|
Perc d-e cor stent ather br
|
Facility
|
OP
|
$14,052.00
|
|
|
Service Code
|
HCPCS C9603
|
| Hospital Charge Code |
76102527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,826.76 |
| Max. Negotiated Rate |
$13,489.92 |
| Rate for Payer: Aetna Commercial |
$10,820.04
|
| Rate for Payer: Anthem Medicaid |
$4,832.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,960.56
|
| Rate for Payer: Cash Price |
$7,026.00
|
| Rate for Payer: Cigna Commercial |
$11,663.16
|
| Rate for Payer: First Health Commercial |
$13,349.40
|
| Rate for Payer: Humana Commercial |
$11,944.20
|
| Rate for Payer: Humana KY Medicaid |
$4,832.48
|
| Rate for Payer: Kentucky WC Medicaid |
$4,881.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,522.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,215.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,929.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,365.76
|
| Rate for Payer: Ohio Health Group HMO |
$10,539.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,826.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,356.12
|
| Rate for Payer: PHCS Commercial |
$13,489.92
|
| Rate for Payer: United Healthcare All Payer |
$12,365.76
|
|
|
Perc d-e cor stent ather br
|
Facility
|
OP
|
$14,052.00
|
|
|
Service Code
|
HCPCS C9603
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,826.76 |
| Max. Negotiated Rate |
$13,489.92 |
| Rate for Payer: Aetna Commercial |
$10,820.04
|
| Rate for Payer: Anthem Medicaid |
$4,832.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,960.56
|
| Rate for Payer: Cash Price |
$7,026.00
|
| Rate for Payer: Cigna Commercial |
$11,663.16
|
| Rate for Payer: First Health Commercial |
$13,349.40
|
| Rate for Payer: Humana Commercial |
$11,944.20
|
| Rate for Payer: Humana KY Medicaid |
$4,832.48
|
| Rate for Payer: Kentucky WC Medicaid |
$4,881.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,522.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,215.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,929.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,365.76
|
| Rate for Payer: Ohio Health Group HMO |
$10,539.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,826.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,356.12
|
| Rate for Payer: PHCS Commercial |
$13,489.92
|
| Rate for Payer: United Healthcare All Payer |
$12,365.76
|
|
|
Perc d-e cor stent ather br
|
Facility
|
IP
|
$14,052.00
|
|
|
Service Code
|
HCPCS C9603
|
| Hospital Charge Code |
76102527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,826.76 |
| Max. Negotiated Rate |
$13,489.92 |
| Rate for Payer: Aetna Commercial |
$10,820.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,960.56
|
| Rate for Payer: Cash Price |
$7,026.00
|
| Rate for Payer: Cigna Commercial |
$11,663.16
|
| Rate for Payer: First Health Commercial |
$13,349.40
|
| Rate for Payer: Humana Commercial |
$11,944.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,522.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,215.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,365.76
|
| Rate for Payer: Ohio Health Group HMO |
$10,539.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,826.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,356.12
|
| Rate for Payer: PHCS Commercial |
$13,489.92
|
| Rate for Payer: United Healthcare All Payer |
$12,365.76
|
|
|
Perc d-e cor stent ather br
|
Facility
|
IP
|
$14,052.00
|
|
|
Service Code
|
HCPCS C9603
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,826.76 |
| Max. Negotiated Rate |
$13,489.92 |
| Rate for Payer: Aetna Commercial |
$10,820.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,960.56
|
| Rate for Payer: Cash Price |
$7,026.00
|
| Rate for Payer: Cigna Commercial |
$11,663.16
|
| Rate for Payer: First Health Commercial |
$13,349.40
|
| Rate for Payer: Humana Commercial |
$11,944.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,522.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,215.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,365.76
|
| Rate for Payer: Ohio Health Group HMO |
$10,539.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,826.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,356.12
|
| Rate for Payer: PHCS Commercial |
$13,489.92
|
| Rate for Payer: United Healthcare All Payer |
$12,365.76
|
|
|
Perc d-e cor stent ather s
|
Facility
|
OP
|
$27,495.00
|
|
|
Service Code
|
HCPCS C9602
|
| Hospital Charge Code |
76102526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,574.35 |
| Max. Negotiated Rate |
$26,395.20 |
| Rate for Payer: Aetna Commercial |
$21,171.15
|
| Rate for Payer: Anthem Medicaid |
$9,455.53
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$15,163.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$21,446.10
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$21,228.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$20,470.79
|
| Rate for Payer: Cash Price |
$13,747.50
|
| Rate for Payer: Cash Price |
$13,747.50
|
| Rate for Payer: Cigna Commercial |
$22,820.85
|
| Rate for Payer: First Health Commercial |
$26,120.25
|
| Rate for Payer: Humana Commercial |
$23,370.75
|
| Rate for Payer: Humana KY Medicaid |
$9,455.53
|
| Rate for Payer: Humana Medicare Advantage |
$15,163.55
|
| Rate for Payer: Kentucky WC Medicaid |
$9,551.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$22,545.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$20,291.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$18,196.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,645.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$24,195.60
|
| Rate for Payer: Ohio Health Group HMO |
$20,621.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,499.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,574.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,523.45
|
| Rate for Payer: PHCS Commercial |
$26,395.20
|
| Rate for Payer: United Healthcare All Payer |
$24,195.60
|
|
|
Perc d-e cor stent ather s
|
Facility
|
IP
|
$29,007.00
|
|
|
Service Code
|
HCPCS C9602
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,770.91 |
| Max. Negotiated Rate |
$27,846.72 |
| Rate for Payer: Aetna Commercial |
$22,335.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,625.46
|
| Rate for Payer: Cash Price |
$14,503.50
|
| Rate for Payer: Cigna Commercial |
$24,075.81
|
| Rate for Payer: First Health Commercial |
$27,556.65
|
| Rate for Payer: Humana Commercial |
$24,655.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,785.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,407.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,702.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,526.16
|
| Rate for Payer: Ohio Health Group HMO |
$21,755.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,801.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,770.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,992.17
|
| Rate for Payer: PHCS Commercial |
$27,846.72
|
| Rate for Payer: United Healthcare All Payer |
$25,526.16
|
|
|
Perc d-e cor stent ather s
|
Facility
|
OP
|
$29,007.00
|
|
|
Service Code
|
HCPCS C9602
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,770.91 |
| Max. Negotiated Rate |
$27,846.72 |
| Rate for Payer: Aetna Commercial |
$22,335.39
|
| Rate for Payer: Anthem Medicaid |
$9,975.51
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$15,163.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,625.46
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$21,228.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$20,470.79
|
| Rate for Payer: Cash Price |
$14,503.50
|
| Rate for Payer: Cash Price |
$14,503.50
|
| Rate for Payer: Cigna Commercial |
$24,075.81
|
| Rate for Payer: First Health Commercial |
$27,556.65
|
| Rate for Payer: Humana Commercial |
$24,655.95
|
| Rate for Payer: Humana KY Medicaid |
$9,975.51
|
| Rate for Payer: Humana Medicare Advantage |
$15,163.55
|
| Rate for Payer: Kentucky WC Medicaid |
$10,077.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,785.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,407.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$18,196.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,175.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,526.16
|
| Rate for Payer: Ohio Health Group HMO |
$21,755.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,801.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,770.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,992.17
|
| Rate for Payer: PHCS Commercial |
$27,846.72
|
| Rate for Payer: United Healthcare All Payer |
$25,526.16
|
|
|
Perc d-e cor stent ather s
|
Facility
|
IP
|
$27,495.00
|
|
|
Service Code
|
HCPCS C9602
|
| Hospital Charge Code |
76102526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,574.35 |
| Max. Negotiated Rate |
$26,395.20 |
| Rate for Payer: Aetna Commercial |
$21,171.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$21,446.10
|
| Rate for Payer: Cash Price |
$13,747.50
|
| Rate for Payer: Cigna Commercial |
$22,820.85
|
| Rate for Payer: First Health Commercial |
$26,120.25
|
| Rate for Payer: Humana Commercial |
$23,370.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$22,545.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$20,291.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,248.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$24,195.60
|
| Rate for Payer: Ohio Health Group HMO |
$20,621.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,499.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,574.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,523.45
|
| Rate for Payer: PHCS Commercial |
$26,395.20
|
| Rate for Payer: United Healthcare All Payer |
$24,195.60
|
|
|
PERC DE COR STENT SINGLE
|
Facility
|
IP
|
$19,493.00
|
|
|
Service Code
|
HCPCS C9600
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,534.09 |
| Max. Negotiated Rate |
$18,713.28 |
| Rate for Payer: Aetna Commercial |
$15,009.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,204.54
|
| Rate for Payer: Cash Price |
$9,746.50
|
| Rate for Payer: Cigna Commercial |
$16,179.19
|
| Rate for Payer: First Health Commercial |
$18,518.35
|
| Rate for Payer: Humana Commercial |
$16,569.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,984.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,385.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,847.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,153.84
|
| Rate for Payer: Ohio Health Group HMO |
$14,619.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,898.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,534.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,042.83
|
| Rate for Payer: PHCS Commercial |
$18,713.28
|
| Rate for Payer: United Healthcare All Payer |
$17,153.84
|
|
|
PERC DE COR STENT SINGLE
|
Facility
|
OP
|
$19,493.00
|
|
|
Service Code
|
HCPCS C9600
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,534.09 |
| Max. Negotiated Rate |
$18,713.28 |
| Rate for Payer: Aetna Commercial |
$15,009.61
|
| Rate for Payer: Anthem Medicaid |
$6,703.64
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$9,513.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,204.54
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$13,318.61
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,842.94
|
| Rate for Payer: Cash Price |
$9,746.50
|
| Rate for Payer: Cash Price |
$9,746.50
|
| Rate for Payer: Cigna Commercial |
$16,179.19
|
| Rate for Payer: First Health Commercial |
$18,518.35
|
| Rate for Payer: Humana Commercial |
$16,569.05
|
| Rate for Payer: Humana KY Medicaid |
$6,703.64
|
| Rate for Payer: Humana Medicare Advantage |
$9,513.29
|
| Rate for Payer: Kentucky WC Medicaid |
$6,771.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,984.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,385.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,415.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,838.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,153.84
|
| Rate for Payer: Ohio Health Group HMO |
$14,619.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,898.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,534.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,042.83
|
| Rate for Payer: PHCS Commercial |
$18,713.28
|
| Rate for Payer: United Healthcare All Payer |
$17,153.84
|
|
|
PERC DE COR STENT SINGLE
|
Facility
|
IP
|
$18,761.00
|
|
|
Service Code
|
HCPCS C9600
|
| Hospital Charge Code |
76102524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,438.93 |
| Max. Negotiated Rate |
$18,010.56 |
| Rate for Payer: Aetna Commercial |
$14,445.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,633.58
|
| Rate for Payer: Cash Price |
$9,380.50
|
| Rate for Payer: Cigna Commercial |
$15,571.63
|
| Rate for Payer: First Health Commercial |
$17,822.95
|
| Rate for Payer: Humana Commercial |
$15,946.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,384.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,845.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,628.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,509.68
|
| Rate for Payer: Ohio Health Group HMO |
$14,070.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,752.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,438.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,815.91
|
| Rate for Payer: PHCS Commercial |
$18,010.56
|
| Rate for Payer: United Healthcare All Payer |
$16,509.68
|
|
|
PERC DE COR STENT SINGLE
|
Facility
|
OP
|
$18,761.00
|
|
|
Service Code
|
HCPCS C9600
|
| Hospital Charge Code |
76102524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,438.93 |
| Max. Negotiated Rate |
$18,010.56 |
| Rate for Payer: Aetna Commercial |
$14,445.97
|
| Rate for Payer: Anthem Medicaid |
$6,451.91
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$9,513.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,633.58
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$13,318.61
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,842.94
|
| Rate for Payer: Cash Price |
$9,380.50
|
| Rate for Payer: Cash Price |
$9,380.50
|
| Rate for Payer: Cigna Commercial |
$15,571.63
|
| Rate for Payer: First Health Commercial |
$17,822.95
|
| Rate for Payer: Humana Commercial |
$15,946.85
|
| Rate for Payer: Humana KY Medicaid |
$6,451.91
|
| Rate for Payer: Humana Medicare Advantage |
$9,513.29
|
| Rate for Payer: Kentucky WC Medicaid |
$6,517.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,384.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,845.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,415.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,581.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$16,509.68
|
| Rate for Payer: Ohio Health Group HMO |
$14,070.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,752.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,438.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,815.91
|
| Rate for Payer: PHCS Commercial |
$18,010.56
|
| Rate for Payer: United Healthcare All Payer |
$16,509.68
|
|
|
Perc drug-el cor stent bran
|
Facility
|
IP
|
$14,825.00
|
|
|
Service Code
|
HCPCS C9601
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,927.25 |
| Max. Negotiated Rate |
$14,232.00 |
| Rate for Payer: Aetna Commercial |
$11,415.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,563.50
|
| Rate for Payer: Cash Price |
$7,412.50
|
| Rate for Payer: Cigna Commercial |
$12,304.75
|
| Rate for Payer: First Health Commercial |
$14,083.75
|
| Rate for Payer: Humana Commercial |
$12,601.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,156.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,940.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,447.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,046.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,118.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,927.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,595.75
|
| Rate for Payer: PHCS Commercial |
$14,232.00
|
| Rate for Payer: United Healthcare All Payer |
$13,046.00
|
|
|
Perc drug-el cor stent bran
|
Facility
|
OP
|
$14,052.00
|
|
|
Service Code
|
HCPCS C9601
|
| Hospital Charge Code |
76102525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,826.76 |
| Max. Negotiated Rate |
$13,489.92 |
| Rate for Payer: Aetna Commercial |
$10,820.04
|
| Rate for Payer: Anthem Medicaid |
$4,832.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,960.56
|
| Rate for Payer: Cash Price |
$7,026.00
|
| Rate for Payer: Cigna Commercial |
$11,663.16
|
| Rate for Payer: First Health Commercial |
$13,349.40
|
| Rate for Payer: Humana Commercial |
$11,944.20
|
| Rate for Payer: Humana KY Medicaid |
$4,832.48
|
| Rate for Payer: Kentucky WC Medicaid |
$4,881.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,522.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,215.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,929.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,365.76
|
| Rate for Payer: Ohio Health Group HMO |
$10,539.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,826.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,356.12
|
| Rate for Payer: PHCS Commercial |
$13,489.92
|
| Rate for Payer: United Healthcare All Payer |
$12,365.76
|
|
|
Perc drug-el cor stent bran
|
Facility
|
OP
|
$14,825.00
|
|
|
Service Code
|
HCPCS C9601
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,927.25 |
| Max. Negotiated Rate |
$14,232.00 |
| Rate for Payer: Aetna Commercial |
$11,415.25
|
| Rate for Payer: Anthem Medicaid |
$5,098.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,563.50
|
| Rate for Payer: Cash Price |
$7,412.50
|
| Rate for Payer: Cigna Commercial |
$12,304.75
|
| Rate for Payer: First Health Commercial |
$14,083.75
|
| Rate for Payer: Humana Commercial |
$12,601.25
|
| Rate for Payer: Humana KY Medicaid |
$5,098.32
|
| Rate for Payer: Kentucky WC Medicaid |
$5,150.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,156.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,940.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,447.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,200.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,046.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,118.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,927.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,595.75
|
| Rate for Payer: PHCS Commercial |
$14,232.00
|
| Rate for Payer: United Healthcare All Payer |
$13,046.00
|
|
|
Perc drug-el cor stent bran
|
Facility
|
IP
|
$14,052.00
|
|
|
Service Code
|
HCPCS C9601
|
| Hospital Charge Code |
76102525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,826.76 |
| Max. Negotiated Rate |
$13,489.92 |
| Rate for Payer: Aetna Commercial |
$10,820.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,960.56
|
| Rate for Payer: Cash Price |
$7,026.00
|
| Rate for Payer: Cigna Commercial |
$11,663.16
|
| Rate for Payer: First Health Commercial |
$13,349.40
|
| Rate for Payer: Humana Commercial |
$11,944.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,522.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,370.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,215.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,365.76
|
| Rate for Payer: Ohio Health Group HMO |
$10,539.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,826.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,356.12
|
| Rate for Payer: PHCS Commercial |
$13,489.92
|
| Rate for Payer: United Healthcare All Payer |
$12,365.76
|
|
|
PERCLOSE PROGLIDE
|
Facility
|
OP
|
$2,029.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.77 |
| Max. Negotiated Rate |
$1,947.84 |
| Rate for Payer: Aetna Commercial |
$1,562.33
|
| Rate for Payer: Anthem Medicaid |
$697.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,582.62
|
| Rate for Payer: Cash Price |
$1,014.50
|
| Rate for Payer: Cigna Commercial |
$1,684.07
|
| Rate for Payer: First Health Commercial |
$1,927.55
|
| Rate for Payer: Humana Commercial |
$1,724.65
|
| Rate for Payer: Humana KY Medicaid |
$697.77
|
| Rate for Payer: Kentucky WC Medicaid |
$704.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,663.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,497.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$608.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$711.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,785.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,521.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$405.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$263.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$628.99
|
| Rate for Payer: PHCS Commercial |
$1,947.84
|
| Rate for Payer: United Healthcare All Payer |
$1,785.52
|
|
|
PERCLOSE PROGLIDE
|
Facility
|
IP
|
$2,029.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.77 |
| Max. Negotiated Rate |
$1,947.84 |
| Rate for Payer: Aetna Commercial |
$1,562.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,582.62
|
| Rate for Payer: Cash Price |
$1,014.50
|
| Rate for Payer: Cigna Commercial |
$1,684.07
|
| Rate for Payer: First Health Commercial |
$1,927.55
|
| Rate for Payer: Humana Commercial |
$1,724.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,663.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,497.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$608.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,785.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,521.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$405.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$263.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$628.99
|
| Rate for Payer: PHCS Commercial |
$1,947.84
|
| Rate for Payer: United Healthcare All Payer |
$1,785.52
|
|
|
PERCLOSE PROGLIDE SYSTEM
|
Facility
|
OP
|
$1,962.50
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.12 |
| Max. Negotiated Rate |
$1,884.00 |
| Rate for Payer: Aetna Commercial |
$1,511.12
|
| Rate for Payer: Anthem Medicaid |
$674.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,530.75
|
| Rate for Payer: Cash Price |
$981.25
|
| Rate for Payer: Cigna Commercial |
$1,628.88
|
| Rate for Payer: First Health Commercial |
$1,864.38
|
| Rate for Payer: Humana Commercial |
$1,668.12
|
| Rate for Payer: Humana KY Medicaid |
$674.90
|
| Rate for Payer: Kentucky WC Medicaid |
$681.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,609.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,448.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$588.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$688.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,727.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,471.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$392.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$255.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$608.38
|
| Rate for Payer: PHCS Commercial |
$1,884.00
|
| Rate for Payer: United Healthcare All Payer |
$1,727.00
|
|
|
PERCLOSE PROGLIDE SYSTEM
|
Facility
|
IP
|
$1,962.50
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.12 |
| Max. Negotiated Rate |
$1,884.00 |
| Rate for Payer: Aetna Commercial |
$1,511.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,530.75
|
| Rate for Payer: Cash Price |
$981.25
|
| Rate for Payer: Cigna Commercial |
$1,628.88
|
| Rate for Payer: First Health Commercial |
$1,864.38
|
| Rate for Payer: Humana Commercial |
$1,668.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,609.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,448.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$588.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,727.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,471.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$392.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$255.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$608.38
|
| Rate for Payer: PHCS Commercial |
$1,884.00
|
| Rate for Payer: United Healthcare All Payer |
$1,727.00
|
|
|
PERCLOSE PROSTYLE
|
Facility
|
IP
|
$11,074.50
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,439.68 |
| Max. Negotiated Rate |
$10,631.52 |
| Rate for Payer: Aetna Commercial |
$8,527.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,638.11
|
| Rate for Payer: Cash Price |
$5,537.25
|
| Rate for Payer: Cigna Commercial |
$9,191.84
|
| Rate for Payer: First Health Commercial |
$10,520.78
|
| Rate for Payer: Humana Commercial |
$9,413.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,081.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,172.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,322.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,745.56
|
| Rate for Payer: Ohio Health Group HMO |
$8,305.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,214.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,439.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,433.10
|
| Rate for Payer: PHCS Commercial |
$10,631.52
|
| Rate for Payer: United Healthcare All Payer |
$9,745.56
|
|
|
PERCLOSE PROSTYLE
|
Facility
|
OP
|
$11,074.50
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,439.68 |
| Max. Negotiated Rate |
$10,631.52 |
| Rate for Payer: Aetna Commercial |
$8,527.36
|
| Rate for Payer: Anthem Medicaid |
$3,808.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,638.11
|
| Rate for Payer: Cash Price |
$5,537.25
|
| Rate for Payer: Cigna Commercial |
$9,191.84
|
| Rate for Payer: First Health Commercial |
$10,520.78
|
| Rate for Payer: Humana Commercial |
$9,413.32
|
| Rate for Payer: Humana KY Medicaid |
$3,808.52
|
| Rate for Payer: Kentucky WC Medicaid |
$3,847.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,081.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,172.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,322.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,884.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,745.56
|
| Rate for Payer: Ohio Health Group HMO |
$8,305.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,214.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,439.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,433.10
|
| Rate for Payer: PHCS Commercial |
$10,631.52
|
| Rate for Payer: United Healthcare All Payer |
$9,745.56
|
|
|
PERC NEPH NEW ACCESS W/O CATH
|
Professional
|
Both
|
$5,637.00
|
|
|
Service Code
|
HCPCS 50694
|
| Hospital Charge Code |
76102055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.95 |
| Max. Negotiated Rate |
$5,637.00 |
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$228.95
|
| Rate for Payer: Anthem Medicaid |
$231.14
|
| Rate for Payer: Buckeye Medicare Advantage |
$5,637.00
|
| Rate for Payer: Cash Price |
$2,818.50
|
| Rate for Payer: Cash Price |
$2,818.50
|
| Rate for Payer: Cigna Commercial |
$471.97
|
| Rate for Payer: Humana Medicaid |
$231.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$385.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$235.76
|
| Rate for Payer: Molina Healthcare Passport |
$231.14
|
| Rate for Payer: Multiplan PHCS |
$3,382.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3,945.90
|
| Rate for Payer: UHCCP Medicaid |
$240.40
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$233.45
|
|
|
PERC NEPH NEW ACCESS W/O CATH
|
Facility
|
OP
|
$5,637.00
|
|
|
Service Code
|
HCPCS 50694
|
| Hospital Charge Code |
76102055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$732.81 |
| Max. Negotiated Rate |
$5,411.52 |
| Rate for Payer: Aetna Commercial |
$4,340.49
|
| Rate for Payer: Anthem Medicaid |
$1,938.56
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,014.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,396.86
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,220.54
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,069.80
|
| Rate for Payer: Cash Price |
$2,818.50
|
| Rate for Payer: Cash Price |
$2,818.50
|
| Rate for Payer: Cigna Commercial |
$4,678.71
|
| Rate for Payer: First Health Commercial |
$5,355.15
|
| Rate for Payer: Humana Commercial |
$4,791.45
|
| Rate for Payer: Humana KY Medicaid |
$1,938.56
|
| Rate for Payer: Humana Medicare Advantage |
$3,014.67
|
| Rate for Payer: Kentucky WC Medicaid |
$1,958.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,622.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,160.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,977.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,960.56
|
| Rate for Payer: Ohio Health Group HMO |
$4,227.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,127.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$732.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,747.47
|
| Rate for Payer: PHCS Commercial |
$5,411.52
|
| Rate for Payer: United Healthcare All Payer |
$4,960.56
|
|
|
PERC NEPH NEW ACCESS W/O CATH
|
Facility
|
IP
|
$5,637.00
|
|
|
Service Code
|
HCPCS 50694
|
| Hospital Charge Code |
76102055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$732.81 |
| Max. Negotiated Rate |
$5,411.52 |
| Rate for Payer: Aetna Commercial |
$4,340.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,396.86
|
| Rate for Payer: Cash Price |
$2,818.50
|
| Rate for Payer: Cigna Commercial |
$4,678.71
|
| Rate for Payer: First Health Commercial |
$5,355.15
|
| Rate for Payer: Humana Commercial |
$4,791.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,622.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,160.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,691.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,960.56
|
| Rate for Payer: Ohio Health Group HMO |
$4,227.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,127.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$732.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,747.47
|
| Rate for Payer: PHCS Commercial |
$5,411.52
|
| Rate for Payer: United Healthcare All Payer |
$4,960.56
|
|
