|
ARANESP 1mcg(200mcgPFS) ESRD
|
Facility
|
IP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004408
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,096.76 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,530.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(200mcgPFS)nonESRD
|
Facility
|
OP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25004398
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem Medicaid |
$2,901.35
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Humana KY Medicaid |
$2,901.35
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$2,930.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,959.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(200mcgPFS)nonESRD
|
Facility
|
IP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25004398
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,096.76 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,530.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(200mcgSDV) ESRD
|
Facility
|
IP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004407
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,096.76 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,530.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(200mcgSDV) ESRD
|
Facility
|
OP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004407
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem Medicaid |
$2,901.35
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Humana KY Medicaid |
$2,901.35
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$2,930.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,959.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(200mcgSDV)nonESR
|
Facility
|
OP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25001985
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem Medicaid |
$2,901.35
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Humana KY Medicaid |
$2,901.35
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$2,930.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,959.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(200mcgSDV)nonESR
|
Facility
|
IP
|
$8,436.60
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25001985
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,096.76 |
| Max. Negotiated Rate |
$8,099.14 |
| Rate for Payer: Aetna Commercial |
$6,496.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,580.55
|
| Rate for Payer: Cash Price |
$4,218.30
|
| Rate for Payer: Cigna Commercial |
$7,002.38
|
| Rate for Payer: First Health Commercial |
$8,014.77
|
| Rate for Payer: Humana Commercial |
$7,171.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,918.01
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,226.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,530.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,424.21
|
| Rate for Payer: Ohio Health Group HMO |
$6,327.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,687.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,096.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,615.35
|
| Rate for Payer: PHCS Commercial |
$8,099.14
|
| Rate for Payer: United Healthcare All Payer |
$7,424.21
|
|
|
ARANESP 1mcg(25mcgPFS) ESRD
|
Facility
|
OP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004400
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem Medicaid |
$362.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Humana KY Medicaid |
$362.67
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$366.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$369.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgPFS) ESRD
|
Facility
|
IP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004400
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$316.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgPFS)nonESRD
|
Facility
|
IP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25003781
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$316.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgPFS)nonESRD
|
Facility
|
OP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25003781
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem Medicaid |
$362.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Humana KY Medicaid |
$362.67
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$366.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$369.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgSDV) ESRD
|
Facility
|
IP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004399
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$316.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgSDV) ESRD
|
Facility
|
OP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004399
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem Medicaid |
$362.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Humana KY Medicaid |
$362.67
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$366.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$369.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgSDV)nonESRD
|
Facility
|
IP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25004396
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$316.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(25mcgSDV)nonESRD
|
Facility
|
OP
|
$1,054.58
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25004396
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,012.40 |
| Rate for Payer: Aetna Commercial |
$812.03
|
| Rate for Payer: Anthem Medicaid |
$362.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$822.57
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cash Price |
$527.29
|
| Rate for Payer: Cigna Commercial |
$875.30
|
| Rate for Payer: First Health Commercial |
$1,001.85
|
| Rate for Payer: Humana Commercial |
$896.39
|
| Rate for Payer: Humana KY Medicaid |
$362.67
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$366.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$864.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$778.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$369.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$928.03
|
| Rate for Payer: Ohio Health Group HMO |
$790.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.92
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$137.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$326.92
|
| Rate for Payer: PHCS Commercial |
$1,012.40
|
| Rate for Payer: United Healthcare All Payer |
$928.03
|
|
|
ARANESP 1mcg(300mcgPFS) ESRD
|
Facility
|
IP
|
$12,654.90
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004409
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,645.14 |
| Max. Negotiated Rate |
$12,148.70 |
| Rate for Payer: Aetna Commercial |
$9,744.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,870.82
|
| Rate for Payer: Cash Price |
$6,327.45
|
| Rate for Payer: Cigna Commercial |
$10,503.57
|
| Rate for Payer: First Health Commercial |
$12,022.16
|
| Rate for Payer: Humana Commercial |
$10,756.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,377.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,339.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,796.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,136.31
|
| Rate for Payer: Ohio Health Group HMO |
$9,491.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,530.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,645.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,923.02
|
| Rate for Payer: PHCS Commercial |
$12,148.70
|
| Rate for Payer: United Healthcare All Payer |
$11,136.31
|
|
|
ARANESP 1mcg(300mcgPFS) ESRD
|
Facility
|
OP
|
$12,654.90
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004409
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$12,148.70 |
| Rate for Payer: Aetna Commercial |
$9,744.27
|
| Rate for Payer: Anthem Medicaid |
$4,352.02
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,870.82
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$6,327.45
|
| Rate for Payer: Cash Price |
$6,327.45
|
| Rate for Payer: Cigna Commercial |
$10,503.57
|
| Rate for Payer: First Health Commercial |
$12,022.16
|
| Rate for Payer: Humana Commercial |
$10,756.66
|
| Rate for Payer: Humana KY Medicaid |
$4,352.02
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$4,396.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,377.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,339.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,439.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,136.31
|
| Rate for Payer: Ohio Health Group HMO |
$9,491.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,530.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,645.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,923.02
|
| Rate for Payer: PHCS Commercial |
$12,148.70
|
| Rate for Payer: United Healthcare All Payer |
$11,136.31
|
|
|
ARANESP 1mcg(300mcgPFS)nonESRD
|
Facility
|
OP
|
$12,654.90
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25001988
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$12,148.70 |
| Rate for Payer: Aetna Commercial |
$9,744.27
|
| Rate for Payer: Anthem Medicaid |
$4,352.02
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,870.82
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$6,327.45
|
| Rate for Payer: Cash Price |
$6,327.45
|
| Rate for Payer: Cigna Commercial |
$10,503.57
|
| Rate for Payer: First Health Commercial |
$12,022.16
|
| Rate for Payer: Humana Commercial |
$10,756.66
|
| Rate for Payer: Humana KY Medicaid |
$4,352.02
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$4,396.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,377.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,339.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,439.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,136.31
|
| Rate for Payer: Ohio Health Group HMO |
$9,491.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,530.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,645.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,923.02
|
| Rate for Payer: PHCS Commercial |
$12,148.70
|
| Rate for Payer: United Healthcare All Payer |
$11,136.31
|
|
|
ARANESP 1mcg(300mcgPFS)nonESRD
|
Facility
|
IP
|
$12,654.90
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25001988
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,645.14 |
| Max. Negotiated Rate |
$12,148.70 |
| Rate for Payer: Aetna Commercial |
$9,744.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,870.82
|
| Rate for Payer: Cash Price |
$6,327.45
|
| Rate for Payer: Cigna Commercial |
$10,503.57
|
| Rate for Payer: First Health Commercial |
$12,022.16
|
| Rate for Payer: Humana Commercial |
$10,756.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,377.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,339.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,796.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,136.31
|
| Rate for Payer: Ohio Health Group HMO |
$9,491.18
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,530.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,645.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,923.02
|
| Rate for Payer: PHCS Commercial |
$12,148.70
|
| Rate for Payer: United Healthcare All Payer |
$11,136.31
|
|
|
ARANESP 1mcg(40mcgPFS) ESRD
|
Facility
|
OP
|
$1,687.32
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004402
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,619.83 |
| Rate for Payer: Aetna Commercial |
$1,299.24
|
| Rate for Payer: Anthem Medicaid |
$580.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.11
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cigna Commercial |
$1,400.48
|
| Rate for Payer: First Health Commercial |
$1,602.95
|
| Rate for Payer: Humana Commercial |
$1,434.22
|
| Rate for Payer: Humana KY Medicaid |
$580.27
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$586.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$591.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,484.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$337.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$523.07
|
| Rate for Payer: PHCS Commercial |
$1,619.83
|
| Rate for Payer: United Healthcare All Payer |
$1,484.84
|
|
|
ARANESP 1mcg(40mcgPFS) ESRD
|
Facility
|
IP
|
$1,687.32
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004402
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$219.35 |
| Max. Negotiated Rate |
$1,619.83 |
| Rate for Payer: Aetna Commercial |
$1,299.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.11
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cigna Commercial |
$1,400.48
|
| Rate for Payer: First Health Commercial |
$1,602.95
|
| Rate for Payer: Humana Commercial |
$1,434.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$506.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,484.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$337.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$523.07
|
| Rate for Payer: PHCS Commercial |
$1,619.83
|
| Rate for Payer: United Healthcare All Payer |
$1,484.84
|
|
|
ARANESP 1mcg(40mcgPFS)nonESRD
|
Facility
|
OP
|
$1,687.32
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25003782
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,619.83 |
| Rate for Payer: Aetna Commercial |
$1,299.24
|
| Rate for Payer: Anthem Medicaid |
$580.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.11
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cigna Commercial |
$1,400.48
|
| Rate for Payer: First Health Commercial |
$1,602.95
|
| Rate for Payer: Humana Commercial |
$1,434.22
|
| Rate for Payer: Humana KY Medicaid |
$580.27
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$586.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$591.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,484.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$337.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$523.07
|
| Rate for Payer: PHCS Commercial |
$1,619.83
|
| Rate for Payer: United Healthcare All Payer |
$1,484.84
|
|
|
ARANESP 1mcg(40mcgPFS)nonESRD
|
Facility
|
IP
|
$1,687.32
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
25003782
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$219.35 |
| Max. Negotiated Rate |
$1,619.83 |
| Rate for Payer: Aetna Commercial |
$1,299.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.11
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cigna Commercial |
$1,400.48
|
| Rate for Payer: First Health Commercial |
$1,602.95
|
| Rate for Payer: Humana Commercial |
$1,434.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$506.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,484.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$337.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$523.07
|
| Rate for Payer: PHCS Commercial |
$1,619.83
|
| Rate for Payer: United Healthcare All Payer |
$1,484.84
|
|
|
ARANESP 1mcg(40mcgSDV) ESRD
|
Facility
|
OP
|
$1,687.32
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004401
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$1,619.83 |
| Rate for Payer: Aetna Commercial |
$1,299.24
|
| Rate for Payer: Anthem Medicaid |
$580.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.11
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$3.96
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cigna Commercial |
$1,400.48
|
| Rate for Payer: First Health Commercial |
$1,602.95
|
| Rate for Payer: Humana Commercial |
$1,434.22
|
| Rate for Payer: Humana KY Medicaid |
$580.27
|
| Rate for Payer: Humana Medicare Advantage |
$2.93
|
| Rate for Payer: Kentucky WC Medicaid |
$586.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$591.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,484.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$337.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$523.07
|
| Rate for Payer: PHCS Commercial |
$1,619.83
|
| Rate for Payer: United Healthcare All Payer |
$1,484.84
|
|
|
ARANESP 1mcg(40mcgSDV) ESRD
|
Facility
|
IP
|
$1,687.32
|
|
|
Service Code
|
HCPCS J0882
|
| Hospital Charge Code |
25004401
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$219.35 |
| Max. Negotiated Rate |
$1,619.83 |
| Rate for Payer: Aetna Commercial |
$1,299.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,316.11
|
| Rate for Payer: Cash Price |
$843.66
|
| Rate for Payer: Cigna Commercial |
$1,400.48
|
| Rate for Payer: First Health Commercial |
$1,602.95
|
| Rate for Payer: Humana Commercial |
$1,434.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,383.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,245.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$506.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,484.84
|
| Rate for Payer: Ohio Health Group HMO |
$1,265.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$337.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$523.07
|
| Rate for Payer: PHCS Commercial |
$1,619.83
|
| Rate for Payer: United Healthcare All Payer |
$1,484.84
|
|
