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Service Code HCPCS 86747
Hospital Charge Code 30001198
Hospital Revenue Code 300
Min. Negotiated Rate $33.67
Max. Negotiated Rate $248.64
Rate for Payer: Aetna Commercial $199.43
Rate for Payer: Anthem POS/PPO/Traditional $207.98
Rate for Payer: Cash Price $129.50
Rate for Payer: Cigna Commercial $214.97
Rate for Payer: First Health Commercial $246.05
Rate for Payer: Humana Commercial $220.15
Rate for Payer: Medical Mutual Of Ohio HMO $212.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $191.14
Rate for Payer: Molina Healthcare Benefit Exchange $77.70
Rate for Payer: Ohio Health Choice Commercial $227.92
Rate for Payer: Ohio Health Group HMO $194.25
Rate for Payer: Ohio Health Group PPO Differential $51.80
Rate for Payer: Ohio Health Group PPO No Differential $33.67
Rate for Payer: Ohio Health Group PPO SOMC Employees $80.29
Rate for Payer: PHCS Commercial $248.64
Rate for Payer: United Healthcare All Payer $227.92
Service Code HCPCS 86747
Hospital Charge Code 30001198
Hospital Revenue Code 300
Min. Negotiated Rate $15.03
Max. Negotiated Rate $248.64
Rate for Payer: Aetna Commercial $199.43
Rate for Payer: Anthem Medicaid $15.03
Rate for Payer: Anthem Medicare Advantage/PPO $15.03
Rate for Payer: Anthem POS/PPO/Traditional $207.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $21.04
Rate for Payer: CareSource Just4Me Medicare $15.03
Rate for Payer: Cash Price $129.50
Rate for Payer: Cash Price $129.50
Rate for Payer: Cigna Commercial $214.97
Rate for Payer: First Health Commercial $246.05
Rate for Payer: Humana Commercial $220.15
Rate for Payer: Humana KY Medicaid $15.03
Rate for Payer: Humana Medicare Advantage $15.03
Rate for Payer: Kentucky WC Medicaid $15.18
Rate for Payer: Medical Mutual Of Ohio HMO $212.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $191.14
Rate for Payer: Molina Healthcare Benefit Exchange $18.04
Rate for Payer: Molina Healthcare Medicaid $15.33
Rate for Payer: Ohio Health Choice Commercial $227.92
Rate for Payer: Ohio Health Group HMO $194.25
Rate for Payer: Ohio Health Group PPO Differential $51.80
Rate for Payer: Ohio Health Group PPO No Differential $33.67
Rate for Payer: Ohio Health Group PPO SOMC Employees $80.29
Rate for Payer: PHCS Commercial $248.64
Rate for Payer: United Healthcare All Payer $227.92
Service Code HCPCS 87798
Hospital Charge Code 30001399
Hospital Revenue Code 300
Min. Negotiated Rate $45.24
Max. Negotiated Rate $334.08
Rate for Payer: Aetna Commercial $267.96
Rate for Payer: Anthem POS/PPO/Traditional $279.44
Rate for Payer: Cash Price $174.00
Rate for Payer: Cigna Commercial $288.84
Rate for Payer: First Health Commercial $330.60
Rate for Payer: Humana Commercial $295.80
Rate for Payer: Medical Mutual Of Ohio HMO $285.36
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $256.82
Rate for Payer: Molina Healthcare Benefit Exchange $104.40
Rate for Payer: Ohio Health Choice Commercial $306.24
Rate for Payer: Ohio Health Group HMO $261.00
Rate for Payer: Ohio Health Group PPO Differential $69.60
Rate for Payer: Ohio Health Group PPO No Differential $45.24
Rate for Payer: Ohio Health Group PPO SOMC Employees $107.88
Rate for Payer: PHCS Commercial $334.08
Rate for Payer: United Healthcare All Payer $306.24
Service Code HCPCS 87798
Hospital Charge Code 30001399
Hospital Revenue Code 300
Min. Negotiated Rate $35.09
Max. Negotiated Rate $334.08
Rate for Payer: Aetna Commercial $267.96
Rate for Payer: Anthem Medicaid $35.09
Rate for Payer: Anthem Medicare Advantage/PPO $35.09
Rate for Payer: Anthem POS/PPO/Traditional $279.44
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $49.13
Rate for Payer: CareSource Just4Me Medicare $35.09
Rate for Payer: Cash Price $174.00
Rate for Payer: Cash Price $174.00
Rate for Payer: Cigna Commercial $288.84
Rate for Payer: First Health Commercial $330.60
Rate for Payer: Humana Commercial $295.80
Rate for Payer: Humana KY Medicaid $35.09
Rate for Payer: Humana Medicare Advantage $35.09
Rate for Payer: Kentucky WC Medicaid $35.44
Rate for Payer: Medical Mutual Of Ohio HMO $285.36
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $256.82
Rate for Payer: Molina Healthcare Benefit Exchange $42.11
Rate for Payer: Molina Healthcare Medicaid $35.79
Rate for Payer: Ohio Health Choice Commercial $306.24
Rate for Payer: Ohio Health Group HMO $261.00
Rate for Payer: Ohio Health Group PPO Differential $69.60
Rate for Payer: Ohio Health Group PPO No Differential $45.24
Rate for Payer: Ohio Health Group PPO SOMC Employees $107.88
Rate for Payer: PHCS Commercial $334.08
Rate for Payer: United Healthcare All Payer $306.24
Service Code HCPCS 86003
Hospital Charge Code 30000812
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 30000812
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 88323
Hospital Charge Code 30001519
Hospital Revenue Code 300
Min. Negotiated Rate $46.86
Max. Negotiated Rate $466.56
Rate for Payer: Aetna Commercial $374.22
Rate for Payer: Anthem Medicaid $167.14
Rate for Payer: Anthem Medicare Advantage/PPO $46.86
Rate for Payer: Anthem POS/PPO/Traditional $390.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $65.60
Rate for Payer: CareSource Just4Me Medicare $63.26
Rate for Payer: Cash Price $243.00
Rate for Payer: Cash Price $243.00
Rate for Payer: Cigna Commercial $403.38
Rate for Payer: First Health Commercial $461.70
Rate for Payer: Humana Commercial $413.10
Rate for Payer: Humana KY Medicaid $167.14
Rate for Payer: Humana Medicare Advantage $46.86
Rate for Payer: Kentucky WC Medicaid $168.84
Rate for Payer: Medical Mutual Of Ohio HMO $398.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $358.67
Rate for Payer: Molina Healthcare Benefit Exchange $56.23
Rate for Payer: Molina Healthcare Medicaid $170.49
Rate for Payer: Ohio Health Choice Commercial $427.68
Rate for Payer: Ohio Health Group HMO $364.50
Rate for Payer: Ohio Health Group PPO Differential $97.20
Rate for Payer: Ohio Health Group PPO No Differential $63.18
Rate for Payer: Ohio Health Group PPO SOMC Employees $150.66
Rate for Payer: PHCS Commercial $466.56
Rate for Payer: United Healthcare All Payer $427.68
Service Code HCPCS 88323
Hospital Charge Code 30001519
Hospital Revenue Code 300
Min. Negotiated Rate $63.18
Max. Negotiated Rate $466.56
Rate for Payer: Aetna Commercial $374.22
Rate for Payer: Anthem POS/PPO/Traditional $390.26
Rate for Payer: Cash Price $243.00
Rate for Payer: Cigna Commercial $403.38
Rate for Payer: First Health Commercial $461.70
Rate for Payer: Humana Commercial $413.10
Rate for Payer: Medical Mutual Of Ohio HMO $398.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $358.67
Rate for Payer: Molina Healthcare Benefit Exchange $145.80
Rate for Payer: Ohio Health Choice Commercial $427.68
Rate for Payer: Ohio Health Group HMO $364.50
Rate for Payer: Ohio Health Group PPO Differential $97.20
Rate for Payer: Ohio Health Group PPO No Differential $63.18
Rate for Payer: Ohio Health Group PPO SOMC Employees $150.66
Rate for Payer: PHCS Commercial $466.56
Rate for Payer: United Healthcare All Payer $427.68
Service Code HCPCS 81405
Hospital Charge Code 30001884
Hospital Revenue Code 300
Min. Negotiated Rate $110.50
Max. Negotiated Rate $816.00
Rate for Payer: Aetna Commercial $654.50
Rate for Payer: Anthem POS/PPO/Traditional $682.55
Rate for Payer: Cash Price $425.00
Rate for Payer: Cigna Commercial $705.50
Rate for Payer: First Health Commercial $807.50
Rate for Payer: Humana Commercial $722.50
Rate for Payer: Medical Mutual Of Ohio HMO $697.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $627.30
Rate for Payer: Molina Healthcare Benefit Exchange $255.00
Rate for Payer: Ohio Health Choice Commercial $748.00
Rate for Payer: Ohio Health Group HMO $637.50
Rate for Payer: Ohio Health Group PPO Differential $170.00
Rate for Payer: Ohio Health Group PPO No Differential $110.50
Rate for Payer: Ohio Health Group PPO SOMC Employees $263.50
Rate for Payer: PHCS Commercial $816.00
Rate for Payer: United Healthcare All Payer $748.00
Service Code HCPCS 81405
Hospital Charge Code 30001884
Hospital Revenue Code 300
Min. Negotiated Rate $110.50
Max. Negotiated Rate $816.00
Rate for Payer: Aetna Commercial $654.50
Rate for Payer: Anthem Medicaid $301.35
Rate for Payer: Anthem Medicare Advantage/PPO $301.35
Rate for Payer: Anthem POS/PPO/Traditional $682.55
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $421.89
Rate for Payer: CareSource Just4Me Medicare $301.35
Rate for Payer: Cash Price $425.00
Rate for Payer: Cash Price $425.00
Rate for Payer: Cigna Commercial $705.50
Rate for Payer: First Health Commercial $807.50
Rate for Payer: Humana Commercial $722.50
Rate for Payer: Humana KY Medicaid $301.35
Rate for Payer: Humana Medicare Advantage $301.35
Rate for Payer: Kentucky WC Medicaid $304.36
Rate for Payer: Medical Mutual Of Ohio HMO $697.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $627.30
Rate for Payer: Molina Healthcare Benefit Exchange $361.62
Rate for Payer: Molina Healthcare Medicaid $307.38
Rate for Payer: Ohio Health Choice Commercial $748.00
Rate for Payer: Ohio Health Group HMO $637.50
Rate for Payer: Ohio Health Group PPO Differential $170.00
Rate for Payer: Ohio Health Group PPO No Differential $110.50
Rate for Payer: Ohio Health Group PPO SOMC Employees $263.50
Rate for Payer: PHCS Commercial $816.00
Rate for Payer: United Healthcare All Payer $748.00
Service Code HCPCS 81406
Hospital Charge Code 30002056
Hospital Revenue Code 310
Min. Negotiated Rate $15.11
Max. Negotiated Rate $111.55
Rate for Payer: Aetna Commercial $89.47
Rate for Payer: Anthem POS/PPO/Traditional $93.31
Rate for Payer: Cash Price $58.10
Rate for Payer: Cigna Commercial $96.45
Rate for Payer: First Health Commercial $110.39
Rate for Payer: Humana Commercial $98.77
Rate for Payer: Medical Mutual Of Ohio HMO $95.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $85.76
Rate for Payer: Molina Healthcare Benefit Exchange $34.86
Rate for Payer: Ohio Health Choice Commercial $102.26
Rate for Payer: Ohio Health Group HMO $87.15
Rate for Payer: Ohio Health Group PPO Differential $23.24
Rate for Payer: Ohio Health Group PPO No Differential $15.11
Rate for Payer: Ohio Health Group PPO SOMC Employees $36.02
Rate for Payer: PHCS Commercial $111.55
Rate for Payer: United Healthcare All Payer $102.26
Service Code HCPCS 81406
Hospital Charge Code 30002056
Hospital Revenue Code 310
Min. Negotiated Rate $15.11
Max. Negotiated Rate $396.03
Rate for Payer: Aetna Commercial $89.47
Rate for Payer: Anthem Medicaid $282.88
Rate for Payer: Anthem Medicare Advantage/PPO $282.88
Rate for Payer: Anthem POS/PPO/Traditional $93.31
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $396.03
Rate for Payer: CareSource Just4Me Medicare $282.88
Rate for Payer: Cash Price $58.10
Rate for Payer: Cash Price $58.10
Rate for Payer: Cigna Commercial $96.45
Rate for Payer: First Health Commercial $110.39
Rate for Payer: Humana Commercial $98.77
Rate for Payer: Humana KY Medicaid $282.88
Rate for Payer: Humana Medicare Advantage $282.88
Rate for Payer: Kentucky WC Medicaid $285.71
Rate for Payer: Medical Mutual Of Ohio HMO $95.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $85.76
Rate for Payer: Molina Healthcare Benefit Exchange $339.46
Rate for Payer: Molina Healthcare Medicaid $288.54
Rate for Payer: Ohio Health Choice Commercial $102.26
Rate for Payer: Ohio Health Group HMO $87.15
Rate for Payer: Ohio Health Group PPO Differential $23.24
Rate for Payer: Ohio Health Group PPO No Differential $15.11
Rate for Payer: Ohio Health Group PPO SOMC Employees $36.02
Rate for Payer: PHCS Commercial $111.55
Rate for Payer: United Healthcare All Payer $102.26
Service Code HCPCS 81407
Hospital Charge Code 30002057
Hospital Revenue Code 310
Min. Negotiated Rate $45.19
Max. Negotiated Rate $333.73
Rate for Payer: Aetna Commercial $267.68
Rate for Payer: Anthem POS/PPO/Traditional $279.15
Rate for Payer: Cash Price $173.82
Rate for Payer: Cigna Commercial $288.54
Rate for Payer: First Health Commercial $330.26
Rate for Payer: Humana Commercial $295.49
Rate for Payer: Medical Mutual Of Ohio HMO $285.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $256.56
Rate for Payer: Molina Healthcare Benefit Exchange $104.29
Rate for Payer: Ohio Health Choice Commercial $305.92
Rate for Payer: Ohio Health Group HMO $260.73
Rate for Payer: Ohio Health Group PPO Differential $69.53
Rate for Payer: Ohio Health Group PPO No Differential $45.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $107.77
Rate for Payer: PHCS Commercial $333.73
Rate for Payer: United Healthcare All Payer $305.92
Service Code HCPCS 81407
Hospital Charge Code 30002057
Hospital Revenue Code 310
Min. Negotiated Rate $45.19
Max. Negotiated Rate $1,184.78
Rate for Payer: Aetna Commercial $267.68
Rate for Payer: Anthem Medicaid $846.27
Rate for Payer: Anthem Medicare Advantage/PPO $846.27
Rate for Payer: Anthem POS/PPO/Traditional $279.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,184.78
Rate for Payer: CareSource Just4Me Medicare $846.27
Rate for Payer: Cash Price $173.82
Rate for Payer: Cash Price $173.82
Rate for Payer: Cigna Commercial $288.54
Rate for Payer: First Health Commercial $330.26
Rate for Payer: Humana Commercial $295.49
Rate for Payer: Humana KY Medicaid $846.27
Rate for Payer: Humana Medicare Advantage $846.27
Rate for Payer: Kentucky WC Medicaid $854.73
Rate for Payer: Medical Mutual Of Ohio HMO $285.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $256.56
Rate for Payer: Molina Healthcare Benefit Exchange $1,015.52
Rate for Payer: Molina Healthcare Medicaid $863.20
Rate for Payer: Ohio Health Choice Commercial $305.92
Rate for Payer: Ohio Health Group HMO $260.73
Rate for Payer: Ohio Health Group PPO Differential $69.53
Rate for Payer: Ohio Health Group PPO No Differential $45.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $107.77
Rate for Payer: PHCS Commercial $333.73
Rate for Payer: United Healthcare All Payer $305.92
Service Code HCPCS 81408
Hospital Charge Code 30001956
Hospital Revenue Code 300
Min. Negotiated Rate $212.94
Max. Negotiated Rate $1,572.48
Rate for Payer: Aetna Commercial $1,261.26
Rate for Payer: Anthem POS/PPO/Traditional $1,315.31
Rate for Payer: Cash Price $819.00
Rate for Payer: Cigna Commercial $1,359.54
Rate for Payer: First Health Commercial $1,556.10
Rate for Payer: Humana Commercial $1,392.30
Rate for Payer: Medical Mutual Of Ohio HMO $1,343.16
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,208.84
Rate for Payer: Molina Healthcare Benefit Exchange $491.40
Rate for Payer: Ohio Health Choice Commercial $1,441.44
Rate for Payer: Ohio Health Group HMO $1,228.50
Rate for Payer: Ohio Health Group PPO Differential $327.60
Rate for Payer: Ohio Health Group PPO No Differential $212.94
Rate for Payer: Ohio Health Group PPO SOMC Employees $507.78
Rate for Payer: PHCS Commercial $1,572.48
Rate for Payer: United Healthcare All Payer $1,441.44
Service Code HCPCS 81408
Hospital Charge Code 30001956
Hospital Revenue Code 300
Min. Negotiated Rate $212.94
Max. Negotiated Rate $2,800.00
Rate for Payer: Aetna Commercial $1,261.26
Rate for Payer: Anthem Medicaid $2,000.00
Rate for Payer: Anthem Medicare Advantage/PPO $2,000.00
Rate for Payer: Anthem POS/PPO/Traditional $1,315.31
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,800.00
Rate for Payer: CareSource Just4Me Medicare $2,000.00
Rate for Payer: Cash Price $819.00
Rate for Payer: Cash Price $819.00
Rate for Payer: Cigna Commercial $1,359.54
Rate for Payer: First Health Commercial $1,556.10
Rate for Payer: Humana Commercial $1,392.30
Rate for Payer: Humana KY Medicaid $2,000.00
Rate for Payer: Humana Medicare Advantage $2,000.00
Rate for Payer: Kentucky WC Medicaid $2,020.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,343.16
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,208.84
Rate for Payer: Molina Healthcare Benefit Exchange $2,400.00
Rate for Payer: Molina Healthcare Medicaid $2,040.00
Rate for Payer: Ohio Health Choice Commercial $1,441.44
Rate for Payer: Ohio Health Group HMO $1,228.50
Rate for Payer: Ohio Health Group PPO Differential $327.60
Rate for Payer: Ohio Health Group PPO No Differential $212.94
Rate for Payer: Ohio Health Group PPO SOMC Employees $507.78
Rate for Payer: PHCS Commercial $1,572.48
Rate for Payer: United Healthcare All Payer $1,441.44
Service Code HCPCS 86255
Hospital Charge Code 30001026
Hospital Revenue Code 300
Min. Negotiated Rate $21.19
Max. Negotiated Rate $156.48
Rate for Payer: Aetna Commercial $125.51
Rate for Payer: Anthem POS/PPO/Traditional $130.89
Rate for Payer: Cash Price $81.50
Rate for Payer: Cigna Commercial $135.29
Rate for Payer: First Health Commercial $154.85
Rate for Payer: Humana Commercial $138.55
Rate for Payer: Medical Mutual Of Ohio HMO $133.66
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $120.29
Rate for Payer: Molina Healthcare Benefit Exchange $48.90
Rate for Payer: Ohio Health Choice Commercial $143.44
Rate for Payer: Ohio Health Group HMO $122.25
Rate for Payer: Ohio Health Group PPO Differential $32.60
Rate for Payer: Ohio Health Group PPO No Differential $21.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $50.53
Rate for Payer: PHCS Commercial $156.48
Rate for Payer: United Healthcare All Payer $143.44
Service Code HCPCS 86255
Hospital Charge Code 30001026
Hospital Revenue Code 300
Min. Negotiated Rate $12.05
Max. Negotiated Rate $156.48
Rate for Payer: Aetna Commercial $125.51
Rate for Payer: Anthem Medicaid $12.05
Rate for Payer: Anthem Medicare Advantage/PPO $12.05
Rate for Payer: Anthem POS/PPO/Traditional $130.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.87
Rate for Payer: CareSource Just4Me Medicare $12.05
Rate for Payer: Cash Price $81.50
Rate for Payer: Cash Price $81.50
Rate for Payer: Cigna Commercial $135.29
Rate for Payer: First Health Commercial $154.85
Rate for Payer: Humana Commercial $138.55
Rate for Payer: Humana KY Medicaid $12.05
Rate for Payer: Humana Medicare Advantage $12.05
Rate for Payer: Kentucky WC Medicaid $12.17
Rate for Payer: Medical Mutual Of Ohio HMO $133.66
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $120.29
Rate for Payer: Molina Healthcare Benefit Exchange $14.46
Rate for Payer: Molina Healthcare Medicaid $12.29
Rate for Payer: Ohio Health Choice Commercial $143.44
Rate for Payer: Ohio Health Group HMO $122.25
Rate for Payer: Ohio Health Group PPO Differential $32.60
Rate for Payer: Ohio Health Group PPO No Differential $21.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $50.53
Rate for Payer: PHCS Commercial $156.48
Rate for Payer: United Healthcare All Payer $143.44
Service Code HCPCS 86255
Hospital Charge Code 30001025
Hospital Revenue Code 300
Min. Negotiated Rate $21.19
Max. Negotiated Rate $156.48
Rate for Payer: Aetna Commercial $125.51
Rate for Payer: Anthem POS/PPO/Traditional $130.89
Rate for Payer: Cash Price $81.50
Rate for Payer: Cigna Commercial $135.29
Rate for Payer: First Health Commercial $154.85
Rate for Payer: Humana Commercial $138.55
Rate for Payer: Medical Mutual Of Ohio HMO $133.66
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $120.29
Rate for Payer: Molina Healthcare Benefit Exchange $48.90
Rate for Payer: Ohio Health Choice Commercial $143.44
Rate for Payer: Ohio Health Group HMO $122.25
Rate for Payer: Ohio Health Group PPO Differential $32.60
Rate for Payer: Ohio Health Group PPO No Differential $21.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $50.53
Rate for Payer: PHCS Commercial $156.48
Rate for Payer: United Healthcare All Payer $143.44
Service Code HCPCS 86255
Hospital Charge Code 30001025
Hospital Revenue Code 300
Min. Negotiated Rate $12.05
Max. Negotiated Rate $156.48
Rate for Payer: Aetna Commercial $125.51
Rate for Payer: Anthem Medicaid $12.05
Rate for Payer: Anthem Medicare Advantage/PPO $12.05
Rate for Payer: Anthem POS/PPO/Traditional $130.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.87
Rate for Payer: CareSource Just4Me Medicare $12.05
Rate for Payer: Cash Price $81.50
Rate for Payer: Cash Price $81.50
Rate for Payer: Cigna Commercial $135.29
Rate for Payer: First Health Commercial $154.85
Rate for Payer: Humana Commercial $138.55
Rate for Payer: Humana KY Medicaid $12.05
Rate for Payer: Humana Medicare Advantage $12.05
Rate for Payer: Kentucky WC Medicaid $12.17
Rate for Payer: Medical Mutual Of Ohio HMO $133.66
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $120.29
Rate for Payer: Molina Healthcare Benefit Exchange $14.46
Rate for Payer: Molina Healthcare Medicaid $12.29
Rate for Payer: Ohio Health Choice Commercial $143.44
Rate for Payer: Ohio Health Group HMO $122.25
Rate for Payer: Ohio Health Group PPO Differential $32.60
Rate for Payer: Ohio Health Group PPO No Differential $21.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $50.53
Rate for Payer: PHCS Commercial $156.48
Rate for Payer: United Healthcare All Payer $143.44
Service Code HCPCS 86255
Hospital Charge Code 30001022
Hospital Revenue Code 300
Min. Negotiated Rate $12.05
Max. Negotiated Rate $156.48
Rate for Payer: Aetna Commercial $125.51
Rate for Payer: Anthem Medicaid $12.05
Rate for Payer: Anthem Medicare Advantage/PPO $12.05
Rate for Payer: Anthem POS/PPO/Traditional $130.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.87
Rate for Payer: CareSource Just4Me Medicare $12.05
Rate for Payer: Cash Price $81.50
Rate for Payer: Cash Price $81.50
Rate for Payer: Cigna Commercial $135.29
Rate for Payer: First Health Commercial $154.85
Rate for Payer: Humana Commercial $138.55
Rate for Payer: Humana KY Medicaid $12.05
Rate for Payer: Humana Medicare Advantage $12.05
Rate for Payer: Kentucky WC Medicaid $12.17
Rate for Payer: Medical Mutual Of Ohio HMO $133.66
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $120.29
Rate for Payer: Molina Healthcare Benefit Exchange $14.46
Rate for Payer: Molina Healthcare Medicaid $12.29
Rate for Payer: Ohio Health Choice Commercial $143.44
Rate for Payer: Ohio Health Group HMO $122.25
Rate for Payer: Ohio Health Group PPO Differential $32.60
Rate for Payer: Ohio Health Group PPO No Differential $21.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $50.53
Rate for Payer: PHCS Commercial $156.48
Rate for Payer: United Healthcare All Payer $143.44
Service Code HCPCS 86255
Hospital Charge Code 30001022
Hospital Revenue Code 300
Min. Negotiated Rate $21.19
Max. Negotiated Rate $156.48
Rate for Payer: Aetna Commercial $125.51
Rate for Payer: Anthem POS/PPO/Traditional $130.89
Rate for Payer: Cash Price $81.50
Rate for Payer: Cigna Commercial $135.29
Rate for Payer: First Health Commercial $154.85
Rate for Payer: Humana Commercial $138.55
Rate for Payer: Medical Mutual Of Ohio HMO $133.66
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $120.29
Rate for Payer: Molina Healthcare Benefit Exchange $48.90
Rate for Payer: Ohio Health Choice Commercial $143.44
Rate for Payer: Ohio Health Group HMO $122.25
Rate for Payer: Ohio Health Group PPO Differential $32.60
Rate for Payer: Ohio Health Group PPO No Differential $21.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $50.53
Rate for Payer: PHCS Commercial $156.48
Rate for Payer: United Healthcare All Payer $143.44
Service Code HCPCS 83992
Hospital Charge Code 30000467
Hospital Revenue Code 300
Min. Negotiated Rate $20.17
Max. Negotiated Rate $162.24
Rate for Payer: Aetna Commercial $130.13
Rate for Payer: Anthem Medicaid $20.17
Rate for Payer: Anthem POS/PPO/Traditional $135.71
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 $20.17
Rate for Payer: Kentucky WC Medicaid $20.37
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: Molina Healthcare Medicaid $20.57
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 83992
Hospital Charge Code 30000467
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 81314
Hospital Charge Code 30002002
Hospital Revenue Code 300
Min. Negotiated Rate $149.33
Max. Negotiated Rate $1,102.74
Rate for Payer: Aetna Commercial $884.49
Rate for Payer: Anthem Medicaid $329.51
Rate for Payer: Anthem Medicare Advantage/PPO $329.51
Rate for Payer: Anthem POS/PPO/Traditional $922.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $461.31
Rate for Payer: CareSource Just4Me Medicare $329.51
Rate for Payer: Cash Price $574.34
Rate for Payer: Cash Price $574.34
Rate for Payer: Cigna Commercial $953.41
Rate for Payer: First Health Commercial $1,091.26
Rate for Payer: Humana Commercial $976.39
Rate for Payer: Humana KY Medicaid $329.51
Rate for Payer: Humana Medicare Advantage $329.51
Rate for Payer: Kentucky WC Medicaid $332.81
Rate for Payer: Medical Mutual Of Ohio HMO $941.93
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $847.73
Rate for Payer: Molina Healthcare Benefit Exchange $395.41
Rate for Payer: Molina Healthcare Medicaid $336.10
Rate for Payer: Ohio Health Choice Commercial $1,010.85
Rate for Payer: Ohio Health Group HMO $861.52
Rate for Payer: Ohio Health Group PPO Differential $229.74
Rate for Payer: Ohio Health Group PPO No Differential $149.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $356.09
Rate for Payer: PHCS Commercial $1,102.74
Rate for Payer: United Healthcare All Payer $1,010.85