|
NXGN RHART SRF PROV 26M FEM 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 RHART SRF PROV 26M FEM E
|
Facility
|
IP
|
$2,990.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$2,870.40 |
| Rate for Payer: Aetna Commercial |
$2,302.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,332.20
|
| Rate for Payer: Cash Price |
$1,495.00
|
| Rate for Payer: Cigna Commercial |
$2,481.70
|
| Rate for Payer: First Health Commercial |
$2,840.50
|
| Rate for Payer: Humana Commercial |
$2,541.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,451.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,206.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$897.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,631.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,242.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,392.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,601.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,063.10
|
| Rate for Payer: PHCS Commercial |
$2,870.40
|
| Rate for Payer: United Healthcare All Payer |
$2,631.20
|
|
|
NXGN RHART SRF PROV 26M FEM E
|
Facility
|
OP
|
$2,990.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$2,870.40 |
| Rate for Payer: Aetna Commercial |
$2,302.30
|
| Rate for Payer: Anthem Medicaid |
$1,028.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,332.20
|
| Rate for Payer: Cash Price |
$1,495.00
|
| Rate for Payer: Cigna Commercial |
$2,481.70
|
| Rate for Payer: First Health Commercial |
$2,840.50
|
| Rate for Payer: Humana Commercial |
$2,541.50
|
| Rate for Payer: Humana KY Medicaid |
$1,028.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,038.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,451.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,206.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$897.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,048.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,631.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,242.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,392.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,601.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,063.10
|
| Rate for Payer: PHCS Commercial |
$2,870.40
|
| Rate for Payer: United Healthcare All Payer |
$2,631.20
|
|
|
NXGN RHART SRF PROV 26M FEM F
|
Facility
|
IP
|
$2,990.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$2,870.40 |
| Rate for Payer: Aetna Commercial |
$2,302.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,332.20
|
| Rate for Payer: Cash Price |
$1,495.00
|
| Rate for Payer: Cigna Commercial |
$2,481.70
|
| Rate for Payer: First Health Commercial |
$2,840.50
|
| Rate for Payer: Humana Commercial |
$2,541.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,451.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,206.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$897.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,631.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,242.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,392.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,601.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,063.10
|
| Rate for Payer: PHCS Commercial |
$2,870.40
|
| Rate for Payer: United Healthcare All Payer |
$2,631.20
|
|
|
NXGN RHART SRF PROV 26M FEM F
|
Facility
|
OP
|
$2,990.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$2,870.40 |
| Rate for Payer: Aetna Commercial |
$2,302.30
|
| Rate for Payer: Anthem Medicaid |
$1,028.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,332.20
|
| Rate for Payer: Cash Price |
$1,495.00
|
| Rate for Payer: Cigna Commercial |
$2,481.70
|
| Rate for Payer: First Health Commercial |
$2,840.50
|
| Rate for Payer: Humana Commercial |
$2,541.50
|
| Rate for Payer: Humana KY Medicaid |
$1,028.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,038.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,451.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,206.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$897.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,048.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,631.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,242.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,392.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,601.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,063.10
|
| Rate for Payer: PHCS Commercial |
$2,870.40
|
| Rate for Payer: United Healthcare All Payer |
$2,631.20
|
|
|
NXGN RH FULL TIB AGMT 10M SZ2
|
Facility
|
IP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ2
|
Facility
|
OP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem Medicaid |
$3,021.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Humana KY Medicaid |
$3,021.70
|
| Rate for Payer: Kentucky WC Medicaid |
$3,052.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,082.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ3
|
Facility
|
IP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ3
|
Facility
|
OP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem Medicaid |
$3,021.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Humana KY Medicaid |
$3,021.70
|
| Rate for Payer: Kentucky WC Medicaid |
$3,052.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,082.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ4
|
Facility
|
IP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ4
|
Facility
|
OP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem Medicaid |
$3,021.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Humana KY Medicaid |
$3,021.70
|
| Rate for Payer: Kentucky WC Medicaid |
$3,052.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,082.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ5
|
Facility
|
IP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ5
|
Facility
|
OP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem Medicaid |
$3,021.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Humana KY Medicaid |
$3,021.70
|
| Rate for Payer: Kentucky WC Medicaid |
$3,052.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,082.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ6
|
Facility
|
IP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH FULL TIB AGMT 10M SZ6
|
Facility
|
OP
|
$8,786.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,635.97 |
| Max. Negotiated Rate |
$8,435.10 |
| Rate for Payer: Aetna Commercial |
$6,765.65
|
| Rate for Payer: Anthem Medicaid |
$3,021.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,853.52
|
| Rate for Payer: Cash Price |
$4,393.28
|
| Rate for Payer: Cigna Commercial |
$7,292.84
|
| Rate for Payer: First Health Commercial |
$8,347.23
|
| Rate for Payer: Humana Commercial |
$7,468.58
|
| Rate for Payer: Humana KY Medicaid |
$3,021.70
|
| Rate for Payer: Kentucky WC Medicaid |
$3,052.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,204.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,484.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,635.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,082.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,732.17
|
| Rate for Payer: Ohio Health Group HMO |
$6,589.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,029.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,644.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,062.73
|
| Rate for Payer: PHCS Commercial |
$8,435.10
|
| Rate for Payer: United Healthcare All Payer |
$7,732.17
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ1
|
Facility
|
IP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ1
|
Facility
|
OP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem Medicaid |
$1,079.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Humana KY Medicaid |
$1,079.85
|
| Rate for Payer: Kentucky WC Medicaid |
$1,090.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,101.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ2
|
Facility
|
IP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ2
|
Facility
|
OP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem Medicaid |
$1,079.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Humana KY Medicaid |
$1,079.85
|
| Rate for Payer: Kentucky WC Medicaid |
$1,090.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,101.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ3
|
Facility
|
IP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ3
|
Facility
|
OP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem Medicaid |
$1,079.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Humana KY Medicaid |
$1,079.85
|
| Rate for Payer: Kentucky WC Medicaid |
$1,090.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,101.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ4
|
Facility
|
OP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem Medicaid |
$1,079.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Humana KY Medicaid |
$1,079.85
|
| Rate for Payer: Kentucky WC Medicaid |
$1,090.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,101.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ4
|
Facility
|
IP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ5
|
Facility
|
OP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem Medicaid |
$1,079.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Humana KY Medicaid |
$1,079.85
|
| Rate for Payer: Kentucky WC Medicaid |
$1,090.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,101.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
|
NXGN RH KNE FBTIB AGMT 10M SZ5
|
Facility
|
IP
|
$3,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$942.00 |
| Max. Negotiated Rate |
$3,014.40 |
| Rate for Payer: Aetna Commercial |
$2,417.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,449.20
|
| Rate for Payer: Cash Price |
$1,570.00
|
| Rate for Payer: Cigna Commercial |
$2,606.20
|
| Rate for Payer: First Health Commercial |
$2,983.00
|
| Rate for Payer: Humana Commercial |
$2,669.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,574.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,317.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$942.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,763.20
|
| Rate for Payer: Ohio Health Group HMO |
$2,355.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,512.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,731.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,166.60
|
| Rate for Payer: PHCS Commercial |
$3,014.40
|
| Rate for Payer: United Healthcare All Payer |
$2,763.20
|
|
