|
NXGN M FLL BLK TIB AGT 10M S5
|
Facility
|
IP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M FLL BLK TIB AGT 10M S6
|
Facility
|
IP
|
$12,066.33
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,619.90 |
| Max. Negotiated Rate |
$11,583.68 |
| Rate for Payer: Aetna Commercial |
$9,291.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,411.74
|
| Rate for Payer: Cash Price |
$6,033.17
|
| Rate for Payer: Cigna Commercial |
$10,015.05
|
| Rate for Payer: First Health Commercial |
$11,463.01
|
| Rate for Payer: Humana Commercial |
$10,256.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,894.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,904.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,619.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,618.37
|
| Rate for Payer: Ohio Health Group HMO |
$9,049.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,653.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,497.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,325.77
|
| Rate for Payer: PHCS Commercial |
$11,583.68
|
| Rate for Payer: United Healthcare All Payer |
$10,618.37
|
|
|
NXGN M FLL BLK TIB AGT 10M S6
|
Facility
|
OP
|
$12,066.33
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,619.90 |
| Max. Negotiated Rate |
$11,583.68 |
| Rate for Payer: Aetna Commercial |
$9,291.07
|
| Rate for Payer: Anthem Medicaid |
$4,149.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,411.74
|
| Rate for Payer: Cash Price |
$6,033.17
|
| Rate for Payer: Cigna Commercial |
$10,015.05
|
| Rate for Payer: First Health Commercial |
$11,463.01
|
| Rate for Payer: Humana Commercial |
$10,256.38
|
| Rate for Payer: Humana KY Medicaid |
$4,149.61
|
| Rate for Payer: Kentucky WC Medicaid |
$4,191.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,894.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,904.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,619.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,232.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,618.37
|
| Rate for Payer: Ohio Health Group HMO |
$9,049.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,653.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,497.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,325.77
|
| Rate for Payer: PHCS Commercial |
$11,583.68
|
| Rate for Payer: United Healthcare All Payer |
$10,618.37
|
|
|
NXGN M FLL BLK TIB AGT 10M S7
|
Facility
|
IP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M FLL BLK TIB AGT 10M S7
|
Facility
|
OP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem Medicaid |
$7,711.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Humana KY Medicaid |
$7,711.37
|
| Rate for Payer: Kentucky WC Medicaid |
$7,789.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,866.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M FLL BLK TIB AGT 10M SZ2
|
Facility
|
IP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M FLL BLK TIB AGT 10M SZ2
|
Facility
|
OP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem Medicaid |
$7,711.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Humana KY Medicaid |
$7,711.37
|
| Rate for Payer: Kentucky WC Medicaid |
$7,789.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,866.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M FLL BLK TIB AGT 10M SZ3
|
Facility
|
IP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M FLL BLK TIB AGT 10M SZ3
|
Facility
|
OP
|
$22,423.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,726.99 |
| Max. Negotiated Rate |
$21,526.36 |
| Rate for Payer: Aetna Commercial |
$17,265.93
|
| Rate for Payer: Anthem Medicaid |
$7,711.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,490.17
|
| Rate for Payer: Cash Price |
$11,211.64
|
| Rate for Payer: Cigna Commercial |
$18,611.33
|
| Rate for Payer: First Health Commercial |
$21,302.13
|
| Rate for Payer: Humana Commercial |
$19,059.80
|
| Rate for Payer: Humana KY Medicaid |
$7,711.37
|
| Rate for Payer: Kentucky WC Medicaid |
$7,789.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,387.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,548.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,726.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,866.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,732.50
|
| Rate for Payer: Ohio Health Group HMO |
$16,817.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,938.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,508.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,472.07
|
| Rate for Payer: PHCS Commercial |
$21,526.36
|
| Rate for Payer: United Healthcare All Payer |
$19,732.50
|
|
|
NXGN M TIB AG BLK 10M LL/RM S2
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S2
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S3
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S3
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S4
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S4
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S5
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S5
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S6
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S6
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S7
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M LL/RM S7
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M RL/LM S2
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M RL/LM S2
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M RL/LM S3
|
Facility
|
IP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
|
NXGN M TIB AG BLK 10M RL/LM S3
|
Facility
|
OP
|
$11,572.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,471.64 |
| Max. Negotiated Rate |
$11,109.24 |
| Rate for Payer: Aetna Commercial |
$8,910.54
|
| Rate for Payer: Anthem Medicaid |
$3,979.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,026.26
|
| Rate for Payer: Cash Price |
$5,786.06
|
| Rate for Payer: Cigna Commercial |
$9,604.87
|
| Rate for Payer: First Health Commercial |
$10,993.52
|
| Rate for Payer: Humana Commercial |
$9,836.31
|
| Rate for Payer: Humana KY Medicaid |
$3,979.66
|
| Rate for Payer: Kentucky WC Medicaid |
$4,020.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,489.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,540.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,471.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,059.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,183.47
|
| Rate for Payer: Ohio Health Group HMO |
$8,679.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,257.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,067.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,984.77
|
| Rate for Payer: PHCS Commercial |
$11,109.24
|
| Rate for Payer: United Healthcare All Payer |
$10,183.47
|
|
