|
LEGION PS NP FEM SZ 3 RT
|
Facility
|
IP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 4 LT
|
Facility
|
IP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 4 LT
|
Facility
|
OP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem Medicaid |
$3,408.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Humana KY Medicaid |
$3,408.12
|
| Rate for Payer: Kentucky WC Medicaid |
$3,442.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,476.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 4 RT
|
Facility
|
IP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 4 RT
|
Facility
|
OP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem Medicaid |
$3,408.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Humana KY Medicaid |
$3,408.12
|
| Rate for Payer: Kentucky WC Medicaid |
$3,442.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,476.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 5 LT
|
Facility
|
IP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 5 LT
|
Facility
|
OP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem Medicaid |
$3,653.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Humana KY Medicaid |
$3,653.50
|
| Rate for Payer: Kentucky WC Medicaid |
$3,690.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,726.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 5 RT
|
Facility
|
OP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem Medicaid |
$3,653.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Humana KY Medicaid |
$3,653.50
|
| Rate for Payer: Kentucky WC Medicaid |
$3,690.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,726.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 5 RT
|
Facility
|
IP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 6 LT
|
Facility
|
IP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 6 LT
|
Facility
|
OP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem Medicaid |
$3,653.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Humana KY Medicaid |
$3,653.50
|
| Rate for Payer: Kentucky WC Medicaid |
$3,690.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,726.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 6 RT
|
Facility
|
OP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem Medicaid |
$3,653.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Humana KY Medicaid |
$3,653.50
|
| Rate for Payer: Kentucky WC Medicaid |
$3,690.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,726.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 6 RT
|
Facility
|
IP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 7 LT
|
Facility
|
IP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 7 LT
|
Facility
|
OP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem Medicaid |
$3,408.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Humana KY Medicaid |
$3,408.12
|
| Rate for Payer: Kentucky WC Medicaid |
$3,442.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,476.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 7RT
|
Facility
|
IP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 7RT
|
Facility
|
OP
|
$9,910.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.33 |
| Max. Negotiated Rate |
$9,513.79 |
| Rate for Payer: Aetna Commercial |
$7,630.85
|
| Rate for Payer: Anthem Medicaid |
$3,408.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,729.96
|
| Rate for Payer: Cash Price |
$4,955.10
|
| Rate for Payer: Cigna Commercial |
$8,225.47
|
| Rate for Payer: First Health Commercial |
$9,414.69
|
| Rate for Payer: Humana Commercial |
$8,423.67
|
| Rate for Payer: Humana KY Medicaid |
$3,408.12
|
| Rate for Payer: Kentucky WC Medicaid |
$3,442.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,126.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,313.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,973.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,476.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,720.98
|
| Rate for Payer: Ohio Health Group HMO |
$7,432.65
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,982.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,288.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.16
|
| Rate for Payer: PHCS Commercial |
$9,513.79
|
| Rate for Payer: United Healthcare All Payer |
$8,720.98
|
|
|
LEGION PS NP FEM SZ 8 LT
|
Facility
|
OP
|
$9,464.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,230.44 |
| Max. Negotiated Rate |
$9,086.30 |
| Rate for Payer: Aetna Commercial |
$7,287.97
|
| Rate for Payer: Anthem Medicaid |
$3,254.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,382.62
|
| Rate for Payer: Cash Price |
$4,732.45
|
| Rate for Payer: Cigna Commercial |
$7,855.87
|
| Rate for Payer: First Health Commercial |
$8,991.66
|
| Rate for Payer: Humana Commercial |
$8,045.16
|
| Rate for Payer: Humana KY Medicaid |
$3,254.98
|
| Rate for Payer: Kentucky WC Medicaid |
$3,288.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,761.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,985.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,839.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,320.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,329.11
|
| Rate for Payer: Ohio Health Group HMO |
$7,098.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,892.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,230.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,934.12
|
| Rate for Payer: PHCS Commercial |
$9,086.30
|
| Rate for Payer: United Healthcare All Payer |
$8,329.11
|
|
|
LEGION PS NP FEM SZ 8 LT
|
Facility
|
IP
|
$9,464.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,230.44 |
| Max. Negotiated Rate |
$9,086.30 |
| Rate for Payer: Aetna Commercial |
$7,287.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,382.62
|
| Rate for Payer: Cash Price |
$4,732.45
|
| Rate for Payer: Cigna Commercial |
$7,855.87
|
| Rate for Payer: First Health Commercial |
$8,991.66
|
| Rate for Payer: Humana Commercial |
$8,045.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,761.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,985.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,839.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,329.11
|
| Rate for Payer: Ohio Health Group HMO |
$7,098.68
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,892.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,230.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,934.12
|
| Rate for Payer: PHCS Commercial |
$9,086.30
|
| Rate for Payer: United Healthcare All Payer |
$8,329.11
|
|
|
LEGION PS NP FEM SZ 8 RT
|
Facility
|
IP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS NP FEM SZ 8 RT
|
Facility
|
OP
|
$10,623.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,381.08 |
| Max. Negotiated Rate |
$10,198.78 |
| Rate for Payer: Aetna Commercial |
$8,180.27
|
| Rate for Payer: Anthem Medicaid |
$3,653.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,286.51
|
| Rate for Payer: Cash Price |
$5,311.86
|
| Rate for Payer: Cigna Commercial |
$8,817.70
|
| Rate for Payer: First Health Commercial |
$10,092.54
|
| Rate for Payer: Humana Commercial |
$9,030.17
|
| Rate for Payer: Humana KY Medicaid |
$3,653.50
|
| Rate for Payer: Kentucky WC Medicaid |
$3,690.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,711.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,840.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,187.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,726.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,348.88
|
| Rate for Payer: Ohio Health Group HMO |
$7,967.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,124.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,381.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,293.36
|
| Rate for Payer: PHCS Commercial |
$10,198.78
|
| Rate for Payer: United Healthcare All Payer |
$9,348.88
|
|
|
LEGION PS OXIN FEM SZ 2 LT
|
Facility
|
IP
|
$11,722.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,523.91 |
| Max. Negotiated Rate |
$11,253.48 |
| Rate for Payer: Aetna Commercial |
$9,026.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,143.46
|
| Rate for Payer: Cash Price |
$5,861.19
|
| Rate for Payer: Cigna Commercial |
$9,729.58
|
| Rate for Payer: First Health Commercial |
$11,136.26
|
| Rate for Payer: Humana Commercial |
$9,964.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,612.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,651.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,516.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,315.69
|
| Rate for Payer: Ohio Health Group HMO |
$8,791.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,344.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,523.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,633.94
|
| Rate for Payer: PHCS Commercial |
$11,253.48
|
| Rate for Payer: United Healthcare All Payer |
$10,315.69
|
|
|
LEGION PS OXIN FEM SZ 2 LT
|
Facility
|
OP
|
$11,722.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,523.91 |
| Max. Negotiated Rate |
$11,253.48 |
| Rate for Payer: Aetna Commercial |
$9,026.23
|
| Rate for Payer: Anthem Medicaid |
$4,031.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,143.46
|
| Rate for Payer: Cash Price |
$5,861.19
|
| Rate for Payer: Cigna Commercial |
$9,729.58
|
| Rate for Payer: First Health Commercial |
$11,136.26
|
| Rate for Payer: Humana Commercial |
$9,964.02
|
| Rate for Payer: Humana KY Medicaid |
$4,031.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,072.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,612.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,651.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,516.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,112.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,315.69
|
| Rate for Payer: Ohio Health Group HMO |
$8,791.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,344.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,523.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,633.94
|
| Rate for Payer: PHCS Commercial |
$11,253.48
|
| Rate for Payer: United Healthcare All Payer |
$10,315.69
|
|
|
LEGION PS OXIN FEM SZ 2 RT
|
Facility
|
OP
|
$11,722.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,523.91 |
| Max. Negotiated Rate |
$11,253.48 |
| Rate for Payer: Aetna Commercial |
$9,026.23
|
| Rate for Payer: Anthem Medicaid |
$4,031.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,143.46
|
| Rate for Payer: Cash Price |
$5,861.19
|
| Rate for Payer: Cigna Commercial |
$9,729.58
|
| Rate for Payer: First Health Commercial |
$11,136.26
|
| Rate for Payer: Humana Commercial |
$9,964.02
|
| Rate for Payer: Humana KY Medicaid |
$4,031.33
|
| Rate for Payer: Kentucky WC Medicaid |
$4,072.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,612.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,651.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,516.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,112.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,315.69
|
| Rate for Payer: Ohio Health Group HMO |
$8,791.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,344.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,523.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,633.94
|
| Rate for Payer: PHCS Commercial |
$11,253.48
|
| Rate for Payer: United Healthcare All Payer |
$10,315.69
|
|
|
LEGION PS OXIN FEM SZ 2 RT
|
Facility
|
IP
|
$11,722.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,523.91 |
| Max. Negotiated Rate |
$11,253.48 |
| Rate for Payer: Aetna Commercial |
$9,026.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,143.46
|
| Rate for Payer: Cash Price |
$5,861.19
|
| Rate for Payer: Cigna Commercial |
$9,729.58
|
| Rate for Payer: First Health Commercial |
$11,136.26
|
| Rate for Payer: Humana Commercial |
$9,964.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,612.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,651.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,516.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,315.69
|
| Rate for Payer: Ohio Health Group HMO |
$8,791.78
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,344.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,523.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,633.94
|
| Rate for Payer: PHCS Commercial |
$11,253.48
|
| Rate for Payer: United Healthcare All Payer |
$10,315.69
|
|
