|
LARYNGOSCOPY FLEX DIAG
|
Facility
|
IP
|
$4,998.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
45000215
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,499.40 |
| Max. Negotiated Rate |
$4,798.08 |
| Rate for Payer: Aetna Commercial |
$3,848.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,898.44
|
| 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: 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 |
$1,499.40
|
| 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
|
|
|
LARYNGOSCOPY FLEX DIAG
|
Facility
|
OP
|
$5,918.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
76101164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,593.38 |
| Max. Negotiated Rate |
$5,681.28 |
| Rate for Payer: Aetna Commercial |
$4,556.86
|
| Rate for Payer: Anthem Medicaid |
$2,035.20
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,593.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,616.04
|
| 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 |
$2,959.00
|
| Rate for Payer: Cash Price |
$2,959.00
|
| Rate for Payer: Cigna Commercial |
$4,911.94
|
| Rate for Payer: First Health Commercial |
$5,622.10
|
| Rate for Payer: Humana Commercial |
$5,030.30
|
| Rate for Payer: Humana KY Medicaid |
$2,035.20
|
| Rate for Payer: Humana Medicare Advantage |
$1,593.38
|
| Rate for Payer: Kentucky WC Medicaid |
$2,055.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,852.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,367.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,912.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,076.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,207.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,438.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,734.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,148.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,083.42
|
| Rate for Payer: PHCS Commercial |
$5,681.28
|
| Rate for Payer: United Healthcare All Payer |
$5,207.84
|
|
|
LARYNGOSCOPY FLEX DIAG(P
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
761P1164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.41 |
| Max. Negotiated Rate |
$552.00 |
| 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 |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| 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 |
$552.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$243.63
|
| Rate for Payer: UHCCP Medicaid |
$322.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$208.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$187.41
|
|
|
LARYNGOSCOPY FLEX DIAG(T
|
Facility
|
OP
|
$4,998.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
761T1164
|
|
Hospital Revenue Code
|
761
|
| 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(T
|
Facility
|
IP
|
$4,998.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
761T1164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,499.40 |
| Max. Negotiated Rate |
$4,798.08 |
| Rate for Payer: Aetna Commercial |
$3,848.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,898.44
|
| 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: 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 |
$1,499.40
|
| 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 INDIRECT
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
76101162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$70.88
|
| Rate for Payer: Ambetter Exchange |
$46.23
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$24.92
|
| Rate for Payer: Anthem Medicaid |
$30.65
|
| Rate for Payer: Buckeye Individual/Medicaid |
$46.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$46.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$55.48
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$116.56
|
| Rate for Payer: Healthspan PPO |
$96.80
|
| Rate for Payer: Humana Medicaid |
$30.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$62.27
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$46.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$46.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$31.26
|
| Rate for Payer: Molina Healthcare Passport |
$30.65
|
| Rate for Payer: Multiplan PHCS |
$360.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$60.10
|
| Rate for Payer: UHCCP Medicaid |
$26.17
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$46.23
|
|
|
LARYNGOSCOPY INDIRECT
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
45000213
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$137.56 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$308.00
|
| Rate for Payer: Anthem Medicaid |
$137.56
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$179.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$312.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$251.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.16
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna Commercial |
$332.00
|
| Rate for Payer: First Health Commercial |
$380.00
|
| Rate for Payer: Humana Commercial |
$340.00
|
| Rate for Payer: Humana KY Medicaid |
$137.56
|
| Rate for Payer: Humana Medicare Advantage |
$179.38
|
| Rate for Payer: Kentucky WC Medicaid |
$138.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$328.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$295.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$215.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$140.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$352.00
|
| Rate for Payer: Ohio Health Group HMO |
$300.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$320.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$348.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$276.00
|
| Rate for Payer: PHCS Commercial |
$384.00
|
| Rate for Payer: United Healthcare All Payer |
$352.00
|
|
|
LARYNGOSCOPY INDIRECT
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
76101162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.38 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna Commercial |
$462.00
|
| Rate for Payer: Anthem Medicaid |
$206.34
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$179.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$468.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$251.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.16
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$498.00
|
| Rate for Payer: First Health Commercial |
$570.00
|
| Rate for Payer: Humana Commercial |
$510.00
|
| Rate for Payer: Humana KY Medicaid |
$206.34
|
| Rate for Payer: Humana Medicare Advantage |
$179.38
|
| Rate for Payer: Kentucky WC Medicaid |
$208.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$492.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$442.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$215.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$210.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$528.00
|
| Rate for Payer: Ohio Health Group HMO |
$450.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$522.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$414.00
|
| Rate for Payer: PHCS Commercial |
$576.00
|
| Rate for Payer: United Healthcare All Payer |
$528.00
|
|
|
LARYNGOSCOPY INDIRECT
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31512
|
| Hospital Charge Code |
41000017
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$65.24 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$195.48
|
| Rate for Payer: Ambetter Exchange |
$121.73
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$65.24
|
| Rate for Payer: Anthem Medicaid |
$113.61
|
| Rate for Payer: Buckeye Individual/Medicaid |
$121.73
|
| Rate for Payer: Buckeye Medicare Advantage |
$121.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$146.08
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$194.44
|
| Rate for Payer: Healthspan PPO |
$247.90
|
| Rate for Payer: Humana Medicaid |
$113.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$169.59
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$121.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$121.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$115.88
|
| Rate for Payer: Molina Healthcare Passport |
$113.61
|
| Rate for Payer: Multiplan PHCS |
$510.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$158.25
|
| Rate for Payer: UHCCP Medicaid |
$68.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$114.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$121.73
|
|
|
LARYNGOSCOPY INDIRECT
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
HCPCS 31512
|
| Hospital Charge Code |
41000017
|
|
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 INDIRECT
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
45000213
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$308.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$312.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna Commercial |
$332.00
|
| Rate for Payer: First Health Commercial |
$380.00
|
| Rate for Payer: Humana Commercial |
$340.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$328.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$295.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$120.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$352.00
|
| Rate for Payer: Ohio Health Group HMO |
$300.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$320.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$348.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$276.00
|
| Rate for Payer: PHCS Commercial |
$384.00
|
| Rate for Payer: United Healthcare All Payer |
$352.00
|
|
|
LARYNGOSCOPY INDIRECT
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
76101162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna Commercial |
$462.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$468.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$498.00
|
| Rate for Payer: First Health Commercial |
$570.00
|
| Rate for Payer: Humana Commercial |
$510.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$492.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$442.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$180.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$528.00
|
| Rate for Payer: Ohio Health Group HMO |
$450.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$522.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$414.00
|
| Rate for Payer: PHCS Commercial |
$576.00
|
| Rate for Payer: United Healthcare All Payer |
$528.00
|
|
|
LARYNGOSCOPY INDIRECT
|
Facility
|
IP
|
$850.00
|
|
|
Service Code
|
HCPCS 31512
|
| Hospital Charge Code |
41000017
|
|
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 INDIRECT(P
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31512
|
| Hospital Charge Code |
410P0017
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$65.24 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$195.48
|
| Rate for Payer: Ambetter Exchange |
$121.73
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$65.24
|
| Rate for Payer: Anthem Medicaid |
$113.61
|
| Rate for Payer: Buckeye Individual/Medicaid |
$121.73
|
| Rate for Payer: Buckeye Medicare Advantage |
$121.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$146.08
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$194.44
|
| Rate for Payer: Healthspan PPO |
$247.90
|
| Rate for Payer: Humana Medicaid |
$113.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$169.59
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$121.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$121.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$115.88
|
| Rate for Payer: Molina Healthcare Passport |
$113.61
|
| Rate for Payer: Multiplan PHCS |
$510.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$158.25
|
| Rate for Payer: UHCCP Medicaid |
$68.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$114.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$121.73
|
|
|
LARYNGOSCOPY INDIRECT(P
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
761P1162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$70.88
|
| Rate for Payer: Ambetter Exchange |
$46.23
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$24.92
|
| Rate for Payer: Anthem Medicaid |
$30.65
|
| Rate for Payer: Buckeye Individual/Medicaid |
$46.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$46.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$55.48
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cigna Commercial |
$116.56
|
| Rate for Payer: Healthspan PPO |
$96.80
|
| Rate for Payer: Humana Medicaid |
$30.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$62.27
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$46.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$46.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$31.26
|
| Rate for Payer: Molina Healthcare Passport |
$30.65
|
| Rate for Payer: Multiplan PHCS |
$120.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$60.10
|
| Rate for Payer: UHCCP Medicaid |
$26.17
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$46.23
|
|
|
LARYNGOSCOPY INDIRECT(T
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
761T1162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$308.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$312.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna Commercial |
$332.00
|
| Rate for Payer: First Health Commercial |
$380.00
|
| Rate for Payer: Humana Commercial |
$340.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$328.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$295.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$120.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$352.00
|
| Rate for Payer: Ohio Health Group HMO |
$300.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$320.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$348.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$276.00
|
| Rate for Payer: PHCS Commercial |
$384.00
|
| Rate for Payer: United Healthcare All Payer |
$352.00
|
|
|
LARYNGOSCOPY INDIRECT(T
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
761T1162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$137.56 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$308.00
|
| Rate for Payer: Anthem Medicaid |
$137.56
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$179.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$312.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$251.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.16
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna Commercial |
$332.00
|
| Rate for Payer: First Health Commercial |
$380.00
|
| Rate for Payer: Humana Commercial |
$340.00
|
| Rate for Payer: Humana KY Medicaid |
$137.56
|
| Rate for Payer: Humana Medicare Advantage |
$179.38
|
| Rate for Payer: Kentucky WC Medicaid |
$138.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$328.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$295.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$215.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$140.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$352.00
|
| Rate for Payer: Ohio Health Group HMO |
$300.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$320.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$348.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$276.00
|
| Rate for Payer: PHCS Commercial |
$384.00
|
| Rate for Payer: United Healthcare All Payer |
$352.00
|
|
|
LARYNGOSCOPY(P
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 31540
|
| Hospital Charge Code |
410P0023
|
|
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(P
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 31511
|
| Hospital Charge Code |
410P0016
|
|
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 W/BIOPSY
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 31510
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$181.10
|
| Rate for Payer: Ambetter Exchange |
$114.48
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$60.91
|
| Rate for Payer: Anthem Medicaid |
$72.79
|
| Rate for Payer: Buckeye Individual/Medicaid |
$114.48
|
| Rate for Payer: Buckeye Medicare Advantage |
$114.48
|
| Rate for Payer: CareSource Just4Me Medicare |
$137.38
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cigna Commercial |
$180.30
|
| Rate for Payer: Healthspan PPO |
$249.32
|
| Rate for Payer: Humana Medicaid |
$72.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$157.12
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$114.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.48
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$74.25
|
| Rate for Payer: Molina Healthcare Passport |
$72.79
|
| Rate for Payer: Multiplan PHCS |
$345.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$148.82
|
| Rate for Payer: UHCCP Medicaid |
$63.96
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$73.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$114.48
|
|
|
LARYNGOSCOPY W/BIOPSY
|
Facility
|
OP
|
$575.00
|
|
|
Service Code
|
HCPCS 31510
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$197.74 |
| Max. Negotiated Rate |
$4,769.34 |
| Rate for Payer: Aetna Commercial |
$442.75
|
| Rate for Payer: Anthem Medicaid |
$197.74
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,406.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$448.50
|
| 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 |
$287.50
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cigna Commercial |
$477.25
|
| Rate for Payer: First Health Commercial |
$546.25
|
| Rate for Payer: Humana Commercial |
$488.75
|
| Rate for Payer: Humana KY Medicaid |
$197.74
|
| Rate for Payer: Humana Medicare Advantage |
$3,406.67
|
| Rate for Payer: Kentucky WC Medicaid |
$199.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$471.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$424.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,088.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$201.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$506.00
|
| Rate for Payer: Ohio Health Group HMO |
$431.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$460.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$500.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$396.75
|
| Rate for Payer: PHCS Commercial |
$552.00
|
| Rate for Payer: United Healthcare All Payer |
$506.00
|
|
|
LARYNGOSCOPY W/BIOPSY
|
Facility
|
IP
|
$575.00
|
|
|
Service Code
|
HCPCS 31510
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$172.50 |
| Max. Negotiated Rate |
$552.00 |
| Rate for Payer: Aetna Commercial |
$442.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$448.50
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cigna Commercial |
$477.25
|
| Rate for Payer: First Health Commercial |
$546.25
|
| Rate for Payer: Humana Commercial |
$488.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$471.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$424.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$172.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$506.00
|
| Rate for Payer: Ohio Health Group HMO |
$431.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$460.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$500.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$396.75
|
| Rate for Payer: PHCS Commercial |
$552.00
|
| Rate for Payer: United Healthcare All Payer |
$506.00
|
|
|
LARYNGOSCOPY W/BIOPSY(P
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 31510
|
| Hospital Charge Code |
410P0015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$181.10
|
| Rate for Payer: Ambetter Exchange |
$114.48
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$60.91
|
| Rate for Payer: Anthem Medicaid |
$72.79
|
| Rate for Payer: Buckeye Individual/Medicaid |
$114.48
|
| Rate for Payer: Buckeye Medicare Advantage |
$114.48
|
| Rate for Payer: CareSource Just4Me Medicare |
$137.38
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cigna Commercial |
$180.30
|
| Rate for Payer: Healthspan PPO |
$249.32
|
| Rate for Payer: Humana Medicaid |
$72.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$157.12
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$114.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.48
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$74.25
|
| Rate for Payer: Molina Healthcare Passport |
$72.79
|
| Rate for Payer: Multiplan PHCS |
$345.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$148.82
|
| Rate for Payer: UHCCP Medicaid |
$63.96
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$73.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$114.48
|
|
|
LARYNGOSCOPY W/STROBOSCOPY
|
Professional
|
Both
|
$1,899.00
|
|
|
Service Code
|
HCPCS 31579
|
| Hospital Charge Code |
76101166
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$73.01 |
| Max. Negotiated Rate |
$1,139.40 |
| Rate for Payer: Aetna Commercial |
$211.26
|
| Rate for Payer: Ambetter Exchange |
$112.78
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$73.01
|
| Rate for Payer: Anthem Medicaid |
$135.13
|
| Rate for Payer: Buckeye Individual/Medicaid |
$112.78
|
| Rate for Payer: Buckeye Medicare Advantage |
$112.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$135.34
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cash Price |
$949.50
|
| Rate for Payer: Cigna Commercial |
$331.47
|
| Rate for Payer: Healthspan PPO |
$260.75
|
| Rate for Payer: Humana Medicaid |
$135.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$184.01
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$112.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$112.78
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$137.83
|
| Rate for Payer: Molina Healthcare Passport |
$135.13
|
| Rate for Payer: Multiplan PHCS |
$1,139.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$146.61
|
| Rate for Payer: UHCCP Medicaid |
$76.66
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$136.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$112.78
|
|
