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Service Code NDC 31722059730
Hospital Charge Code 25001107
Hospital Revenue Code 637
Min. Negotiated Rate $1.39
Max. Negotiated Rate $10.24
Rate for Payer: Aetna Commercial $8.22
Rate for Payer: Anthem Medicaid $3.67
Rate for Payer: Anthem POS/PPO/Traditional $8.32
Rate for Payer: Cash Price $5.34
Rate for Payer: Cigna Commercial $8.86
Rate for Payer: First Health Commercial $10.14
Rate for Payer: Humana Commercial $9.07
Rate for Payer: Humana KY Medicaid $3.67
Rate for Payer: Kentucky WC Medicaid $3.71
Rate for Payer: Medical Mutual Of Ohio HMO $8.75
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.87
Rate for Payer: Molina Healthcare Benefit Exchange $3.20
Rate for Payer: Molina Healthcare Medicaid $3.74
Rate for Payer: Ohio Health Choice Commercial $9.39
Rate for Payer: Ohio Health Group HMO $8.00
Rate for Payer: Ohio Health Group PPO Differential $2.13
Rate for Payer: Ohio Health Group PPO No Differential $1.39
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.31
Rate for Payer: PHCS Commercial $10.24
Rate for Payer: United Healthcare All Payer $9.39
Service Code HCPCS J7189
Hospital Charge Code 25002476
Hospital Revenue Code 636
Min. Negotiated Rate $10.23
Max. Negotiated Rate $75.53
Rate for Payer: Aetna Commercial $60.58
Rate for Payer: Anthem POS/PPO/Traditional $61.37
Rate for Payer: Cash Price $39.34
Rate for Payer: Cigna Commercial $65.30
Rate for Payer: First Health Commercial $74.75
Rate for Payer: Humana Commercial $66.88
Rate for Payer: Medical Mutual Of Ohio HMO $64.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $58.07
Rate for Payer: Molina Healthcare Benefit Exchange $23.60
Rate for Payer: Ohio Health Choice Commercial $69.24
Rate for Payer: Ohio Health Group HMO $59.01
Rate for Payer: Ohio Health Group PPO Differential $15.74
Rate for Payer: Ohio Health Group PPO No Differential $10.23
Rate for Payer: Ohio Health Group PPO SOMC Employees $24.39
Rate for Payer: PHCS Commercial $75.53
Rate for Payer: United Healthcare All Payer $69.24
Service Code HCPCS J7189
Hospital Charge Code 25002476
Hospital Revenue Code 636
Min. Negotiated Rate $2.43
Max. Negotiated Rate $75.53
Rate for Payer: Aetna Commercial $60.58
Rate for Payer: Anthem Medicaid $27.06
Rate for Payer: Anthem Medicare Advantage/PPO $2.43
Rate for Payer: Anthem POS/PPO/Traditional $61.37
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3.40
Rate for Payer: CareSource Just4Me Medicare $3.28
Rate for Payer: Cash Price $39.34
Rate for Payer: Cash Price $39.34
Rate for Payer: Cigna Commercial $65.30
Rate for Payer: First Health Commercial $74.75
Rate for Payer: Humana Commercial $66.88
Rate for Payer: Humana KY Medicaid $27.06
Rate for Payer: Humana Medicare Advantage $2.43
Rate for Payer: Kentucky WC Medicaid $27.33
Rate for Payer: Medical Mutual Of Ohio HMO $64.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $58.07
Rate for Payer: Molina Healthcare Benefit Exchange $2.91
Rate for Payer: Molina Healthcare Medicaid $27.60
Rate for Payer: Ohio Health Choice Commercial $69.24
Rate for Payer: Ohio Health Group HMO $59.01
Rate for Payer: Ohio Health Group PPO Differential $15.74
Rate for Payer: Ohio Health Group PPO No Differential $10.23
Rate for Payer: Ohio Health Group PPO SOMC Employees $24.39
Rate for Payer: PHCS Commercial $75.53
Rate for Payer: United Healthcare All Payer $69.24
Service Code HCPCS J1815
Hospital Charge Code 25002191
Hospital Revenue Code 637
Min. Negotiated Rate $51.25
Max. Negotiated Rate $378.48
Rate for Payer: Anthem POS/PPO/Traditional $307.52
Rate for Payer: Cash Price $197.12
Rate for Payer: Cigna Commercial $327.23
Rate for Payer: First Health Commercial $374.54
Rate for Payer: Humana Commercial $335.11
Rate for Payer: Humana KY Medicaid $135.58
Rate for Payer: Kentucky WC Medicaid $136.96
Rate for Payer: Medical Mutual Of Ohio HMO $323.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $290.96
Rate for Payer: Molina Healthcare Benefit Exchange $118.28
Rate for Payer: Molina Healthcare Medicaid $138.30
Rate for Payer: Ohio Health Choice Commercial $346.94
Rate for Payer: Ohio Health Group HMO $295.69
Rate for Payer: Ohio Health Group PPO Differential $78.85
Rate for Payer: Ohio Health Group PPO No Differential $51.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $122.22
Rate for Payer: PHCS Commercial $378.48
Rate for Payer: United Healthcare All Payer $346.94
Rate for Payer: Aetna Commercial $303.57
Rate for Payer: Anthem Medicaid $135.58
Service Code HCPCS J1815
Hospital Charge Code 25002191
Hospital Revenue Code 637
Min. Negotiated Rate $51.25
Max. Negotiated Rate $378.48
Rate for Payer: Aetna Commercial $303.57
Rate for Payer: Anthem POS/PPO/Traditional $307.52
Rate for Payer: Cash Price $197.12
Rate for Payer: Cigna Commercial $327.23
Rate for Payer: First Health Commercial $374.54
Rate for Payer: Humana Commercial $335.11
Rate for Payer: Medical Mutual Of Ohio HMO $323.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $290.96
Rate for Payer: Molina Healthcare Benefit Exchange $118.28
Rate for Payer: Ohio Health Choice Commercial $346.94
Rate for Payer: Ohio Health Group HMO $295.69
Rate for Payer: Ohio Health Group PPO Differential $78.85
Rate for Payer: Ohio Health Group PPO No Differential $51.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $122.22
Rate for Payer: PHCS Commercial $378.48
Rate for Payer: United Healthcare All Payer $346.94
Service Code HCPCS J1815
Hospital Charge Code 25002194
Hospital Revenue Code 637
Min. Negotiated Rate $19.80
Max. Negotiated Rate $146.18
Rate for Payer: Aetna Commercial $117.25
Rate for Payer: Anthem POS/PPO/Traditional $118.77
Rate for Payer: Cash Price $76.14
Rate for Payer: Cigna Commercial $126.38
Rate for Payer: First Health Commercial $144.66
Rate for Payer: Humana Commercial $129.43
Rate for Payer: Medical Mutual Of Ohio HMO $124.86
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $112.38
Rate for Payer: Molina Healthcare Benefit Exchange $45.68
Rate for Payer: Ohio Health Choice Commercial $134.00
Rate for Payer: Ohio Health Group HMO $114.20
Rate for Payer: Ohio Health Group PPO Differential $30.45
Rate for Payer: Ohio Health Group PPO No Differential $19.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $47.20
Rate for Payer: PHCS Commercial $146.18
Rate for Payer: United Healthcare All Payer $134.00
Service Code HCPCS J1815
Hospital Charge Code 25002194
Hospital Revenue Code 637
Min. Negotiated Rate $19.80
Max. Negotiated Rate $146.18
Rate for Payer: Aetna Commercial $117.25
Rate for Payer: Anthem Medicaid $52.37
Rate for Payer: Anthem POS/PPO/Traditional $118.77
Rate for Payer: Cash Price $76.14
Rate for Payer: Cigna Commercial $126.38
Rate for Payer: First Health Commercial $144.66
Rate for Payer: Humana Commercial $129.43
Rate for Payer: Humana KY Medicaid $52.37
Rate for Payer: Kentucky WC Medicaid $52.90
Rate for Payer: Medical Mutual Of Ohio HMO $124.86
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $112.38
Rate for Payer: Molina Healthcare Benefit Exchange $45.68
Rate for Payer: Molina Healthcare Medicaid $53.42
Rate for Payer: Ohio Health Choice Commercial $134.00
Rate for Payer: Ohio Health Group HMO $114.20
Rate for Payer: Ohio Health Group PPO Differential $30.45
Rate for Payer: Ohio Health Group PPO No Differential $19.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $47.20
Rate for Payer: PHCS Commercial $146.18
Rate for Payer: United Healthcare All Payer $134.00
Service Code HCPCS J1815
Hospital Charge Code 25004017
Hospital Revenue Code 636
Min. Negotiated Rate $39.95
Max. Negotiated Rate $295.05
Rate for Payer: Aetna Commercial $236.65
Rate for Payer: Anthem Medicaid $105.69
Rate for Payer: Anthem POS/PPO/Traditional $239.73
Rate for Payer: Cash Price $153.67
Rate for Payer: Cigna Commercial $255.09
Rate for Payer: First Health Commercial $291.97
Rate for Payer: Humana Commercial $261.24
Rate for Payer: Humana KY Medicaid $105.69
Rate for Payer: Kentucky WC Medicaid $106.77
Rate for Payer: Medical Mutual Of Ohio HMO $252.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $226.82
Rate for Payer: Molina Healthcare Benefit Exchange $92.20
Rate for Payer: Molina Healthcare Medicaid $107.81
Rate for Payer: Ohio Health Choice Commercial $270.46
Rate for Payer: Ohio Health Group HMO $230.50
Rate for Payer: Ohio Health Group PPO Differential $61.47
Rate for Payer: Ohio Health Group PPO No Differential $39.95
Rate for Payer: Ohio Health Group PPO SOMC Employees $95.28
Rate for Payer: PHCS Commercial $295.05
Rate for Payer: United Healthcare All Payer $270.46
Service Code HCPCS J1815
Hospital Charge Code 25004017
Hospital Revenue Code 636
Min. Negotiated Rate $39.95
Max. Negotiated Rate $295.05
Rate for Payer: Aetna Commercial $236.65
Rate for Payer: Anthem POS/PPO/Traditional $239.73
Rate for Payer: Cash Price $153.67
Rate for Payer: Cigna Commercial $255.09
Rate for Payer: First Health Commercial $291.97
Rate for Payer: Humana Commercial $261.24
Rate for Payer: Medical Mutual Of Ohio HMO $252.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $226.82
Rate for Payer: Molina Healthcare Benefit Exchange $92.20
Rate for Payer: Ohio Health Choice Commercial $270.46
Rate for Payer: Ohio Health Group HMO $230.50
Rate for Payer: Ohio Health Group PPO Differential $61.47
Rate for Payer: Ohio Health Group PPO No Differential $39.95
Rate for Payer: Ohio Health Group PPO SOMC Employees $95.28
Rate for Payer: PHCS Commercial $295.05
Rate for Payer: United Healthcare All Payer $270.46
Service Code HCPCS J7189
Hospital Charge Code 25002475
Hospital Revenue Code 636
Min. Negotiated Rate $2.43
Max. Negotiated Rate $75.53
Rate for Payer: Aetna Commercial $60.58
Rate for Payer: Anthem Medicaid $27.06
Rate for Payer: Anthem Medicare Advantage/PPO $2.43
Rate for Payer: Anthem POS/PPO/Traditional $61.37
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3.40
Rate for Payer: CareSource Just4Me Medicare $3.28
Rate for Payer: Cash Price $39.34
Rate for Payer: Cash Price $39.34
Rate for Payer: Cigna Commercial $65.30
Rate for Payer: First Health Commercial $74.75
Rate for Payer: Humana Commercial $66.88
Rate for Payer: Humana KY Medicaid $27.06
Rate for Payer: Humana Medicare Advantage $2.43
Rate for Payer: Kentucky WC Medicaid $27.33
Rate for Payer: Medical Mutual Of Ohio HMO $64.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $58.07
Rate for Payer: Molina Healthcare Benefit Exchange $2.91
Rate for Payer: Molina Healthcare Medicaid $27.60
Rate for Payer: Ohio Health Choice Commercial $69.24
Rate for Payer: Ohio Health Group HMO $59.01
Rate for Payer: Ohio Health Group PPO Differential $15.74
Rate for Payer: Ohio Health Group PPO No Differential $10.23
Rate for Payer: Ohio Health Group PPO SOMC Employees $24.39
Rate for Payer: PHCS Commercial $75.53
Rate for Payer: United Healthcare All Payer $69.24
Service Code HCPCS J7189
Hospital Charge Code 25002475
Hospital Revenue Code 636
Min. Negotiated Rate $10.23
Max. Negotiated Rate $75.53
Rate for Payer: Aetna Commercial $60.58
Rate for Payer: Anthem POS/PPO/Traditional $61.37
Rate for Payer: Cash Price $39.34
Rate for Payer: Cigna Commercial $65.30
Rate for Payer: First Health Commercial $74.75
Rate for Payer: Humana Commercial $66.88
Rate for Payer: Medical Mutual Of Ohio HMO $64.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $58.07
Rate for Payer: Molina Healthcare Benefit Exchange $23.60
Rate for Payer: Ohio Health Choice Commercial $69.24
Rate for Payer: Ohio Health Group HMO $59.01
Rate for Payer: Ohio Health Group PPO Differential $15.74
Rate for Payer: Ohio Health Group PPO No Differential $10.23
Rate for Payer: Ohio Health Group PPO SOMC Employees $24.39
Rate for Payer: PHCS Commercial $75.53
Rate for Payer: United Healthcare All Payer $69.24
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $11,463.40
Max. Negotiated Rate $84,652.80
Rate for Payer: Aetna Commercial $67,898.60
Rate for Payer: Anthem POS/PPO/Traditional $68,780.40
Rate for Payer: Cash Price $44,090.00
Rate for Payer: Cigna Commercial $73,189.40
Rate for Payer: First Health Commercial $83,771.00
Rate for Payer: Humana Commercial $74,953.00
Rate for Payer: Medical Mutual Of Ohio HMO $72,307.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $65,076.84
Rate for Payer: Molina Healthcare Benefit Exchange $26,454.00
Rate for Payer: Ohio Health Choice Commercial $77,598.40
Rate for Payer: Ohio Health Group HMO $66,135.00
Rate for Payer: Ohio Health Group PPO Differential $17,636.00
Rate for Payer: Ohio Health Group PPO No Differential $11,463.40
Rate for Payer: Ohio Health Group PPO SOMC Employees $27,335.80
Rate for Payer: PHCS Commercial $84,652.80
Rate for Payer: United Healthcare All Payer $77,598.40
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $11,463.40
Max. Negotiated Rate $84,652.80
Rate for Payer: Aetna Commercial $67,898.60
Rate for Payer: Anthem Medicaid $30,325.10
Rate for Payer: Anthem POS/PPO/Traditional $68,780.40
Rate for Payer: Cash Price $44,090.00
Rate for Payer: Cigna Commercial $73,189.40
Rate for Payer: First Health Commercial $83,771.00
Rate for Payer: Humana Commercial $74,953.00
Rate for Payer: Humana KY Medicaid $30,325.10
Rate for Payer: Kentucky WC Medicaid $30,633.73
Rate for Payer: Medical Mutual Of Ohio HMO $72,307.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $65,076.84
Rate for Payer: Molina Healthcare Benefit Exchange $26,454.00
Rate for Payer: Molina Healthcare Medicaid $30,933.54
Rate for Payer: Ohio Health Choice Commercial $77,598.40
Rate for Payer: Ohio Health Group HMO $66,135.00
Rate for Payer: Ohio Health Group PPO Differential $17,636.00
Rate for Payer: Ohio Health Group PPO No Differential $11,463.40
Rate for Payer: Ohio Health Group PPO SOMC Employees $27,335.80
Rate for Payer: PHCS Commercial $84,652.80
Rate for Payer: United Healthcare All Payer $77,598.40
Service Code HCPCS J2796
Hospital Charge Code 25004205
Hospital Revenue Code 636
Min. Negotiated Rate $96.03
Max. Negotiated Rate $6,859.05
Rate for Payer: Aetna Commercial $5,501.53
Rate for Payer: Anthem Medicaid $2,457.11
Rate for Payer: Anthem Medicare Advantage/PPO $96.03
Rate for Payer: Anthem POS/PPO/Traditional $5,572.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $134.44
Rate for Payer: CareSource Just4Me Medicare $129.64
Rate for Payer: Cash Price $3,572.42
Rate for Payer: Cash Price $3,572.42
Rate for Payer: Cigna Commercial $5,930.22
Rate for Payer: First Health Commercial $6,787.60
Rate for Payer: Humana Commercial $6,073.11
Rate for Payer: Humana KY Medicaid $2,457.11
Rate for Payer: Humana Medicare Advantage $96.03
Rate for Payer: Kentucky WC Medicaid $2,482.12
Rate for Payer: Medical Mutual Of Ohio HMO $5,858.77
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $5,272.89
Rate for Payer: Molina Healthcare Benefit Exchange $115.23
Rate for Payer: Molina Healthcare Medicaid $2,506.41
Rate for Payer: Ohio Health Choice Commercial $6,287.46
Rate for Payer: Ohio Health Group HMO $5,358.63
Rate for Payer: Ohio Health Group PPO Differential $1,428.97
Rate for Payer: Ohio Health Group PPO No Differential $928.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,214.90
Rate for Payer: PHCS Commercial $6,859.05
Rate for Payer: United Healthcare All Payer $6,287.46
Service Code HCPCS J2796
Hospital Charge Code 25004205
Hospital Revenue Code 636
Min. Negotiated Rate $928.83
Max. Negotiated Rate $6,859.05
Rate for Payer: Aetna Commercial $5,501.53
Rate for Payer: Anthem POS/PPO/Traditional $5,572.98
Rate for Payer: Cash Price $3,572.42
Rate for Payer: Cigna Commercial $5,930.22
Rate for Payer: First Health Commercial $6,787.60
Rate for Payer: Humana Commercial $6,073.11
Rate for Payer: Medical Mutual Of Ohio HMO $5,858.77
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $5,272.89
Rate for Payer: Molina Healthcare Benefit Exchange $2,143.45
Rate for Payer: Ohio Health Choice Commercial $6,287.46
Rate for Payer: Ohio Health Group HMO $5,358.63
Rate for Payer: Ohio Health Group PPO Differential $1,428.97
Rate for Payer: Ohio Health Group PPO No Differential $928.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,214.90
Rate for Payer: PHCS Commercial $6,859.05
Rate for Payer: United Healthcare All Payer $6,287.46
Service Code HCPCS J2796
Hospital Charge Code 25002353
Hospital Revenue Code 636
Min. Negotiated Rate $96.03
Max. Negotiated Rate $13,717.88
Rate for Payer: Aetna Commercial $11,002.88
Rate for Payer: Anthem Medicaid $4,914.15
Rate for Payer: Anthem Medicare Advantage/PPO $96.03
Rate for Payer: Anthem POS/PPO/Traditional $11,145.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $134.44
Rate for Payer: CareSource Just4Me Medicare $129.64
Rate for Payer: Cash Price $7,144.73
Rate for Payer: Cash Price $7,144.73
Rate for Payer: Cigna Commercial $11,860.25
Rate for Payer: First Health Commercial $13,574.99
Rate for Payer: Humana Commercial $12,146.04
Rate for Payer: Humana KY Medicaid $4,914.15
Rate for Payer: Humana Medicare Advantage $96.03
Rate for Payer: Kentucky WC Medicaid $4,964.16
Rate for Payer: Medical Mutual Of Ohio HMO $11,717.36
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $10,545.62
Rate for Payer: Molina Healthcare Benefit Exchange $115.23
Rate for Payer: Molina Healthcare Medicaid $5,012.74
Rate for Payer: Ohio Health Choice Commercial $12,574.72
Rate for Payer: Ohio Health Group HMO $10,717.10
Rate for Payer: Ohio Health Group PPO Differential $2,857.89
Rate for Payer: Ohio Health Group PPO No Differential $1,857.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $4,429.73
Rate for Payer: PHCS Commercial $13,717.88
Rate for Payer: United Healthcare All Payer $12,574.72
Service Code HCPCS J2796
Hospital Charge Code 25002353
Hospital Revenue Code 636
Min. Negotiated Rate $1,857.63
Max. Negotiated Rate $13,717.88
Rate for Payer: Aetna Commercial $11,002.88
Rate for Payer: Anthem POS/PPO/Traditional $11,145.78
Rate for Payer: Cash Price $7,144.73
Rate for Payer: Cigna Commercial $11,860.25
Rate for Payer: First Health Commercial $13,574.99
Rate for Payer: Humana Commercial $12,146.04
Rate for Payer: Medical Mutual Of Ohio HMO $11,717.36
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $10,545.62
Rate for Payer: Molina Healthcare Benefit Exchange $4,286.84
Rate for Payer: Ohio Health Choice Commercial $12,574.72
Rate for Payer: Ohio Health Group HMO $10,717.10
Rate for Payer: Ohio Health Group PPO Differential $2,857.89
Rate for Payer: Ohio Health Group PPO No Differential $1,857.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $4,429.73
Rate for Payer: PHCS Commercial $13,717.88
Rate for Payer: United Healthcare All Payer $12,574.72
Service Code HCPCS J2796
Hospital Charge Code 25002354
Hospital Revenue Code 636
Min. Negotiated Rate $3,715.25
Max. Negotiated Rate $27,435.72
Rate for Payer: Aetna Commercial $22,005.73
Rate for Payer: Anthem POS/PPO/Traditional $22,291.52
Rate for Payer: Cash Price $14,289.43
Rate for Payer: Cigna Commercial $23,720.46
Rate for Payer: First Health Commercial $27,149.93
Rate for Payer: Humana Commercial $24,292.04
Rate for Payer: Medical Mutual Of Ohio HMO $23,434.67
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $21,091.21
Rate for Payer: Molina Healthcare Benefit Exchange $8,573.66
Rate for Payer: Ohio Health Choice Commercial $25,149.41
Rate for Payer: Ohio Health Group HMO $21,434.15
Rate for Payer: Ohio Health Group PPO Differential $5,715.77
Rate for Payer: Ohio Health Group PPO No Differential $3,715.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $8,859.45
Rate for Payer: PHCS Commercial $27,435.72
Rate for Payer: United Healthcare All Payer $25,149.41
Service Code HCPCS J2796
Hospital Charge Code 25002354
Hospital Revenue Code 636
Min. Negotiated Rate $96.03
Max. Negotiated Rate $27,435.72
Rate for Payer: Aetna Commercial $22,005.73
Rate for Payer: Anthem Medicaid $9,828.27
Rate for Payer: Anthem Medicare Advantage/PPO $96.03
Rate for Payer: Anthem POS/PPO/Traditional $22,291.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $134.44
Rate for Payer: CareSource Just4Me Medicare $129.64
Rate for Payer: Cash Price $14,289.43
Rate for Payer: Cash Price $14,289.43
Rate for Payer: Cigna Commercial $23,720.46
Rate for Payer: First Health Commercial $27,149.93
Rate for Payer: Humana Commercial $24,292.04
Rate for Payer: Humana KY Medicaid $9,828.27
Rate for Payer: Humana Medicare Advantage $96.03
Rate for Payer: Kentucky WC Medicaid $9,928.30
Rate for Payer: Medical Mutual Of Ohio HMO $23,434.67
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $21,091.21
Rate for Payer: Molina Healthcare Benefit Exchange $115.23
Rate for Payer: Molina Healthcare Medicaid $10,025.47
Rate for Payer: Ohio Health Choice Commercial $25,149.41
Rate for Payer: Ohio Health Group HMO $21,434.15
Rate for Payer: Ohio Health Group PPO Differential $5,715.77
Rate for Payer: Ohio Health Group PPO No Differential $3,715.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $8,859.45
Rate for Payer: PHCS Commercial $27,435.72
Rate for Payer: United Healthcare All Payer $25,149.41
Service Code HCPCS 96132
Hospital Charge Code 51000050
Hospital Revenue Code 510
Min. Negotiated Rate $89.70
Max. Negotiated Rate $662.40
Rate for Payer: Aetna Commercial $531.30
Rate for Payer: Anthem POS/PPO/Traditional $538.20
Rate for Payer: Cash Price $345.00
Rate for Payer: Cigna Commercial $572.70
Rate for Payer: First Health Commercial $655.50
Rate for Payer: Humana Commercial $586.50
Rate for Payer: Medical Mutual Of Ohio HMO $565.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $509.22
Rate for Payer: Molina Healthcare Benefit Exchange $207.00
Rate for Payer: Ohio Health Choice Commercial $607.20
Rate for Payer: Ohio Health Group HMO $517.50
Rate for Payer: Ohio Health Group PPO Differential $138.00
Rate for Payer: Ohio Health Group PPO No Differential $89.70
Rate for Payer: Ohio Health Group PPO SOMC Employees $213.90
Rate for Payer: PHCS Commercial $662.40
Rate for Payer: United Healthcare All Payer $607.20
Service Code HCPCS 96132
Hospital Charge Code 51000050
Hospital Revenue Code 510
Min. Negotiated Rate $85.69
Max. Negotiated Rate $690.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $85.69
Rate for Payer: Anthem Medicaid $88.32
Rate for Payer: Buckeye Medicare Advantage $690.00
Rate for Payer: Cash Price $345.00
Rate for Payer: Cash Price $345.00
Rate for Payer: Cigna Commercial $186.47
Rate for Payer: Humana Medicaid $88.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $138.36
Rate for Payer: Molina Healthcare CHIP/Medicaid $90.09
Rate for Payer: Molina Healthcare Passport $88.32
Rate for Payer: Multiplan PHCS $414.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $483.00
Rate for Payer: UHCCP Medicaid $89.97
Rate for Payer: Wellcare CHIP/Medicaid $89.20
Service Code HCPCS 96132
Hospital Charge Code 51000050
Hospital Revenue Code 510
Min. Negotiated Rate $89.70
Max. Negotiated Rate $662.40
Rate for Payer: Aetna Commercial $531.30
Rate for Payer: Anthem Medicaid $237.29
Rate for Payer: Anthem Medicare Advantage/PPO $463.49
Rate for Payer: Anthem POS/PPO/Traditional $538.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $648.89
Rate for Payer: CareSource Just4Me Medicare $625.71
Rate for Payer: Cash Price $345.00
Rate for Payer: Cash Price $345.00
Rate for Payer: Cigna Commercial $572.70
Rate for Payer: First Health Commercial $655.50
Rate for Payer: Humana Commercial $586.50
Rate for Payer: Humana KY Medicaid $237.29
Rate for Payer: Humana Medicare Advantage $463.49
Rate for Payer: Kentucky WC Medicaid $239.71
Rate for Payer: Medical Mutual Of Ohio HMO $565.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $509.22
Rate for Payer: Molina Healthcare Benefit Exchange $556.19
Rate for Payer: Molina Healthcare Medicaid $242.05
Rate for Payer: Ohio Health Choice Commercial $607.20
Rate for Payer: Ohio Health Group HMO $517.50
Rate for Payer: Ohio Health Group PPO Differential $138.00
Rate for Payer: Ohio Health Group PPO No Differential $89.70
Rate for Payer: Ohio Health Group PPO SOMC Employees $213.90
Rate for Payer: PHCS Commercial $662.40
Rate for Payer: United Healthcare All Payer $607.20
Service Code HCPCS 96132
Hospital Charge Code 510P0050
Hospital Revenue Code 510
Min. Negotiated Rate $85.69
Max. Negotiated Rate $310.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $85.69
Rate for Payer: Anthem Medicaid $88.32
Rate for Payer: Buckeye Medicare Advantage $310.00
Rate for Payer: Cash Price $155.00
Rate for Payer: Cash Price $155.00
Rate for Payer: Cigna Commercial $186.47
Rate for Payer: Humana Medicaid $88.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $138.36
Rate for Payer: Molina Healthcare CHIP/Medicaid $90.09
Rate for Payer: Molina Healthcare Passport $88.32
Rate for Payer: Multiplan PHCS $186.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $217.00
Rate for Payer: UHCCP Medicaid $89.97
Rate for Payer: Wellcare CHIP/Medicaid $89.20
Service Code HCPCS 96132
Hospital Charge Code 510T0050
Hospital Revenue Code 510
Min. Negotiated Rate $49.40
Max. Negotiated Rate $648.89
Rate for Payer: Aetna Commercial $292.60
Rate for Payer: Anthem Medicaid $130.68
Rate for Payer: Anthem Medicare Advantage/PPO $463.49
Rate for Payer: Anthem POS/PPO/Traditional $296.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $648.89
Rate for Payer: CareSource Just4Me Medicare $625.71
Rate for Payer: Cash Price $190.00
Rate for Payer: Cash Price $190.00
Rate for Payer: Cigna Commercial $315.40
Rate for Payer: First Health Commercial $361.00
Rate for Payer: Humana Commercial $323.00
Rate for Payer: Humana KY Medicaid $130.68
Rate for Payer: Humana Medicare Advantage $463.49
Rate for Payer: Kentucky WC Medicaid $132.01
Rate for Payer: Medical Mutual Of Ohio HMO $311.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $280.44
Rate for Payer: Molina Healthcare Benefit Exchange $556.19
Rate for Payer: Molina Healthcare Medicaid $133.30
Rate for Payer: Ohio Health Choice Commercial $334.40
Rate for Payer: Ohio Health Group HMO $285.00
Rate for Payer: Ohio Health Group PPO Differential $76.00
Rate for Payer: Ohio Health Group PPO No Differential $49.40
Rate for Payer: Ohio Health Group PPO SOMC Employees $117.80
Rate for Payer: PHCS Commercial $364.80
Rate for Payer: United Healthcare All Payer $334.40
Service Code HCPCS 96132
Hospital Charge Code 510T0050
Hospital Revenue Code 510
Min. Negotiated Rate $49.40
Max. Negotiated Rate $364.80
Rate for Payer: Aetna Commercial $292.60
Rate for Payer: Anthem POS/PPO/Traditional $296.40
Rate for Payer: Cash Price $190.00
Rate for Payer: Cigna Commercial $315.40
Rate for Payer: First Health Commercial $361.00
Rate for Payer: Humana Commercial $323.00
Rate for Payer: Medical Mutual Of Ohio HMO $311.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $280.44
Rate for Payer: Molina Healthcare Benefit Exchange $114.00
Rate for Payer: Ohio Health Choice Commercial $334.40
Rate for Payer: Ohio Health Group HMO $285.00
Rate for Payer: Ohio Health Group PPO Differential $76.00
Rate for Payer: Ohio Health Group PPO No Differential $49.40
Rate for Payer: Ohio Health Group PPO SOMC Employees $117.80
Rate for Payer: PHCS Commercial $364.80
Rate for Payer: United Healthcare All Payer $334.40