|
MRI ABD-CHOLANGIOG W AND WO CO
|
Facility
|
IP
|
$4,509.00
|
|
|
Service Code
|
HCPCS 74183
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,352.70 |
| Max. Negotiated Rate |
$4,328.64 |
| Rate for Payer: Aetna Commercial |
$3,471.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,517.02
|
| Rate for Payer: Cash Price |
$2,254.50
|
| Rate for Payer: Cigna Commercial |
$3,742.47
|
| Rate for Payer: First Health Commercial |
$4,283.55
|
| Rate for Payer: Humana Commercial |
$3,832.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,697.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,327.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,352.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,967.92
|
| Rate for Payer: Ohio Health Group HMO |
$3,381.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,607.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,922.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,111.21
|
| Rate for Payer: PHCS Commercial |
$4,328.64
|
| Rate for Payer: United Healthcare All Payer |
$3,967.92
|
|
|
MRI ABD-CHOLANGIOG W AND WO CO
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 74183
|
| Hospital Charge Code |
610P0042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$1,485.65 |
| Rate for Payer: Aetna Commercial |
$993.42
|
| Rate for Payer: Ambetter Exchange |
$309.85
|
| Rate for Payer: Anthem Medicaid |
$723.49
|
| Rate for Payer: Buckeye Individual/Medicaid |
$309.85
|
| Rate for Payer: Buckeye Medicare Advantage |
$309.85
|
| Rate for Payer: CareSource Just4Me Medicare |
$371.82
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cigna Commercial |
$1,485.65
|
| Rate for Payer: Healthspan PPO |
$682.63
|
| Rate for Payer: Humana Medicaid |
$723.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$142.73
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$309.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$309.85
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$737.96
|
| Rate for Payer: Molina Healthcare Passport |
$723.49
|
| Rate for Payer: Multiplan PHCS |
$150.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$402.81
|
| Rate for Payer: UHCCP Medicaid |
$87.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$730.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$309.85
|
|
|
MRI ABDOMEN W AND WO CO
|
Facility
|
OP
|
$4,259.00
|
|
|
Service Code
|
HCPCS 74183
|
| Hospital Charge Code |
610T0042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$329.98 |
| Max. Negotiated Rate |
$4,088.64 |
| Rate for Payer: Aetna Commercial |
$3,279.43
|
| Rate for Payer: Anthem Medicaid |
$1,464.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$329.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,322.02
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$461.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$445.47
|
| Rate for Payer: Cash Price |
$2,129.50
|
| Rate for Payer: Cash Price |
$2,129.50
|
| Rate for Payer: Cigna Commercial |
$3,534.97
|
| Rate for Payer: First Health Commercial |
$4,046.05
|
| Rate for Payer: Humana Commercial |
$3,620.15
|
| Rate for Payer: Humana KY Medicaid |
$1,464.67
|
| Rate for Payer: Humana Medicare Advantage |
$329.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,479.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,492.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,143.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$395.98
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,494.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,747.92
|
| Rate for Payer: Ohio Health Group HMO |
$3,194.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,407.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,705.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,938.71
|
| Rate for Payer: PHCS Commercial |
$4,088.64
|
| Rate for Payer: United Healthcare All Payer |
$3,747.92
|
|
|
MRI ABDOMEN W AND WO CO
|
Facility
|
IP
|
$4,259.00
|
|
|
Service Code
|
HCPCS 74183
|
| Hospital Charge Code |
610T0042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,277.70 |
| Max. Negotiated Rate |
$4,088.64 |
| Rate for Payer: Aetna Commercial |
$3,279.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,322.02
|
| Rate for Payer: Cash Price |
$2,129.50
|
| Rate for Payer: Cigna Commercial |
$3,534.97
|
| Rate for Payer: First Health Commercial |
$4,046.05
|
| Rate for Payer: Humana Commercial |
$3,620.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,492.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,143.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,277.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,747.92
|
| Rate for Payer: Ohio Health Group HMO |
$3,194.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,407.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,705.33
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,938.71
|
| Rate for Payer: PHCS Commercial |
$4,088.64
|
| Rate for Payer: United Healthcare All Payer |
$3,747.92
|
|
|
MRI ABDOMEN W/CONTRAST
|
Professional
|
Both
|
$3,921.00
|
|
|
Service Code
|
HCPCS 74182
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$109.93 |
| Max. Negotiated Rate |
$2,352.60 |
| Rate for Payer: Aetna Commercial |
$780.75
|
| Rate for Payer: Ambetter Exchange |
$276.22
|
| Rate for Payer: Anthem Medicaid |
$405.62
|
| Rate for Payer: Buckeye Individual/Medicaid |
$276.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$276.22
|
| Rate for Payer: CareSource Just4Me Medicare |
$331.46
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cigna Commercial |
$932.85
|
| Rate for Payer: Healthspan PPO |
$536.49
|
| Rate for Payer: Humana Medicaid |
$405.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$109.93
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$276.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$276.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$413.73
|
| Rate for Payer: Molina Healthcare Passport |
$405.62
|
| Rate for Payer: Multiplan PHCS |
$2,352.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$359.09
|
| Rate for Payer: UHCCP Medicaid |
$1,372.35
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$409.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$276.22
|
|
|
MRI ABDOMEN W/CONTRAST
|
Facility
|
IP
|
$3,921.00
|
|
|
Service Code
|
HCPCS 74182
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,176.30 |
| Max. Negotiated Rate |
$3,764.16 |
| Rate for Payer: Aetna Commercial |
$3,019.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,058.38
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cigna Commercial |
$3,254.43
|
| Rate for Payer: First Health Commercial |
$3,724.95
|
| Rate for Payer: Humana Commercial |
$3,332.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,215.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,893.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,176.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,450.48
|
| Rate for Payer: Ohio Health Group HMO |
$2,940.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,136.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,411.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,705.49
|
| Rate for Payer: PHCS Commercial |
$3,764.16
|
| Rate for Payer: United Healthcare All Payer |
$3,450.48
|
|
|
MRI ABDOMEN W/CONTRAST
|
Facility
|
OP
|
$3,921.00
|
|
|
Service Code
|
HCPCS 74182
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$329.98 |
| Max. Negotiated Rate |
$3,764.16 |
| Rate for Payer: Aetna Commercial |
$3,019.17
|
| Rate for Payer: Anthem Medicaid |
$1,348.43
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$329.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,058.38
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$461.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$445.47
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cigna Commercial |
$3,254.43
|
| Rate for Payer: First Health Commercial |
$3,724.95
|
| Rate for Payer: Humana Commercial |
$3,332.85
|
| Rate for Payer: Humana KY Medicaid |
$1,348.43
|
| Rate for Payer: Humana Medicare Advantage |
$329.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,362.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,215.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,893.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$395.98
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,375.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,450.48
|
| Rate for Payer: Ohio Health Group HMO |
$2,940.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,136.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,411.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,705.49
|
| Rate for Payer: PHCS Commercial |
$3,764.16
|
| Rate for Payer: United Healthcare All Payer |
$3,450.48
|
|
|
MRI ABDOMEN W/CONTRAST(P
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 74182
|
| Hospital Charge Code |
610P0057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$101.50 |
| Max. Negotiated Rate |
$932.85 |
| Rate for Payer: Aetna Commercial |
$780.75
|
| Rate for Payer: Ambetter Exchange |
$276.22
|
| Rate for Payer: Anthem Medicaid |
$405.62
|
| Rate for Payer: Buckeye Individual/Medicaid |
$276.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$276.22
|
| Rate for Payer: CareSource Just4Me Medicare |
$331.46
|
| Rate for Payer: Cash Price |
$145.00
|
| Rate for Payer: Cash Price |
$145.00
|
| Rate for Payer: Cigna Commercial |
$932.85
|
| Rate for Payer: Healthspan PPO |
$536.49
|
| Rate for Payer: Humana Medicaid |
$405.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$109.93
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$276.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$276.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$413.73
|
| Rate for Payer: Molina Healthcare Passport |
$405.62
|
| Rate for Payer: Multiplan PHCS |
$174.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$359.09
|
| Rate for Payer: UHCCP Medicaid |
$101.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$409.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$276.22
|
|
|
MRI ABDOMEN W/CONTRAST(T
|
Facility
|
OP
|
$3,631.00
|
|
|
Service Code
|
HCPCS 74182
|
| Hospital Charge Code |
610T0057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$329.98 |
| Max. Negotiated Rate |
$3,485.76 |
| Rate for Payer: Aetna Commercial |
$2,795.87
|
| Rate for Payer: Anthem Medicaid |
$1,248.70
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$329.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,832.18
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$461.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$445.47
|
| Rate for Payer: Cash Price |
$1,815.50
|
| Rate for Payer: Cash Price |
$1,815.50
|
| Rate for Payer: Cigna Commercial |
$3,013.73
|
| Rate for Payer: First Health Commercial |
$3,449.45
|
| Rate for Payer: Humana Commercial |
$3,086.35
|
| Rate for Payer: Humana KY Medicaid |
$1,248.70
|
| Rate for Payer: Humana Medicare Advantage |
$329.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,261.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,977.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,679.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$395.98
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,273.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,195.28
|
| Rate for Payer: Ohio Health Group HMO |
$2,723.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,904.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,158.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,505.39
|
| Rate for Payer: PHCS Commercial |
$3,485.76
|
| Rate for Payer: United Healthcare All Payer |
$3,195.28
|
|
|
MRI ABDOMEN W/CONTRAST(T
|
Facility
|
IP
|
$3,631.00
|
|
|
Service Code
|
HCPCS 74182
|
| Hospital Charge Code |
610T0057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,089.30 |
| Max. Negotiated Rate |
$3,485.76 |
| Rate for Payer: Aetna Commercial |
$2,795.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,832.18
|
| Rate for Payer: Cash Price |
$1,815.50
|
| Rate for Payer: Cigna Commercial |
$3,013.73
|
| Rate for Payer: First Health Commercial |
$3,449.45
|
| Rate for Payer: Humana Commercial |
$3,086.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,977.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,679.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,089.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,195.28
|
| Rate for Payer: Ohio Health Group HMO |
$2,723.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,904.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,158.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,505.39
|
| Rate for Payer: PHCS Commercial |
$3,485.76
|
| Rate for Payer: United Healthcare All Payer |
$3,195.28
|
|
|
MRI ANGIO ABDOM W ORW/O DYE
|
Facility
|
OP
|
$2,938.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$223.34 |
| Max. Negotiated Rate |
$2,820.48 |
| Rate for Payer: Aetna Commercial |
$2,262.26
|
| Rate for Payer: Anthem Medicaid |
$1,010.38
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$223.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,291.64
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$312.68
|
| Rate for Payer: CareSource Just4Me Medicare |
$301.51
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cigna Commercial |
$2,438.54
|
| Rate for Payer: First Health Commercial |
$2,791.10
|
| Rate for Payer: Humana Commercial |
$2,497.30
|
| Rate for Payer: Humana KY Medicaid |
$1,010.38
|
| Rate for Payer: Humana Medicare Advantage |
$223.34
|
| Rate for Payer: Kentucky WC Medicaid |
$1,020.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,409.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,168.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$268.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,030.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,585.44
|
| Rate for Payer: Ohio Health Group HMO |
$2,203.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,350.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,556.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,027.22
|
| Rate for Payer: PHCS Commercial |
$2,820.48
|
| Rate for Payer: United Healthcare All Payer |
$2,585.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE
|
Facility
|
OP
|
$2,938.00
|
|
|
Service Code
|
HCPCS 74185
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$881.40 |
| Max. Negotiated Rate |
$2,820.48 |
| Rate for Payer: Aetna Commercial |
$2,262.26
|
| Rate for Payer: Anthem Medicaid |
$1,010.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,291.64
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cigna Commercial |
$2,438.54
|
| Rate for Payer: First Health Commercial |
$2,791.10
|
| Rate for Payer: Humana Commercial |
$2,497.30
|
| Rate for Payer: Humana KY Medicaid |
$1,010.38
|
| Rate for Payer: Kentucky WC Medicaid |
$1,020.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,409.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,168.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$881.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,030.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,585.44
|
| Rate for Payer: Ohio Health Group HMO |
$2,203.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,350.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,556.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,027.22
|
| Rate for Payer: PHCS Commercial |
$2,820.48
|
| Rate for Payer: United Healthcare All Payer |
$2,585.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE
|
Facility
|
IP
|
$2,938.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$881.40 |
| Max. Negotiated Rate |
$2,820.48 |
| Rate for Payer: Aetna Commercial |
$2,262.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,291.64
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cigna Commercial |
$2,438.54
|
| Rate for Payer: First Health Commercial |
$2,791.10
|
| Rate for Payer: Humana Commercial |
$2,497.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,409.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,168.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$881.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,585.44
|
| Rate for Payer: Ohio Health Group HMO |
$2,203.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,350.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,556.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,027.22
|
| Rate for Payer: PHCS Commercial |
$2,820.48
|
| Rate for Payer: United Healthcare All Payer |
$2,585.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE
|
Professional
|
Both
|
$2,938.00
|
|
|
Service Code
|
HCPCS 74185
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$114.23 |
| Max. Negotiated Rate |
$1,762.80 |
| Rate for Payer: Aetna Commercial |
$788.52
|
| Rate for Payer: Ambetter Exchange |
$307.78
|
| Rate for Payer: Anthem Medicaid |
$377.54
|
| Rate for Payer: Buckeye Individual/Medicaid |
$307.78
|
| Rate for Payer: Buckeye Medicare Advantage |
$307.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$369.34
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cigna Commercial |
$818.48
|
| Rate for Payer: Healthspan PPO |
$541.83
|
| Rate for Payer: Humana Medicaid |
$377.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$114.23
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$307.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$307.78
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$385.09
|
| Rate for Payer: Molina Healthcare Passport |
$377.54
|
| Rate for Payer: Multiplan PHCS |
$1,762.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$400.11
|
| Rate for Payer: UHCCP Medicaid |
$1,028.30
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$381.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$307.78
|
|
|
MRI ANGIO ABDOM W ORW/O DYE
|
Facility
|
IP
|
$2,938.00
|
|
|
Service Code
|
HCPCS 74185
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$881.40 |
| Max. Negotiated Rate |
$2,820.48 |
| Rate for Payer: Aetna Commercial |
$2,262.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,291.64
|
| Rate for Payer: Cash Price |
$1,469.00
|
| Rate for Payer: Cigna Commercial |
$2,438.54
|
| Rate for Payer: First Health Commercial |
$2,791.10
|
| Rate for Payer: Humana Commercial |
$2,497.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,409.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,168.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$881.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,585.44
|
| Rate for Payer: Ohio Health Group HMO |
$2,203.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,350.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,556.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,027.22
|
| Rate for Payer: PHCS Commercial |
$2,820.48
|
| Rate for Payer: United Healthcare All Payer |
$2,585.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE(P
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 74185
|
| Hospital Charge Code |
610P0043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$96.25 |
| Max. Negotiated Rate |
$818.48 |
| Rate for Payer: Aetna Commercial |
$788.52
|
| Rate for Payer: Ambetter Exchange |
$307.78
|
| Rate for Payer: Anthem Medicaid |
$377.54
|
| Rate for Payer: Buckeye Individual/Medicaid |
$307.78
|
| Rate for Payer: Buckeye Medicare Advantage |
$307.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$369.34
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cash Price |
$137.50
|
| Rate for Payer: Cigna Commercial |
$818.48
|
| Rate for Payer: Healthspan PPO |
$541.83
|
| Rate for Payer: Humana Medicaid |
$377.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$114.23
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$307.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$307.78
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$385.09
|
| Rate for Payer: Molina Healthcare Passport |
$377.54
|
| Rate for Payer: Multiplan PHCS |
$165.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$400.11
|
| Rate for Payer: UHCCP Medicaid |
$96.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$381.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$307.78
|
|
|
MRI ANGIO ABDOM W ORW/O DYE(T
|
Facility
|
IP
|
$2,663.00
|
|
|
Service Code
|
HCPCS 74185
|
| Hospital Charge Code |
610T0043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$798.90 |
| Max. Negotiated Rate |
$2,556.48 |
| Rate for Payer: Aetna Commercial |
$2,050.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,077.14
|
| Rate for Payer: Cash Price |
$1,331.50
|
| Rate for Payer: Cigna Commercial |
$2,210.29
|
| Rate for Payer: First Health Commercial |
$2,529.85
|
| Rate for Payer: Humana Commercial |
$2,263.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,183.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,965.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$798.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,343.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,997.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,130.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,316.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,837.47
|
| Rate for Payer: PHCS Commercial |
$2,556.48
|
| Rate for Payer: United Healthcare All Payer |
$2,343.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE(T
|
Facility
|
OP
|
$2,663.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
610T0043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$223.34 |
| Max. Negotiated Rate |
$2,556.48 |
| Rate for Payer: Aetna Commercial |
$2,050.51
|
| Rate for Payer: Anthem Medicaid |
$915.81
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$223.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,077.14
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$312.68
|
| Rate for Payer: CareSource Just4Me Medicare |
$301.51
|
| Rate for Payer: Cash Price |
$1,331.50
|
| Rate for Payer: Cash Price |
$1,331.50
|
| Rate for Payer: Cigna Commercial |
$2,210.29
|
| Rate for Payer: First Health Commercial |
$2,529.85
|
| Rate for Payer: Humana Commercial |
$2,263.55
|
| Rate for Payer: Humana KY Medicaid |
$915.81
|
| Rate for Payer: Humana Medicare Advantage |
$223.34
|
| Rate for Payer: Kentucky WC Medicaid |
$925.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,183.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,965.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$268.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$934.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,343.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,997.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,130.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,316.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,837.47
|
| Rate for Payer: PHCS Commercial |
$2,556.48
|
| Rate for Payer: United Healthcare All Payer |
$2,343.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE(T
|
Facility
|
IP
|
$2,663.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
610T0043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$798.90 |
| Max. Negotiated Rate |
$2,556.48 |
| Rate for Payer: Aetna Commercial |
$2,050.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,077.14
|
| Rate for Payer: Cash Price |
$1,331.50
|
| Rate for Payer: Cigna Commercial |
$2,210.29
|
| Rate for Payer: First Health Commercial |
$2,529.85
|
| Rate for Payer: Humana Commercial |
$2,263.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,183.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,965.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$798.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,343.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,997.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,130.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,316.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,837.47
|
| Rate for Payer: PHCS Commercial |
$2,556.48
|
| Rate for Payer: United Healthcare All Payer |
$2,343.44
|
|
|
MRI ANGIO ABDOM W ORW/O DYE(T
|
Facility
|
OP
|
$2,663.00
|
|
|
Service Code
|
HCPCS 74185
|
| Hospital Charge Code |
610T0043
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$798.90 |
| Max. Negotiated Rate |
$2,556.48 |
| Rate for Payer: Aetna Commercial |
$2,050.51
|
| Rate for Payer: Anthem Medicaid |
$915.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,077.14
|
| Rate for Payer: Cash Price |
$1,331.50
|
| Rate for Payer: Cigna Commercial |
$2,210.29
|
| Rate for Payer: First Health Commercial |
$2,529.85
|
| Rate for Payer: Humana Commercial |
$2,263.55
|
| Rate for Payer: Humana KY Medicaid |
$915.81
|
| Rate for Payer: Kentucky WC Medicaid |
$925.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,183.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,965.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$798.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$934.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,343.44
|
| Rate for Payer: Ohio Health Group HMO |
$1,997.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,130.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,316.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,837.47
|
| Rate for Payer: PHCS Commercial |
$2,556.48
|
| Rate for Payer: United Healthcare All Payer |
$2,343.44
|
|
|
MRI ANGIO CHEST W OR W/O DYE
|
Facility
|
IP
|
$4,415.00
|
|
|
Service Code
|
HCPCS 71555
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,324.50 |
| Max. Negotiated Rate |
$4,238.40 |
| Rate for Payer: Aetna Commercial |
$3,399.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,443.70
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cigna Commercial |
$3,664.45
|
| Rate for Payer: First Health Commercial |
$4,194.25
|
| Rate for Payer: Humana Commercial |
$3,752.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,620.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,258.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,324.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,885.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,311.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,532.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,841.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,046.35
|
| Rate for Payer: PHCS Commercial |
$4,238.40
|
| Rate for Payer: United Healthcare All Payer |
$3,885.20
|
|
|
MRI ANGIO CHEST W OR W/O DYE
|
Facility
|
IP
|
$4,415.00
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,324.50 |
| Max. Negotiated Rate |
$4,238.40 |
| Rate for Payer: Aetna Commercial |
$3,399.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,443.70
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cigna Commercial |
$3,664.45
|
| Rate for Payer: First Health Commercial |
$4,194.25
|
| Rate for Payer: Humana Commercial |
$3,752.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,620.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,258.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,324.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,885.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,311.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,532.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,841.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,046.35
|
| Rate for Payer: PHCS Commercial |
$4,238.40
|
| Rate for Payer: United Healthcare All Payer |
$3,885.20
|
|
|
MRI ANGIO CHEST W OR W/O DYE
|
Professional
|
Both
|
$4,415.00
|
|
|
Service Code
|
HCPCS 71555
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$115.49 |
| Max. Negotiated Rate |
$2,649.00 |
| Rate for Payer: Aetna Commercial |
$789.97
|
| Rate for Payer: Ambetter Exchange |
$304.19
|
| Rate for Payer: Anthem Medicaid |
$377.83
|
| Rate for Payer: Buckeye Individual/Medicaid |
$304.19
|
| Rate for Payer: Buckeye Medicare Advantage |
$304.19
|
| Rate for Payer: CareSource Just4Me Medicare |
$365.03
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cigna Commercial |
$824.60
|
| Rate for Payer: Healthspan PPO |
$542.83
|
| Rate for Payer: Humana Medicaid |
$377.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$115.49
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$304.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$304.19
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$385.39
|
| Rate for Payer: Molina Healthcare Passport |
$377.83
|
| Rate for Payer: Multiplan PHCS |
$2,649.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$395.45
|
| Rate for Payer: UHCCP Medicaid |
$1,545.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$381.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$304.19
|
|
|
MRI ANGIO CHEST W OR W/O DYE
|
Facility
|
OP
|
$4,415.00
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$329.98 |
| Max. Negotiated Rate |
$4,238.40 |
| Rate for Payer: Aetna Commercial |
$3,399.55
|
| Rate for Payer: Anthem Medicaid |
$1,518.32
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$329.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,443.70
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$461.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$445.47
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cigna Commercial |
$3,664.45
|
| Rate for Payer: First Health Commercial |
$4,194.25
|
| Rate for Payer: Humana Commercial |
$3,752.75
|
| Rate for Payer: Humana KY Medicaid |
$1,518.32
|
| Rate for Payer: Humana Medicare Advantage |
$329.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,533.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,620.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,258.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$395.98
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,548.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,885.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,311.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,532.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,841.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,046.35
|
| Rate for Payer: PHCS Commercial |
$4,238.40
|
| Rate for Payer: United Healthcare All Payer |
$3,885.20
|
|
|
MRI ANGIO CHEST W OR W/O DYE
|
Facility
|
OP
|
$4,415.00
|
|
|
Service Code
|
HCPCS 71555
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,324.50 |
| Max. Negotiated Rate |
$4,238.40 |
| Rate for Payer: Aetna Commercial |
$3,399.55
|
| Rate for Payer: Anthem Medicaid |
$1,518.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,443.70
|
| Rate for Payer: Cash Price |
$2,207.50
|
| Rate for Payer: Cigna Commercial |
$3,664.45
|
| Rate for Payer: First Health Commercial |
$4,194.25
|
| Rate for Payer: Humana Commercial |
$3,752.75
|
| Rate for Payer: Humana KY Medicaid |
$1,518.32
|
| Rate for Payer: Kentucky WC Medicaid |
$1,533.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,620.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,258.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,324.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,548.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,885.20
|
| Rate for Payer: Ohio Health Group HMO |
$3,311.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,532.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,841.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,046.35
|
| Rate for Payer: PHCS Commercial |
$4,238.40
|
| Rate for Payer: United Healthcare All Payer |
$3,885.20
|
|
