|
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
|
|
|
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 |
$960.00 |
| Rate for Payer: Aetna Commercial |
$405.04
|
| Rate for Payer: Ambetter Exchange |
$247.19
|
| Rate for Payer: Anthem Medicaid |
$244.99
|
| Rate for Payer: Buckeye Individual/Medicaid |
$247.19
|
| Rate for Payer: Buckeye Medicare Advantage |
$247.19
|
| Rate for Payer: CareSource Just4Me Medicare |
$296.63
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$247.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$247.19
|
| 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 |
$321.35
|
| Rate for Payer: UHCCP Medicaid |
$560.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$247.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$247.19
|
|
|
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
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 31546
|
| Hospital Charge Code |
41000025
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$839.66 |
| Rate for Payer: Aetna Commercial |
$837.23
|
| Rate for Payer: Ambetter Exchange |
$515.08
|
| Rate for Payer: Anthem Medicaid |
$435.71
|
| Rate for Payer: Buckeye Individual/Medicaid |
$515.08
|
| Rate for Payer: Buckeye Medicare Advantage |
$515.08
|
| Rate for Payer: CareSource Just4Me Medicare |
$618.10
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$515.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.08
|
| 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 |
$669.60
|
| Rate for Payer: UHCCP Medicaid |
$315.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$440.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$515.08
|
|
|
LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$1,250.00
|
|
|
Service Code
|
HCPCS 31536
|
| Hospital Charge Code |
41000022
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$429.88 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Aetna Commercial |
$962.50
|
| Rate for Payer: Anthem Medicaid |
$429.88
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$975.00
|
| 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 |
$625.00
|
| 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: Humana KY Medicaid |
$429.88
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Kentucky WC Medicaid |
$434.25
|
| 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 |
$4,088.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$438.50
|
| 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
|
$1,600.00
|
|
|
Service Code
|
HCPCS 31541
|
| Hospital Charge Code |
41000024
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$550.24 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Aetna Commercial |
$1,232.00
|
| Rate for Payer: Anthem Medicaid |
$550.24
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,248.00
|
| 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 |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cigna Commercial |
$1,328.00
|
| Rate for Payer: First Health Commercial |
$1,520.00
|
| Rate for Payer: Humana Commercial |
$1,360.00
|
| Rate for Payer: Humana KY Medicaid |
$550.24
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Kentucky WC Medicaid |
$555.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,312.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,180.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$561.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,408.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,200.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,280.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,392.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,104.00
|
| Rate for Payer: PHCS Commercial |
$1,536.00
|
| Rate for Payer: United Healthcare All Payer |
$1,408.00
|
|
|
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
|
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
|
IP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 31541
|
| Hospital Charge Code |
41000024
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$480.00 |
| Max. Negotiated Rate |
$1,536.00 |
| Rate for Payer: Aetna Commercial |
$1,232.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,248.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cigna Commercial |
$1,328.00
|
| Rate for Payer: First Health Commercial |
$1,520.00
|
| Rate for Payer: Humana Commercial |
$1,360.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,312.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,180.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$480.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,408.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,200.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,280.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,392.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,104.00
|
| Rate for Payer: PHCS Commercial |
$1,536.00
|
| Rate for Payer: United Healthcare All Payer |
$1,408.00
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY;
|
Facility
|
OP
|
$4,769.34
|
|
|
Service Code
|
CPT 31535
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,406.67 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$4,769.34
|
|
|
Service Code
|
CPT 31536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,406.67 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$4,769.34
|
|
|
Service Code
|
CPT 31541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,406.67 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
|
|
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 |
$356.09 |
| 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 |
$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 |
$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 |
$330.00
|
| 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(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 |
$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
|
|
|
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 |
$839.66 |
| Rate for Payer: Aetna Commercial |
$837.23
|
| Rate for Payer: Ambetter Exchange |
$515.08
|
| Rate for Payer: Anthem Medicaid |
$435.71
|
| Rate for Payer: Buckeye Individual/Medicaid |
$515.08
|
| Rate for Payer: Buckeye Medicare Advantage |
$515.08
|
| Rate for Payer: CareSource Just4Me Medicare |
$618.10
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$515.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$515.08
|
| 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 |
$669.60
|
| Rate for Payer: UHCCP Medicaid |
$315.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$440.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$515.08
|
|
|
LARYNGOSCOPY DIRECT(P
|
Professional
|
Both
|
$1,250.00
|
|
|
Service Code
|
HCPCS 31536
|
| Hospital Charge Code |
410P0022
|
|
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(P
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31535
|
| Hospital Charge Code |
410P0021
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$178.66 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$288.18
|
| Rate for Payer: Ambetter Exchange |
$178.66
|
| Rate for Payer: Anthem Medicaid |
$211.22
|
| Rate for Payer: Buckeye Individual/Medicaid |
$178.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$178.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$214.39
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$178.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$178.66
|
| 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 |
$232.26
|
| Rate for Payer: UHCCP Medicaid |
$297.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$213.33
|
| Rate for Payer: Wellcare Medicare Advantage |
$178.66
|
|
|
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 |
$960.00 |
| Rate for Payer: Aetna Commercial |
$405.04
|
| Rate for Payer: Ambetter Exchange |
$247.19
|
| Rate for Payer: Anthem Medicaid |
$244.99
|
| Rate for Payer: Buckeye Individual/Medicaid |
$247.19
|
| Rate for Payer: Buckeye Medicare Advantage |
$247.19
|
| Rate for Payer: CareSource Just4Me Medicare |
$296.63
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$247.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$247.19
|
| 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 |
$321.35
|
| Rate for Payer: UHCCP Medicaid |
$560.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$247.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$247.19
|
|
|
LARYNGOSCOPY DIRECT(T
|
Facility
|
OP
|
$3,649.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
761T1163
|
|
Hospital Revenue Code
|
761
|
| 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(T
|
Facility
|
IP
|
$3,649.58
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
761T1163
|
|
Hospital Revenue Code
|
761
|
| 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, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, EXCEPT NEWBORN
|
Facility
|
OP
|
$2,230.73
|
|
|
Service Code
|
CPT 31525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,593.38 |
| Max. Negotiated Rate |
$2,230.73 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,593.38
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,230.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,151.06
|
| Rate for Payer: Humana Medicare Advantage |
$1,593.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,912.06
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$2,230.73
|
|
|
Service Code
|
CPT 31526
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,593.38 |
| Max. Negotiated Rate |
$2,230.73 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,593.38
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,230.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,151.06
|
| Rate for Payer: Humana Medicare Advantage |
$1,593.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,912.06
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, INITIAL
|
Facility
|
OP
|
$4,769.34
|
|
|
Service Code
|
CPT 31528
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,406.67 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,769.34
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,599.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
|
|
LARYNGOSCOPY FLEX DIAG
|
Facility
|
OP
|
$4,998.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
45000215
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,593.38 |
| Max. Negotiated Rate |
$4,798.08 |
| Rate for Payer: Aetna Commercial |
$3,848.46
|
| Rate for Payer: Anthem Medicaid |
$1,718.81
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,593.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,898.44
|
| 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 |
$2,499.00
|
| Rate for Payer: Cash Price |
$2,499.00
|
| Rate for Payer: Cigna Commercial |
$4,148.34
|
| Rate for Payer: First Health Commercial |
$4,748.10
|
| Rate for Payer: Humana Commercial |
$4,248.30
|
| Rate for Payer: Humana KY Medicaid |
$1,718.81
|
| Rate for Payer: Humana Medicare Advantage |
$1,593.38
|
| Rate for Payer: Kentucky WC Medicaid |
$1,736.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,098.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,688.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,912.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,753.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,398.24
|
| Rate for Payer: Ohio Health Group HMO |
$3,748.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,998.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,348.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,448.62
|
| Rate for Payer: PHCS Commercial |
$4,798.08
|
| Rate for Payer: United Healthcare All Payer |
$4,398.24
|
|
|
LARYNGOSCOPY FLEX DIAG
|
Professional
|
Both
|
$5,918.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
76101164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.41 |
| Max. Negotiated Rate |
$3,550.80 |
| Rate for Payer: Aetna Commercial |
$301.95
|
| Rate for Payer: Ambetter Exchange |
$187.41
|
| Rate for Payer: Anthem Medicaid |
$206.31
|
| Rate for Payer: Buckeye Individual/Medicaid |
$187.41
|
| Rate for Payer: Buckeye Medicare Advantage |
$187.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$224.89
|
| Rate for Payer: Cash Price |
$2,959.00
|
| Rate for Payer: Cash Price |
$2,959.00
|
| Rate for Payer: Cigna Commercial |
$302.31
|
| Rate for Payer: Healthspan PPO |
$254.64
|
| Rate for Payer: Humana Medicaid |
$206.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$259.62
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$187.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$187.41
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$210.44
|
| Rate for Payer: Molina Healthcare Passport |
$206.31
|
| Rate for Payer: Multiplan PHCS |
$3,550.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$243.63
|
| Rate for Payer: UHCCP Medicaid |
$2,071.30
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$208.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$187.41
|
|
