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Service Code HCPCS 84120
Hospital Charge Code 30000479
Hospital Revenue Code 300
Min. Negotiated Rate $14.71
Max. Negotiated Rate $147.84
Rate for Payer: Aetna Commercial $118.58
Rate for Payer: Anthem Medicaid $14.71
Rate for Payer: Anthem Medicare Advantage/PPO $14.71
Rate for Payer: Anthem POS/PPO/Traditional $123.66
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $20.59
Rate for Payer: CareSource Just4Me Medicare $14.71
Rate for Payer: Cash Price $77.00
Rate for Payer: Cash Price $77.00
Rate for Payer: Cigna Commercial $127.82
Rate for Payer: First Health Commercial $146.30
Rate for Payer: Humana Commercial $130.90
Rate for Payer: Humana KY Medicaid $14.71
Rate for Payer: Humana Medicare Advantage $14.71
Rate for Payer: Kentucky WC Medicaid $14.86
Rate for Payer: Medical Mutual Of Ohio HMO $126.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $113.65
Rate for Payer: Molina Healthcare Benefit Exchange $17.65
Rate for Payer: Molina Healthcare Medicaid $15.00
Rate for Payer: Ohio Health Choice Commercial $135.52
Rate for Payer: Ohio Health Group HMO $115.50
Rate for Payer: Ohio Health Group PPO Differential $30.80
Rate for Payer: Ohio Health Group PPO No Differential $20.02
Rate for Payer: Ohio Health Group PPO SOMC Employees $47.74
Rate for Payer: PHCS Commercial $147.84
Rate for Payer: United Healthcare All Payer $135.52
Service Code HCPCS 84120
Hospital Charge Code 30000479
Hospital Revenue Code 300
Min. Negotiated Rate $20.02
Max. Negotiated Rate $147.84
Rate for Payer: Aetna Commercial $118.58
Rate for Payer: Anthem POS/PPO/Traditional $123.66
Rate for Payer: Cash Price $77.00
Rate for Payer: Cigna Commercial $127.82
Rate for Payer: First Health Commercial $146.30
Rate for Payer: Humana Commercial $130.90
Rate for Payer: Medical Mutual Of Ohio HMO $126.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $113.65
Rate for Payer: Molina Healthcare Benefit Exchange $46.20
Rate for Payer: Ohio Health Choice Commercial $135.52
Rate for Payer: Ohio Health Group HMO $115.50
Rate for Payer: Ohio Health Group PPO Differential $30.80
Rate for Payer: Ohio Health Group PPO No Differential $20.02
Rate for Payer: Ohio Health Group PPO SOMC Employees $47.74
Rate for Payer: PHCS Commercial $147.84
Rate for Payer: United Healthcare All Payer $135.52
Service Code HCPCS 84311
Hospital Charge Code 30000517
Hospital Revenue Code 301
Min. Negotiated Rate $18.59
Max. Negotiated Rate $137.28
Rate for Payer: Aetna Commercial $110.11
Rate for Payer: Anthem POS/PPO/Traditional $114.83
Rate for Payer: Cash Price $71.50
Rate for Payer: Cigna Commercial $118.69
Rate for Payer: First Health Commercial $135.85
Rate for Payer: Humana Commercial $121.55
Rate for Payer: Medical Mutual Of Ohio HMO $117.26
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $105.53
Rate for Payer: Molina Healthcare Benefit Exchange $42.90
Rate for Payer: Ohio Health Choice Commercial $125.84
Rate for Payer: Ohio Health Group HMO $107.25
Rate for Payer: Ohio Health Group PPO Differential $28.60
Rate for Payer: Ohio Health Group PPO No Differential $18.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $44.33
Rate for Payer: PHCS Commercial $137.28
Rate for Payer: United Healthcare All Payer $125.84
Service Code HCPCS 84311
Hospital Charge Code 30000517
Hospital Revenue Code 301
Min. Negotiated Rate $8.10
Max. Negotiated Rate $137.28
Rate for Payer: Aetna Commercial $110.11
Rate for Payer: Anthem Medicaid $8.10
Rate for Payer: Anthem Medicare Advantage/PPO $8.10
Rate for Payer: Anthem POS/PPO/Traditional $114.83
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $11.34
Rate for Payer: CareSource Just4Me Medicare $8.10
Rate for Payer: Cash Price $71.50
Rate for Payer: Cash Price $71.50
Rate for Payer: Cigna Commercial $118.69
Rate for Payer: First Health Commercial $135.85
Rate for Payer: Humana Commercial $121.55
Rate for Payer: Humana KY Medicaid $8.10
Rate for Payer: Humana Medicare Advantage $8.10
Rate for Payer: Kentucky WC Medicaid $8.18
Rate for Payer: Medical Mutual Of Ohio HMO $117.26
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $105.53
Rate for Payer: Molina Healthcare Benefit Exchange $9.72
Rate for Payer: Molina Healthcare Medicaid $8.26
Rate for Payer: Ohio Health Choice Commercial $125.84
Rate for Payer: Ohio Health Group HMO $107.25
Rate for Payer: Ohio Health Group PPO Differential $28.60
Rate for Payer: Ohio Health Group PPO No Differential $18.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $44.33
Rate for Payer: PHCS Commercial $137.28
Rate for Payer: United Healthcare All Payer $125.84
Service Code HCPCS 84999
Hospital Charge Code 30000563
Hospital Revenue Code 300
Min. Negotiated Rate $8.32
Max. Negotiated Rate $61.44
Rate for Payer: Aetna Commercial $49.28
Rate for Payer: Anthem Medicaid $22.01
Rate for Payer: Anthem POS/PPO/Traditional $51.39
Rate for Payer: Cash Price $32.00
Rate for Payer: Cigna Commercial $53.12
Rate for Payer: First Health Commercial $60.80
Rate for Payer: Humana Commercial $54.40
Rate for Payer: Humana KY Medicaid $22.01
Rate for Payer: Kentucky WC Medicaid $22.23
Rate for Payer: Medical Mutual Of Ohio HMO $52.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.23
Rate for Payer: Molina Healthcare Benefit Exchange $19.20
Rate for Payer: Molina Healthcare Medicaid $22.45
Rate for Payer: Ohio Health Choice Commercial $56.32
Rate for Payer: Ohio Health Group HMO $48.00
Rate for Payer: Ohio Health Group PPO Differential $12.80
Rate for Payer: Ohio Health Group PPO No Differential $8.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $19.84
Rate for Payer: PHCS Commercial $61.44
Rate for Payer: United Healthcare All Payer $56.32
Service Code HCPCS 84999
Hospital Charge Code 30000563
Hospital Revenue Code 300
Min. Negotiated Rate $8.32
Max. Negotiated Rate $61.44
Rate for Payer: Aetna Commercial $49.28
Rate for Payer: Anthem POS/PPO/Traditional $51.39
Rate for Payer: Cash Price $32.00
Rate for Payer: Cigna Commercial $53.12
Rate for Payer: First Health Commercial $60.80
Rate for Payer: Humana Commercial $54.40
Rate for Payer: Medical Mutual Of Ohio HMO $52.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $47.23
Rate for Payer: Molina Healthcare Benefit Exchange $19.20
Rate for Payer: Ohio Health Choice Commercial $56.32
Rate for Payer: Ohio Health Group HMO $48.00
Rate for Payer: Ohio Health Group PPO Differential $12.80
Rate for Payer: Ohio Health Group PPO No Differential $8.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $19.84
Rate for Payer: PHCS Commercial $61.44
Rate for Payer: United Healthcare All Payer $56.32
Service Code HCPCS G0480
Hospital Charge Code 30000160
Hospital Revenue Code 300
Min. Negotiated Rate $3.38
Max. Negotiated Rate $24.96
Rate for Payer: Aetna Commercial $20.02
Rate for Payer: Anthem POS/PPO/Traditional $20.88
Rate for Payer: Cash Price $13.00
Rate for Payer: Cigna Commercial $21.58
Rate for Payer: First Health Commercial $24.70
Rate for Payer: Humana Commercial $22.10
Rate for Payer: Medical Mutual Of Ohio HMO $21.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $19.19
Rate for Payer: Molina Healthcare Benefit Exchange $7.80
Rate for Payer: Ohio Health Choice Commercial $22.88
Rate for Payer: Ohio Health Group HMO $19.50
Rate for Payer: Ohio Health Group PPO Differential $5.20
Rate for Payer: Ohio Health Group PPO No Differential $3.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.06
Rate for Payer: PHCS Commercial $24.96
Rate for Payer: United Healthcare All Payer $22.88
Service Code HCPCS G0480
Hospital Charge Code 30000160
Hospital Revenue Code 300
Min. Negotiated Rate $3.38
Max. Negotiated Rate $160.20
Rate for Payer: Aetna Commercial $20.02
Rate for Payer: Anthem Medicaid $114.43
Rate for Payer: Anthem Medicare Advantage/PPO $114.43
Rate for Payer: Anthem POS/PPO/Traditional $20.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $160.20
Rate for Payer: CareSource Just4Me Medicare $114.43
Rate for Payer: Cash Price $13.00
Rate for Payer: Cash Price $13.00
Rate for Payer: Cigna Commercial $21.58
Rate for Payer: First Health Commercial $24.70
Rate for Payer: Humana Commercial $22.10
Rate for Payer: Humana KY Medicaid $114.43
Rate for Payer: Humana Medicare Advantage $114.43
Rate for Payer: Kentucky WC Medicaid $115.57
Rate for Payer: Medical Mutual Of Ohio HMO $21.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $19.19
Rate for Payer: Molina Healthcare Benefit Exchange $137.32
Rate for Payer: Molina Healthcare Medicaid $116.72
Rate for Payer: Ohio Health Choice Commercial $22.88
Rate for Payer: Ohio Health Group HMO $19.50
Rate for Payer: Ohio Health Group PPO Differential $5.20
Rate for Payer: Ohio Health Group PPO No Differential $3.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.06
Rate for Payer: PHCS Commercial $24.96
Rate for Payer: United Healthcare All Payer $22.88
Service Code HCPCS G0480
Hospital Charge Code 30000161
Hospital Revenue Code 300
Min. Negotiated Rate $3.38
Max. Negotiated Rate $24.96
Rate for Payer: Aetna Commercial $20.02
Rate for Payer: Anthem POS/PPO/Traditional $20.88
Rate for Payer: Cash Price $13.00
Rate for Payer: Cigna Commercial $21.58
Rate for Payer: First Health Commercial $24.70
Rate for Payer: Humana Commercial $22.10
Rate for Payer: Medical Mutual Of Ohio HMO $21.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $19.19
Rate for Payer: Molina Healthcare Benefit Exchange $7.80
Rate for Payer: Ohio Health Choice Commercial $22.88
Rate for Payer: Ohio Health Group HMO $19.50
Rate for Payer: Ohio Health Group PPO Differential $5.20
Rate for Payer: Ohio Health Group PPO No Differential $3.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.06
Rate for Payer: PHCS Commercial $24.96
Rate for Payer: United Healthcare All Payer $22.88
Service Code HCPCS G0480
Hospital Charge Code 30000161
Hospital Revenue Code 300
Min. Negotiated Rate $3.38
Max. Negotiated Rate $160.20
Rate for Payer: Aetna Commercial $20.02
Rate for Payer: Anthem Medicaid $114.43
Rate for Payer: Anthem Medicare Advantage/PPO $114.43
Rate for Payer: Anthem POS/PPO/Traditional $20.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $160.20
Rate for Payer: CareSource Just4Me Medicare $114.43
Rate for Payer: Cash Price $13.00
Rate for Payer: Cash Price $13.00
Rate for Payer: Cigna Commercial $21.58
Rate for Payer: First Health Commercial $24.70
Rate for Payer: Humana Commercial $22.10
Rate for Payer: Humana KY Medicaid $114.43
Rate for Payer: Humana Medicare Advantage $114.43
Rate for Payer: Kentucky WC Medicaid $115.57
Rate for Payer: Medical Mutual Of Ohio HMO $21.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $19.19
Rate for Payer: Molina Healthcare Benefit Exchange $137.32
Rate for Payer: Molina Healthcare Medicaid $116.72
Rate for Payer: Ohio Health Choice Commercial $22.88
Rate for Payer: Ohio Health Group HMO $19.50
Rate for Payer: Ohio Health Group PPO Differential $5.20
Rate for Payer: Ohio Health Group PPO No Differential $3.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.06
Rate for Payer: PHCS Commercial $24.96
Rate for Payer: United Healthcare All Payer $22.88
Service Code HCPCS 80366
Hospital Charge Code 30000161
Hospital Revenue Code 300
Min. Negotiated Rate $9.10
Max. Negotiated Rate $26.00
Rate for Payer: Buckeye Medicare Advantage $26.00
Rate for Payer: Cash Price $13.00
Rate for Payer: Multiplan PHCS $15.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $18.20
Rate for Payer: UHCCP Medicaid $9.10
Service Code HCPCS 80188
Hospital Charge Code 30000045
Hospital Revenue Code 300
Min. Negotiated Rate $9.88
Max. Negotiated Rate $72.96
Rate for Payer: Aetna Commercial $58.52
Rate for Payer: Anthem POS/PPO/Traditional $61.03
Rate for Payer: Cash Price $38.00
Rate for Payer: Cigna Commercial $63.08
Rate for Payer: First Health Commercial $72.20
Rate for Payer: Humana Commercial $64.60
Rate for Payer: Medical Mutual Of Ohio HMO $62.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $56.09
Rate for Payer: Molina Healthcare Benefit Exchange $22.80
Rate for Payer: Ohio Health Choice Commercial $66.88
Rate for Payer: Ohio Health Group HMO $57.00
Rate for Payer: Ohio Health Group PPO Differential $15.20
Rate for Payer: Ohio Health Group PPO No Differential $9.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $23.56
Rate for Payer: PHCS Commercial $72.96
Rate for Payer: United Healthcare All Payer $66.88
Service Code HCPCS 80188
Hospital Charge Code 30000045
Hospital Revenue Code 300
Min. Negotiated Rate $9.88
Max. Negotiated Rate $72.96
Rate for Payer: Aetna Commercial $58.52
Rate for Payer: Anthem Medicaid $16.59
Rate for Payer: Anthem Medicare Advantage/PPO $16.59
Rate for Payer: Anthem POS/PPO/Traditional $61.03
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $23.23
Rate for Payer: CareSource Just4Me Medicare $16.59
Rate for Payer: Cash Price $38.00
Rate for Payer: Cash Price $38.00
Rate for Payer: Cigna Commercial $63.08
Rate for Payer: First Health Commercial $72.20
Rate for Payer: Humana Commercial $64.60
Rate for Payer: Humana KY Medicaid $16.59
Rate for Payer: Humana Medicare Advantage $16.59
Rate for Payer: Kentucky WC Medicaid $16.76
Rate for Payer: Medical Mutual Of Ohio HMO $62.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $56.09
Rate for Payer: Molina Healthcare Benefit Exchange $19.91
Rate for Payer: Molina Healthcare Medicaid $16.92
Rate for Payer: Ohio Health Choice Commercial $66.88
Rate for Payer: Ohio Health Group HMO $57.00
Rate for Payer: Ohio Health Group PPO Differential $15.20
Rate for Payer: Ohio Health Group PPO No Differential $9.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $23.56
Rate for Payer: PHCS Commercial $72.96
Rate for Payer: United Healthcare All Payer $66.88
Service Code HCPCS 84206
Hospital Charge Code 30000503
Hospital Revenue Code 300
Min. Negotiated Rate $35.75
Max. Negotiated Rate $264.00
Rate for Payer: Aetna Commercial $211.75
Rate for Payer: Anthem POS/PPO/Traditional $220.82
Rate for Payer: Cash Price $137.50
Rate for Payer: Cigna Commercial $228.25
Rate for Payer: First Health Commercial $261.25
Rate for Payer: Humana Commercial $233.75
Rate for Payer: Medical Mutual Of Ohio HMO $225.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $202.95
Rate for Payer: Molina Healthcare Benefit Exchange $82.50
Rate for Payer: Ohio Health Choice Commercial $242.00
Rate for Payer: Ohio Health Group HMO $206.25
Rate for Payer: Ohio Health Group PPO Differential $55.00
Rate for Payer: Ohio Health Group PPO No Differential $35.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $85.25
Rate for Payer: PHCS Commercial $264.00
Rate for Payer: United Healthcare All Payer $242.00
Service Code HCPCS 84206
Hospital Charge Code 30000503
Hospital Revenue Code 300
Min. Negotiated Rate $26.69
Max. Negotiated Rate $264.00
Rate for Payer: Aetna Commercial $211.75
Rate for Payer: Anthem Medicaid $26.69
Rate for Payer: Anthem Medicare Advantage/PPO $26.69
Rate for Payer: Anthem POS/PPO/Traditional $220.82
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $37.37
Rate for Payer: CareSource Just4Me Medicare $26.69
Rate for Payer: Cash Price $137.50
Rate for Payer: Cash Price $137.50
Rate for Payer: Cigna Commercial $228.25
Rate for Payer: First Health Commercial $261.25
Rate for Payer: Humana Commercial $233.75
Rate for Payer: Humana KY Medicaid $26.69
Rate for Payer: Humana Medicare Advantage $26.69
Rate for Payer: Kentucky WC Medicaid $26.96
Rate for Payer: Medical Mutual Of Ohio HMO $225.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $202.95
Rate for Payer: Molina Healthcare Benefit Exchange $32.03
Rate for Payer: Molina Healthcare Medicaid $27.22
Rate for Payer: Ohio Health Choice Commercial $242.00
Rate for Payer: Ohio Health Group HMO $206.25
Rate for Payer: Ohio Health Group PPO Differential $55.00
Rate for Payer: Ohio Health Group PPO No Differential $35.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $85.25
Rate for Payer: PHCS Commercial $264.00
Rate for Payer: United Healthcare All Payer $242.00
Service Code HCPCS G0480
Hospital Charge Code 30000162
Hospital Revenue Code 300
Min. Negotiated Rate $3.38
Max. Negotiated Rate $160.20
Rate for Payer: Aetna Commercial $20.02
Rate for Payer: Anthem Medicaid $114.43
Rate for Payer: Anthem Medicare Advantage/PPO $114.43
Rate for Payer: Anthem POS/PPO/Traditional $20.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $160.20
Rate for Payer: CareSource Just4Me Medicare $114.43
Rate for Payer: Cash Price $13.00
Rate for Payer: Cash Price $13.00
Rate for Payer: Cigna Commercial $21.58
Rate for Payer: First Health Commercial $24.70
Rate for Payer: Humana Commercial $22.10
Rate for Payer: Humana KY Medicaid $114.43
Rate for Payer: Humana Medicare Advantage $114.43
Rate for Payer: Kentucky WC Medicaid $115.57
Rate for Payer: Medical Mutual Of Ohio HMO $21.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $19.19
Rate for Payer: Molina Healthcare Benefit Exchange $137.32
Rate for Payer: Molina Healthcare Medicaid $116.72
Rate for Payer: Ohio Health Choice Commercial $22.88
Rate for Payer: Ohio Health Group HMO $19.50
Rate for Payer: Ohio Health Group PPO Differential $5.20
Rate for Payer: Ohio Health Group PPO No Differential $3.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.06
Rate for Payer: PHCS Commercial $24.96
Rate for Payer: United Healthcare All Payer $22.88
Service Code HCPCS 80367
Hospital Charge Code 30000162
Hospital Revenue Code 300
Min. Negotiated Rate $9.10
Max. Negotiated Rate $26.00
Rate for Payer: Buckeye Medicare Advantage $26.00
Rate for Payer: Cash Price $13.00
Rate for Payer: Multiplan PHCS $15.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $18.20
Rate for Payer: UHCCP Medicaid $9.10
Service Code HCPCS G0480
Hospital Charge Code 30000162
Hospital Revenue Code 300
Min. Negotiated Rate $3.38
Max. Negotiated Rate $24.96
Rate for Payer: Aetna Commercial $20.02
Rate for Payer: Anthem POS/PPO/Traditional $20.88
Rate for Payer: Cash Price $13.00
Rate for Payer: Cigna Commercial $21.58
Rate for Payer: First Health Commercial $24.70
Rate for Payer: Humana Commercial $22.10
Rate for Payer: Medical Mutual Of Ohio HMO $21.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $19.19
Rate for Payer: Molina Healthcare Benefit Exchange $7.80
Rate for Payer: Ohio Health Choice Commercial $22.88
Rate for Payer: Ohio Health Group HMO $19.50
Rate for Payer: Ohio Health Group PPO Differential $5.20
Rate for Payer: Ohio Health Group PPO No Differential $3.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $8.06
Rate for Payer: PHCS Commercial $24.96
Rate for Payer: United Healthcare All Payer $22.88
Service Code HCPCS 80299
Hospital Charge Code 30000055
Hospital Revenue Code 300
Min. Negotiated Rate $24.31
Max. Negotiated Rate $179.52
Rate for Payer: Aetna Commercial $143.99
Rate for Payer: Anthem POS/PPO/Traditional $150.16
Rate for Payer: Cash Price $93.50
Rate for Payer: Cigna Commercial $155.21
Rate for Payer: First Health Commercial $177.65
Rate for Payer: Humana Commercial $158.95
Rate for Payer: Medical Mutual Of Ohio HMO $153.34
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $138.01
Rate for Payer: Molina Healthcare Benefit Exchange $56.10
Rate for Payer: Ohio Health Choice Commercial $164.56
Rate for Payer: Ohio Health Group HMO $140.25
Rate for Payer: Ohio Health Group PPO Differential $37.40
Rate for Payer: Ohio Health Group PPO No Differential $24.31
Rate for Payer: Ohio Health Group PPO SOMC Employees $57.97
Rate for Payer: PHCS Commercial $179.52
Rate for Payer: United Healthcare All Payer $164.56
Service Code HCPCS 80299
Hospital Charge Code 30000055
Hospital Revenue Code 300
Min. Negotiated Rate $18.64
Max. Negotiated Rate $179.52
Rate for Payer: Aetna Commercial $143.99
Rate for Payer: Anthem Medicaid $18.64
Rate for Payer: Anthem Medicare Advantage/PPO $18.64
Rate for Payer: Anthem POS/PPO/Traditional $150.16
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $26.10
Rate for Payer: CareSource Just4Me Medicare $18.64
Rate for Payer: Cash Price $93.50
Rate for Payer: Cash Price $93.50
Rate for Payer: Cigna Commercial $155.21
Rate for Payer: First Health Commercial $177.65
Rate for Payer: Humana Commercial $158.95
Rate for Payer: Humana KY Medicaid $18.64
Rate for Payer: Humana Medicare Advantage $18.64
Rate for Payer: Kentucky WC Medicaid $18.83
Rate for Payer: Medical Mutual Of Ohio HMO $153.34
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $138.01
Rate for Payer: Molina Healthcare Benefit Exchange $22.37
Rate for Payer: Molina Healthcare Medicaid $19.01
Rate for Payer: Ohio Health Choice Commercial $164.56
Rate for Payer: Ohio Health Group HMO $140.25
Rate for Payer: Ohio Health Group PPO Differential $37.40
Rate for Payer: Ohio Health Group PPO No Differential $24.31
Rate for Payer: Ohio Health Group PPO SOMC Employees $57.97
Rate for Payer: PHCS Commercial $179.52
Rate for Payer: United Healthcare All Payer $164.56
Service Code HCPCS 84066
Hospital Charge Code 30000470
Hospital Revenue Code 300
Min. Negotiated Rate $7.80
Max. Negotiated Rate $57.60
Rate for Payer: Aetna Commercial $46.20
Rate for Payer: Anthem Medicaid $9.66
Rate for Payer: Anthem Medicare Advantage/PPO $9.66
Rate for Payer: Anthem POS/PPO/Traditional $48.18
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $13.52
Rate for Payer: CareSource Just4Me Medicare $9.66
Rate for Payer: Cash Price $30.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $49.80
Rate for Payer: First Health Commercial $57.00
Rate for Payer: Humana Commercial $51.00
Rate for Payer: Humana KY Medicaid $9.66
Rate for Payer: Humana Medicare Advantage $9.66
Rate for Payer: Kentucky WC Medicaid $9.76
Rate for Payer: Medical Mutual Of Ohio HMO $49.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $44.28
Rate for Payer: Molina Healthcare Benefit Exchange $11.59
Rate for Payer: Molina Healthcare Medicaid $9.85
Rate for Payer: Ohio Health Choice Commercial $52.80
Rate for Payer: Ohio Health Group HMO $45.00
Rate for Payer: Ohio Health Group PPO Differential $12.00
Rate for Payer: Ohio Health Group PPO No Differential $7.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $18.60
Rate for Payer: PHCS Commercial $57.60
Rate for Payer: United Healthcare All Payer $52.80
Service Code HCPCS 84066
Hospital Charge Code 30000470
Hospital Revenue Code 300
Min. Negotiated Rate $7.80
Max. Negotiated Rate $57.60
Rate for Payer: Aetna Commercial $46.20
Rate for Payer: Anthem POS/PPO/Traditional $48.18
Rate for Payer: Cash Price $30.00
Rate for Payer: Cigna Commercial $49.80
Rate for Payer: First Health Commercial $57.00
Rate for Payer: Humana Commercial $51.00
Rate for Payer: Medical Mutual Of Ohio HMO $49.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $44.28
Rate for Payer: Molina Healthcare Benefit Exchange $18.00
Rate for Payer: Ohio Health Choice Commercial $52.80
Rate for Payer: Ohio Health Group HMO $45.00
Rate for Payer: Ohio Health Group PPO Differential $12.00
Rate for Payer: Ohio Health Group PPO No Differential $7.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $18.60
Rate for Payer: PHCS Commercial $57.60
Rate for Payer: United Healthcare All Payer $52.80
Service Code HCPCS 85302
Hospital Charge Code 30000590
Hospital Revenue Code 300
Min. Negotiated Rate $48.10
Max. Negotiated Rate $355.20
Rate for Payer: Aetna Commercial $284.90
Rate for Payer: Anthem POS/PPO/Traditional $297.11
Rate for Payer: Cash Price $185.00
Rate for Payer: Cigna Commercial $307.10
Rate for Payer: First Health Commercial $351.50
Rate for Payer: Humana Commercial $314.50
Rate for Payer: Medical Mutual Of Ohio HMO $303.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $273.06
Rate for Payer: Molina Healthcare Benefit Exchange $111.00
Rate for Payer: Ohio Health Choice Commercial $325.60
Rate for Payer: Ohio Health Group HMO $277.50
Rate for Payer: Ohio Health Group PPO Differential $74.00
Rate for Payer: Ohio Health Group PPO No Differential $48.10
Rate for Payer: Ohio Health Group PPO SOMC Employees $114.70
Rate for Payer: PHCS Commercial $355.20
Rate for Payer: United Healthcare All Payer $325.60
Service Code HCPCS 85302
Hospital Charge Code 30000590
Hospital Revenue Code 300
Min. Negotiated Rate $12.01
Max. Negotiated Rate $355.20
Rate for Payer: Aetna Commercial $284.90
Rate for Payer: Anthem Medicaid $12.01
Rate for Payer: Anthem Medicare Advantage/PPO $12.01
Rate for Payer: Anthem POS/PPO/Traditional $297.11
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.81
Rate for Payer: CareSource Just4Me Medicare $12.01
Rate for Payer: Cash Price $185.00
Rate for Payer: Cash Price $185.00
Rate for Payer: Cigna Commercial $307.10
Rate for Payer: First Health Commercial $351.50
Rate for Payer: Humana Commercial $314.50
Rate for Payer: Humana KY Medicaid $12.01
Rate for Payer: Humana Medicare Advantage $12.01
Rate for Payer: Kentucky WC Medicaid $12.13
Rate for Payer: Medical Mutual Of Ohio HMO $303.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $273.06
Rate for Payer: Molina Healthcare Benefit Exchange $14.41
Rate for Payer: Molina Healthcare Medicaid $12.25
Rate for Payer: Ohio Health Choice Commercial $325.60
Rate for Payer: Ohio Health Group HMO $277.50
Rate for Payer: Ohio Health Group PPO Differential $74.00
Rate for Payer: Ohio Health Group PPO No Differential $48.10
Rate for Payer: Ohio Health Group PPO SOMC Employees $114.70
Rate for Payer: PHCS Commercial $355.20
Rate for Payer: United Healthcare All Payer $325.60
Service Code HCPCS 84166
Hospital Charge Code 30000497
Hospital Revenue Code 300
Min. Negotiated Rate $17.42
Max. Negotiated Rate $128.64
Rate for Payer: Aetna Commercial $103.18
Rate for Payer: Anthem POS/PPO/Traditional $107.60
Rate for Payer: Cash Price $67.00
Rate for Payer: Cigna Commercial $111.22
Rate for Payer: First Health Commercial $127.30
Rate for Payer: Humana Commercial $113.90
Rate for Payer: Medical Mutual Of Ohio HMO $109.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $98.89
Rate for Payer: Molina Healthcare Benefit Exchange $40.20
Rate for Payer: Ohio Health Choice Commercial $117.92
Rate for Payer: Ohio Health Group HMO $100.50
Rate for Payer: Ohio Health Group PPO Differential $26.80
Rate for Payer: Ohio Health Group PPO No Differential $17.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $41.54
Rate for Payer: PHCS Commercial $128.64
Rate for Payer: United Healthcare All Payer $117.92