|
PATH CONS INTRAOP 1 BLOC
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30002036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna Commercial |
$138.09
|
| Rate for Payer: Anthem Medicaid |
$65.92
|
| Rate for Payer: Buckeye Medicare Advantage |
$367.00
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cigna Commercial |
$56.76
|
| Rate for Payer: Healthspan PPO |
$131.12
|
| Rate for Payer: Humana Medicaid |
$65.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$31.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$67.24
|
| Rate for Payer: Molina Healthcare Passport |
$65.92
|
| Rate for Payer: Multiplan PHCS |
$220.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$256.90
|
| Rate for Payer: UHCCP Medicaid |
$128.45
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$66.58
|
|
|
PATH CONS INTRAOP 1 BLOC
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30002036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$352.32 |
| Rate for Payer: Aetna Commercial |
$282.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$294.70
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cigna Commercial |
$304.61
|
| Rate for Payer: First Health Commercial |
$348.65
|
| Rate for Payer: Humana Commercial |
$311.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$300.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$270.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$110.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$322.96
|
| Rate for Payer: Ohio Health Group HMO |
$275.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$73.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$47.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$113.77
|
| Rate for Payer: PHCS Commercial |
$352.32
|
| Rate for Payer: United Healthcare All Payer |
$322.96
|
|
|
PATH CONS INTRAOP 1 BLOC
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30002036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$352.32 |
| Rate for Payer: Aetna Commercial |
$282.59
|
| Rate for Payer: Anthem Medicaid |
$126.21
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$147.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$294.70
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$206.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$199.40
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cigna Commercial |
$304.61
|
| Rate for Payer: First Health Commercial |
$348.65
|
| Rate for Payer: Humana Commercial |
$311.95
|
| Rate for Payer: Humana KY Medicaid |
$126.21
|
| Rate for Payer: Humana Medicare Advantage |
$147.70
|
| Rate for Payer: Kentucky WC Medicaid |
$127.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$300.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$270.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$177.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$128.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$322.96
|
| Rate for Payer: Ohio Health Group HMO |
$275.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$73.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$47.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$113.77
|
| Rate for Payer: PHCS Commercial |
$352.32
|
| Rate for Payer: United Healthcare All Payer |
$322.96
|
|
|
PATH CONS INTRAOP 1 BLOC (P
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
300P2036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$29.75 |
| Max. Negotiated Rate |
$138.09 |
| Rate for Payer: Aetna Commercial |
$138.09
|
| Rate for Payer: Anthem Medicaid |
$65.92
|
| Rate for Payer: Buckeye Medicare Advantage |
$85.00
|
| Rate for Payer: Cash Price |
$42.50
|
| Rate for Payer: Cash Price |
$42.50
|
| Rate for Payer: Cigna Commercial |
$56.76
|
| Rate for Payer: Healthspan PPO |
$131.12
|
| Rate for Payer: Humana Medicaid |
$65.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$31.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$67.24
|
| Rate for Payer: Molina Healthcare Passport |
$65.92
|
| Rate for Payer: Multiplan PHCS |
$51.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$59.50
|
| Rate for Payer: UHCCP Medicaid |
$29.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$66.58
|
|
|
PATH CONS INTRAOP 1 BLOC (T
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
300T2036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.96 |
| Max. Negotiated Rate |
$280.32 |
| Rate for Payer: Aetna Commercial |
$224.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$234.48
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cigna Commercial |
$242.36
|
| Rate for Payer: First Health Commercial |
$277.40
|
| Rate for Payer: Humana Commercial |
$248.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$239.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$215.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$87.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$256.96
|
| Rate for Payer: Ohio Health Group HMO |
$219.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$37.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$90.52
|
| Rate for Payer: PHCS Commercial |
$280.32
|
| Rate for Payer: United Healthcare All Payer |
$256.96
|
|
|
PATH CONS INTRAOP 1 BLOC (T
|
Facility
|
OP
|
$292.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
300T2036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.96 |
| Max. Negotiated Rate |
$280.32 |
| Rate for Payer: Aetna Commercial |
$224.84
|
| Rate for Payer: Anthem Medicaid |
$100.42
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$147.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$234.48
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$206.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$199.40
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cash Price |
$146.00
|
| Rate for Payer: Cigna Commercial |
$242.36
|
| Rate for Payer: First Health Commercial |
$277.40
|
| Rate for Payer: Humana Commercial |
$248.20
|
| Rate for Payer: Humana KY Medicaid |
$100.42
|
| Rate for Payer: Humana Medicare Advantage |
$147.70
|
| Rate for Payer: Kentucky WC Medicaid |
$101.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$239.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$215.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$177.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$102.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$256.96
|
| Rate for Payer: Ohio Health Group HMO |
$219.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$37.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$90.52
|
| Rate for Payer: PHCS Commercial |
$280.32
|
| Rate for Payer: United Healthcare All Payer |
$256.96
|
|
|
PATH CONS INTRAOP ADDl
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30002037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$231.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$240.90
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$249.00
|
| Rate for Payer: First Health Commercial |
$285.00
|
| Rate for Payer: Humana Commercial |
$255.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$246.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$221.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$90.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$264.00
|
| Rate for Payer: Ohio Health Group HMO |
$225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$39.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$93.00
|
| Rate for Payer: PHCS Commercial |
$288.00
|
| Rate for Payer: United Healthcare All Payer |
$264.00
|
|
|
PATH CONS INTRAOP ADDl
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30002037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$62.06
|
| Rate for Payer: Anthem Medicaid |
$30.37
|
| Rate for Payer: Buckeye Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$25.61
|
| Rate for Payer: Healthspan PPO |
$58.93
|
| Rate for Payer: Humana Medicaid |
$30.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.60
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$30.98
|
| Rate for Payer: Molina Healthcare Passport |
$30.37
|
| Rate for Payer: Multiplan PHCS |
$180.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$210.00
|
| Rate for Payer: UHCCP Medicaid |
$105.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.67
|
|
|
PATH CONS INTRAOP ADDl
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30002037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$231.00
|
| Rate for Payer: Anthem Medicaid |
$103.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$240.90
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$249.00
|
| Rate for Payer: First Health Commercial |
$285.00
|
| Rate for Payer: Humana Commercial |
$255.00
|
| Rate for Payer: Humana KY Medicaid |
$103.17
|
| Rate for Payer: Kentucky WC Medicaid |
$104.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$246.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$221.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$90.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$105.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$264.00
|
| Rate for Payer: Ohio Health Group HMO |
$225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$39.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$93.00
|
| Rate for Payer: PHCS Commercial |
$288.00
|
| Rate for Payer: United Healthcare All Payer |
$264.00
|
|
|
PATH CONS INTRAOP ADDl (P
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
300P2037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$62.06 |
| Rate for Payer: Aetna Commercial |
$62.06
|
| Rate for Payer: Anthem Medicaid |
$30.37
|
| Rate for Payer: Buckeye Medicare Advantage |
$55.00
|
| Rate for Payer: Cash Price |
$27.50
|
| Rate for Payer: Cash Price |
$27.50
|
| Rate for Payer: Cigna Commercial |
$25.61
|
| Rate for Payer: Healthspan PPO |
$58.93
|
| Rate for Payer: Humana Medicaid |
$30.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.60
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$30.98
|
| Rate for Payer: Molina Healthcare Passport |
$30.37
|
| Rate for Payer: Multiplan PHCS |
$33.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$38.50
|
| Rate for Payer: UHCCP Medicaid |
$19.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.67
|
|
|
PATH CONS INTRAOP ADDl (T
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
300T2037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$49.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$75.95
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATH CONS INTRAOP ADDl (T
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
300T2037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem Medicaid |
$84.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Humana KY Medicaid |
$84.26
|
| Rate for Payer: Kentucky WC Medicaid |
$85.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$85.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$49.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$75.95
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATH CONSULT INTRAOP 1 BLOC
|
Facility
|
IP
|
$289.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30001521
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$37.57 |
| Max. Negotiated Rate |
$277.44 |
| Rate for Payer: Aetna Commercial |
$222.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$232.07
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$239.87
|
| Rate for Payer: First Health Commercial |
$274.55
|
| Rate for Payer: Humana Commercial |
$245.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$236.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$213.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$86.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$254.32
|
| Rate for Payer: Ohio Health Group HMO |
$216.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$37.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$89.59
|
| Rate for Payer: PHCS Commercial |
$277.44
|
| Rate for Payer: United Healthcare All Payer |
$254.32
|
|
|
PATH CONSULT INTRAOP 1 BLOC
|
Facility
|
OP
|
$289.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30001521
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$37.57 |
| Max. Negotiated Rate |
$277.44 |
| Rate for Payer: Aetna Commercial |
$222.53
|
| Rate for Payer: Anthem Medicaid |
$99.39
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$147.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$232.07
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$206.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$199.40
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$239.87
|
| Rate for Payer: First Health Commercial |
$274.55
|
| Rate for Payer: Humana Commercial |
$245.65
|
| Rate for Payer: Humana KY Medicaid |
$99.39
|
| Rate for Payer: Humana Medicare Advantage |
$147.70
|
| Rate for Payer: Kentucky WC Medicaid |
$100.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$236.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$213.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$177.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$101.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$254.32
|
| Rate for Payer: Ohio Health Group HMO |
$216.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$37.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$89.59
|
| Rate for Payer: PHCS Commercial |
$277.44
|
| Rate for Payer: United Healthcare All Payer |
$254.32
|
|
|
PATH CONSULT INTRAOP 1 BLOC
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30001521
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$289.00 |
| Rate for Payer: Aetna Commercial |
$138.09
|
| Rate for Payer: Anthem Medicaid |
$65.92
|
| Rate for Payer: Buckeye Medicare Advantage |
$289.00
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$56.76
|
| Rate for Payer: Healthspan PPO |
$131.12
|
| Rate for Payer: Humana Medicaid |
$65.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$31.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$67.24
|
| Rate for Payer: Molina Healthcare Passport |
$65.92
|
| Rate for Payer: Multiplan PHCS |
$173.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$202.30
|
| Rate for Payer: UHCCP Medicaid |
$101.15
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$66.58
|
|
|
PATH CONSULT INTRAOP ADDL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30001522
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$49.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$75.95
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATH CONSULT INTRAOP ADDL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30001522
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem Medicaid |
$84.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Humana KY Medicaid |
$84.26
|
| Rate for Payer: Kentucky WC Medicaid |
$85.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$85.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$49.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$75.95
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATH CONSULT INTRAOP ADDL
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30001522
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna Commercial |
$62.06
|
| Rate for Payer: Anthem Medicaid |
$30.37
|
| Rate for Payer: Buckeye Medicare Advantage |
$245.00
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$25.61
|
| Rate for Payer: Healthspan PPO |
$58.93
|
| Rate for Payer: Humana Medicaid |
$30.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.60
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$30.98
|
| Rate for Payer: Molina Healthcare Passport |
$30.37
|
| Rate for Payer: Multiplan PHCS |
$147.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$171.50
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$30.67
|
|
|
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
|
IP
|
$12,759.22
|
|
|
Service Code
|
MSDRG 543
|
| Min. Negotiated Rate |
$8,658.04 |
| Max. Negotiated Rate |
$12,759.22 |
| Rate for Payer: Anthem Medicaid |
$8,658.04
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$9,113.73
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$12,759.22
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,303.54
|
| Rate for Payer: Humana KY Medicaid |
$8,658.04
|
| Rate for Payer: Humana Medicare Advantage |
$9,113.73
|
| Rate for Payer: Kentucky WC Medicaid |
$8,744.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,936.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,831.20
|
|
|
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$21,334.03
|
|
|
Service Code
|
MSDRG 542
|
| Min. Negotiated Rate |
$14,476.66 |
| Max. Negotiated Rate |
$21,334.03 |
| Rate for Payer: Anthem Medicaid |
$14,476.66
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$15,238.59
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$21,334.03
|
| Rate for Payer: CareSource Just4Me Medicare |
$20,572.10
|
| Rate for Payer: Humana KY Medicaid |
$14,476.66
|
| Rate for Payer: Humana Medicare Advantage |
$15,238.59
|
| Rate for Payer: Kentucky WC Medicaid |
$14,621.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$18,286.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,766.19
|
|
|
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$8,978.37
|
|
|
Service Code
|
MSDRG 544
|
| Min. Negotiated Rate |
$6,092.46 |
| Max. Negotiated Rate |
$8,978.37 |
| Rate for Payer: Anthem Medicaid |
$6,092.46
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$6,413.12
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$8,978.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$8,657.71
|
| Rate for Payer: Humana KY Medicaid |
$6,092.46
|
| Rate for Payer: Humana Medicare Advantage |
$6,413.12
|
| Rate for Payer: Kentucky WC Medicaid |
$6,153.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,695.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,214.31
|
|
|
PATHOLOGY CONSULT INTROP
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 88329
|
| Hospital Charge Code |
30001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem Medicaid |
$84.26
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$52.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$74.05
|
| Rate for Payer: CareSource Just4Me Medicare |
$71.40
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Humana KY Medicaid |
$84.26
|
| Rate for Payer: Humana Medicare Advantage |
$52.89
|
| Rate for Payer: Kentucky WC Medicaid |
$85.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$63.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$85.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$49.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$75.95
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATHOLOGY CONSULT INTROP
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 88329
|
| Hospital Charge Code |
30001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.85 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$49.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$75.95
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATHOLOGY CONSULT INTROP
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 88329
|
| Hospital Charge Code |
30001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.44 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna Commercial |
$52.41
|
| Rate for Payer: Anthem Medicaid |
$28.04
|
| Rate for Payer: Buckeye Medicare Advantage |
$245.00
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$22.37
|
| Rate for Payer: Healthspan PPO |
$71.62
|
| Rate for Payer: Humana Medicaid |
$28.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$18.44
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$28.60
|
| Rate for Payer: Molina Healthcare Passport |
$28.04
|
| Rate for Payer: Multiplan PHCS |
$147.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$171.50
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$28.32
|
|
|
PATIENT EVAL/DEMO RESP DEVICES
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
HCPCS 94664
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$34.19 |
| Max. Negotiated Rate |
$252.48 |
| Rate for Payer: Aetna Commercial |
$202.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$205.14
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cigna Commercial |
$218.29
|
| Rate for Payer: First Health Commercial |
$249.85
|
| Rate for Payer: Humana Commercial |
$223.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$215.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$194.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$78.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$231.44
|
| Rate for Payer: Ohio Health Group HMO |
$197.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34.19
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$81.53
|
| Rate for Payer: PHCS Commercial |
$252.48
|
| Rate for Payer: United Healthcare All Payer |
$231.44
|
|
