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Service Code HCPCS 85385
Hospital Charge Code 30001796
Hospital Revenue Code 300
Min. Negotiated Rate $24.96
Max. Negotiated Rate $184.32
Rate for Payer: Aetna Commercial $147.84
Rate for Payer: Anthem POS/PPO/Traditional $154.18
Rate for Payer: Cash Price $96.00
Rate for Payer: Cigna Commercial $159.36
Rate for Payer: First Health Commercial $182.40
Rate for Payer: Humana Commercial $163.20
Rate for Payer: Medical Mutual Of Ohio HMO $157.44
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $141.70
Rate for Payer: Molina Healthcare Benefit Exchange $57.60
Rate for Payer: Ohio Health Choice Commercial $168.96
Rate for Payer: Ohio Health Group HMO $144.00
Rate for Payer: Ohio Health Group PPO Differential $38.40
Rate for Payer: Ohio Health Group PPO No Differential $24.96
Rate for Payer: Ohio Health Group PPO SOMC Employees $59.52
Rate for Payer: PHCS Commercial $184.32
Rate for Payer: United Healthcare All Payer $168.96
Service Code HCPCS 85385
Hospital Charge Code 30001796
Hospital Revenue Code 300
Min. Negotiated Rate $14.46
Max. Negotiated Rate $184.32
Rate for Payer: Aetna Commercial $147.84
Rate for Payer: Anthem Medicaid $14.46
Rate for Payer: Anthem Medicare Advantage/PPO $14.46
Rate for Payer: Anthem POS/PPO/Traditional $154.18
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $20.24
Rate for Payer: CareSource Just4Me Medicare $14.46
Rate for Payer: Cash Price $96.00
Rate for Payer: Cash Price $96.00
Rate for Payer: Cigna Commercial $159.36
Rate for Payer: First Health Commercial $182.40
Rate for Payer: Humana Commercial $163.20
Rate for Payer: Humana KY Medicaid $14.46
Rate for Payer: Humana Medicare Advantage $14.46
Rate for Payer: Kentucky WC Medicaid $14.60
Rate for Payer: Medical Mutual Of Ohio HMO $157.44
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $141.70
Rate for Payer: Molina Healthcare Benefit Exchange $17.35
Rate for Payer: Molina Healthcare Medicaid $14.75
Rate for Payer: Ohio Health Choice Commercial $168.96
Rate for Payer: Ohio Health Group HMO $144.00
Rate for Payer: Ohio Health Group PPO Differential $38.40
Rate for Payer: Ohio Health Group PPO No Differential $24.96
Rate for Payer: Ohio Health Group PPO SOMC Employees $59.52
Rate for Payer: PHCS Commercial $184.32
Rate for Payer: United Healthcare All Payer $168.96
Service Code HCPCS 85385
Hospital Charge Code 30001796
Hospital Revenue Code 300
Min. Negotiated Rate $7.44
Max. Negotiated Rate $192.00
Rate for Payer: Aetna Commercial $18.31
Rate for Payer: Buckeye Medicare Advantage $192.00
Rate for Payer: Cash Price $96.00
Rate for Payer: Cash Price $96.00
Rate for Payer: Cigna Commercial $7.44
Rate for Payer: Healthspan PPO $8.90
Rate for Payer: Multiplan PHCS $115.20
Rate for Payer: Ohio Health Choice Preferred Health Choice $134.40
Rate for Payer: UHCCP Medicaid $67.20
Rate for Payer: Wellcare CHIP/Medicaid $8.68
Service Code HCPCS 85611
Hospital Charge Code 30000621
Hospital Revenue Code 300
Min. Negotiated Rate $3.94
Max. Negotiated Rate $160.32
Rate for Payer: Aetna Commercial $128.59
Rate for Payer: Anthem Medicaid $3.94
Rate for Payer: Anthem Medicare Advantage/PPO $3.94
Rate for Payer: Anthem POS/PPO/Traditional $134.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $5.52
Rate for Payer: CareSource Just4Me Medicare $3.94
Rate for Payer: Cash Price $83.50
Rate for Payer: Cash Price $83.50
Rate for Payer: Cigna Commercial $138.61
Rate for Payer: First Health Commercial $158.65
Rate for Payer: Humana Commercial $141.95
Rate for Payer: Humana KY Medicaid $3.94
Rate for Payer: Humana Medicare Advantage $3.94
Rate for Payer: Kentucky WC Medicaid $3.98
Rate for Payer: Medical Mutual Of Ohio HMO $136.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $123.25
Rate for Payer: Molina Healthcare Benefit Exchange $4.73
Rate for Payer: Molina Healthcare Medicaid $4.02
Rate for Payer: Ohio Health Choice Commercial $146.96
Rate for Payer: Ohio Health Group HMO $125.25
Rate for Payer: Ohio Health Group PPO Differential $33.40
Rate for Payer: Ohio Health Group PPO No Differential $21.71
Rate for Payer: Ohio Health Group PPO SOMC Employees $51.77
Rate for Payer: PHCS Commercial $160.32
Rate for Payer: United Healthcare All Payer $146.96
Service Code HCPCS 85611
Hospital Charge Code 30000621
Hospital Revenue Code 300
Min. Negotiated Rate $21.71
Max. Negotiated Rate $160.32
Rate for Payer: Aetna Commercial $128.59
Rate for Payer: Anthem POS/PPO/Traditional $134.10
Rate for Payer: Cash Price $83.50
Rate for Payer: Cigna Commercial $138.61
Rate for Payer: First Health Commercial $158.65
Rate for Payer: Humana Commercial $141.95
Rate for Payer: Medical Mutual Of Ohio HMO $136.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $123.25
Rate for Payer: Molina Healthcare Benefit Exchange $50.10
Rate for Payer: Ohio Health Choice Commercial $146.96
Rate for Payer: Ohio Health Group HMO $125.25
Rate for Payer: Ohio Health Group PPO Differential $33.40
Rate for Payer: Ohio Health Group PPO No Differential $21.71
Rate for Payer: Ohio Health Group PPO SOMC Employees $51.77
Rate for Payer: PHCS Commercial $160.32
Rate for Payer: United Healthcare All Payer $146.96
Service Code HCPCS 85611
Hospital Charge Code 30000622
Hospital Revenue Code 300
Min. Negotiated Rate $32.24
Max. Negotiated Rate $238.08
Rate for Payer: Aetna Commercial $190.96
Rate for Payer: Anthem POS/PPO/Traditional $199.14
Rate for Payer: Cash Price $124.00
Rate for Payer: Cigna Commercial $205.84
Rate for Payer: First Health Commercial $235.60
Rate for Payer: Humana Commercial $210.80
Rate for Payer: Medical Mutual Of Ohio HMO $203.36
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $183.02
Rate for Payer: Molina Healthcare Benefit Exchange $74.40
Rate for Payer: Ohio Health Choice Commercial $218.24
Rate for Payer: Ohio Health Group HMO $186.00
Rate for Payer: Ohio Health Group PPO Differential $49.60
Rate for Payer: Ohio Health Group PPO No Differential $32.24
Rate for Payer: Ohio Health Group PPO SOMC Employees $76.88
Rate for Payer: PHCS Commercial $238.08
Rate for Payer: United Healthcare All Payer $218.24
Service Code HCPCS 85611
Hospital Charge Code 30000622
Hospital Revenue Code 300
Min. Negotiated Rate $3.94
Max. Negotiated Rate $238.08
Rate for Payer: Aetna Commercial $190.96
Rate for Payer: Anthem Medicaid $3.94
Rate for Payer: Anthem Medicare Advantage/PPO $3.94
Rate for Payer: Anthem POS/PPO/Traditional $199.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $5.52
Rate for Payer: CareSource Just4Me Medicare $3.94
Rate for Payer: Cash Price $124.00
Rate for Payer: Cash Price $124.00
Rate for Payer: Cigna Commercial $205.84
Rate for Payer: First Health Commercial $235.60
Rate for Payer: Humana Commercial $210.80
Rate for Payer: Humana KY Medicaid $3.94
Rate for Payer: Humana Medicare Advantage $3.94
Rate for Payer: Kentucky WC Medicaid $3.98
Rate for Payer: Medical Mutual Of Ohio HMO $203.36
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $183.02
Rate for Payer: Molina Healthcare Benefit Exchange $4.73
Rate for Payer: Molina Healthcare Medicaid $4.02
Rate for Payer: Ohio Health Choice Commercial $218.24
Rate for Payer: Ohio Health Group HMO $186.00
Rate for Payer: Ohio Health Group PPO Differential $49.60
Rate for Payer: Ohio Health Group PPO No Differential $32.24
Rate for Payer: Ohio Health Group PPO SOMC Employees $76.88
Rate for Payer: PHCS Commercial $238.08
Rate for Payer: United Healthcare All Payer $218.24
Service Code HCPCS 84220
Hospital Charge Code 30000505
Hospital Revenue Code 300
Min. Negotiated Rate $26.52
Max. Negotiated Rate $195.84
Rate for Payer: Aetna Commercial $157.08
Rate for Payer: Anthem POS/PPO/Traditional $163.81
Rate for Payer: Cash Price $102.00
Rate for Payer: Cigna Commercial $169.32
Rate for Payer: First Health Commercial $193.80
Rate for Payer: Humana Commercial $173.40
Rate for Payer: Medical Mutual Of Ohio HMO $167.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $150.55
Rate for Payer: Molina Healthcare Benefit Exchange $61.20
Rate for Payer: Ohio Health Choice Commercial $179.52
Rate for Payer: Ohio Health Group HMO $153.00
Rate for Payer: Ohio Health Group PPO Differential $40.80
Rate for Payer: Ohio Health Group PPO No Differential $26.52
Rate for Payer: Ohio Health Group PPO SOMC Employees $63.24
Rate for Payer: PHCS Commercial $195.84
Rate for Payer: United Healthcare All Payer $179.52
Service Code HCPCS 84220
Hospital Charge Code 30000505
Hospital Revenue Code 300
Min. Negotiated Rate $9.44
Max. Negotiated Rate $195.84
Rate for Payer: Aetna Commercial $157.08
Rate for Payer: Anthem Medicaid $9.44
Rate for Payer: Anthem Medicare Advantage/PPO $9.44
Rate for Payer: Anthem POS/PPO/Traditional $163.81
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $13.22
Rate for Payer: CareSource Just4Me Medicare $9.44
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cigna Commercial $169.32
Rate for Payer: First Health Commercial $193.80
Rate for Payer: Humana Commercial $173.40
Rate for Payer: Humana KY Medicaid $9.44
Rate for Payer: Humana Medicare Advantage $9.44
Rate for Payer: Kentucky WC Medicaid $9.53
Rate for Payer: Medical Mutual Of Ohio HMO $167.28
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $150.55
Rate for Payer: Molina Healthcare Benefit Exchange $11.33
Rate for Payer: Molina Healthcare Medicaid $9.63
Rate for Payer: Ohio Health Choice Commercial $179.52
Rate for Payer: Ohio Health Group HMO $153.00
Rate for Payer: Ohio Health Group PPO Differential $40.80
Rate for Payer: Ohio Health Group PPO No Differential $26.52
Rate for Payer: Ohio Health Group PPO SOMC Employees $63.24
Rate for Payer: PHCS Commercial $195.84
Rate for Payer: United Healthcare All Payer $179.52
Service Code HCPCS 86638
Hospital Charge Code 30001136
Hospital Revenue Code 300
Min. Negotiated Rate $16.64
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $38.40
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001136
Hospital Revenue Code 300
Min. Negotiated Rate $12.12
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem Medicaid $12.12
Rate for Payer: Anthem Medicare Advantage/PPO $12.12
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.97
Rate for Payer: CareSource Just4Me Medicare $12.12
Rate for Payer: Cash Price $64.00
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Humana KY Medicaid $12.12
Rate for Payer: Humana Medicare Advantage $12.12
Rate for Payer: Kentucky WC Medicaid $12.24
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $14.54
Rate for Payer: Molina Healthcare Medicaid $12.36
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001138
Hospital Revenue Code 300
Min. Negotiated Rate $12.12
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem Medicaid $12.12
Rate for Payer: Anthem Medicare Advantage/PPO $12.12
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.97
Rate for Payer: CareSource Just4Me Medicare $12.12
Rate for Payer: Cash Price $64.00
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Humana KY Medicaid $12.12
Rate for Payer: Humana Medicare Advantage $12.12
Rate for Payer: Kentucky WC Medicaid $12.24
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $14.54
Rate for Payer: Molina Healthcare Medicaid $12.36
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001138
Hospital Revenue Code 300
Min. Negotiated Rate $16.64
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $38.40
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001137
Hospital Revenue Code 300
Min. Negotiated Rate $16.64
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $38.40
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001137
Hospital Revenue Code 300
Min. Negotiated Rate $12.12
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem Medicaid $12.12
Rate for Payer: Anthem Medicare Advantage/PPO $12.12
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.97
Rate for Payer: CareSource Just4Me Medicare $12.12
Rate for Payer: Cash Price $64.00
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Humana KY Medicaid $12.12
Rate for Payer: Humana Medicare Advantage $12.12
Rate for Payer: Kentucky WC Medicaid $12.24
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $14.54
Rate for Payer: Molina Healthcare Medicaid $12.36
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001139
Hospital Revenue Code 300
Min. Negotiated Rate $16.64
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $38.40
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 86638
Hospital Charge Code 30001139
Hospital Revenue Code 300
Min. Negotiated Rate $12.12
Max. Negotiated Rate $122.88
Rate for Payer: Aetna Commercial $98.56
Rate for Payer: Anthem Medicaid $12.12
Rate for Payer: Anthem Medicare Advantage/PPO $12.12
Rate for Payer: Anthem POS/PPO/Traditional $102.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $16.97
Rate for Payer: CareSource Just4Me Medicare $12.12
Rate for Payer: Cash Price $64.00
Rate for Payer: Cash Price $64.00
Rate for Payer: Cigna Commercial $106.24
Rate for Payer: First Health Commercial $121.60
Rate for Payer: Humana Commercial $108.80
Rate for Payer: Humana KY Medicaid $12.12
Rate for Payer: Humana Medicare Advantage $12.12
Rate for Payer: Kentucky WC Medicaid $12.24
Rate for Payer: Medical Mutual Of Ohio HMO $104.96
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $94.46
Rate for Payer: Molina Healthcare Benefit Exchange $14.54
Rate for Payer: Molina Healthcare Medicaid $12.36
Rate for Payer: Ohio Health Choice Commercial $112.64
Rate for Payer: Ohio Health Group HMO $96.00
Rate for Payer: Ohio Health Group PPO Differential $25.60
Rate for Payer: Ohio Health Group PPO No Differential $16.64
Rate for Payer: Ohio Health Group PPO SOMC Employees $39.68
Rate for Payer: PHCS Commercial $122.88
Rate for Payer: United Healthcare All Payer $112.64
Service Code HCPCS 80194
Hospital Charge Code 30000046
Hospital Revenue Code 300
Min. Negotiated Rate $8.71
Max. Negotiated Rate $64.32
Rate for Payer: Aetna Commercial $51.59
Rate for Payer: Anthem POS/PPO/Traditional $53.80
Rate for Payer: Cash Price $33.50
Rate for Payer: Cigna Commercial $55.61
Rate for Payer: First Health Commercial $63.65
Rate for Payer: Humana Commercial $56.95
Rate for Payer: Medical Mutual Of Ohio HMO $54.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $49.45
Rate for Payer: Molina Healthcare Benefit Exchange $20.10
Rate for Payer: Ohio Health Choice Commercial $58.96
Rate for Payer: Ohio Health Group HMO $50.25
Rate for Payer: Ohio Health Group PPO Differential $13.40
Rate for Payer: Ohio Health Group PPO No Differential $8.71
Rate for Payer: Ohio Health Group PPO SOMC Employees $20.77
Rate for Payer: PHCS Commercial $64.32
Rate for Payer: United Healthcare All Payer $58.96
Service Code HCPCS 80194
Hospital Charge Code 30000046
Hospital Revenue Code 300
Min. Negotiated Rate $8.71
Max. Negotiated Rate $64.32
Rate for Payer: Aetna Commercial $51.59
Rate for Payer: Anthem Medicaid $14.60
Rate for Payer: Anthem Medicare Advantage/PPO $14.60
Rate for Payer: Anthem POS/PPO/Traditional $53.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $20.44
Rate for Payer: CareSource Just4Me Medicare $14.60
Rate for Payer: Cash Price $33.50
Rate for Payer: Cash Price $33.50
Rate for Payer: Cigna Commercial $55.61
Rate for Payer: First Health Commercial $63.65
Rate for Payer: Humana Commercial $56.95
Rate for Payer: Humana KY Medicaid $14.60
Rate for Payer: Humana Medicare Advantage $14.60
Rate for Payer: Kentucky WC Medicaid $14.75
Rate for Payer: Medical Mutual Of Ohio HMO $54.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $49.45
Rate for Payer: Molina Healthcare Benefit Exchange $17.52
Rate for Payer: Molina Healthcare Medicaid $14.89
Rate for Payer: Ohio Health Choice Commercial $58.96
Rate for Payer: Ohio Health Group HMO $50.25
Rate for Payer: Ohio Health Group PPO Differential $13.40
Rate for Payer: Ohio Health Group PPO No Differential $8.71
Rate for Payer: Ohio Health Group PPO SOMC Employees $20.77
Rate for Payer: PHCS Commercial $64.32
Rate for Payer: United Healthcare All Payer $58.96
Service Code HCPCS 86003
Hospital Charge Code 30000894
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 30000894
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 86431
Hospital Charge Code 30001099
Hospital Revenue Code 300
Min. Negotiated Rate $5.67
Max. Negotiated Rate $134.40
Rate for Payer: Aetna Commercial $107.80
Rate for Payer: Anthem Medicaid $5.67
Rate for Payer: Anthem Medicare Advantage/PPO $5.67
Rate for Payer: Anthem POS/PPO/Traditional $112.42
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $7.94
Rate for Payer: CareSource Just4Me Medicare $5.67
Rate for Payer: Cash Price $70.00
Rate for Payer: Cash Price $70.00
Rate for Payer: Cigna Commercial $116.20
Rate for Payer: First Health Commercial $133.00
Rate for Payer: Humana Commercial $119.00
Rate for Payer: Humana KY Medicaid $5.67
Rate for Payer: Humana Medicare Advantage $5.67
Rate for Payer: Kentucky WC Medicaid $5.73
Rate for Payer: Medical Mutual Of Ohio HMO $114.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $103.32
Rate for Payer: Molina Healthcare Benefit Exchange $6.80
Rate for Payer: Molina Healthcare Medicaid $5.78
Rate for Payer: Ohio Health Choice Commercial $123.20
Rate for Payer: Ohio Health Group HMO $105.00
Rate for Payer: Ohio Health Group PPO Differential $28.00
Rate for Payer: Ohio Health Group PPO No Differential $18.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $43.40
Rate for Payer: PHCS Commercial $134.40
Rate for Payer: United Healthcare All Payer $123.20
Service Code HCPCS 86431
Hospital Charge Code 30001099
Hospital Revenue Code 300
Min. Negotiated Rate $18.20
Max. Negotiated Rate $134.40
Rate for Payer: Aetna Commercial $107.80
Rate for Payer: Anthem POS/PPO/Traditional $112.42
Rate for Payer: Cash Price $70.00
Rate for Payer: Cigna Commercial $116.20
Rate for Payer: First Health Commercial $133.00
Rate for Payer: Humana Commercial $119.00
Rate for Payer: Medical Mutual Of Ohio HMO $114.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $103.32
Rate for Payer: Molina Healthcare Benefit Exchange $42.00
Rate for Payer: Ohio Health Choice Commercial $123.20
Rate for Payer: Ohio Health Group HMO $105.00
Rate for Payer: Ohio Health Group PPO Differential $28.00
Rate for Payer: Ohio Health Group PPO No Differential $18.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $43.40
Rate for Payer: PHCS Commercial $134.40
Rate for Payer: United Healthcare All Payer $123.20
Service Code HCPCS 80195
Hospital Charge Code 30000047
Hospital Revenue Code 300
Min. Negotiated Rate $8.24
Max. Negotiated Rate $190.00
Rate for Payer: Aetna Commercial $16.34
Rate for Payer: Buckeye Medicare Advantage $190.00
Rate for Payer: Cash Price $95.00
Rate for Payer: Cash Price $95.00
Rate for Payer: Cigna Commercial $12.23
Rate for Payer: Healthspan PPO $14.38
Rate for Payer: Multiplan PHCS $114.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $133.00
Rate for Payer: UHCCP Medicaid $66.50
Rate for Payer: Wellcare CHIP/Medicaid $8.24
Service Code HCPCS 80195
Hospital Charge Code 30000047
Hospital Revenue Code 300
Min. Negotiated Rate $13.73
Max. Negotiated Rate $182.40
Rate for Payer: Aetna Commercial $146.30
Rate for Payer: Anthem Medicaid $13.73
Rate for Payer: Anthem Medicare Advantage/PPO $13.73
Rate for Payer: Anthem POS/PPO/Traditional $152.57
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $19.22
Rate for Payer: CareSource Just4Me Medicare $13.73
Rate for Payer: Cash Price $95.00
Rate for Payer: Cash Price $95.00
Rate for Payer: Cigna Commercial $157.70
Rate for Payer: First Health Commercial $180.50
Rate for Payer: Humana Commercial $161.50
Rate for Payer: Humana KY Medicaid $13.73
Rate for Payer: Humana Medicare Advantage $13.73
Rate for Payer: Kentucky WC Medicaid $13.87
Rate for Payer: Medical Mutual Of Ohio HMO $155.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $140.22
Rate for Payer: Molina Healthcare Benefit Exchange $16.48
Rate for Payer: Molina Healthcare Medicaid $14.00
Rate for Payer: Ohio Health Choice Commercial $167.20
Rate for Payer: Ohio Health Group HMO $142.50
Rate for Payer: Ohio Health Group PPO Differential $38.00
Rate for Payer: Ohio Health Group PPO No Differential $24.70
Rate for Payer: Ohio Health Group PPO SOMC Employees $58.90
Rate for Payer: PHCS Commercial $182.40
Rate for Payer: United Healthcare All Payer $167.20