medicaid |
$1,224.87
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,708.73
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,708.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,050.48
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cigna Commercial |
$2,511.87
|
| Rate for Payer: Healthspan PPO |
$2,258.62
|
| Rate for Payer: Humana Medicaid |
$1,224.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,342.20
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,708.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,708.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,249.37
|
| Rate for Payer: Molina Healthcare Passport |
$1,224.87
|
| Rate for Payer: Multiplan PHCS |
$2,400.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,221.35
|
| Rate for Payer: UHCCP Medicaid |
$1,400.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,237.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,708.73
|
|
|
LAP COLECTOMY PART W/ANAST
|
Facility
|
OP
|
$4,000.00
|
|
|
Service Code
|
HCPCS 44207
|
| Hospital Charge Code |
76101831
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,200.00 |
| Max. Negotiated Rate |
$3,840.00 |
| Rate for Payer: Aetna Commercial |
$3,080.00
|
| Rate for Payer: Anthem Medicaid |
$1,375.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,120.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cigna Commercial |
$3,320.00
|
| Rate for Payer: First Health Commercial |
$3,800.00
|
| Rate for Payer: Humana Commercial |
$3,400.00
|
| Rate for Payer: Humana KY Medicaid |
$1,375.60
|
| Rate for Payer: Kentucky WC Medicaid |
$1,389.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,280.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,952.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,200.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,403.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,520.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,200.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,480.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,760.00
|
| Rate for Payer: PHCS Commercial |
$3,840.00
|
| Rate for Payer: United Healthcare All Payer |
$3,520.00
|
|
|
LAP COLECTOMY PART W/ANAST
|
Facility
|
IP
|
$4,000.00
|
|
|
Service Code
|
HCPCS 44207
|
| Hospital Charge Code |
76101831
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,200.00 |
| Max. Negotiated Rate |
$3,840.00 |
| Rate for Payer: Aetna Commercial |
$3,080.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,120.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cigna Commercial |
$3,320.00
|
| Rate for Payer: First Health Commercial |
$3,800.00
|
| Rate for Payer: Humana Commercial |
$3,400.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,280.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,952.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,200.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,520.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,200.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,480.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,760.00
|
| Rate for Payer: PHCS Commercial |
$3,840.00
|
| Rate for Payer: United Healthcare All Payer |
$3,520.00
|
|
|
LAP COLECTOMY PART W/ANAST(P
|
Professional
|
Both
|
$4,000.00
|
|
|
Service Code
|
HCPCS 44207
|
| Hospital Charge Code |
761P1831
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,224.87 |
| Max. Negotiated Rate |
$2,678.25 |
| Rate for Payer: Aetna Commercial |
$2,678.25
|
| Rate for Payer: Ambetter Exchange |
$1,708.73
|
| Rate for Payer: Anthem Medicaid |
$1,224.87
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,708.73
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,708.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,050.48
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cigna Commercial |
$2,511.87
|
| Rate for Payer: Healthspan PPO |
$2,258.62
|
| Rate for Payer: Humana Medicaid |
$1,224.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,342.20
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,708.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,708.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,249.37
|
| Rate for Payer: Molina Healthcare Passport |
$1,224.87
|
| Rate for Payer: Multiplan PHCS |
$2,400.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,221.35
|
| Rate for Payer: UHCCP Medicaid |
$1,400.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,237.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,708.73
|
|
|
LAP COLOSTOMY
|
Facility
|
IP
|
$3,020.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
76101826
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$906.00 |
| Max. Negotiated Rate |
$2,899.20 |
| Rate for Payer: Aetna Commercial |
$2,325.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,355.60
|
| Rate for Payer: Cash Price |
$1,510.00
|
| Rate for Payer: Cigna Commercial |
$2,506.60
|
| Rate for Payer: First Health Commercial |
$2,869.00
|
| Rate for Payer: Humana Commercial |
$2,567.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,476.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,228.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$906.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,657.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,265.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,416.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,627.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,083.80
|
| Rate for Payer: PHCS Commercial |
$2,899.20
|
| Rate for Payer: United Healthcare All Payer |
$2,657.60
|
|
|
LAP COLOSTOMY
|
Professional
|
Both
|
$3,020.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
76101826
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$806.58 |
| Max. Negotiated Rate |
$1,812.00 |
| Rate for Payer: Aetna Commercial |
$1,746.88
|
| Rate for Payer: Ambetter Exchange |
$1,144.41
|
| Rate for Payer: Anthem Medicaid |
$806.58
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,144.41
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,144.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,373.29
|
| Rate for Payer: Cash Price |
$1,510.00
|
| Rate for Payer: Cash Price |
$1,510.00
|
| Rate for Payer: Cigna Commercial |
$1,632.93
|
| Rate for Payer: Healthspan PPO |
$1,473.17
|
| Rate for Payer: Humana Medicaid |
$806.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,551.44
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,144.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,144.41
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$822.71
|
| Rate for Payer: Molina Healthcare Passport |
$806.58
|
| Rate for Payer: Multiplan PHCS |
$1,812.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,487.73
|
| Rate for Payer: UHCCP Medicaid |
$1,057.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$814.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,144.41
|
|
|
LAP COLOSTOMY
|
Facility
|
OP
|
$3,020.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
76101826
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$906.00 |
| Max. Negotiated Rate |
$2,899.20 |
| Rate for Payer: Aetna Commercial |
$2,325.40
|
| Rate for Payer: Anthem Medicaid |
$1,038.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,355.60
|
| Rate for Payer: Cash Price |
$1,510.00
|
| Rate for Payer: Cigna Commercial |
$2,506.60
|
| Rate for Payer: First Health Commercial |
$2,869.00
|
| Rate for Payer: Humana Commercial |
$2,567.00
|
| Rate for Payer: Humana KY Medicaid |
$1,038.58
|
| Rate for Payer: Kentucky WC Medicaid |
$1,049.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,476.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,228.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$906.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,059.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,657.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,265.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,416.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,627.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,083.80
|
| Rate for Payer: PHCS Commercial |
$2,899.20
|
| Rate for Payer: United Healthcare All Payer |
$2,657.60
|
|
|
LAP COLOSTOMY(P
|
Professional
|
Both
|
$3,020.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
761P1826
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$806.58 |
| Max. Negotiated Rate |
$1,812.00 |
| Rate for Payer: Aetna Commercial |
$1,746.88
|
| Rate for Payer: Ambetter Exchange |
$1,144.41
|
| Rate for Payer: Anthem Medicaid |
$806.58
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,144.41
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,144.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,373.29
|
| Rate for Payer: Cash Price |
$1,510.00
|
| Rate for Payer: Cash Price |
$1,510.00
|
| Rate for Payer: Cigna Commercial |
$1,632.93
|
| Rate for Payer: Healthspan PPO |
$1,473.17
|
| Rate for Payer: Humana Medicaid |
$806.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,551.44
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,144.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,144.41
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$822.71
|
| Rate for Payer: Molina Healthcare Passport |
$806.58
|
| Rate for Payer: Multiplan PHCS |
$1,812.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,487.73
|
| Rate for Payer: UHCCP Medicaid |
$1,057.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$814.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,144.41
|
|
|
LAP CURVED SPATULA ELECTRODE
|
Facility
|
OP
|
$562.03
|
|
| Hospital Charge Code |
27000242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.61 |
| Max. Negotiated Rate |
$539.55 |
| Rate for Payer: Aetna Commercial |
$432.76
|
| Rate for Payer: Anthem Medicaid |
$193.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$438.38
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cigna Commercial |
$466.48
|
| Rate for Payer: First Health Commercial |
$533.93
|
| Rate for Payer: Humana Commercial |
$477.73
|
| Rate for Payer: Humana KY Medicaid |
$193.28
|
| Rate for Payer: Kentucky WC Medicaid |
$195.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$460.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$414.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$197.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$494.59
|
| Rate for Payer: Ohio Health Group HMO |
$421.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$449.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$488.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$387.80
|
| Rate for Payer: PHCS Commercial |
$539.55
|
| Rate for Payer: United Healthcare All Payer |
$494.59
|
|
|
LAP CURVED SPATULA ELECTRODE
|
Facility
|
IP
|
$562.03
|
|
| Hospital Charge Code |
27000242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.61 |
| Max. Negotiated Rate |
$539.55 |
| Rate for Payer: Aetna Commercial |
$432.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$438.38
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cigna Commercial |
$466.48
|
| Rate for Payer: First Health Commercial |
$533.93
|
| Rate for Payer: Humana Commercial |
$477.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$460.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$414.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$168.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$494.59
|
| Rate for Payer: Ohio Health Group HMO |
$421.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$449.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$488.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$387.80
|
| Rate for Payer: PHCS Commercial |
$539.55
|
| Rate for Payer: United Healthcare All Payer |
$494.59
|
|
|
LAP DRAINAGE ABDPLVIC ABSCESS
|
Facility
|
IP
|
$2,138.00
|
|
|
Service Code
|
HCPCS 49329
|
| Hospital Charge Code |
76102967
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$641.40 |
| Max. Negotiated Rate |
$2,052.48 |
| Rate for Payer: Aetna Commercial |
$1,646.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,667.64
|
| Rate for Payer: Cash Price |
$1,069.00
|
| Rate for Payer: Cigna Commercial |
$1,774.54
|
| Rate for Payer: First Health Commercial |
$2,031.10
|
| Rate for Payer: Humana Commercial |
$1,817.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,753.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,577.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$641.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,881.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,603.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,710.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,860.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,475.22
|
| Rate for Payer: PHCS Commercial |
$2,052.48
|
| Rate for Payer: United Healthcare All Payer |
$1,881.44
|
|
|
LAP DRAINAGE ABDPLVIC ABSCESS
|
Facility
|
OP
|
$2,138.00
|
|
|
Service Code
|
HCPCS 49329
|
| Hospital Charge Code |
76102967
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$735.26 |
| Max. Negotiated Rate |
$7,547.16 |
| Rate for Payer: Aetna Commercial |
$1,646.26
|
| Rate for Payer: Anthem Medicaid |
$735.26
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,390.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,667.64
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,547.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,277.62
|
| Rate for Payer: Cash Price |
$1,069.00
|
| Rate for Payer: Cash Price |
$1,069.00
|
| Rate for Payer: Cigna Commercial |
$1,774.54
|
| Rate for Payer: First Health Commercial |
$2,031.10
|
| Rate for Payer: Humana Commercial |
$1,817.30
|
| Rate for Payer: Humana KY Medicaid |
$735.26
|
| Rate for Payer: Humana Medicare Advantage |
$5,390.83
|
| Rate for Payer: Kentucky WC Medicaid |
$742.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,753.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,577.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,469.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$750.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,881.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,603.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,710.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,860.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,475.22
|
| Rate for Payer: PHCS Commercial |
$2,052.48
|
| Rate for Payer: United Healthcare All Payer |
$1,881.44
|
|
|
LAP DRAINAGE ABDPLVIC ABSCESS
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 49329
|
| Hospital Charge Code |
76102967
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$1,496.60 |
| Rate for Payer: Cash Price |
$1,069.00
|
| Rate for Payer: Cash Price |
$1,069.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$1,282.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,496.60
|
| Rate for Payer: UHCCP Medicaid |
$748.30
|
|
|
LAPIDUS WEDGE 5*5MM
|
Facility
|
OP
|
$9,568.17
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,870.45 |
| Max. Negotiated Rate |
$9,185.44 |
| Rate for Payer: Aetna Commercial |
$7,367.49
|
| Rate for Payer: Anthem Medicaid |
$3,290.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,463.17
|
| Rate for Payer: Cash Price |
$4,784.09
|
| Rate for Payer: Cigna Commercial |
$7,941.58
|
| Rate for Payer: First Health Commercial |
$9,089.76
|
| Rate for Payer: Humana Commercial |
$8,132.94
|
| Rate for Payer: Humana KY Medicaid |
$3,290.49
|
| Rate for Payer: Kentucky WC Medicaid |
$3,323.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,845.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,061.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,870.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,356.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,419.99
|
| Rate for Payer: Ohio Health Group HMO |
$7,176.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,654.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,324.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,602.04
|
| Rate for Payer: PHCS Commercial |
$9,185.44
|
| Rate for Payer: United Healthcare All Payer |
$8,419.99
|
|
|
LAPIDUS WEDGE 5*5MM
|
Facility
|
IP
|
$9,568.17
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,870.45 |
| Max. Negotiated Rate |
$9,185.44 |
| Rate for Payer: Aetna Commercial |
$7,367.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,463.17
|
| Rate for Payer: Cash Price |
$4,784.09
|
| Rate for Payer: Cigna Commercial |
$7,941.58
|
| Rate for Payer: First Health Commercial |
$9,089.76
|
| Rate for Payer: Humana Commercial |
$8,132.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,845.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,061.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,870.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,419.99
|
| Rate for Payer: Ohio Health Group HMO |
$7,176.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,654.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,324.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,602.04
|
| Rate for Payer: PHCS Commercial |
$9,185.44
|
| Rate for Payer: United Healthcare All Payer |
$8,419.99
|
|
|
LAPIDUS WEDGE 8*8MM
|
Facility
|
OP
|
$9,568.17
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
27000051
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,870.45 |
| Max. Negotiated Rate |
$9,185.44 |
| Rate for Payer: Aetna Commercial |
$7,367.49
|
| Rate for Payer: Anthem Medicaid |
$3,290.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,463.17
|
| Rate for Payer: Cash Price |
$4,784.09
|
| Rate for Payer: Cigna Commercial |
$7,941.58
|
| Rate for Payer: First Health Commercial |
$9,089.76
|
| Rate for Payer: Humana Commercial |
$8,132.94
|
| Rate for Payer: Humana KY Medicaid |
$3,290.49
|
| Rate for Payer: Kentucky WC Medicaid |
$3,323.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,845.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,061.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,870.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,356.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,419.99
|
| Rate for Payer: Ohio Health Group HMO |
$7,176.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,654.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,324.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,602.04
|
| Rate for Payer: PHCS Commercial |
$9,185.44
|
| Rate for Payer: United Healthcare All Payer |
$8,419.99
|
|
|
LAPIDUS WEDGE 8*8MM
|
Facility
|
IP
|
$9,568.17
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
27000051
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,870.45 |
| Max. Negotiated Rate |
$9,185.44 |
| Rate for Payer: Aetna Commercial |
$7,367.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,463.17
|
| Rate for Payer: Cash Price |
$4,784.09
|
| Rate for Payer: Cigna Commercial |
$7,941.58
|
| Rate for Payer: First Health Commercial |
$9,089.76
|
| Rate for Payer: Humana Commercial |
$8,132.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,845.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,061.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,870.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,419.99
|
| Rate for Payer: Ohio Health Group HMO |
$7,176.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,654.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,324.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,602.04
|
| Rate for Payer: PHCS Commercial |
$9,185.44
|
| Rate for Payer: United Healthcare All Payer |
$8,419.99
|
|
