|
LARYNGOSCOP FLEX AIRWAY
|
Facility
|
IP
|
$524.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
45000216
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$157.20 |
| Max. Negotiated Rate |
$503.04 |
| Rate for Payer: Aetna Commercial |
$403.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$408.72
|
| Rate for Payer: Cash Price |
$262.00
|
| Rate for Payer: Cigna Commercial |
$434.92
|
| Rate for Payer: First Health Commercial |
$497.80
|
| Rate for Payer: Humana Commercial |
$445.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$429.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$386.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$157.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$461.12
|
| Rate for Payer: Ohio Health Group HMO |
$393.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$419.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$455.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$361.56
|
| Rate for Payer: PHCS Commercial |
$503.04
|
| Rate for Payer: United Healthcare All Payer |
$461.12
|
|
|
LARYNGOSCOP FLEX AIRWAY
|
Professional
|
Both
|
$874.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
76101165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$524.40 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Ambetter Exchange |
$64.89
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$43.85
|
| Rate for Payer: Anthem Medicaid |
$58.04
|
| Rate for Payer: Buckeye Individual/Medicaid |
$64.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$64.89
|
| Rate for Payer: CareSource Just4Me Medicare |
$77.87
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$168.18
|
| Rate for Payer: Healthspan PPO |
$137.50
|
| Rate for Payer: Humana Medicaid |
$58.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$97.85
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$64.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$64.89
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$59.20
|
| Rate for Payer: Molina Healthcare Passport |
$58.04
|
| Rate for Payer: Multiplan PHCS |
$524.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.36
|
| Rate for Payer: UHCCP Medicaid |
$46.04
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$58.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$64.89
|
|
|
LARYNGOSCOP FLEX AIRWAY(P
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
761P1165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Ambetter Exchange |
$64.89
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$43.85
|
| Rate for Payer: Anthem Medicaid |
$58.04
|
| Rate for Payer: Buckeye Individual/Medicaid |
$64.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$64.89
|
| Rate for Payer: CareSource Just4Me Medicare |
$77.87
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cigna Commercial |
$168.18
|
| Rate for Payer: Healthspan PPO |
$137.50
|
| Rate for Payer: Humana Medicaid |
$58.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$97.85
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$64.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$64.89
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$59.20
|
| Rate for Payer: Molina Healthcare Passport |
$58.04
|
| Rate for Payer: Multiplan PHCS |
$210.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.36
|
| Rate for Payer: UHCCP Medicaid |
$46.04
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$58.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$64.89
|
|
|
LARYNGOSCOP FLEX AIRWAY(T
|
Facility
|
IP
|
$524.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
761T1165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.20 |
| Max. Negotiated Rate |
$503.04 |
| Rate for Payer: Aetna Commercial |
$403.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$408.72
|
| Rate for Payer: Cash Price |
$262.00
|
| Rate for Payer: Cigna Commercial |
$434.92
|
| Rate for Payer: First Health Commercial |
$497.80
|
| Rate for Payer: Humana Commercial |
$445.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$429.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$386.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$157.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$461.12
|
| Rate for Payer: Ohio Health Group HMO |
$393.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$419.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$455.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$361.56
|
| Rate for Payer: PHCS Commercial |
$503.04
|
| Rate for Payer: United Healthcare All Payer |
$461.12
|
|
|
LARYNGOSCOP FLEX AIRWAY(T
|
Facility
|
OP
|
$524.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
761T1165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.38 |
| Max. Negotiated Rate |
$503.04 |
| Rate for Payer: Aetna Commercial |
$403.48
|
| Rate for Payer: Anthem Medicaid |
$180.20
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$179.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$408.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$251.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.16
|
| Rate for Payer: Cash Price |
$262.00
|
| Rate for Payer: Cash Price |
$262.00
|
| Rate for Payer: Cigna Commercial |
$434.92
|
| Rate for Payer: First Health Commercial |
$497.80
|
| Rate for Payer: Humana Commercial |
$445.40
|
| Rate for Payer: Humana KY Medicaid |
$180.20
|
| Rate for Payer: Humana Medicare Advantage |
$179.38
|
| Rate for Payer: Kentucky WC Medicaid |
$182.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$429.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$386.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$215.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$183.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$461.12
|
| Rate for Payer: Ohio Health Group HMO |
$393.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$419.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$455.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$361.56
|
| Rate for Payer: PHCS Commercial |
$503.04
|
| Rate for Payer: United Healthcare All Payer |
$461.12
|
|
|
LARYNGOSCOPY
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
HCPCS 31540
|
| Hospital Charge Code |
41000023
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$292.31 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Anthem Medicaid |
$292.31
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$663.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$705.50
|
| Rate for Payer: First Health Commercial |
$807.50
|
| Rate for Payer: Humana Commercial |
$722.50
|
| Rate for Payer: Humana KY Medicaid |
$292.31
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Kentucky WC Medicaid |
$295.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$697.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$627.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$298.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$748.00
|
| Rate for Payer: Ohio Health Group HMO |
$637.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$739.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$586.50
|
| Rate for Payer: PHCS Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Payer |
$748.00
|
|
|
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 |
$450.00 |
| Rate for Payer: Aetna Commercial |
$195.49
|
| Rate for Payer: Ambetter Exchange |
$126.16
|
| 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 Individual/Medicaid |
$126.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$126.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$151.39
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$126.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$126.16
|
| 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 |
$164.01
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$92.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$126.16
|
|
|
LARYNGOSCOPY
|
Facility
|
IP
|
$850.00
|
|
|
Service Code
|
HCPCS 31540
|
| Hospital Charge Code |
41000023
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$663.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$705.50
|
| Rate for Payer: First Health Commercial |
$807.50
|
| Rate for Payer: Humana Commercial |
$722.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$697.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$627.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$255.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$748.00
|
| Rate for Payer: Ohio Health Group HMO |
$637.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$739.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$586.50
|
| Rate for Payer: PHCS Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Payer |
$748.00
|
|
|
LARYNGOSCOPY
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 31511
|
| Hospital Charge Code |
41000016
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$179.38 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem Medicaid |
$257.93
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$179.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$251.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.16
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Humana KY Medicaid |
$257.93
|
| Rate for Payer: Humana Medicare Advantage |
$179.38
|
| Rate for Payer: Kentucky WC Medicaid |
$260.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$215.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$263.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
LARYNGOSCOPY
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31540
|
| Hospital Charge Code |
41000023
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$226.99 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$370.00
|
| Rate for Payer: Ambetter Exchange |
$226.99
|
| Rate for Payer: Anthem Medicaid |
$277.90
|
| Rate for Payer: Buckeye Individual/Medicaid |
$226.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$226.99
|
| Rate for Payer: CareSource Just4Me Medicare |
$272.39
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$226.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$226.99
|
| 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 |
$295.09
|
| Rate for Payer: UHCCP Medicaid |
$297.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$280.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$226.99
|
|
|
LARYNGOSCOPY
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 31511
|
| Hospital Charge Code |
41000016
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
LARYNGOSCOPY AND DILATION
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
HCPCS 31528
|
| Hospital Charge Code |
76102928
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.00 |
| 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 |
$280.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$304.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$241.50
|
| Rate for Payer: PHCS Commercial |
$336.00
|
| Rate for Payer: United Healthcare All Payer |
$308.00
|
|
|
LARYNGOSCOPY AND DILATION
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
HCPCS 31528
|
| Hospital Charge Code |
76102928
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.36 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Aetna Commercial |
$269.50
|
| Rate for Payer: Anthem Medicaid |
$120.36
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$273.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| 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 |
$3,406.67
|
| 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 |
$4,088.00
|
| 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 |
$280.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$304.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$241.50
|
| 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 |
$217.79 |
| Rate for Payer: Aetna Commercial |
$217.79
|
| Rate for Payer: Ambetter Exchange |
$136.09
|
| Rate for Payer: Anthem Medicaid |
$148.18
|
| Rate for Payer: Buckeye Individual/Medicaid |
$136.09
|
| Rate for Payer: Buckeye Medicare Advantage |
$136.09
|
| Rate for Payer: CareSource Just4Me Medicare |
$163.31
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$136.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$136.09
|
| 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 |
$176.92
|
| Rate for Payer: UHCCP Medicaid |
$122.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$149.66
|
| Rate for Payer: Wellcare Medicare Advantage |
$136.09
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$3,649.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
45000214
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,094.87 |
| Max. Negotiated Rate |
$3,503.60 |
| Rate for Payer: Aetna Commercial |
$2,810.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,846.67
|
| Rate for Payer: Cash Price |
$1,824.79
|
| Rate for Payer: Cigna Commercial |
$3,029.15
|
| Rate for Payer: First Health Commercial |
$3,467.10
|
| Rate for Payer: Humana Commercial |
$3,102.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,992.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,693.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,094.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,211.63
|
| Rate for Payer: Ohio Health Group HMO |
$2,737.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,919.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,175.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,518.21
|
| Rate for Payer: PHCS Commercial |
$3,503.60
|
| Rate for Payer: United Healthcare All Payer |
$3,211.63
|
|
|
LARYNGOSCOPY DIRECT
|
Professional
|
Both
|
$1,250.00
|
|
|
Service Code
|
HCPCS 31536
|
| Hospital Charge Code |
41000022
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$197.58 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$321.92
|
| Rate for Payer: Ambetter Exchange |
$197.58
|
| Rate for Payer: Anthem Medicaid |
$216.25
|
| Rate for Payer: Buckeye Individual/Medicaid |
$197.58
|
| Rate for Payer: Buckeye Medicare Advantage |
$197.58
|
| Rate for Payer: CareSource Just4Me Medicare |
$237.10
|
| 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 |
$271.49
|
| Rate for Payer: Humana Medicaid |
$216.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$277.53
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$197.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$197.58
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$220.57
|
| Rate for Payer: Molina Healthcare Passport |
$216.25
|
| Rate for Payer: Multiplan PHCS |
$750.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$256.85
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$218.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$197.58
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
HCPCS 31535
|
| Hospital Charge Code |
41000021
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$292.31 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Anthem Medicaid |
$292.31
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$663.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$705.50
|
| Rate for Payer: First Health Commercial |
$807.50
|
| Rate for Payer: Humana Commercial |
$722.50
|
| Rate for Payer: Humana KY Medicaid |
$292.31
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Kentucky WC Medicaid |
$295.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$697.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$627.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$298.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$748.00
|
| Rate for Payer: Ohio Health Group HMO |
$637.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$739.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$586.50
|
| Rate for Payer: PHCS Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Payer |
$748.00
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$850.00
|
|
|
Service Code
|
HCPCS 31535
|
| Hospital Charge Code |
41000021
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$663.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$705.50
|
| Rate for Payer: First Health Commercial |
$807.50
|
| Rate for Payer: Humana Commercial |
$722.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$697.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$627.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$255.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$748.00
|
| Rate for Payer: Ohio Health Group HMO |
$637.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$739.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$586.50
|
| Rate for Payer: PHCS Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Payer |
$748.00
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
HCPCS 31546
|
| Hospital Charge Code |
41000025
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$309.51 |
| Max. Negotiated Rate |
$8,954.71 |
| Rate for Payer: Aetna Commercial |
$693.00
|
| Rate for Payer: Anthem Medicaid |
$309.51
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$6,396.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$702.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$8,954.71
|
| Rate for Payer: CareSource Just4Me Medicare |
$8,634.90
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cigna Commercial |
$747.00
|
| Rate for Payer: First Health Commercial |
$855.00
|
| Rate for Payer: Humana Commercial |
$765.00
|
| Rate for Payer: Humana KY Medicaid |
$309.51
|
| Rate for Payer: Humana Medicare Advantage |
$6,396.22
|
| Rate for Payer: Kentucky WC Medicaid |
$312.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$738.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$664.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,675.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$315.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$792.00
|
| Rate for Payer: Ohio Health Group HMO |
$675.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$783.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.00
|
| Rate for Payer: PHCS Commercial |
$864.00
|
| Rate for Payer: United Healthcare All Payer |
$792.00
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$1,250.00
|
|
|
Service Code
|
HCPCS 31536
|
| Hospital Charge Code |
41000022
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$375.00 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$962.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$975.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cigna Commercial |
$1,037.50
|
| Rate for Payer: First Health Commercial |
$1,187.50
|
| Rate for Payer: Humana Commercial |
$1,062.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,025.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$922.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$375.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,100.00
|
| Rate for Payer: Ohio Health Group HMO |
$937.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,087.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$862.50
|
| Rate for Payer: PHCS Commercial |
$1,200.00
|
| Rate for Payer: United Healthcare All Payer |
$1,100.00
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$3,649.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
45000214
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,255.09 |
| Max. Negotiated Rate |
$3,503.60 |
| Rate for Payer: Aetna Commercial |
$2,810.18
|
| Rate for Payer: Anthem Medicaid |
$1,255.09
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,593.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,846.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,230.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,151.06
|
| Rate for Payer: Cash Price |
$1,824.79
|
| Rate for Payer: Cash Price |
$1,824.79
|
| Rate for Payer: Cigna Commercial |
$3,029.15
|
| Rate for Payer: First Health Commercial |
$3,467.10
|
| Rate for Payer: Humana Commercial |
$3,102.14
|
| Rate for Payer: Humana KY Medicaid |
$1,255.09
|
| Rate for Payer: Humana Medicare Advantage |
$1,593.38
|
| Rate for Payer: Kentucky WC Medicaid |
$1,267.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,992.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,693.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,912.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,280.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,211.63
|
| Rate for Payer: Ohio Health Group HMO |
$2,737.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,919.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,175.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,518.21
|
| Rate for Payer: PHCS Commercial |
$3,503.60
|
| Rate for Payer: United Healthcare All Payer |
$3,211.63
|
|
|
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 |
$2,519.75 |
| Rate for Payer: Aetna Commercial |
$240.64
|
| Rate for Payer: Ambetter Exchange |
$150.85
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$81.15
|
| Rate for Payer: Anthem Medicaid |
$141.77
|
| Rate for Payer: Buckeye Individual/Medicaid |
$150.85
|
| Rate for Payer: Buckeye Medicare Advantage |
$150.85
|
| Rate for Payer: CareSource Just4Me Medicare |
$181.02
|
| 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 |
$141.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$208.02
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$150.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$150.85
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$144.61
|
| Rate for Payer: Molina Healthcare Passport |
$141.77
|
| Rate for Payer: Multiplan PHCS |
$2,519.75
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$196.10
|
| Rate for Payer: UHCCP Medicaid |
$85.21
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$143.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$150.85
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$4,199.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
76101163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,444.24 |
| 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 |
$1,593.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,275.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,230.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,151.06
|
| 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 |
$1,593.38
|
| 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 |
$1,912.06
|
| 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 |
$3,359.66
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,653.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,897.71
|
| Rate for Payer: PHCS Commercial |
$4,031.60
|
| Rate for Payer: United Healthcare All Payer |
$3,695.63
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
HCPCS 31515
|
| Hospital Charge Code |
41000018
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$231.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$234.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$249.00
|
| Rate for Payer: First Health Commercial |
$285.00
|
| Rate for Payer: Humana Commercial |
$255.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$246.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$221.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$90.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$264.00
|
| Rate for Payer: Ohio Health Group HMO |
$225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$240.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$261.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$207.00
|
| Rate for Payer: PHCS Commercial |
$288.00
|
| Rate for Payer: United Healthcare All Payer |
$264.00
|
|
|
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 |
$245.44 |
| Rate for Payer: Aetna Commercial |
$165.27
|
| Rate for Payer: Ambetter Exchange |
$104.96
|
| 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 Individual/Medicaid |
$104.96
|
| Rate for Payer: Buckeye Medicare Advantage |
$104.96
|
| Rate for Payer: CareSource Just4Me Medicare |
$125.95
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$104.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$104.96
|
| 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 |
$136.45
|
| Rate for Payer: UHCCP Medicaid |
$59.41
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$87.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$104.96
|
|
