|
LEGION CR NP FEM SZ 4 RT
|
Facility
|
IP
|
$16,959.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,087.81 |
| Max. Negotiated Rate |
$16,280.98 |
| Rate for Payer: Aetna Commercial |
$13,058.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,228.29
|
| Rate for Payer: Cash Price |
$8,479.68
|
| Rate for Payer: Cigna Commercial |
$14,076.26
|
| Rate for Payer: First Health Commercial |
$16,111.38
|
| Rate for Payer: Humana Commercial |
$14,415.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,906.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,516.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,087.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,924.23
|
| Rate for Payer: Ohio Health Group HMO |
$12,719.51
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,567.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,754.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,701.95
|
| Rate for Payer: PHCS Commercial |
$16,280.98
|
| Rate for Payer: United Healthcare All Payer |
$14,924.23
|
|
|
LEGION CR NP FEM SZ 5 LT
|
Facility
|
OP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem Medicaid |
$3,413.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Humana KY Medicaid |
$3,413.51
|
| Rate for Payer: Kentucky WC Medicaid |
$3,448.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,482.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 5 LT
|
Facility
|
IP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 5 RT
|
Facility
|
IP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 5 RT
|
Facility
|
OP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem Medicaid |
$3,412.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Humana KY Medicaid |
$3,412.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,447.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,481.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 6 LT
|
Facility
|
IP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 6 LT
|
Facility
|
OP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem Medicaid |
$3,413.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Humana KY Medicaid |
$3,413.51
|
| Rate for Payer: Kentucky WC Medicaid |
$3,448.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,482.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 6 RT
|
Facility
|
IP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 6 RT
|
Facility
|
OP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem Medicaid |
$3,412.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Humana KY Medicaid |
$3,412.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,447.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,481.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 7LT
|
Facility
|
IP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 7LT
|
Facility
|
OP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem Medicaid |
$3,413.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Humana KY Medicaid |
$3,413.51
|
| Rate for Payer: Kentucky WC Medicaid |
$3,448.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,482.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 7 RT
|
Facility
|
OP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem Medicaid |
$3,412.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Humana KY Medicaid |
$3,412.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,447.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,481.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 7 RT
|
Facility
|
IP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 8 LT
|
Facility
|
IP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 8 LT
|
Facility
|
OP
|
$9,925.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.76 |
| Max. Negotiated Rate |
$9,528.84 |
| Rate for Payer: Aetna Commercial |
$7,642.93
|
| Rate for Payer: Anthem Medicaid |
$3,413.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,742.19
|
| Rate for Payer: Cash Price |
$4,962.94
|
| Rate for Payer: Cigna Commercial |
$8,238.48
|
| Rate for Payer: First Health Commercial |
$9,429.59
|
| Rate for Payer: Humana Commercial |
$8,437.00
|
| Rate for Payer: Humana KY Medicaid |
$3,413.51
|
| Rate for Payer: Kentucky WC Medicaid |
$3,448.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,139.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,325.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,482.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,734.77
|
| Rate for Payer: Ohio Health Group HMO |
$7,444.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,940.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,635.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,848.86
|
| Rate for Payer: PHCS Commercial |
$9,528.84
|
| Rate for Payer: United Healthcare All Payer |
$8,734.77
|
|
|
LEGION CR NP FEM SZ 8 RT
|
Facility
|
OP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem Medicaid |
$3,412.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Humana KY Medicaid |
$3,412.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,447.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,481.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR NP FEM SZ 8 RT
|
Facility
|
IP
|
$9,924.05
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,977.22 |
| Max. Negotiated Rate |
$9,527.09 |
| Rate for Payer: Aetna Commercial |
$7,641.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,740.76
|
| Rate for Payer: Cash Price |
$4,962.02
|
| Rate for Payer: Cigna Commercial |
$8,236.96
|
| Rate for Payer: First Health Commercial |
$9,427.85
|
| Rate for Payer: Humana Commercial |
$8,435.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,137.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,323.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,977.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,733.16
|
| Rate for Payer: Ohio Health Group HMO |
$7,443.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,939.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,633.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,847.59
|
| Rate for Payer: PHCS Commercial |
$9,527.09
|
| Rate for Payer: United Healthcare All Payer |
$8,733.16
|
|
|
LEGION CR OXIN FEM SZ 2 LT
|
Facility
|
OP
|
$11,592.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,477.70 |
| Max. Negotiated Rate |
$11,128.66 |
| Rate for Payer: Aetna Commercial |
$8,926.11
|
| Rate for Payer: Anthem Medicaid |
$3,986.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,042.03
|
| Rate for Payer: Cash Price |
$5,796.18
|
| Rate for Payer: Cigna Commercial |
$9,621.65
|
| Rate for Payer: First Health Commercial |
$11,012.73
|
| Rate for Payer: Humana Commercial |
$9,853.50
|
| Rate for Payer: Humana KY Medicaid |
$3,986.61
|
| Rate for Payer: Kentucky WC Medicaid |
$4,027.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,505.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,555.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,477.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,066.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,201.27
|
| Rate for Payer: Ohio Health Group HMO |
$8,694.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,273.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,085.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,998.72
|
| Rate for Payer: PHCS Commercial |
$11,128.66
|
| Rate for Payer: United Healthcare All Payer |
$10,201.27
|
|
|
LEGION CR OXIN FEM SZ 2 LT
|
Facility
|
IP
|
$11,592.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,477.70 |
| Max. Negotiated Rate |
$11,128.66 |
| Rate for Payer: Aetna Commercial |
$8,926.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,042.03
|
| Rate for Payer: Cash Price |
$5,796.18
|
| Rate for Payer: Cigna Commercial |
$9,621.65
|
| Rate for Payer: First Health Commercial |
$11,012.73
|
| Rate for Payer: Humana Commercial |
$9,853.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,505.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,555.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,477.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,201.27
|
| Rate for Payer: Ohio Health Group HMO |
$8,694.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,273.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,085.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,998.72
|
| Rate for Payer: PHCS Commercial |
$11,128.66
|
| Rate for Payer: United Healthcare All Payer |
$10,201.27
|
|
|
LEGION CR OXIN FEM SZ 2 RT
|
Facility
|
OP
|
$11,592.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,477.70 |
| Max. Negotiated Rate |
$11,128.66 |
| Rate for Payer: Aetna Commercial |
$8,926.11
|
| Rate for Payer: Anthem Medicaid |
$3,986.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,042.03
|
| Rate for Payer: Cash Price |
$5,796.18
|
| Rate for Payer: Cigna Commercial |
$9,621.65
|
| Rate for Payer: First Health Commercial |
$11,012.73
|
| Rate for Payer: Humana Commercial |
$9,853.50
|
| Rate for Payer: Humana KY Medicaid |
$3,986.61
|
| Rate for Payer: Kentucky WC Medicaid |
$4,027.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,505.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,555.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,477.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,066.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,201.27
|
| Rate for Payer: Ohio Health Group HMO |
$8,694.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,273.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,085.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,998.72
|
| Rate for Payer: PHCS Commercial |
$11,128.66
|
| Rate for Payer: United Healthcare All Payer |
$10,201.27
|
|
|
LEGION CR OXIN FEM SZ 2 RT
|
Facility
|
IP
|
$11,592.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,477.70 |
| Max. Negotiated Rate |
$11,128.66 |
| Rate for Payer: Aetna Commercial |
$8,926.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,042.03
|
| Rate for Payer: Cash Price |
$5,796.18
|
| Rate for Payer: Cigna Commercial |
$9,621.65
|
| Rate for Payer: First Health Commercial |
$11,012.73
|
| Rate for Payer: Humana Commercial |
$9,853.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,505.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,555.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,477.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,201.27
|
| Rate for Payer: Ohio Health Group HMO |
$8,694.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,273.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,085.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,998.72
|
| Rate for Payer: PHCS Commercial |
$11,128.66
|
| Rate for Payer: United Healthcare All Payer |
$10,201.27
|
|
|
LEGION CR OXIN FEM SZ 3 LT
|
Facility
|
IP
|
$18,756.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,627.01 |
| Max. Negotiated Rate |
$18,006.43 |
| Rate for Payer: Aetna Commercial |
$14,442.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,630.23
|
| Rate for Payer: Cash Price |
$9,378.35
|
| Rate for Payer: Cigna Commercial |
$15,568.06
|
| Rate for Payer: First Health Commercial |
$17,818.87
|
| Rate for Payer: Humana Commercial |
$15,943.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,380.49
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,842.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,627.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,505.90
|
| Rate for Payer: Ohio Health Group HMO |
$14,067.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,005.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,318.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,942.12
|
| Rate for Payer: PHCS Commercial |
$18,006.43
|
| Rate for Payer: United Healthcare All Payer |
$16,505.90
|
|
|
LEGION CR OXIN FEM SZ 3 LT
|
Facility
|
OP
|
$18,756.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,627.01 |
| Max. Negotiated Rate |
$18,006.43 |
| Rate for Payer: Aetna Commercial |
$14,442.66
|
| Rate for Payer: Anthem Medicaid |
$6,450.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,630.23
|
| Rate for Payer: Cash Price |
$9,378.35
|
| Rate for Payer: Cigna Commercial |
$15,568.06
|
| Rate for Payer: First Health Commercial |
$17,818.87
|
| Rate for Payer: Humana Commercial |
$15,943.19
|
| Rate for Payer: Humana KY Medicaid |
$6,450.43
|
| Rate for Payer: Kentucky WC Medicaid |
$6,516.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,380.49
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,842.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,627.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,579.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,505.90
|
| Rate for Payer: Ohio Health Group HMO |
$14,067.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,005.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,318.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,942.12
|
| Rate for Payer: PHCS Commercial |
$18,006.43
|
| Rate for Payer: United Healthcare All Payer |
$16,505.90
|
|
|
LEGION CR OXIN FEM SZ 3 RT
|
Facility
|
OP
|
$18,756.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,627.01 |
| Max. Negotiated Rate |
$18,006.43 |
| Rate for Payer: Aetna Commercial |
$14,442.66
|
| Rate for Payer: Anthem Medicaid |
$6,450.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,630.23
|
| Rate for Payer: Cash Price |
$9,378.35
|
| Rate for Payer: Cigna Commercial |
$15,568.06
|
| Rate for Payer: First Health Commercial |
$17,818.87
|
| Rate for Payer: Humana Commercial |
$15,943.19
|
| Rate for Payer: Humana KY Medicaid |
$6,450.43
|
| Rate for Payer: Kentucky WC Medicaid |
$6,516.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,380.49
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,842.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,627.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,579.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,505.90
|
| Rate for Payer: Ohio Health Group HMO |
$14,067.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,005.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,318.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,942.12
|
| Rate for Payer: PHCS Commercial |
$18,006.43
|
| Rate for Payer: United Healthcare All Payer |
$16,505.90
|
|
|
LEGION CR OXIN FEM SZ 3 RT
|
Facility
|
IP
|
$18,756.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,627.01 |
| Max. Negotiated Rate |
$18,006.43 |
| Rate for Payer: Aetna Commercial |
$14,442.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,630.23
|
| Rate for Payer: Cash Price |
$9,378.35
|
| Rate for Payer: Cigna Commercial |
$15,568.06
|
| Rate for Payer: First Health Commercial |
$17,818.87
|
| Rate for Payer: Humana Commercial |
$15,943.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,380.49
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,842.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,627.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,505.90
|
| Rate for Payer: Ohio Health Group HMO |
$14,067.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$15,005.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$16,318.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,942.12
|
| Rate for Payer: PHCS Commercial |
$18,006.43
|
| Rate for Payer: United Healthcare All Payer |
$16,505.90
|
|
