|
NURSING FACILITY CARE SUBSQN(T
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
HCPCS 99309
|
| Hospital Charge Code |
510T0065
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$174.72 |
| Rate for Payer: Aetna Commercial |
$140.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$141.96
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cigna Commercial |
$151.06
|
| Rate for Payer: First Health Commercial |
$172.90
|
| Rate for Payer: Humana Commercial |
$154.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$149.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$134.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$54.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$160.16
|
| Rate for Payer: Ohio Health Group HMO |
$136.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$36.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$56.42
|
| Rate for Payer: PHCS Commercial |
$174.72
|
| Rate for Payer: United Healthcare All Payer |
$160.16
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
HCPCS 99307
|
| Hospital Charge Code |
51000063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$140.16 |
| Rate for Payer: Aetna Commercial |
$112.42
|
| Rate for Payer: Anthem Medicaid |
$50.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$113.88
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cigna Commercial |
$121.18
|
| Rate for Payer: First Health Commercial |
$138.70
|
| Rate for Payer: Humana Commercial |
$124.10
|
| Rate for Payer: Humana KY Medicaid |
$50.21
|
| Rate for Payer: Kentucky WC Medicaid |
$50.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$119.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$107.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$43.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$51.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$128.48
|
| Rate for Payer: Ohio Health Group HMO |
$109.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.26
|
| Rate for Payer: PHCS Commercial |
$140.16
|
| Rate for Payer: United Healthcare All Payer |
$128.48
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
HCPCS 99308
|
| Hospital Charge Code |
51000064
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$198.72 |
| Rate for Payer: Aetna Commercial |
$159.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$161.46
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cigna Commercial |
$171.81
|
| Rate for Payer: First Health Commercial |
$196.65
|
| Rate for Payer: Humana Commercial |
$175.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$169.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$152.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$62.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$182.16
|
| Rate for Payer: Ohio Health Group HMO |
$155.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$41.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$64.17
|
| Rate for Payer: PHCS Commercial |
$198.72
|
| Rate for Payer: United Healthcare All Payer |
$182.16
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 99308
|
| Hospital Charge Code |
51000064
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$95.50
|
| Rate for Payer: Anthem Medicaid |
$42.19
|
| Rate for Payer: Buckeye Medicare Advantage |
$207.00
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cigna Commercial |
$80.23
|
| Rate for Payer: Healthspan PPO |
$71.00
|
| Rate for Payer: Humana Medicaid |
$42.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$88.40
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$43.03
|
| Rate for Payer: Molina Healthcare Passport |
$42.19
|
| Rate for Payer: Multiplan PHCS |
$124.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$144.90
|
| Rate for Payer: UHCCP Medicaid |
$72.45
|
| Rate for Payer: United Healthcare Non-Options |
$65.77
|
| Rate for Payer: United Healthcare Options |
$53.85
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$42.61
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 99309
|
| Hospital Charge Code |
51000065
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$59.51 |
| Max. Negotiated Rate |
$302.00 |
| Rate for Payer: Aetna Commercial |
$126.94
|
| Rate for Payer: Anthem Medicaid |
$59.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$302.00
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$112.61
|
| Rate for Payer: Healthspan PPO |
$94.37
|
| Rate for Payer: Humana Medicaid |
$59.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$116.08
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$60.70
|
| Rate for Payer: Molina Healthcare Passport |
$59.51
|
| Rate for Payer: Multiplan PHCS |
$181.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$211.40
|
| Rate for Payer: UHCCP Medicaid |
$105.70
|
| Rate for Payer: United Healthcare Non-Options |
$87.43
|
| Rate for Payer: United Healthcare Options |
$71.57
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$60.11
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
HCPCS 99310
|
| Hospital Charge Code |
51000066
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.75 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$134.75
|
| Rate for Payer: Anthem Medicaid |
$60.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$136.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: First Health Commercial |
$166.25
|
| Rate for Payer: Humana Commercial |
$148.75
|
| Rate for Payer: Humana KY Medicaid |
$60.18
|
| Rate for Payer: Kentucky WC Medicaid |
$60.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$143.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$129.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$52.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$61.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$154.00
|
| Rate for Payer: Ohio Health Group HMO |
$131.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$35.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$54.25
|
| Rate for Payer: PHCS Commercial |
$168.00
|
| Rate for Payer: United Healthcare All Payer |
$154.00
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
HCPCS 99309
|
| Hospital Charge Code |
51000065
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.26 |
| Max. Negotiated Rate |
$289.92 |
| Rate for Payer: Aetna Commercial |
$232.54
|
| Rate for Payer: Anthem Medicaid |
$103.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$235.56
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$250.66
|
| Rate for Payer: First Health Commercial |
$286.90
|
| Rate for Payer: Humana Commercial |
$256.70
|
| Rate for Payer: Humana KY Medicaid |
$103.86
|
| Rate for Payer: Kentucky WC Medicaid |
$104.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$247.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$222.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$90.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$105.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$265.76
|
| Rate for Payer: Ohio Health Group HMO |
$226.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$39.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$93.62
|
| Rate for Payer: PHCS Commercial |
$289.92
|
| Rate for Payer: United Healthcare All Payer |
$265.76
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 99307
|
| Hospital Charge Code |
51000063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.42 |
| Max. Negotiated Rate |
$146.00 |
| Rate for Payer: Aetna Commercial |
$62.61
|
| Rate for Payer: Anthem Medicaid |
$34.42
|
| Rate for Payer: Buckeye Medicare Advantage |
$146.00
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cigna Commercial |
$53.50
|
| Rate for Payer: Healthspan PPO |
$46.54
|
| Rate for Payer: Humana Medicaid |
$34.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$57.34
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$35.11
|
| Rate for Payer: Molina Healthcare Passport |
$34.42
|
| Rate for Payer: Multiplan PHCS |
$87.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$102.20
|
| Rate for Payer: UHCCP Medicaid |
$51.10
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$34.76
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
HCPCS 99310
|
| Hospital Charge Code |
51000066
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.75 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$134.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$136.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: First Health Commercial |
$166.25
|
| Rate for Payer: Humana Commercial |
$148.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$143.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$129.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$52.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$154.00
|
| Rate for Payer: Ohio Health Group HMO |
$131.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$35.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$54.25
|
| Rate for Payer: PHCS Commercial |
$168.00
|
| Rate for Payer: United Healthcare All Payer |
$154.00
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
HCPCS 99307
|
| Hospital Charge Code |
51000063
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$140.16 |
| Rate for Payer: Aetna Commercial |
$112.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$113.88
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cigna Commercial |
$121.18
|
| Rate for Payer: First Health Commercial |
$138.70
|
| Rate for Payer: Humana Commercial |
$124.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$119.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$107.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$43.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$128.48
|
| Rate for Payer: Ohio Health Group HMO |
$109.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.26
|
| Rate for Payer: PHCS Commercial |
$140.16
|
| Rate for Payer: United Healthcare All Payer |
$128.48
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 99310
|
| Hospital Charge Code |
51000066
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$187.39 |
| Rate for Payer: Aetna Commercial |
$187.39
|
| Rate for Payer: Anthem Medicaid |
$74.49
|
| Rate for Payer: Buckeye Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$140.89
|
| Rate for Payer: Healthspan PPO |
$139.30
|
| Rate for Payer: Humana Medicaid |
$74.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$172.41
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$75.98
|
| Rate for Payer: Molina Healthcare Passport |
$74.49
|
| Rate for Payer: Multiplan PHCS |
$105.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$122.50
|
| Rate for Payer: UHCCP Medicaid |
$61.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$75.23
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
HCPCS 99308
|
| Hospital Charge Code |
51000064
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$198.72 |
| Rate for Payer: Aetna Commercial |
$159.39
|
| Rate for Payer: Anthem Medicaid |
$71.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$161.46
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cigna Commercial |
$171.81
|
| Rate for Payer: First Health Commercial |
$196.65
|
| Rate for Payer: Humana Commercial |
$175.95
|
| Rate for Payer: Humana KY Medicaid |
$71.19
|
| Rate for Payer: Kentucky WC Medicaid |
$71.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$169.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$152.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$62.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$72.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$182.16
|
| Rate for Payer: Ohio Health Group HMO |
$155.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$41.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$64.17
|
| Rate for Payer: PHCS Commercial |
$198.72
|
| Rate for Payer: United Healthcare All Payer |
$182.16
|
|
|
NURSING FACILITY CARE SUBSQNT
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
HCPCS 99309
|
| Hospital Charge Code |
51000065
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.26 |
| Max. Negotiated Rate |
$289.92 |
| Rate for Payer: Aetna Commercial |
$232.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$235.56
|
| Rate for Payer: Cash Price |
$151.00
|
| Rate for Payer: Cigna Commercial |
$250.66
|
| Rate for Payer: First Health Commercial |
$286.90
|
| Rate for Payer: Humana Commercial |
$256.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$247.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$222.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$90.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$265.76
|
| Rate for Payer: Ohio Health Group HMO |
$226.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$39.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$93.62
|
| Rate for Payer: PHCS Commercial |
$289.92
|
| Rate for Payer: United Healthcare All Payer |
$265.76
|
|
|
NURSING FACILITY DISCHARGE
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 99315
|
| Hospital Charge Code |
51000067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$77.00
|
| Rate for Payer: Anthem Medicaid |
$34.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$78.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$83.00
|
| Rate for Payer: First Health Commercial |
$95.00
|
| Rate for Payer: Humana Commercial |
$85.00
|
| Rate for Payer: Humana KY Medicaid |
$34.39
|
| Rate for Payer: Kentucky WC Medicaid |
$34.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$82.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$73.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$35.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$88.00
|
| Rate for Payer: Ohio Health Group HMO |
$75.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$20.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$31.00
|
| Rate for Payer: PHCS Commercial |
$96.00
|
| Rate for Payer: United Healthcare All Payer |
$88.00
|
|
|
NURSING FACILITY DISCHARGE
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99315
|
| Hospital Charge Code |
51000067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Anthem Medicaid |
$46.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$100.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$87.33
|
| Rate for Payer: Healthspan PPO |
$68.25
|
| Rate for Payer: Humana Medicaid |
$46.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$83.89
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$47.63
|
| Rate for Payer: Molina Healthcare Passport |
$46.70
|
| Rate for Payer: Multiplan PHCS |
$60.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$70.00
|
| Rate for Payer: UHCCP Medicaid |
$35.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$47.17
|
|
|
NURSING FACILITY DISCHARGE
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 99315
|
| Hospital Charge Code |
51000067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$77.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$78.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$83.00
|
| Rate for Payer: First Health Commercial |
$95.00
|
| Rate for Payer: Humana Commercial |
$85.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$82.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$73.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$88.00
|
| Rate for Payer: Ohio Health Group HMO |
$75.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$20.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$31.00
|
| Rate for Payer: PHCS Commercial |
$96.00
|
| Rate for Payer: United Healthcare All Payer |
$88.00
|
|
|
NURSING FACILITY DISCHARGE(P
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99315
|
| Hospital Charge Code |
510P0067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Anthem Medicaid |
$46.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$100.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$87.33
|
| Rate for Payer: Healthspan PPO |
$68.25
|
| Rate for Payer: Humana Medicaid |
$46.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$83.89
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$47.63
|
| Rate for Payer: Molina Healthcare Passport |
$46.70
|
| Rate for Payer: Multiplan PHCS |
$60.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$70.00
|
| Rate for Payer: UHCCP Medicaid |
$35.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$47.17
|
|
|
NURSING HOME DISCHG PROLONG
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
HCPCS 99316
|
| Hospital Charge Code |
51000068
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna Commercial |
$92.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$93.60
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$99.60
|
| Rate for Payer: First Health Commercial |
$114.00
|
| Rate for Payer: Humana Commercial |
$102.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$98.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$88.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$36.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$105.60
|
| Rate for Payer: Ohio Health Group HMO |
$90.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$37.20
|
| Rate for Payer: PHCS Commercial |
$115.20
|
| Rate for Payer: United Healthcare All Payer |
$105.60
|
|
|
NURSING HOME DISCHG PROLONG
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 99316
|
| Hospital Charge Code |
51000068
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$119.77
|
| Rate for Payer: Anthem Medicaid |
$81.26
|
| Rate for Payer: Buckeye Medicare Advantage |
$120.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$114.54
|
| Rate for Payer: Healthspan PPO |
$89.04
|
| Rate for Payer: Humana Medicaid |
$81.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$108.83
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$82.89
|
| Rate for Payer: Molina Healthcare Passport |
$81.26
|
| Rate for Payer: Multiplan PHCS |
$72.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.00
|
| Rate for Payer: UHCCP Medicaid |
$42.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$82.07
|
|
|
NURSING HOME DISCHG PROLONG
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
HCPCS 99316
|
| Hospital Charge Code |
51000068
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna Commercial |
$92.40
|
| Rate for Payer: Anthem Medicaid |
$41.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$93.60
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$99.60
|
| Rate for Payer: First Health Commercial |
$114.00
|
| Rate for Payer: Humana Commercial |
$102.00
|
| Rate for Payer: Humana KY Medicaid |
$41.27
|
| Rate for Payer: Kentucky WC Medicaid |
$41.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$98.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$88.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$36.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$42.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$105.60
|
| Rate for Payer: Ohio Health Group HMO |
$90.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$37.20
|
| Rate for Payer: PHCS Commercial |
$115.20
|
| Rate for Payer: United Healthcare All Payer |
$105.60
|
|
|
NURSING HOME DISCHG PROLONG(P
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 99316
|
| Hospital Charge Code |
510P0068
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$119.77
|
| Rate for Payer: Anthem Medicaid |
$81.26
|
| Rate for Payer: Buckeye Medicare Advantage |
$120.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$114.54
|
| Rate for Payer: Healthspan PPO |
$89.04
|
| Rate for Payer: Humana Medicaid |
$81.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$108.83
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$82.89
|
| Rate for Payer: Molina Healthcare Passport |
$81.26
|
| Rate for Payer: Multiplan PHCS |
$72.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.00
|
| Rate for Payer: UHCCP Medicaid |
$42.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$82.07
|
|
|
NUSHIELD 2*3
|
Facility
|
OP
|
$4,982.50
|
|
|
Service Code
|
HCPCS Q4160
|
| Hospital Charge Code |
27000191
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$647.72 |
| Max. Negotiated Rate |
$4,783.20 |
| Rate for Payer: Aetna Commercial |
$3,836.52
|
| Rate for Payer: Anthem Medicaid |
$1,713.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,886.35
|
| Rate for Payer: Cash Price |
$2,491.25
|
| Rate for Payer: Cigna Commercial |
$4,135.48
|
| Rate for Payer: First Health Commercial |
$4,733.38
|
| Rate for Payer: Humana Commercial |
$4,235.12
|
| Rate for Payer: Humana KY Medicaid |
$1,713.48
|
| Rate for Payer: Kentucky WC Medicaid |
$1,730.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,085.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,677.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,494.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,747.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,384.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,736.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$996.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$647.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,544.58
|
| Rate for Payer: PHCS Commercial |
$4,783.20
|
| Rate for Payer: United Healthcare All Payer |
$4,384.60
|
|
|
NUSHIELD 2*3
|
Facility
|
IP
|
$4,982.50
|
|
|
Service Code
|
HCPCS Q4160
|
| Hospital Charge Code |
27000191
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$647.72 |
| Max. Negotiated Rate |
$4,783.20 |
| Rate for Payer: Aetna Commercial |
$3,836.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,886.35
|
| Rate for Payer: Cash Price |
$2,491.25
|
| Rate for Payer: Cigna Commercial |
$4,135.48
|
| Rate for Payer: First Health Commercial |
$4,733.38
|
| Rate for Payer: Humana Commercial |
$4,235.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,085.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,677.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,494.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,384.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,736.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$996.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$647.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,544.58
|
| Rate for Payer: PHCS Commercial |
$4,783.20
|
| Rate for Payer: United Healthcare All Payer |
$4,384.60
|
|
|
NUT CPS CO-CR-MO ALLOY
|
Facility
|
OP
|
$4,027.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$523.51 |
| Max. Negotiated Rate |
$3,865.92 |
| Rate for Payer: Aetna Commercial |
$3,100.79
|
| Rate for Payer: Anthem Medicaid |
$1,384.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,141.06
|
| Rate for Payer: Cash Price |
$2,013.50
|
| Rate for Payer: Cigna Commercial |
$3,342.41
|
| Rate for Payer: First Health Commercial |
$3,825.65
|
| Rate for Payer: Humana Commercial |
$3,422.95
|
| Rate for Payer: Humana KY Medicaid |
$1,384.89
|
| Rate for Payer: Kentucky WC Medicaid |
$1,398.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,302.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,971.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,208.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,412.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,543.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,020.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$805.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$523.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,248.37
|
| Rate for Payer: PHCS Commercial |
$3,865.92
|
| Rate for Payer: United Healthcare All Payer |
$3,543.76
|
|
|
NUT CPS CO-CR-MO ALLOY
|
Facility
|
IP
|
$4,027.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$523.51 |
| Max. Negotiated Rate |
$3,865.92 |
| Rate for Payer: Aetna Commercial |
$3,100.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,141.06
|
| Rate for Payer: Cash Price |
$2,013.50
|
| Rate for Payer: Cigna Commercial |
$3,342.41
|
| Rate for Payer: First Health Commercial |
$3,825.65
|
| Rate for Payer: Humana Commercial |
$3,422.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,302.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,971.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,208.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,543.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,020.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$805.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$523.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,248.37
|
| Rate for Payer: PHCS Commercial |
$3,865.92
|
| Rate for Payer: United Healthcare All Payer |
$3,543.76
|
|
