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Service Code HCPCS 88275
Hospital Charge Code 30001499
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001497
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $50.70
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001497
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001494
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001494
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $50.70
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001493
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001493
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $50.70
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001496
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001496
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $50.70
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001495
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $50.70
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001495
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001492
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $50.70
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88275
Hospital Charge Code 30001492
Hospital Revenue Code 300
Min. Negotiated Rate $21.97
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $51.19
Rate for Payer: Anthem Medicare Advantage/PPO $51.19
Rate for Payer: Anthem POS/PPO/Traditional $135.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $71.67
Rate for Payer: CareSource Just4Me Medicare $51.19
Rate for Payer: Cash Price $84.50
Rate for Payer: Cash Price $84.50
Rate for Payer: Cigna Commercial $140.27
Rate for Payer: First Health Commercial $160.55
Rate for Payer: Humana Commercial $143.65
Rate for Payer: Humana KY Medicaid $51.19
Rate for Payer: Humana Medicare Advantage $51.19
Rate for Payer: Kentucky WC Medicaid $51.70
Rate for Payer: Medical Mutual Of Ohio HMO $138.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $124.72
Rate for Payer: Molina Healthcare Benefit Exchange $61.43
Rate for Payer: Molina Healthcare Medicaid $52.21
Rate for Payer: Ohio Health Choice Commercial $148.72
Rate for Payer: Ohio Health Group HMO $126.75
Rate for Payer: Ohio Health Group PPO Differential $33.80
Rate for Payer: Ohio Health Group PPO No Differential $21.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $52.39
Rate for Payer: PHCS Commercial $162.24
Rate for Payer: United Healthcare All Payer $148.72
Service Code HCPCS 88274
Hospital Charge Code 30001490
Hospital Revenue Code 300
Min. Negotiated Rate $37.96
Max. Negotiated Rate $280.32
Rate for Payer: Aetna Commercial $224.84
Rate for Payer: Anthem Medicaid $42.38
Rate for Payer: Anthem Medicare Advantage/PPO $42.38
Rate for Payer: Anthem POS/PPO/Traditional $234.48
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $59.33
Rate for Payer: CareSource Just4Me Medicare $42.38
Rate for Payer: Cash Price $146.00
Rate for Payer: Cash Price $146.00
Rate for Payer: Cigna Commercial $242.36
Rate for Payer: First Health Commercial $277.40
Rate for Payer: Humana Commercial $248.20
Rate for Payer: Humana KY Medicaid $42.38
Rate for Payer: Humana Medicare Advantage $42.38
Rate for Payer: Kentucky WC Medicaid $42.80
Rate for Payer: Medical Mutual Of Ohio HMO $239.44
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $215.50
Rate for Payer: Molina Healthcare Benefit Exchange $50.86
Rate for Payer: Molina Healthcare Medicaid $43.23
Rate for Payer: Ohio Health Choice Commercial $256.96
Rate for Payer: Ohio Health Group HMO $219.00
Rate for Payer: Ohio Health Group PPO Differential $58.40
Rate for Payer: Ohio Health Group PPO No Differential $37.96
Rate for Payer: Ohio Health Group PPO SOMC Employees $90.52
Rate for Payer: PHCS Commercial $280.32
Rate for Payer: United Healthcare All Payer $256.96
Service Code HCPCS 88274
Hospital Charge Code 30001490
Hospital Revenue Code 300
Min. Negotiated Rate $37.96
Max. Negotiated Rate $280.32
Rate for Payer: Aetna Commercial $224.84
Rate for Payer: Anthem POS/PPO/Traditional $234.48
Rate for Payer: Cash Price $146.00
Rate for Payer: Cigna Commercial $242.36
Rate for Payer: First Health Commercial $277.40
Rate for Payer: Humana Commercial $248.20
Rate for Payer: Medical Mutual Of Ohio HMO $239.44
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $215.50
Rate for Payer: Molina Healthcare Benefit Exchange $87.60
Rate for Payer: Ohio Health Choice Commercial $256.96
Rate for Payer: Ohio Health Group HMO $219.00
Rate for Payer: Ohio Health Group PPO Differential $58.40
Rate for Payer: Ohio Health Group PPO No Differential $37.96
Rate for Payer: Ohio Health Group PPO SOMC Employees $90.52
Rate for Payer: PHCS Commercial $280.32
Rate for Payer: United Healthcare All Payer $256.96
Service Code HCPCS 86340
Hospital Charge Code 30001072
Hospital Revenue Code 300
Min. Negotiated Rate $15.08
Max. Negotiated Rate $165.12
Rate for Payer: Aetna Commercial $132.44
Rate for Payer: Anthem Medicaid $15.08
Rate for Payer: Anthem Medicare Advantage/PPO $15.08
Rate for Payer: Anthem POS/PPO/Traditional $138.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $21.11
Rate for Payer: CareSource Just4Me Medicare $15.08
Rate for Payer: Cash Price $86.00
Rate for Payer: Cash Price $86.00
Rate for Payer: Cigna Commercial $142.76
Rate for Payer: First Health Commercial $163.40
Rate for Payer: Humana Commercial $146.20
Rate for Payer: Humana KY Medicaid $15.08
Rate for Payer: Humana Medicare Advantage $15.08
Rate for Payer: Kentucky WC Medicaid $15.23
Rate for Payer: Medical Mutual Of Ohio HMO $141.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $126.94
Rate for Payer: Molina Healthcare Benefit Exchange $18.10
Rate for Payer: Molina Healthcare Medicaid $15.38
Rate for Payer: Ohio Health Choice Commercial $151.36
Rate for Payer: Ohio Health Group HMO $129.00
Rate for Payer: Ohio Health Group PPO Differential $34.40
Rate for Payer: Ohio Health Group PPO No Differential $22.36
Rate for Payer: Ohio Health Group PPO SOMC Employees $53.32
Rate for Payer: PHCS Commercial $165.12
Rate for Payer: United Healthcare All Payer $151.36
Service Code HCPCS 86340
Hospital Charge Code 30001072
Hospital Revenue Code 300
Min. Negotiated Rate $22.36
Max. Negotiated Rate $165.12
Rate for Payer: Aetna Commercial $132.44
Rate for Payer: Anthem POS/PPO/Traditional $138.12
Rate for Payer: Cash Price $86.00
Rate for Payer: Cigna Commercial $142.76
Rate for Payer: First Health Commercial $163.40
Rate for Payer: Humana Commercial $146.20
Rate for Payer: Medical Mutual Of Ohio HMO $141.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $126.94
Rate for Payer: Molina Healthcare Benefit Exchange $51.60
Rate for Payer: Ohio Health Choice Commercial $151.36
Rate for Payer: Ohio Health Group HMO $129.00
Rate for Payer: Ohio Health Group PPO Differential $34.40
Rate for Payer: Ohio Health Group PPO No Differential $22.36
Rate for Payer: Ohio Health Group PPO SOMC Employees $53.32
Rate for Payer: PHCS Commercial $165.12
Rate for Payer: United Healthcare All Payer $151.36
Service Code HCPCS 83789
Hospital Charge Code 30001866
Hospital Revenue Code 300
Min. Negotiated Rate $33.54
Max. Negotiated Rate $247.68
Rate for Payer: Aetna Commercial $198.66
Rate for Payer: Anthem POS/PPO/Traditional $207.17
Rate for Payer: Cash Price $129.00
Rate for Payer: Cigna Commercial $214.14
Rate for Payer: First Health Commercial $245.10
Rate for Payer: Humana Commercial $219.30
Rate for Payer: Medical Mutual Of Ohio HMO $211.56
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $190.40
Rate for Payer: Molina Healthcare Benefit Exchange $77.40
Rate for Payer: Ohio Health Choice Commercial $227.04
Rate for Payer: Ohio Health Group HMO $193.50
Rate for Payer: Ohio Health Group PPO Differential $51.60
Rate for Payer: Ohio Health Group PPO No Differential $33.54
Rate for Payer: Ohio Health Group PPO SOMC Employees $79.98
Rate for Payer: PHCS Commercial $247.68
Rate for Payer: United Healthcare All Payer $227.04
Service Code HCPCS 83789
Hospital Charge Code 30001866
Hospital Revenue Code 300
Min. Negotiated Rate $24.11
Max. Negotiated Rate $247.68
Rate for Payer: Aetna Commercial $198.66
Rate for Payer: Anthem Medicaid $24.11
Rate for Payer: Anthem Medicare Advantage/PPO $24.11
Rate for Payer: Anthem POS/PPO/Traditional $207.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $33.75
Rate for Payer: CareSource Just4Me Medicare $24.11
Rate for Payer: Cash Price $129.00
Rate for Payer: Cash Price $129.00
Rate for Payer: Cigna Commercial $214.14
Rate for Payer: First Health Commercial $245.10
Rate for Payer: Humana Commercial $219.30
Rate for Payer: Humana KY Medicaid $24.11
Rate for Payer: Humana Medicare Advantage $24.11
Rate for Payer: Kentucky WC Medicaid $24.35
Rate for Payer: Medical Mutual Of Ohio HMO $211.56
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $190.40
Rate for Payer: Molina Healthcare Benefit Exchange $28.93
Rate for Payer: Molina Healthcare Medicaid $24.59
Rate for Payer: Ohio Health Choice Commercial $227.04
Rate for Payer: Ohio Health Group HMO $193.50
Rate for Payer: Ohio Health Group PPO Differential $51.60
Rate for Payer: Ohio Health Group PPO No Differential $33.54
Rate for Payer: Ohio Health Group PPO SOMC Employees $79.98
Rate for Payer: PHCS Commercial $247.68
Rate for Payer: United Healthcare All Payer $227.04
Service Code HCPCS 86341
Hospital Charge Code 30001074
Hospital Revenue Code 300
Min. Negotiated Rate $34.71
Max. Negotiated Rate $256.32
Rate for Payer: Aetna Commercial $205.59
Rate for Payer: Anthem POS/PPO/Traditional $214.40
Rate for Payer: Cash Price $133.50
Rate for Payer: Cigna Commercial $221.61
Rate for Payer: First Health Commercial $253.65
Rate for Payer: Humana Commercial $226.95
Rate for Payer: Medical Mutual Of Ohio HMO $218.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $197.05
Rate for Payer: Molina Healthcare Benefit Exchange $80.10
Rate for Payer: Ohio Health Choice Commercial $234.96
Rate for Payer: Ohio Health Group HMO $200.25
Rate for Payer: Ohio Health Group PPO Differential $53.40
Rate for Payer: Ohio Health Group PPO No Differential $34.71
Rate for Payer: Ohio Health Group PPO SOMC Employees $82.77
Rate for Payer: PHCS Commercial $256.32
Rate for Payer: United Healthcare All Payer $234.96
Service Code HCPCS 86341
Hospital Charge Code 30001074
Hospital Revenue Code 300
Min. Negotiated Rate $23.57
Max. Negotiated Rate $256.32
Rate for Payer: Aetna Commercial $205.59
Rate for Payer: Anthem Medicaid $23.57
Rate for Payer: Anthem Medicare Advantage/PPO $23.57
Rate for Payer: Anthem POS/PPO/Traditional $214.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $33.00
Rate for Payer: CareSource Just4Me Medicare $23.57
Rate for Payer: Cash Price $133.50
Rate for Payer: Cash Price $133.50
Rate for Payer: Cigna Commercial $221.61
Rate for Payer: First Health Commercial $253.65
Rate for Payer: Humana Commercial $226.95
Rate for Payer: Humana KY Medicaid $23.57
Rate for Payer: Humana Medicare Advantage $23.57
Rate for Payer: Kentucky WC Medicaid $23.81
Rate for Payer: Medical Mutual Of Ohio HMO $218.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $197.05
Rate for Payer: Molina Healthcare Benefit Exchange $28.28
Rate for Payer: Molina Healthcare Medicaid $24.04
Rate for Payer: Ohio Health Choice Commercial $234.96
Rate for Payer: Ohio Health Group HMO $200.25
Rate for Payer: Ohio Health Group PPO Differential $53.40
Rate for Payer: Ohio Health Group PPO No Differential $34.71
Rate for Payer: Ohio Health Group PPO SOMC Employees $82.77
Rate for Payer: PHCS Commercial $256.32
Rate for Payer: United Healthcare All Payer $234.96
Service Code HCPCS 86003
Hospital Charge Code 30000817
Hospital Revenue Code 302
Min. Negotiated Rate $8.45
Max. Negotiated Rate $62.40
Rate for Payer: Aetna Commercial $50.05
Rate for Payer: Anthem POS/PPO/Traditional $52.20
Rate for Payer: Cash Price $32.50
Rate for Payer: Cigna Commercial $53.95
Rate for Payer: First Health Commercial $61.75
Rate for Payer: Humana Commercial $55.25
Rate for Payer: Medical Mutual Of Ohio HMO $53.30
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.97
Rate for Payer: Molina Healthcare Benefit Exchange $19.50
Rate for Payer: Ohio Health Choice Commercial $57.20
Rate for Payer: Ohio Health Group HMO $48.75
Rate for Payer: Ohio Health Group PPO Differential $13.00
Rate for Payer: Ohio Health Group PPO No Differential $8.45
Rate for Payer: Ohio Health Group PPO SOMC Employees $20.15
Rate for Payer: PHCS Commercial $62.40
Rate for Payer: United Healthcare All Payer $57.20
Service Code HCPCS 86003
Hospital Charge Code 30000817
Hospital Revenue Code 302
Min. Negotiated Rate $5.22
Max. Negotiated Rate $62.40
Rate for Payer: Aetna Commercial $50.05
Rate for Payer: Anthem Medicaid $5.22
Rate for Payer: Anthem Medicare Advantage/PPO $5.22
Rate for Payer: Anthem POS/PPO/Traditional $52.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $7.31
Rate for Payer: CareSource Just4Me Medicare $5.22
Rate for Payer: Cash Price $32.50
Rate for Payer: Cash Price $32.50
Rate for Payer: Cigna Commercial $53.95
Rate for Payer: First Health Commercial $61.75
Rate for Payer: Humana Commercial $55.25
Rate for Payer: Humana KY Medicaid $5.22
Rate for Payer: Humana Medicare Advantage $5.22
Rate for Payer: Kentucky WC Medicaid $5.27
Rate for Payer: Medical Mutual Of Ohio HMO $53.30
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.97
Rate for Payer: Molina Healthcare Benefit Exchange $6.26
Rate for Payer: Molina Healthcare Medicaid $5.32
Rate for Payer: Ohio Health Choice Commercial $57.20
Rate for Payer: Ohio Health Group HMO $48.75
Rate for Payer: Ohio Health Group PPO Differential $13.00
Rate for Payer: Ohio Health Group PPO No Differential $8.45
Rate for Payer: Ohio Health Group PPO SOMC Employees $20.15
Rate for Payer: PHCS Commercial $62.40
Rate for Payer: United Healthcare All Payer $57.20
Service Code HCPCS 86003
Hospital Charge Code 30000703
Hospital Revenue Code 302
Min. Negotiated Rate $5.22
Max. Negotiated Rate $62.40
Rate for Payer: Aetna Commercial $50.05
Rate for Payer: Anthem Medicaid $5.22
Rate for Payer: Anthem Medicare Advantage/PPO $5.22
Rate for Payer: Anthem POS/PPO/Traditional $52.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $7.31
Rate for Payer: CareSource Just4Me Medicare $5.22
Rate for Payer: Cash Price $32.50
Rate for Payer: Cash Price $32.50
Rate for Payer: Cigna Commercial $53.95
Rate for Payer: First Health Commercial $61.75
Rate for Payer: Humana Commercial $55.25
Rate for Payer: Humana KY Medicaid $5.22
Rate for Payer: Humana Medicare Advantage $5.22
Rate for Payer: Kentucky WC Medicaid $5.27
Rate for Payer: Medical Mutual Of Ohio HMO $53.30
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.97
Rate for Payer: Molina Healthcare Benefit Exchange $6.26
Rate for Payer: Molina Healthcare Medicaid $5.32
Rate for Payer: Ohio Health Choice Commercial $57.20
Rate for Payer: Ohio Health Group HMO $48.75
Rate for Payer: Ohio Health Group PPO Differential $13.00
Rate for Payer: Ohio Health Group PPO No Differential $8.45
Rate for Payer: Ohio Health Group PPO SOMC Employees $20.15
Rate for Payer: PHCS Commercial $62.40
Rate for Payer: United Healthcare All Payer $57.20
Service Code HCPCS 86003
Hospital Charge Code 30000703
Hospital Revenue Code 302
Min. Negotiated Rate $8.45
Max. Negotiated Rate $62.40
Rate for Payer: Aetna Commercial $50.05
Rate for Payer: Anthem POS/PPO/Traditional $52.20
Rate for Payer: Cash Price $32.50
Rate for Payer: Cigna Commercial $53.95
Rate for Payer: First Health Commercial $61.75
Rate for Payer: Humana Commercial $55.25
Rate for Payer: Medical Mutual Of Ohio HMO $53.30
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.97
Rate for Payer: Molina Healthcare Benefit Exchange $19.50
Rate for Payer: Ohio Health Choice Commercial $57.20
Rate for Payer: Ohio Health Group HMO $48.75
Rate for Payer: Ohio Health Group PPO Differential $13.00
Rate for Payer: Ohio Health Group PPO No Differential $8.45
Rate for Payer: Ohio Health Group PPO SOMC Employees $20.15
Rate for Payer: PHCS Commercial $62.40
Rate for Payer: United Healthcare All Payer $57.20