|
OS ASSAY OF CHROMIUM
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
30001933
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$148.50 |
| Max. Negotiated Rate |
$475.20 |
| Rate for Payer: Aetna Commercial |
$381.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$397.49
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cigna Commercial |
$410.85
|
| Rate for Payer: First Health Commercial |
$470.25
|
| Rate for Payer: Humana Commercial |
$420.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$405.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$365.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$148.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$435.60
|
| Rate for Payer: Ohio Health Group HMO |
$371.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$396.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$430.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$341.55
|
| Rate for Payer: PHCS Commercial |
$475.20
|
| Rate for Payer: United Healthcare All Payer |
$435.60
|
|
|
OS ASSAY OF CYANIDE
|
Facility
|
OP
|
$133.50
|
|
|
Service Code
|
HCPCS 82600
|
| Hospital Charge Code |
30002044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$128.16 |
| Rate for Payer: Aetna Commercial |
$102.80
|
| Rate for Payer: Anthem Medicaid |
$19.40
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$19.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$107.20
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$27.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$19.40
|
| Rate for Payer: Cash Price |
$66.75
|
| Rate for Payer: Cash Price |
$66.75
|
| Rate for Payer: Cigna Commercial |
$110.81
|
| Rate for Payer: First Health Commercial |
$126.83
|
| Rate for Payer: Humana Commercial |
$113.47
|
| Rate for Payer: Humana KY Medicaid |
$19.40
|
| Rate for Payer: Humana Medicare Advantage |
$19.40
|
| Rate for Payer: Kentucky WC Medicaid |
$19.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$109.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$98.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$19.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$117.48
|
| Rate for Payer: Ohio Health Group HMO |
$100.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$106.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$116.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$92.11
|
| Rate for Payer: PHCS Commercial |
$128.16
|
| Rate for Payer: United Healthcare All Payer |
$117.48
|
|
|
OS ASSAY OF CYANIDE
|
Facility
|
IP
|
$133.50
|
|
|
Service Code
|
HCPCS 82600
|
| Hospital Charge Code |
30002044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.05 |
| Max. Negotiated Rate |
$128.16 |
| Rate for Payer: Aetna Commercial |
$102.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$107.20
|
| Rate for Payer: Cash Price |
$66.75
|
| Rate for Payer: Cigna Commercial |
$110.81
|
| Rate for Payer: First Health Commercial |
$126.83
|
| Rate for Payer: Humana Commercial |
$113.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$109.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$98.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$40.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$117.48
|
| Rate for Payer: Ohio Health Group HMO |
$100.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$106.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$116.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$92.11
|
| Rate for Payer: PHCS Commercial |
$128.16
|
| Rate for Payer: United Healthcare All Payer |
$117.48
|
|
|
OS ASSAY OF ESTROGENS FRACT
|
Facility
|
OP
|
$44.31
|
|
|
Service Code
|
HCPCS 82671
|
| Hospital Charge Code |
30002043
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.57 |
| Max. Negotiated Rate |
$45.22 |
| Rate for Payer: Aetna Commercial |
$34.12
|
| Rate for Payer: Anthem Medicaid |
$32.30
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$32.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$35.58
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$45.22
|
| Rate for Payer: CareSource Just4Me Medicare |
$32.30
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cigna Commercial |
$36.78
|
| Rate for Payer: First Health Commercial |
$42.09
|
| Rate for Payer: Humana Commercial |
$37.66
|
| Rate for Payer: Humana KY Medicaid |
$32.30
|
| Rate for Payer: Humana Medicare Advantage |
$32.30
|
| Rate for Payer: Kentucky WC Medicaid |
$32.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$36.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$32.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$38.76
|
| Rate for Payer: Molina Healthcare Medicaid |
$32.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$38.99
|
| Rate for Payer: Ohio Health Group HMO |
$33.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$35.45
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$38.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$30.57
|
| Rate for Payer: PHCS Commercial |
$42.54
|
| Rate for Payer: United Healthcare All Payer |
$38.99
|
|
|
OS ASSAY OF ESTROGENS FRACT
|
Facility
|
IP
|
$44.31
|
|
|
Service Code
|
HCPCS 82671
|
| Hospital Charge Code |
30002043
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$42.54 |
| Rate for Payer: Aetna Commercial |
$34.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$35.58
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cigna Commercial |
$36.78
|
| Rate for Payer: First Health Commercial |
$42.09
|
| Rate for Payer: Humana Commercial |
$37.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$36.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$32.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$13.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$38.99
|
| Rate for Payer: Ohio Health Group HMO |
$33.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$35.45
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$38.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$30.57
|
| Rate for Payer: PHCS Commercial |
$42.54
|
| Rate for Payer: United Healthcare All Payer |
$38.99
|
|
|
OS ASSAY OF ETHOSUXIMIDE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
HCPCS 80168
|
| Hospital Charge Code |
30001988
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$63.36 |
| Rate for Payer: Aetna Commercial |
$50.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$54.78
|
| Rate for Payer: First Health Commercial |
$62.70
|
| Rate for Payer: Humana Commercial |
$56.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$54.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$48.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$19.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$58.08
|
| Rate for Payer: Ohio Health Group HMO |
$49.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$57.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.54
|
| Rate for Payer: PHCS Commercial |
$63.36
|
| Rate for Payer: United Healthcare All Payer |
$58.08
|
|
|
OS ASSAY OF ETHOSUXIMIDE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
HCPCS 80168
|
| Hospital Charge Code |
30001988
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.34 |
| Max. Negotiated Rate |
$63.36 |
| Rate for Payer: Aetna Commercial |
$50.82
|
| Rate for Payer: Anthem Medicaid |
$16.34
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$16.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$22.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$16.34
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$54.78
|
| Rate for Payer: First Health Commercial |
$62.70
|
| Rate for Payer: Humana Commercial |
$56.10
|
| Rate for Payer: Humana KY Medicaid |
$16.34
|
| Rate for Payer: Humana Medicare Advantage |
$16.34
|
| Rate for Payer: Kentucky WC Medicaid |
$16.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$54.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$48.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$19.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$16.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$58.08
|
| Rate for Payer: Ohio Health Group HMO |
$49.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$57.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.54
|
| Rate for Payer: PHCS Commercial |
$63.36
|
| Rate for Payer: United Healthcare All Payer |
$58.08
|
|
|
OS ASSAY OF FREE INSULIN
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
HCPCS 83527
|
| Hospital Charge Code |
30002000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$35.52 |
| Rate for Payer: Aetna Commercial |
$28.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29.71
|
| Rate for Payer: Cash Price |
$18.50
|
| Rate for Payer: Cigna Commercial |
$30.71
|
| Rate for Payer: First Health Commercial |
$35.15
|
| Rate for Payer: Humana Commercial |
$31.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$32.56
|
| Rate for Payer: Ohio Health Group HMO |
$27.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25.53
|
| Rate for Payer: PHCS Commercial |
$35.52
|
| Rate for Payer: United Healthcare All Payer |
$32.56
|
|
|
OS ASSAY OF FREE INSULIN
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
HCPCS 83527
|
| Hospital Charge Code |
30002000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$35.52 |
| Rate for Payer: Aetna Commercial |
$28.49
|
| Rate for Payer: Anthem Medicaid |
$12.95
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$12.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29.71
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$18.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$12.95
|
| Rate for Payer: Cash Price |
$18.50
|
| Rate for Payer: Cash Price |
$18.50
|
| Rate for Payer: Cigna Commercial |
$30.71
|
| Rate for Payer: First Health Commercial |
$35.15
|
| Rate for Payer: Humana Commercial |
$31.45
|
| Rate for Payer: Humana KY Medicaid |
$12.95
|
| Rate for Payer: Humana Medicare Advantage |
$12.95
|
| Rate for Payer: Kentucky WC Medicaid |
$13.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$15.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$13.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$32.56
|
| Rate for Payer: Ohio Health Group HMO |
$27.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25.53
|
| Rate for Payer: PHCS Commercial |
$35.52
|
| Rate for Payer: United Healthcare All Payer |
$32.56
|
|
|
OS ASSAY OF NICKEL
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
HCPCS 83885
|
| Hospital Charge Code |
30002011
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.10 |
| Max. Negotiated Rate |
$83.52 |
| Rate for Payer: Aetna Commercial |
$66.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$69.86
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$72.21
|
| Rate for Payer: First Health Commercial |
$82.65
|
| Rate for Payer: Humana Commercial |
$73.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$71.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$64.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$26.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$76.56
|
| Rate for Payer: Ohio Health Group HMO |
$65.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$69.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$75.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$60.03
|
| Rate for Payer: PHCS Commercial |
$83.52
|
| Rate for Payer: United Healthcare All Payer |
$76.56
|
|
|
OS ASSAY OF NICKEL
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
HCPCS 83885
|
| Hospital Charge Code |
30002011
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.51 |
| Max. Negotiated Rate |
$83.52 |
| Rate for Payer: Aetna Commercial |
$66.99
|
| Rate for Payer: Anthem Medicaid |
$24.51
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$24.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$69.86
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$34.31
|
| Rate for Payer: CareSource Just4Me Medicare |
$24.51
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$72.21
|
| Rate for Payer: First Health Commercial |
$82.65
|
| Rate for Payer: Humana Commercial |
$73.95
|
| Rate for Payer: Humana KY Medicaid |
$24.51
|
| Rate for Payer: Humana Medicare Advantage |
$24.51
|
| Rate for Payer: Kentucky WC Medicaid |
$24.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$71.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$64.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$29.41
|
| Rate for Payer: Molina Healthcare Medicaid |
$25.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$76.56
|
| Rate for Payer: Ohio Health Group HMO |
$65.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$69.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$75.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$60.03
|
| Rate for Payer: PHCS Commercial |
$83.52
|
| Rate for Payer: United Healthcare All Payer |
$76.56
|
|
|
OS ASSAY OF NUCLEOTIDASE
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
HCPCS 83915
|
| Hospital Charge Code |
30001871
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$116.16 |
| Rate for Payer: Aetna Commercial |
$93.17
|
| Rate for Payer: Anthem Medicaid |
$11.15
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$11.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$97.16
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$15.61
|
| Rate for Payer: CareSource Just4Me Medicare |
$11.15
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna Commercial |
$100.43
|
| Rate for Payer: First Health Commercial |
$114.95
|
| Rate for Payer: Humana Commercial |
$102.85
|
| Rate for Payer: Humana KY Medicaid |
$11.15
|
| Rate for Payer: Humana Medicare Advantage |
$11.15
|
| Rate for Payer: Kentucky WC Medicaid |
$11.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$99.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$89.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$13.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$11.37
|
| Rate for Payer: Ohio Health Choice Commercial |
$106.48
|
| Rate for Payer: Ohio Health Group HMO |
$90.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$96.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$83.49
|
| Rate for Payer: PHCS Commercial |
$116.16
|
| Rate for Payer: United Healthcare All Payer |
$106.48
|
|
|
OS ASSAY OF NUCLEOTIDASE
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
HCPCS 83915
|
| Hospital Charge Code |
30001871
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.30 |
| Max. Negotiated Rate |
$116.16 |
| Rate for Payer: Aetna Commercial |
$93.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$97.16
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna Commercial |
$100.43
|
| Rate for Payer: First Health Commercial |
$114.95
|
| Rate for Payer: Humana Commercial |
$102.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$99.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$89.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$36.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$106.48
|
| Rate for Payer: Ohio Health Group HMO |
$90.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$96.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$83.49
|
| Rate for Payer: PHCS Commercial |
$116.16
|
| Rate for Payer: United Healthcare All Payer |
$106.48
|
|
|
OS ASSAY OF OSTEOCALCIN
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
HCPCS 83937
|
| Hospital Charge Code |
30001940
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.30 |
| Max. Negotiated Rate |
$116.16 |
| Rate for Payer: Aetna Commercial |
$93.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$97.16
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna Commercial |
$100.43
|
| Rate for Payer: First Health Commercial |
$114.95
|
| Rate for Payer: Humana Commercial |
$102.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$99.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$89.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$36.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$106.48
|
| Rate for Payer: Ohio Health Group HMO |
$90.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$96.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$83.49
|
| Rate for Payer: PHCS Commercial |
$116.16
|
| Rate for Payer: United Healthcare All Payer |
$106.48
|
|
|
OS ASSAY OF OSTEOCALCIN
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
HCPCS 83937
|
| Hospital Charge Code |
30001940
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.85 |
| Max. Negotiated Rate |
$116.16 |
| Rate for Payer: Aetna Commercial |
$93.17
|
| Rate for Payer: Anthem Medicaid |
$29.85
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$29.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$97.16
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$41.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$29.85
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna Commercial |
$100.43
|
| Rate for Payer: First Health Commercial |
$114.95
|
| Rate for Payer: Humana Commercial |
$102.85
|
| Rate for Payer: Humana KY Medicaid |
$29.85
|
| Rate for Payer: Humana Medicare Advantage |
$29.85
|
| Rate for Payer: Kentucky WC Medicaid |
$30.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$99.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$89.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$35.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$30.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$106.48
|
| Rate for Payer: Ohio Health Group HMO |
$90.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$96.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$83.49
|
| Rate for Payer: PHCS Commercial |
$116.16
|
| Rate for Payer: United Healthcare All Payer |
$106.48
|
|
|
OS ASSAY OF OSTEOCALCIN
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 83937
|
| Hospital Charge Code |
30001940
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Aetna Commercial |
$29.58
|
| Rate for Payer: Ambetter Exchange |
$29.85
|
| Rate for Payer: Buckeye Individual/Medicaid |
$29.85
|
| Rate for Payer: Buckeye Medicare Advantage |
$29.85
|
| Rate for Payer: CareSource Just4Me Medicare |
$35.82
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Cigna Commercial |
$26.38
|
| Rate for Payer: Healthspan PPO |
$31.28
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$29.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$29.85
|
| Rate for Payer: Multiplan PHCS |
$72.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$38.80
|
| Rate for Payer: UHCCP Medicaid |
$42.35
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$17.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$29.85
|
|
|
OS ASSAY OF PREGNENOLONE
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
HCPCS 84140
|
| Hospital Charge Code |
30001906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.67 |
| Max. Negotiated Rate |
$118.08 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Anthem Medicaid |
$20.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$20.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$98.77
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$28.94
|
| Rate for Payer: CareSource Just4Me Medicare |
$20.67
|
| Rate for Payer: Cash Price |
$61.50
|
| Rate for Payer: Cash Price |
$61.50
|
| Rate for Payer: Cigna Commercial |
$102.09
|
| Rate for Payer: First Health Commercial |
$116.85
|
| Rate for Payer: Humana Commercial |
$104.55
|
| Rate for Payer: Humana KY Medicaid |
$20.67
|
| Rate for Payer: Humana Medicare Advantage |
$20.67
|
| Rate for Payer: Kentucky WC Medicaid |
$20.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$100.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$90.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$24.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$21.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$108.24
|
| Rate for Payer: Ohio Health Group HMO |
$92.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$98.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$107.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$84.87
|
| Rate for Payer: PHCS Commercial |
$118.08
|
| Rate for Payer: United Healthcare All Payer |
$108.24
|
|
|
OS ASSAY OF PREGNENOLONE
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
HCPCS 84140
|
| Hospital Charge Code |
30001906
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.90 |
| Max. Negotiated Rate |
$118.08 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$98.77
|
| Rate for Payer: Cash Price |
$61.50
|
| Rate for Payer: Cigna Commercial |
$102.09
|
| Rate for Payer: First Health Commercial |
$116.85
|
| Rate for Payer: Humana Commercial |
$104.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$100.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$90.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$36.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$108.24
|
| Rate for Payer: Ohio Health Group HMO |
$92.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$98.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$107.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$84.87
|
| Rate for Payer: PHCS Commercial |
$118.08
|
| Rate for Payer: United Healthcare All Payer |
$108.24
|
|
|
OS ASSAY OF PROTEIN ANY SOURCE
|
Facility
|
IP
|
$36.00
|
|
|
Service Code
|
HCPCS 84160
|
| Hospital Charge Code |
30001921
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$34.56 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28.91
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cigna Commercial |
$29.88
|
| Rate for Payer: First Health Commercial |
$34.20
|
| Rate for Payer: Humana Commercial |
$30.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$31.68
|
| Rate for Payer: Ohio Health Group HMO |
$27.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.84
|
| Rate for Payer: PHCS Commercial |
$34.56
|
| Rate for Payer: United Healthcare All Payer |
$31.68
|
|
|
OS ASSAY OF PROTEIN ANY SOURCE
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
HCPCS 84160
|
| Hospital Charge Code |
30001921
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$34.56 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: Anthem Medicaid |
$5.61
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28.91
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7.85
|
| Rate for Payer: CareSource Just4Me Medicare |
$5.61
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cigna Commercial |
$29.88
|
| Rate for Payer: First Health Commercial |
$34.20
|
| Rate for Payer: Humana Commercial |
$30.60
|
| Rate for Payer: Humana KY Medicaid |
$5.61
|
| Rate for Payer: Humana Medicare Advantage |
$5.61
|
| Rate for Payer: Kentucky WC Medicaid |
$5.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.73
|
| Rate for Payer: Molina Healthcare Medicaid |
$5.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$31.68
|
| Rate for Payer: Ohio Health Group HMO |
$27.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24.84
|
| Rate for Payer: PHCS Commercial |
$34.56
|
| Rate for Payer: United Healthcare All Payer |
$31.68
|
|
|
OS AST
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
HCPCS 84450
|
| Hospital Charge Code |
30000535
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$63.36 |
| Rate for Payer: Aetna Commercial |
$50.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$54.78
|
| Rate for Payer: First Health Commercial |
$62.70
|
| Rate for Payer: Humana Commercial |
$56.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$54.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$48.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$19.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$58.08
|
| Rate for Payer: Ohio Health Group HMO |
$49.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$57.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.54
|
| Rate for Payer: PHCS Commercial |
$63.36
|
| Rate for Payer: United Healthcare All Payer |
$58.08
|
|
|
OS AST
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
HCPCS 84450
|
| Hospital Charge Code |
30000535
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$63.36 |
| Rate for Payer: Aetna Commercial |
$50.82
|
| Rate for Payer: Anthem Medicaid |
$5.18
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$53.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$5.18
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$54.78
|
| Rate for Payer: First Health Commercial |
$62.70
|
| Rate for Payer: Humana Commercial |
$56.10
|
| Rate for Payer: Humana KY Medicaid |
$5.18
|
| Rate for Payer: Humana Medicare Advantage |
$5.18
|
| Rate for Payer: Kentucky WC Medicaid |
$5.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$54.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$48.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$5.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$58.08
|
| Rate for Payer: Ohio Health Group HMO |
$49.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$57.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.54
|
| Rate for Payer: PHCS Commercial |
$63.36
|
| Rate for Payer: United Healthcare All Payer |
$58.08
|
|
|
OS ATG16L1
|
Facility
|
IP
|
$185.00
|
|
|
Service Code
|
HCPCS 81479
|
| Hospital Charge Code |
30000216
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$177.60 |
| Rate for Payer: Aetna Commercial |
$142.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$148.56
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$153.55
|
| Rate for Payer: First Health Commercial |
$175.75
|
| Rate for Payer: Humana Commercial |
$157.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$151.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$136.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$55.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$162.80
|
| Rate for Payer: Ohio Health Group HMO |
$138.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$148.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$160.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$127.65
|
| Rate for Payer: PHCS Commercial |
$177.60
|
| Rate for Payer: United Healthcare All Payer |
$162.80
|
|
|
OS ATG16L1
|
Facility
|
OP
|
$185.00
|
|
|
Service Code
|
HCPCS 81479
|
| Hospital Charge Code |
30000216
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$177.60 |
| Rate for Payer: Aetna Commercial |
$142.45
|
| Rate for Payer: Anthem Medicaid |
$63.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$148.56
|
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Cigna Commercial |
$153.55
|
| Rate for Payer: First Health Commercial |
$175.75
|
| Rate for Payer: Humana Commercial |
$157.25
|
| Rate for Payer: Humana KY Medicaid |
$63.62
|
| Rate for Payer: Kentucky WC Medicaid |
$64.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$151.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$136.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$55.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$64.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$162.80
|
| Rate for Payer: Ohio Health Group HMO |
$138.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$148.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$160.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$127.65
|
| Rate for Payer: PHCS Commercial |
$177.60
|
| Rate for Payer: United Healthcare All Payer |
$162.80
|
|
|
OS AUREOBASIDIUM PULLULAN IGE
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
30000906
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$66.24 |
| Rate for Payer: Aetna Commercial |
$53.13
|
| Rate for Payer: Anthem Medicaid |
$5.22
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55.41
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7.31
|
| Rate for Payer: CareSource Just4Me Medicare |
$5.22
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cigna Commercial |
$57.27
|
| Rate for Payer: First Health Commercial |
$65.55
|
| Rate for Payer: Humana Commercial |
$58.65
|
| 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 |
$56.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$50.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$5.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$60.72
|
| Rate for Payer: Ohio Health Group HMO |
$51.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$55.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$60.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$47.61
|
| Rate for Payer: PHCS Commercial |
$66.24
|
| Rate for Payer: United Healthcare All Payer |
$60.72
|
|
