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Service Code HCPCS 85520
Hospital Charge Code 30000610
Hospital Revenue Code 300
Min. Negotiated Rate $26.39
Max. Negotiated Rate $194.88
Rate for Payer: Aetna Commercial $156.31
Rate for Payer: Anthem POS/PPO/Traditional $163.01
Rate for Payer: Cash Price $101.50
Rate for Payer: Cigna Commercial $168.49
Rate for Payer: First Health Commercial $192.85
Rate for Payer: Humana Commercial $172.55
Rate for Payer: Medical Mutual Of Ohio HMO $166.46
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $149.81
Rate for Payer: Molina Healthcare Benefit Exchange $60.90
Rate for Payer: Ohio Health Choice Commercial $178.64
Rate for Payer: Ohio Health Group HMO $152.25
Rate for Payer: Ohio Health Group PPO Differential $40.60
Rate for Payer: Ohio Health Group PPO No Differential $26.39
Rate for Payer: Ohio Health Group PPO SOMC Employees $62.93
Rate for Payer: PHCS Commercial $194.88
Rate for Payer: United Healthcare All Payer $178.64
Service Code HCPCS 85520
Hospital Charge Code 30000610
Hospital Revenue Code 300
Min. Negotiated Rate $13.09
Max. Negotiated Rate $194.88
Rate for Payer: Aetna Commercial $156.31
Rate for Payer: Anthem Medicaid $13.09
Rate for Payer: Anthem Medicare Advantage/PPO $13.09
Rate for Payer: Anthem POS/PPO/Traditional $163.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $18.33
Rate for Payer: CareSource Just4Me Medicare $13.09
Rate for Payer: Cash Price $101.50
Rate for Payer: Cash Price $101.50
Rate for Payer: Cigna Commercial $168.49
Rate for Payer: First Health Commercial $192.85
Rate for Payer: Humana Commercial $172.55
Rate for Payer: Humana KY Medicaid $13.09
Rate for Payer: Humana Medicare Advantage $13.09
Rate for Payer: Kentucky WC Medicaid $13.22
Rate for Payer: Medical Mutual Of Ohio HMO $166.46
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $149.81
Rate for Payer: Molina Healthcare Benefit Exchange $15.71
Rate for Payer: Molina Healthcare Medicaid $13.35
Rate for Payer: Ohio Health Choice Commercial $178.64
Rate for Payer: Ohio Health Group HMO $152.25
Rate for Payer: Ohio Health Group PPO Differential $40.60
Rate for Payer: Ohio Health Group PPO No Differential $26.39
Rate for Payer: Ohio Health Group PPO SOMC Employees $62.93
Rate for Payer: PHCS Commercial $194.88
Rate for Payer: United Healthcare All Payer $178.64
Service Code HCPCS J1451
Hospital Charge Code 25002065
Hospital Revenue Code 636
Min. Negotiated Rate $207.91
Max. Negotiated Rate $1,535.36
Rate for Payer: Aetna Commercial $1,231.48
Rate for Payer: Anthem POS/PPO/Traditional $1,247.48
Rate for Payer: Cash Price $799.66
Rate for Payer: Cigna Commercial $1,327.44
Rate for Payer: First Health Commercial $1,519.36
Rate for Payer: Humana Commercial $1,359.43
Rate for Payer: Medical Mutual Of Ohio HMO $1,311.45
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,180.31
Rate for Payer: Molina Healthcare Benefit Exchange $479.80
Rate for Payer: Ohio Health Choice Commercial $1,407.41
Rate for Payer: Ohio Health Group HMO $1,199.50
Rate for Payer: Ohio Health Group PPO Differential $319.87
Rate for Payer: Ohio Health Group PPO No Differential $207.91
Rate for Payer: Ohio Health Group PPO SOMC Employees $495.79
Rate for Payer: PHCS Commercial $1,535.36
Rate for Payer: United Healthcare All Payer $1,407.41
Service Code HCPCS J1451
Hospital Charge Code 25002065
Hospital Revenue Code 636
Min. Negotiated Rate $6.06
Max. Negotiated Rate $1,535.36
Rate for Payer: Aetna Commercial $1,231.48
Rate for Payer: Anthem Medicaid $550.01
Rate for Payer: Anthem Medicare Advantage/PPO $6.06
Rate for Payer: Anthem POS/PPO/Traditional $1,247.48
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $8.48
Rate for Payer: CareSource Just4Me Medicare $8.18
Rate for Payer: Cash Price $799.66
Rate for Payer: Cash Price $799.66
Rate for Payer: Cigna Commercial $1,327.44
Rate for Payer: First Health Commercial $1,519.36
Rate for Payer: Humana Commercial $1,359.43
Rate for Payer: Humana KY Medicaid $550.01
Rate for Payer: Humana Medicare Advantage $6.06
Rate for Payer: Kentucky WC Medicaid $555.61
Rate for Payer: Medical Mutual Of Ohio HMO $1,311.45
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,180.31
Rate for Payer: Molina Healthcare Benefit Exchange $7.27
Rate for Payer: Molina Healthcare Medicaid $561.04
Rate for Payer: Ohio Health Choice Commercial $1,407.41
Rate for Payer: Ohio Health Group HMO $1,199.50
Rate for Payer: Ohio Health Group PPO Differential $319.87
Rate for Payer: Ohio Health Group PPO No Differential $207.91
Rate for Payer: Ohio Health Group PPO SOMC Employees $495.79
Rate for Payer: PHCS Commercial $1,535.36
Rate for Payer: United Healthcare All Payer $1,407.41
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $1,384.17
Max. Negotiated Rate $10,221.55
Rate for Payer: Aetna Commercial $8,198.54
Rate for Payer: Anthem POS/PPO/Traditional $8,305.01
Rate for Payer: Cash Price $5,323.73
Rate for Payer: Cigna Commercial $8,837.38
Rate for Payer: First Health Commercial $10,115.08
Rate for Payer: Humana Commercial $9,050.33
Rate for Payer: Medical Mutual Of Ohio HMO $8,730.91
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7,857.82
Rate for Payer: Molina Healthcare Benefit Exchange $3,194.24
Rate for Payer: Ohio Health Choice Commercial $9,369.76
Rate for Payer: Ohio Health Group HMO $7,985.59
Rate for Payer: Ohio Health Group PPO Differential $2,129.49
Rate for Payer: Ohio Health Group PPO No Differential $1,384.17
Rate for Payer: Ohio Health Group PPO SOMC Employees $3,300.71
Rate for Payer: PHCS Commercial $10,221.55
Rate for Payer: United Healthcare All Payer $9,369.76
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $1,384.17
Max. Negotiated Rate $10,221.55
Rate for Payer: Aetna Commercial $8,198.54
Rate for Payer: Anthem Medicaid $3,661.66
Rate for Payer: Anthem POS/PPO/Traditional $8,305.01
Rate for Payer: Cash Price $5,323.73
Rate for Payer: Cigna Commercial $8,837.38
Rate for Payer: First Health Commercial $10,115.08
Rate for Payer: Humana Commercial $9,050.33
Rate for Payer: Humana KY Medicaid $3,661.66
Rate for Payer: Kentucky WC Medicaid $3,698.92
Rate for Payer: Medical Mutual Of Ohio HMO $8,730.91
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7,857.82
Rate for Payer: Molina Healthcare Benefit Exchange $3,194.24
Rate for Payer: Molina Healthcare Medicaid $3,735.13
Rate for Payer: Ohio Health Choice Commercial $9,369.76
Rate for Payer: Ohio Health Group HMO $7,985.59
Rate for Payer: Ohio Health Group PPO Differential $2,129.49
Rate for Payer: Ohio Health Group PPO No Differential $1,384.17
Rate for Payer: Ohio Health Group PPO SOMC Employees $3,300.71
Rate for Payer: PHCS Commercial $10,221.55
Rate for Payer: United Healthcare All Payer $9,369.76
Service Code HCPCS 57260
Hospital Charge Code 76102182
Hospital Revenue Code 761
Min. Negotiated Rate $234.00
Max. Negotiated Rate $1,728.00
Rate for Payer: Aetna Commercial $1,386.00
Rate for Payer: Anthem POS/PPO/Traditional $1,404.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $1,494.00
Rate for Payer: First Health Commercial $1,710.00
Rate for Payer: Humana Commercial $1,530.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,476.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,328.40
Rate for Payer: Molina Healthcare Benefit Exchange $540.00
Rate for Payer: Ohio Health Choice Commercial $1,584.00
Rate for Payer: Ohio Health Group HMO $1,350.00
Rate for Payer: Ohio Health Group PPO Differential $360.00
Rate for Payer: Ohio Health Group PPO No Differential $234.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $558.00
Rate for Payer: PHCS Commercial $1,728.00
Rate for Payer: United Healthcare All Payer $1,584.00
Service Code HCPCS 57260
Hospital Charge Code 76102182
Hospital Revenue Code 761
Min. Negotiated Rate $500.41
Max. Negotiated Rate $1,800.00
Rate for Payer: Aetna Commercial $1,209.05
Rate for Payer: Anthem Medicaid $500.41
Rate for Payer: Buckeye Medicare Advantage $1,800.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $1,126.53
Rate for Payer: Healthspan PPO $1,170.67
Rate for Payer: Humana Medicaid $500.41
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,074.34
Rate for Payer: Molina Healthcare CHIP/Medicaid $510.42
Rate for Payer: Molina Healthcare Passport $500.41
Rate for Payer: Multiplan PHCS $1,080.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,260.00
Rate for Payer: UHCCP Medicaid $630.00
Rate for Payer: Wellcare CHIP/Medicaid $505.41
Service Code HCPCS 57260
Hospital Charge Code 76102182
Hospital Revenue Code 761
Min. Negotiated Rate $234.00
Max. Negotiated Rate $6,021.69
Rate for Payer: Aetna Commercial $1,386.00
Rate for Payer: Anthem Medicaid $619.02
Rate for Payer: Anthem Medicare Advantage/PPO $4,301.21
Rate for Payer: Anthem POS/PPO/Traditional $1,404.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $6,021.69
Rate for Payer: CareSource Just4Me Medicare $5,806.63
Rate for Payer: Cash Price $900.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $1,494.00
Rate for Payer: First Health Commercial $1,710.00
Rate for Payer: Humana Commercial $1,530.00
Rate for Payer: Humana KY Medicaid $619.02
Rate for Payer: Humana Medicare Advantage $4,301.21
Rate for Payer: Kentucky WC Medicaid $625.32
Rate for Payer: Medical Mutual Of Ohio HMO $1,476.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,328.40
Rate for Payer: Molina Healthcare Benefit Exchange $5,161.45
Rate for Payer: Molina Healthcare Medicaid $631.44
Rate for Payer: Ohio Health Choice Commercial $1,584.00
Rate for Payer: Ohio Health Group HMO $1,350.00
Rate for Payer: Ohio Health Group PPO Differential $360.00
Rate for Payer: Ohio Health Group PPO No Differential $234.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $558.00
Rate for Payer: PHCS Commercial $1,728.00
Rate for Payer: United Healthcare All Payer $1,584.00
Service Code HCPCS 57260
Hospital Charge Code 761P2182
Hospital Revenue Code 761
Min. Negotiated Rate $500.41
Max. Negotiated Rate $1,800.00
Rate for Payer: Aetna Commercial $1,209.05
Rate for Payer: Anthem Medicaid $500.41
Rate for Payer: Buckeye Medicare Advantage $1,800.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $1,126.53
Rate for Payer: Healthspan PPO $1,170.67
Rate for Payer: Humana Medicaid $500.41
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,074.34
Rate for Payer: Molina Healthcare CHIP/Medicaid $510.42
Rate for Payer: Molina Healthcare Passport $500.41
Rate for Payer: Multiplan PHCS $1,080.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,260.00
Rate for Payer: UHCCP Medicaid $630.00
Rate for Payer: Wellcare CHIP/Medicaid $505.41
Service Code HCPCS 57265
Hospital Charge Code 76102183
Hospital Revenue Code 761
Min. Negotiated Rate $519.90
Max. Negotiated Rate $2,000.00
Rate for Payer: Aetna Commercial $1,358.55
Rate for Payer: Anthem Medicaid $519.90
Rate for Payer: Buckeye Medicare Advantage $2,000.00
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cigna Commercial $1,285.78
Rate for Payer: Healthspan PPO $1,315.42
Rate for Payer: Humana Medicaid $519.90
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,183.75
Rate for Payer: Molina Healthcare CHIP/Medicaid $530.30
Rate for Payer: Molina Healthcare Passport $519.90
Rate for Payer: Multiplan PHCS $1,200.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,400.00
Rate for Payer: UHCCP Medicaid $700.00
Rate for Payer: Wellcare CHIP/Medicaid $525.10
Service Code HCPCS 57265
Hospital Charge Code 76102183
Hospital Revenue Code 761
Min. Negotiated Rate $260.00
Max. Negotiated Rate $6,021.69
Rate for Payer: Aetna Commercial $1,540.00
Rate for Payer: Anthem Medicaid $687.80
Rate for Payer: Anthem Medicare Advantage/PPO $4,301.21
Rate for Payer: Anthem POS/PPO/Traditional $1,560.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $6,021.69
Rate for Payer: CareSource Just4Me Medicare $5,806.63
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cigna Commercial $1,660.00
Rate for Payer: First Health Commercial $1,900.00
Rate for Payer: Humana Commercial $1,700.00
Rate for Payer: Humana KY Medicaid $687.80
Rate for Payer: Humana Medicare Advantage $4,301.21
Rate for Payer: Kentucky WC Medicaid $694.80
Rate for Payer: Medical Mutual Of Ohio HMO $1,640.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,476.00
Rate for Payer: Molina Healthcare Benefit Exchange $5,161.45
Rate for Payer: Molina Healthcare Medicaid $701.60
Rate for Payer: Ohio Health Choice Commercial $1,760.00
Rate for Payer: Ohio Health Group HMO $1,500.00
Rate for Payer: Ohio Health Group PPO Differential $400.00
Rate for Payer: Ohio Health Group PPO No Differential $260.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $620.00
Rate for Payer: PHCS Commercial $1,920.00
Rate for Payer: United Healthcare All Payer $1,760.00
Service Code HCPCS 57265
Hospital Charge Code 76102183
Hospital Revenue Code 761
Min. Negotiated Rate $260.00
Max. Negotiated Rate $1,920.00
Rate for Payer: Aetna Commercial $1,540.00
Rate for Payer: Anthem POS/PPO/Traditional $1,560.00
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cigna Commercial $1,660.00
Rate for Payer: First Health Commercial $1,900.00
Rate for Payer: Humana Commercial $1,700.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,640.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,476.00
Rate for Payer: Molina Healthcare Benefit Exchange $600.00
Rate for Payer: Ohio Health Choice Commercial $1,760.00
Rate for Payer: Ohio Health Group HMO $1,500.00
Rate for Payer: Ohio Health Group PPO Differential $400.00
Rate for Payer: Ohio Health Group PPO No Differential $260.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $620.00
Rate for Payer: PHCS Commercial $1,920.00
Rate for Payer: United Healthcare All Payer $1,760.00
Service Code HCPCS 57265
Hospital Charge Code 761P2183
Hospital Revenue Code 761
Min. Negotiated Rate $519.90
Max. Negotiated Rate $2,000.00
Rate for Payer: Aetna Commercial $1,358.55
Rate for Payer: Anthem Medicaid $519.90
Rate for Payer: Buckeye Medicare Advantage $2,000.00
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cash Price $1,000.00
Rate for Payer: Cigna Commercial $1,285.78
Rate for Payer: Healthspan PPO $1,315.42
Rate for Payer: Humana Medicaid $519.90
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,183.75
Rate for Payer: Molina Healthcare CHIP/Medicaid $530.30
Rate for Payer: Molina Healthcare Passport $519.90
Rate for Payer: Multiplan PHCS $1,200.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,400.00
Rate for Payer: UHCCP Medicaid $700.00
Rate for Payer: Wellcare CHIP/Medicaid $525.10
Service Code HCPCS 87081
Hospital Charge Code 30001268
Hospital Revenue Code 306
Min. Negotiated Rate $12.87
Max. Negotiated Rate $95.04
Rate for Payer: Aetna Commercial $76.23
Rate for Payer: Anthem POS/PPO/Traditional $79.50
Rate for Payer: Cash Price $49.50
Rate for Payer: Cigna Commercial $82.17
Rate for Payer: First Health Commercial $94.05
Rate for Payer: Humana Commercial $84.15
Rate for Payer: Medical Mutual Of Ohio HMO $81.18
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $73.06
Rate for Payer: Molina Healthcare Benefit Exchange $29.70
Rate for Payer: Ohio Health Choice Commercial $87.12
Rate for Payer: Ohio Health Group HMO $74.25
Rate for Payer: Ohio Health Group PPO Differential $19.80
Rate for Payer: Ohio Health Group PPO No Differential $12.87
Rate for Payer: Ohio Health Group PPO SOMC Employees $30.69
Rate for Payer: PHCS Commercial $95.04
Rate for Payer: United Healthcare All Payer $87.12
Service Code HCPCS 87081
Hospital Charge Code 30001268
Hospital Revenue Code 306
Min. Negotiated Rate $6.63
Max. Negotiated Rate $95.04
Rate for Payer: Aetna Commercial $76.23
Rate for Payer: Anthem Medicaid $6.63
Rate for Payer: Anthem Medicare Advantage/PPO $6.63
Rate for Payer: Anthem POS/PPO/Traditional $79.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $9.28
Rate for Payer: CareSource Just4Me Medicare $6.63
Rate for Payer: Cash Price $49.50
Rate for Payer: Cash Price $49.50
Rate for Payer: Cigna Commercial $82.17
Rate for Payer: First Health Commercial $94.05
Rate for Payer: Humana Commercial $84.15
Rate for Payer: Humana KY Medicaid $6.63
Rate for Payer: Humana Medicare Advantage $6.63
Rate for Payer: Kentucky WC Medicaid $6.70
Rate for Payer: Medical Mutual Of Ohio HMO $81.18
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $73.06
Rate for Payer: Molina Healthcare Benefit Exchange $7.96
Rate for Payer: Molina Healthcare Medicaid $6.76
Rate for Payer: Ohio Health Choice Commercial $87.12
Rate for Payer: Ohio Health Group HMO $74.25
Rate for Payer: Ohio Health Group PPO Differential $19.80
Rate for Payer: Ohio Health Group PPO No Differential $12.87
Rate for Payer: Ohio Health Group PPO SOMC Employees $30.69
Rate for Payer: PHCS Commercial $95.04
Rate for Payer: United Healthcare All Payer $87.12
Service Code NDC 713050324
Hospital Charge Code 25000238
Hospital Revenue Code 637
Min. Negotiated Rate $3.63
Max. Negotiated Rate $26.80
Rate for Payer: Aetna Commercial $21.50
Rate for Payer: Anthem POS/PPO/Traditional $21.78
Rate for Payer: Cash Price $13.96
Rate for Payer: Cigna Commercial $23.17
Rate for Payer: First Health Commercial $26.52
Rate for Payer: Humana Commercial $23.73
Rate for Payer: Medical Mutual Of Ohio HMO $22.89
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $20.60
Rate for Payer: Molina Healthcare Benefit Exchange $8.38
Rate for Payer: Ohio Health Choice Commercial $24.57
Rate for Payer: Ohio Health Group HMO $20.94
Rate for Payer: Ohio Health Group PPO Differential $5.58
Rate for Payer: Ohio Health Group PPO No Differential $3.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.66
Rate for Payer: PHCS Commercial $26.80
Rate for Payer: United Healthcare All Payer $24.57
Service Code NDC 713050324
Hospital Charge Code 25000238
Hospital Revenue Code 637
Min. Negotiated Rate $3.63
Max. Negotiated Rate $26.80
Rate for Payer: Aetna Commercial $21.50
Rate for Payer: Anthem Medicaid $9.60
Rate for Payer: Anthem POS/PPO/Traditional $21.78
Rate for Payer: Cash Price $13.96
Rate for Payer: Cigna Commercial $23.17
Rate for Payer: First Health Commercial $26.52
Rate for Payer: Humana Commercial $23.73
Rate for Payer: Humana KY Medicaid $9.60
Rate for Payer: Kentucky WC Medicaid $9.70
Rate for Payer: Medical Mutual Of Ohio HMO $22.89
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $20.60
Rate for Payer: Molina Healthcare Benefit Exchange $8.38
Rate for Payer: Molina Healthcare Medicaid $9.79
Rate for Payer: Ohio Health Choice Commercial $24.57
Rate for Payer: Ohio Health Group HMO $20.94
Rate for Payer: Ohio Health Group PPO Differential $5.58
Rate for Payer: Ohio Health Group PPO No Differential $3.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.66
Rate for Payer: PHCS Commercial $26.80
Rate for Payer: United Healthcare All Payer $24.57
Service Code NDC 64980032430
Hospital Charge Code 25002840
Hospital Revenue Code 250
Min. Negotiated Rate $0.41
Max. Negotiated Rate $3.03
Rate for Payer: Aetna Commercial $2.43
Rate for Payer: Anthem POS/PPO/Traditional $2.46
Rate for Payer: Cash Price $1.58
Rate for Payer: Cigna Commercial $2.62
Rate for Payer: First Health Commercial $3.00
Rate for Payer: Humana Commercial $2.69
Rate for Payer: Medical Mutual Of Ohio HMO $2.59
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2.33
Rate for Payer: Molina Healthcare Benefit Exchange $0.95
Rate for Payer: Ohio Health Choice Commercial $2.78
Rate for Payer: Ohio Health Group HMO $2.37
Rate for Payer: Ohio Health Group PPO Differential $0.63
Rate for Payer: Ohio Health Group PPO No Differential $0.41
Rate for Payer: Ohio Health Group PPO SOMC Employees $0.98
Rate for Payer: PHCS Commercial $3.03
Rate for Payer: United Healthcare All Payer $2.78
Service Code NDC 64980032430
Hospital Charge Code 25002840
Hospital Revenue Code 250
Min. Negotiated Rate $0.41
Max. Negotiated Rate $3.03
Rate for Payer: Anthem Medicaid $1.09
Rate for Payer: Anthem POS/PPO/Traditional $2.46
Rate for Payer: Cash Price $1.58
Rate for Payer: Cigna Commercial $2.62
Rate for Payer: First Health Commercial $3.00
Rate for Payer: Humana Commercial $2.69
Rate for Payer: Humana KY Medicaid $1.09
Rate for Payer: Kentucky WC Medicaid $1.10
Rate for Payer: Medical Mutual Of Ohio HMO $2.59
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2.33
Rate for Payer: Molina Healthcare Benefit Exchange $0.95
Rate for Payer: Molina Healthcare Medicaid $1.11
Rate for Payer: Ohio Health Choice Commercial $2.78
Rate for Payer: Ohio Health Group HMO $2.37
Rate for Payer: Ohio Health Group PPO Differential $0.63
Rate for Payer: Ohio Health Group PPO No Differential $0.41
Rate for Payer: Ohio Health Group PPO SOMC Employees $0.98
Rate for Payer: PHCS Commercial $3.03
Rate for Payer: United Healthcare All Payer $2.78
Rate for Payer: Aetna Commercial $2.43
Service Code HCPCS 46999
Hospital Charge Code 76101944
Hospital Revenue Code 761
Min. Negotiated Rate $97.50
Max. Negotiated Rate $720.00
Rate for Payer: Aetna Commercial $577.50
Rate for Payer: Anthem POS/PPO/Traditional $585.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cigna Commercial $622.50
Rate for Payer: First Health Commercial $712.50
Rate for Payer: Humana Commercial $637.50
Rate for Payer: Medical Mutual Of Ohio HMO $615.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $553.50
Rate for Payer: Molina Healthcare Benefit Exchange $225.00
Rate for Payer: Ohio Health Choice Commercial $660.00
Rate for Payer: Ohio Health Group HMO $562.50
Rate for Payer: Ohio Health Group PPO Differential $150.00
Rate for Payer: Ohio Health Group PPO No Differential $97.50
Rate for Payer: Ohio Health Group PPO SOMC Employees $232.50
Rate for Payer: PHCS Commercial $720.00
Rate for Payer: United Healthcare All Payer $660.00
Service Code HCPCS 46999
Hospital Charge Code 76101944
Hospital Revenue Code 761
Min. Negotiated Rate $97.50
Max. Negotiated Rate $1,106.49
Rate for Payer: Aetna Commercial $577.50
Rate for Payer: Anthem Medicaid $257.92
Rate for Payer: Anthem Medicare Advantage/PPO $790.35
Rate for Payer: Anthem POS/PPO/Traditional $585.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,106.49
Rate for Payer: CareSource Just4Me Medicare $1,066.97
Rate for Payer: Cash Price $375.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cigna Commercial $622.50
Rate for Payer: First Health Commercial $712.50
Rate for Payer: Humana Commercial $637.50
Rate for Payer: Humana KY Medicaid $257.92
Rate for Payer: Humana Medicare Advantage $790.35
Rate for Payer: Kentucky WC Medicaid $260.55
Rate for Payer: Medical Mutual Of Ohio HMO $615.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $553.50
Rate for Payer: Molina Healthcare Benefit Exchange $948.42
Rate for Payer: Molina Healthcare Medicaid $263.10
Rate for Payer: Ohio Health Choice Commercial $660.00
Rate for Payer: Ohio Health Group HMO $562.50
Rate for Payer: Ohio Health Group PPO Differential $150.00
Rate for Payer: Ohio Health Group PPO No Differential $97.50
Rate for Payer: Ohio Health Group PPO SOMC Employees $232.50
Rate for Payer: PHCS Commercial $720.00
Rate for Payer: United Healthcare All Payer $660.00
Service Code HCPCS 46999
Hospital Charge Code 76101944
Hospital Revenue Code 761
Min. Negotiated Rate $0.60
Max. Negotiated Rate $750.00
Rate for Payer: Buckeye Medicare Advantage $750.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Healthspan PPO $0.60
Rate for Payer: Multiplan PHCS $450.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $525.00
Rate for Payer: UHCCP Medicaid $262.50
Service Code HCPCS 46999
Hospital Charge Code 761P1944
Hospital Revenue Code 761
Min. Negotiated Rate $0.60
Max. Negotiated Rate $750.00
Rate for Payer: Buckeye Medicare Advantage $750.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Healthspan PPO $0.60
Rate for Payer: Multiplan PHCS $450.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $525.00
Rate for Payer: UHCCP Medicaid $262.50
Service Code HCPCS 35646
Hospital Charge Code 761P1410
Hospital Revenue Code 761
Min. Negotiated Rate $1,435.00
Max. Negotiated Rate $4,100.00
Rate for Payer: Aetna Commercial $3,054.45
Rate for Payer: Anthem Medicaid $1,457.00
Rate for Payer: Buckeye Medicare Advantage $4,100.00
Rate for Payer: Cash Price $2,050.00
Rate for Payer: Cash Price $2,050.00
Rate for Payer: Cigna Commercial $2,919.02
Rate for Payer: Healthspan PPO $3,003.12
Rate for Payer: Humana Medicaid $1,457.00
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $2,363.80
Rate for Payer: Molina Healthcare CHIP/Medicaid $1,486.14
Rate for Payer: Molina Healthcare Passport $1,457.00
Rate for Payer: Multiplan PHCS $2,460.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,870.00
Rate for Payer: UHCCP Medicaid $1,435.00
Rate for Payer: Wellcare CHIP/Medicaid $1,471.57