|
NXGN FEM-DSTAL AUG 15MM SZE/F
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NXGN FEM-DSTAL AUG 20MM SZC/D
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NXGN FEM-DSTAL AUG 20MM SZC/D
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NXGN FEM-DSTAL AUG 20MM SZE/F
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NXGN FEM-DSTAL AUG 20MM SZE/F
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
NXGN FLX FXD PR ART AB 1-2 10M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 10M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 12M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 12M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 14M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 14M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 17M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 17M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 20M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 20M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 23M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 1-2 23M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 3-4 10M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 3-4 10M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 3-4 12M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 3-4 12M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 3-4 14M
|
Facility
|
IP
|
$1,993.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$598.05 |
| Max. Negotiated Rate |
$1,913.76 |
| Rate for Payer: Aetna Commercial |
$1,534.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,554.93
|
| Rate for Payer: Cash Price |
$996.75
|
| Rate for Payer: Cigna Commercial |
$1,654.61
|
| Rate for Payer: First Health Commercial |
$1,893.83
|
| Rate for Payer: Humana Commercial |
$1,694.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,634.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,471.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$598.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,754.28
|
| Rate for Payer: Ohio Health Group HMO |
$1,495.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,594.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,734.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,375.52
|
| Rate for Payer: PHCS Commercial |
$1,913.76
|
| Rate for Payer: United Healthcare All Payer |
$1,754.28
|
|
|
NXGN FLX FXD PR ART AB 3-4 14M
|
Facility
|
OP
|
$1,993.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$598.05 |
| Max. Negotiated Rate |
$1,913.76 |
| Rate for Payer: Aetna Commercial |
$1,534.99
|
| Rate for Payer: Anthem Medicaid |
$685.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,554.93
|
| Rate for Payer: Cash Price |
$996.75
|
| Rate for Payer: Cigna Commercial |
$1,654.61
|
| Rate for Payer: First Health Commercial |
$1,893.83
|
| Rate for Payer: Humana Commercial |
$1,694.47
|
| Rate for Payer: Humana KY Medicaid |
$685.56
|
| Rate for Payer: Kentucky WC Medicaid |
$692.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,634.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,471.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$598.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$699.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,754.28
|
| Rate for Payer: Ohio Health Group HMO |
$1,495.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,594.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,734.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,375.52
|
| Rate for Payer: PHCS Commercial |
$1,913.76
|
| Rate for Payer: United Healthcare All Payer |
$1,754.28
|
|
|
NXGN FLX FXD PR ART AB 3-4 17M
|
Facility
|
OP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem Medicaid |
$2,641.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Humana KY Medicaid |
$2,641.54
|
| Rate for Payer: Kentucky WC Medicaid |
$2,668.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,694.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
|
NXGN FLX FXD PR ART AB 3-4 17M
|
Facility
|
IP
|
$7,681.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,304.34 |
| Max. Negotiated Rate |
$7,373.88 |
| Rate for Payer: Aetna Commercial |
$5,914.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,991.27
|
| Rate for Payer: Cash Price |
$3,840.56
|
| Rate for Payer: Cigna Commercial |
$6,375.33
|
| Rate for Payer: First Health Commercial |
$7,297.06
|
| Rate for Payer: Humana Commercial |
$6,528.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,298.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,668.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,304.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,759.39
|
| Rate for Payer: Ohio Health Group HMO |
$5,760.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,144.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,682.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,299.97
|
| Rate for Payer: PHCS Commercial |
$7,373.88
|
| Rate for Payer: United Healthcare All Payer |
$6,759.39
|
|
