|
LEAD 4068-52
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4068-52
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4068-58
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4068-58
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4092
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4092
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4193-78 ATTAIN OTW
|
Facility
|
OP
|
$9,752.50
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,925.75 |
| Max. Negotiated Rate |
$9,362.40 |
| Rate for Payer: Aetna Commercial |
$7,509.43
|
| Rate for Payer: Anthem Medicaid |
$3,353.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,606.95
|
| Rate for Payer: Cash Price |
$4,876.25
|
| Rate for Payer: Cigna Commercial |
$8,094.57
|
| Rate for Payer: First Health Commercial |
$9,264.88
|
| Rate for Payer: Humana Commercial |
$8,289.62
|
| Rate for Payer: Humana KY Medicaid |
$3,353.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,388.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,997.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,197.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,925.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,421.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,582.20
|
| Rate for Payer: Ohio Health Group HMO |
$7,314.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,802.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,484.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,729.23
|
| Rate for Payer: PHCS Commercial |
$9,362.40
|
| Rate for Payer: United Healthcare All Payer |
$8,582.20
|
|
|
LEAD 4193-78 ATTAIN OTW
|
Facility
|
IP
|
$9,752.50
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,925.75 |
| Max. Negotiated Rate |
$9,362.40 |
| Rate for Payer: Aetna Commercial |
$7,509.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,606.95
|
| Rate for Payer: Cash Price |
$4,876.25
|
| Rate for Payer: Cigna Commercial |
$8,094.57
|
| Rate for Payer: First Health Commercial |
$9,264.88
|
| Rate for Payer: Humana Commercial |
$8,289.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,997.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,197.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,925.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,582.20
|
| Rate for Payer: Ohio Health Group HMO |
$7,314.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,802.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,484.67
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,729.23
|
| Rate for Payer: PHCS Commercial |
$9,362.40
|
| Rate for Payer: United Healthcare All Payer |
$8,582.20
|
|
|
LEAD 4523-45
|
Facility
|
OP
|
$5,300.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,590.00 |
| Max. Negotiated Rate |
$5,088.00 |
| Rate for Payer: Aetna Commercial |
$4,081.00
|
| Rate for Payer: Anthem Medicaid |
$1,822.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,134.00
|
| Rate for Payer: Cash Price |
$2,650.00
|
| Rate for Payer: Cigna Commercial |
$4,399.00
|
| Rate for Payer: First Health Commercial |
$5,035.00
|
| Rate for Payer: Humana Commercial |
$4,505.00
|
| Rate for Payer: Humana KY Medicaid |
$1,822.67
|
| Rate for Payer: Kentucky WC Medicaid |
$1,841.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,346.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,911.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,590.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,859.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,664.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,975.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,240.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,611.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,657.00
|
| Rate for Payer: PHCS Commercial |
$5,088.00
|
| Rate for Payer: United Healthcare All Payer |
$4,664.00
|
|
|
LEAD 4523-45
|
Facility
|
IP
|
$5,300.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,590.00 |
| Max. Negotiated Rate |
$5,088.00 |
| Rate for Payer: Aetna Commercial |
$4,081.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,134.00
|
| Rate for Payer: Cash Price |
$2,650.00
|
| Rate for Payer: Cigna Commercial |
$4,399.00
|
| Rate for Payer: First Health Commercial |
$5,035.00
|
| Rate for Payer: Humana Commercial |
$4,505.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,346.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,911.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,590.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,664.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,975.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,240.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,611.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,657.00
|
| Rate for Payer: PHCS Commercial |
$5,088.00
|
| Rate for Payer: United Healthcare All Payer |
$4,664.00
|
|
|
LEAD 4568-45
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4568-45
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4568-53
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 4568-53
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 5068-52
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 5068-52
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 5068-58
|
Facility
|
OP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem Medicaid |
$1,177.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Humana KY Medicaid |
$1,177.86
|
| Rate for Payer: Kentucky WC Medicaid |
$1,189.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,201.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 5068-58
|
Facility
|
IP
|
$3,425.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,637.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,671.50
|
| Rate for Payer: Cash Price |
$1,712.50
|
| Rate for Payer: Cigna Commercial |
$2,842.75
|
| Rate for Payer: First Health Commercial |
$3,253.75
|
| Rate for Payer: Humana Commercial |
$2,911.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,808.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,527.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,027.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,014.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,568.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,979.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,363.25
|
| Rate for Payer: PHCS Commercial |
$3,288.00
|
| Rate for Payer: United Healthcare All Payer |
$3,014.00
|
|
|
LEAD 5076-45 BI SIL STEROID SC
|
Facility
|
IP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
|
LEAD 5076-45 BI SIL STEROID SC
|
Facility
|
OP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem Medicaid |
$1,023.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Humana KY Medicaid |
$1,023.58
|
| Rate for Payer: Kentucky WC Medicaid |
$1,034.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,044.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
|
LEAD 5076-52 BI SIL STEROID FI
|
Facility
|
IP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
|
LEAD 5076-52 BI SIL STEROID FI
|
Facility
|
OP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem Medicaid |
$1,023.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Humana KY Medicaid |
$1,023.58
|
| Rate for Payer: Kentucky WC Medicaid |
$1,034.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,044.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
|
LEAD 5076-58 BI SIL STEROID FI
|
Facility
|
OP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem Medicaid |
$1,023.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Humana KY Medicaid |
$1,023.58
|
| Rate for Payer: Kentucky WC Medicaid |
$1,034.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,044.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
|
LEAD 5076-58 BI SIL STEROID FI
|
Facility
|
IP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27000066
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
|
LEAD 5076-65 BIPOLAR SIL SCREW
|
Facility
|
IP
|
$2,976.39
|
|
|
Service Code
|
HCPCS C1779
|
| Hospital Charge Code |
27000061
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$892.92 |
| Max. Negotiated Rate |
$2,857.33 |
| Rate for Payer: Aetna Commercial |
$2,291.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,321.58
|
| Rate for Payer: Cash Price |
$1,488.19
|
| Rate for Payer: Cigna Commercial |
$2,470.40
|
| Rate for Payer: First Health Commercial |
$2,827.57
|
| Rate for Payer: Humana Commercial |
$2,529.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,440.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,196.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,619.22
|
| Rate for Payer: Ohio Health Group HMO |
$2,232.29
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,381.11
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,589.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,053.71
|
| Rate for Payer: PHCS Commercial |
$2,857.33
|
| Rate for Payer: United Healthcare All Payer |
$2,619.22
|
|
