|
OS FLOW CYTMTRY ADDT MARK14
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK14
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK15
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001461
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK15
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001461
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK16
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001443
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK16
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001443
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK17
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001440
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK17
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001440
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK18
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001435
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK18
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001435
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK19
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001442
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK19
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001442
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK 20
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001433
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK 20
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001433
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK21
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001454
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK21
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001454
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK22
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK22
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK23
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001434
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK23
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001434
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK24
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001441
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK24
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001441
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK25
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001437
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK25
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001437
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
|
OS FLOW CYTMTRY ADDT MARK26
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
HCPCS 88185
|
| Hospital Charge Code |
30001459
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.90 |
| Max. Negotiated Rate |
$98.88 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Anthem Medicaid |
$35.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$82.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna Commercial |
$85.49
|
| Rate for Payer: First Health Commercial |
$97.85
|
| Rate for Payer: Humana Commercial |
$87.55
|
| Rate for Payer: Humana KY Medicaid |
$35.42
|
| Rate for Payer: Kentucky WC Medicaid |
$35.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$84.46
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$76.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$36.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$90.64
|
| Rate for Payer: Ohio Health Group HMO |
$77.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$89.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$71.07
|
| Rate for Payer: PHCS Commercial |
$98.88
|
| Rate for Payer: United Healthcare All Payer |
$90.64
|
|
