|
PINNACLE SHEATH 25CM 5FR
|
Facility
|
OP
|
$494.68
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.31 |
| Max. Negotiated Rate |
$474.89 |
| Rate for Payer: Aetna Commercial |
$380.90
|
| Rate for Payer: Anthem Medicaid |
$170.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$385.85
|
| Rate for Payer: Cash Price |
$247.34
|
| Rate for Payer: Cigna Commercial |
$410.58
|
| Rate for Payer: First Health Commercial |
$469.95
|
| Rate for Payer: Humana Commercial |
$420.48
|
| Rate for Payer: Humana KY Medicaid |
$170.12
|
| Rate for Payer: Kentucky WC Medicaid |
$171.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$405.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$365.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$148.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$173.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$435.32
|
| Rate for Payer: Ohio Health Group HMO |
$371.01
|
| Rate for Payer: Ohio Health Group PPO Differential |
$98.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$64.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$153.35
|
| Rate for Payer: PHCS Commercial |
$474.89
|
| Rate for Payer: United Healthcare All Payer |
$435.32
|
|
|
PINNACLE SHEATH 25CM 7FR
|
Facility
|
IP
|
$476.48
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.94 |
| Max. Negotiated Rate |
$457.42 |
| Rate for Payer: Aetna Commercial |
$366.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$371.65
|
| Rate for Payer: Cash Price |
$238.24
|
| Rate for Payer: Cigna Commercial |
$395.48
|
| Rate for Payer: First Health Commercial |
$452.66
|
| Rate for Payer: Humana Commercial |
$405.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$390.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$351.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$142.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$419.30
|
| Rate for Payer: Ohio Health Group HMO |
$357.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$95.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$147.71
|
| Rate for Payer: PHCS Commercial |
$457.42
|
| Rate for Payer: United Healthcare All Payer |
$419.30
|
|
|
PINNACLE SHEATH 25CM 7FR
|
Facility
|
OP
|
$476.48
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.94 |
| Max. Negotiated Rate |
$457.42 |
| Rate for Payer: Aetna Commercial |
$366.89
|
| Rate for Payer: Anthem Medicaid |
$163.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$371.65
|
| Rate for Payer: Cash Price |
$238.24
|
| Rate for Payer: Cigna Commercial |
$395.48
|
| Rate for Payer: First Health Commercial |
$452.66
|
| Rate for Payer: Humana Commercial |
$405.01
|
| Rate for Payer: Humana KY Medicaid |
$163.86
|
| Rate for Payer: Kentucky WC Medicaid |
$165.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$390.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$351.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$142.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$167.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$419.30
|
| Rate for Payer: Ohio Health Group HMO |
$357.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$95.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$147.71
|
| Rate for Payer: PHCS Commercial |
$457.42
|
| Rate for Payer: United Healthcare All Payer |
$419.30
|
|
|
PINNACLE SHEATH 4FR
|
Facility
|
IP
|
$161.55
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$155.09 |
| Rate for Payer: Aetna Commercial |
$124.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$126.01
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cigna Commercial |
$134.09
|
| Rate for Payer: First Health Commercial |
$153.47
|
| Rate for Payer: Humana Commercial |
$137.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$132.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$119.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$142.16
|
| Rate for Payer: Ohio Health Group HMO |
$121.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.31
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.08
|
| Rate for Payer: PHCS Commercial |
$155.09
|
| Rate for Payer: United Healthcare All Payer |
$142.16
|
|
|
PINNACLE SHEATH 4FR
|
Facility
|
OP
|
$161.55
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$155.09 |
| Rate for Payer: Aetna Commercial |
$124.39
|
| Rate for Payer: Anthem Medicaid |
$55.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$126.01
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cigna Commercial |
$134.09
|
| Rate for Payer: First Health Commercial |
$153.47
|
| Rate for Payer: Humana Commercial |
$137.32
|
| Rate for Payer: Humana KY Medicaid |
$55.56
|
| Rate for Payer: Kentucky WC Medicaid |
$56.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$132.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$119.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$56.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$142.16
|
| Rate for Payer: Ohio Health Group HMO |
$121.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.31
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.08
|
| Rate for Payer: PHCS Commercial |
$155.09
|
| Rate for Payer: United Healthcare All Payer |
$142.16
|
|
|
PINNACLE SHEATH 5FR
|
Facility
|
OP
|
$1,547.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$1,485.60 |
| Rate for Payer: Aetna Commercial |
$1,191.58
|
| Rate for Payer: Anthem Medicaid |
$532.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,207.05
|
| Rate for Payer: Cash Price |
$773.75
|
| Rate for Payer: Cigna Commercial |
$1,284.42
|
| Rate for Payer: First Health Commercial |
$1,470.12
|
| Rate for Payer: Humana Commercial |
$1,315.38
|
| Rate for Payer: Humana KY Medicaid |
$532.19
|
| Rate for Payer: Kentucky WC Medicaid |
$537.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,268.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,142.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$464.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$542.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,361.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,160.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$309.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$201.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$479.72
|
| Rate for Payer: PHCS Commercial |
$1,485.60
|
| Rate for Payer: United Healthcare All Payer |
$1,361.80
|
|
|
PINNACLE SHEATH 5FR
|
Facility
|
IP
|
$1,547.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$1,485.60 |
| Rate for Payer: Aetna Commercial |
$1,191.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,207.05
|
| Rate for Payer: Cash Price |
$773.75
|
| Rate for Payer: Cigna Commercial |
$1,284.42
|
| Rate for Payer: First Health Commercial |
$1,470.12
|
| Rate for Payer: Humana Commercial |
$1,315.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,268.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,142.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$464.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,361.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,160.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$309.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$201.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$479.72
|
| Rate for Payer: PHCS Commercial |
$1,485.60
|
| Rate for Payer: United Healthcare All Payer |
$1,361.80
|
|
|
PINNACLE SHEATH 6F 25CM
|
Facility
|
IP
|
$534.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.42 |
| Max. Negotiated Rate |
$512.64 |
| Rate for Payer: Aetna Commercial |
$411.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$416.52
|
| Rate for Payer: Cash Price |
$267.00
|
| Rate for Payer: Cigna Commercial |
$443.22
|
| Rate for Payer: First Health Commercial |
$507.30
|
| Rate for Payer: Humana Commercial |
$453.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$437.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$394.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$160.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$469.92
|
| Rate for Payer: Ohio Health Group HMO |
$400.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$106.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$69.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.54
|
| Rate for Payer: PHCS Commercial |
$512.64
|
| Rate for Payer: United Healthcare All Payer |
$469.92
|
|
|
PINNACLE SHEATH 6F 25CM
|
Facility
|
OP
|
$534.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.42 |
| Max. Negotiated Rate |
$512.64 |
| Rate for Payer: Aetna Commercial |
$411.18
|
| Rate for Payer: Anthem Medicaid |
$183.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$416.52
|
| Rate for Payer: Cash Price |
$267.00
|
| Rate for Payer: Cigna Commercial |
$443.22
|
| Rate for Payer: First Health Commercial |
$507.30
|
| Rate for Payer: Humana Commercial |
$453.90
|
| Rate for Payer: Humana KY Medicaid |
$183.64
|
| Rate for Payer: Kentucky WC Medicaid |
$185.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$437.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$394.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$160.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$187.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$469.92
|
| Rate for Payer: Ohio Health Group HMO |
$400.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$106.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$69.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.54
|
| Rate for Payer: PHCS Commercial |
$512.64
|
| Rate for Payer: United Healthcare All Payer |
$469.92
|
|
|
PINNACLE SHEATH 7F 25CM
|
Facility
|
OP
|
$3,110.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.30 |
| Max. Negotiated Rate |
$2,985.60 |
| Rate for Payer: Aetna Commercial |
$2,394.70
|
| Rate for Payer: Anthem Medicaid |
$1,069.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,425.80
|
| Rate for Payer: Cash Price |
$1,555.00
|
| Rate for Payer: Cigna Commercial |
$2,581.30
|
| Rate for Payer: First Health Commercial |
$2,954.50
|
| Rate for Payer: Humana Commercial |
$2,643.50
|
| Rate for Payer: Humana KY Medicaid |
$1,069.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,080.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,550.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,295.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$933.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,090.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,736.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,332.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$622.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$404.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$964.10
|
| Rate for Payer: PHCS Commercial |
$2,985.60
|
| Rate for Payer: United Healthcare All Payer |
$2,736.80
|
|
|
PINNACLE SHEATH 7F 25CM
|
Facility
|
IP
|
$3,110.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.30 |
| Max. Negotiated Rate |
$2,985.60 |
| Rate for Payer: Aetna Commercial |
$2,394.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,425.80
|
| Rate for Payer: Cash Price |
$1,555.00
|
| Rate for Payer: Cigna Commercial |
$2,581.30
|
| Rate for Payer: First Health Commercial |
$2,954.50
|
| Rate for Payer: Humana Commercial |
$2,643.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,550.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,295.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$933.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,736.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,332.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$622.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$404.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$964.10
|
| Rate for Payer: PHCS Commercial |
$2,985.60
|
| Rate for Payer: United Healthcare All Payer |
$2,736.80
|
|
|
PINNACLE SHEATH 7FR10CM R/O II
|
Facility
|
OP
|
$514.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$493.92 |
| Rate for Payer: Aetna Commercial |
$396.16
|
| Rate for Payer: Anthem Medicaid |
$176.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$401.31
|
| Rate for Payer: Cash Price |
$257.25
|
| Rate for Payer: Cigna Commercial |
$427.04
|
| Rate for Payer: First Health Commercial |
$488.78
|
| Rate for Payer: Humana Commercial |
$437.32
|
| Rate for Payer: Humana KY Medicaid |
$176.94
|
| Rate for Payer: Kentucky WC Medicaid |
$178.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$421.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$379.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$154.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$180.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$452.76
|
| Rate for Payer: Ohio Health Group HMO |
$385.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$102.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$66.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$159.50
|
| Rate for Payer: PHCS Commercial |
$493.92
|
| Rate for Payer: United Healthcare All Payer |
$452.76
|
|
|
PINNACLE SHEATH 7FR10CM R/O II
|
Facility
|
IP
|
$514.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$493.92 |
| Rate for Payer: Aetna Commercial |
$396.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$401.31
|
| Rate for Payer: Cash Price |
$257.25
|
| Rate for Payer: Cigna Commercial |
$427.04
|
| Rate for Payer: First Health Commercial |
$488.78
|
| Rate for Payer: Humana Commercial |
$437.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$421.89
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$379.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$154.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$452.76
|
| Rate for Payer: Ohio Health Group HMO |
$385.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$102.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$66.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$159.50
|
| Rate for Payer: PHCS Commercial |
$493.92
|
| Rate for Payer: United Healthcare All Payer |
$452.76
|
|
|
PINNACLE SHEATH 8FR INTRODUCER
|
Facility
|
OP
|
$163.12
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.21 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Aetna Commercial |
$125.60
|
| Rate for Payer: Anthem Medicaid |
$56.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$127.23
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cigna Commercial |
$135.39
|
| Rate for Payer: First Health Commercial |
$154.96
|
| Rate for Payer: Humana Commercial |
$138.65
|
| Rate for Payer: Humana KY Medicaid |
$56.10
|
| Rate for Payer: Kentucky WC Medicaid |
$56.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$133.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$120.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$57.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$143.55
|
| Rate for Payer: Ohio Health Group HMO |
$122.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.57
|
| Rate for Payer: PHCS Commercial |
$156.60
|
| Rate for Payer: United Healthcare All Payer |
$143.55
|
|
|
PINNACLE SHEATH 8FR INTRODUCER
|
Facility
|
IP
|
$163.12
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.21 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Aetna Commercial |
$125.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$127.23
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cigna Commercial |
$135.39
|
| Rate for Payer: First Health Commercial |
$154.96
|
| Rate for Payer: Humana Commercial |
$138.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$133.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$120.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$143.55
|
| Rate for Payer: Ohio Health Group HMO |
$122.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.57
|
| Rate for Payer: PHCS Commercial |
$156.60
|
| Rate for Payer: United Healthcare All Payer |
$143.55
|
|
|
PINNACLE SHEATH 9FR INTRODUCER
|
Facility
|
OP
|
$163.12
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.21 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Aetna Commercial |
$125.60
|
| Rate for Payer: Anthem Medicaid |
$56.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$127.23
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cigna Commercial |
$135.39
|
| Rate for Payer: First Health Commercial |
$154.96
|
| Rate for Payer: Humana Commercial |
$138.65
|
| Rate for Payer: Humana KY Medicaid |
$56.10
|
| Rate for Payer: Kentucky WC Medicaid |
$56.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$133.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$120.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$57.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$143.55
|
| Rate for Payer: Ohio Health Group HMO |
$122.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.57
|
| Rate for Payer: PHCS Commercial |
$156.60
|
| Rate for Payer: United Healthcare All Payer |
$143.55
|
|
|
PINNACLE SHEATH 9FR INTRODUCER
|
Facility
|
IP
|
$163.12
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.21 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Aetna Commercial |
$125.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$127.23
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cigna Commercial |
$135.39
|
| Rate for Payer: First Health Commercial |
$154.96
|
| Rate for Payer: Humana Commercial |
$138.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$133.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$120.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$48.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$143.55
|
| Rate for Payer: Ohio Health Group HMO |
$122.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50.57
|
| Rate for Payer: PHCS Commercial |
$156.60
|
| Rate for Payer: United Healthcare All Payer |
$143.55
|
|
|
PINNACLE TIF TIP 10CM 5F
|
Facility
|
IP
|
$166.28
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$159.63 |
| Rate for Payer: Aetna Commercial |
$128.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.70
|
| Rate for Payer: Cash Price |
$83.14
|
| Rate for Payer: Cigna Commercial |
$138.01
|
| Rate for Payer: First Health Commercial |
$157.97
|
| Rate for Payer: Humana Commercial |
$141.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.33
|
| Rate for Payer: Ohio Health Group HMO |
$124.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.55
|
| Rate for Payer: PHCS Commercial |
$159.63
|
| Rate for Payer: United Healthcare All Payer |
$146.33
|
|
|
PINNACLE TIF TIP 10CM 5F
|
Facility
|
OP
|
$166.28
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$159.63 |
| Rate for Payer: Aetna Commercial |
$128.04
|
| Rate for Payer: Anthem Medicaid |
$57.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.70
|
| Rate for Payer: Cash Price |
$83.14
|
| Rate for Payer: Cigna Commercial |
$138.01
|
| Rate for Payer: First Health Commercial |
$157.97
|
| Rate for Payer: Humana Commercial |
$141.34
|
| Rate for Payer: Humana KY Medicaid |
$57.18
|
| Rate for Payer: Kentucky WC Medicaid |
$57.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$58.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.33
|
| Rate for Payer: Ohio Health Group HMO |
$124.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.55
|
| Rate for Payer: PHCS Commercial |
$159.63
|
| Rate for Payer: United Healthcare All Payer |
$146.33
|
|
|
PINNACLE TIF TIP 10CM 6FR
|
Facility
|
OP
|
$166.28
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$159.63 |
| Rate for Payer: Aetna Commercial |
$128.04
|
| Rate for Payer: Anthem Medicaid |
$57.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.70
|
| Rate for Payer: Cash Price |
$83.14
|
| Rate for Payer: Cigna Commercial |
$138.01
|
| Rate for Payer: First Health Commercial |
$157.97
|
| Rate for Payer: Humana Commercial |
$141.34
|
| Rate for Payer: Humana KY Medicaid |
$57.18
|
| Rate for Payer: Kentucky WC Medicaid |
$57.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$58.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.33
|
| Rate for Payer: Ohio Health Group HMO |
$124.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.55
|
| Rate for Payer: PHCS Commercial |
$159.63
|
| Rate for Payer: United Healthcare All Payer |
$146.33
|
|
|
PINNACLE TIF TIP 10CM 6FR
|
Facility
|
IP
|
$166.28
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$159.63 |
| Rate for Payer: Aetna Commercial |
$128.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.70
|
| Rate for Payer: Cash Price |
$83.14
|
| Rate for Payer: Cigna Commercial |
$138.01
|
| Rate for Payer: First Health Commercial |
$157.97
|
| Rate for Payer: Humana Commercial |
$141.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.33
|
| Rate for Payer: Ohio Health Group HMO |
$124.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.55
|
| Rate for Payer: PHCS Commercial |
$159.63
|
| Rate for Payer: United Healthcare All Payer |
$146.33
|
|
|
PINNACLE TIF TIP 10CM 7FR
|
Facility
|
OP
|
$166.28
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$159.63 |
| Rate for Payer: Aetna Commercial |
$128.04
|
| Rate for Payer: Anthem Medicaid |
$57.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.70
|
| Rate for Payer: Cash Price |
$83.14
|
| Rate for Payer: Cigna Commercial |
$138.01
|
| Rate for Payer: First Health Commercial |
$157.97
|
| Rate for Payer: Humana Commercial |
$141.34
|
| Rate for Payer: Humana KY Medicaid |
$57.18
|
| Rate for Payer: Kentucky WC Medicaid |
$57.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$58.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.33
|
| Rate for Payer: Ohio Health Group HMO |
$124.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.55
|
| Rate for Payer: PHCS Commercial |
$159.63
|
| Rate for Payer: United Healthcare All Payer |
$146.33
|
|
|
PINNACLE TIF TIP 10CM 7FR
|
Facility
|
IP
|
$166.28
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$159.63 |
| Rate for Payer: Aetna Commercial |
$128.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.70
|
| Rate for Payer: Cash Price |
$83.14
|
| Rate for Payer: Cigna Commercial |
$138.01
|
| Rate for Payer: First Health Commercial |
$157.97
|
| Rate for Payer: Humana Commercial |
$141.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.33
|
| Rate for Payer: Ohio Health Group HMO |
$124.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.55
|
| Rate for Payer: PHCS Commercial |
$159.63
|
| Rate for Payer: United Healthcare All Payer |
$146.33
|
|
|
PINN LNR CON +4 10^ 28*48
|
Facility
|
IP
|
$28,745.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,736.86 |
| Max. Negotiated Rate |
$27,595.30 |
| Rate for Payer: Aetna Commercial |
$22,133.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,421.18
|
| Rate for Payer: Cash Price |
$14,372.55
|
| Rate for Payer: Cigna Commercial |
$23,858.43
|
| Rate for Payer: First Health Commercial |
$27,307.84
|
| Rate for Payer: Humana Commercial |
$24,433.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,570.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,213.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,623.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,295.69
|
| Rate for Payer: Ohio Health Group HMO |
$21,558.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,749.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,736.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,910.98
|
| Rate for Payer: PHCS Commercial |
$27,595.30
|
| Rate for Payer: United Healthcare All Payer |
$25,295.69
|
|
|
PINN LNR CON +4 10^ 28*48
|
Facility
|
OP
|
$28,745.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,736.86 |
| Max. Negotiated Rate |
$27,595.30 |
| Rate for Payer: Aetna Commercial |
$22,133.73
|
| Rate for Payer: Anthem Medicaid |
$9,885.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,421.18
|
| Rate for Payer: Cash Price |
$14,372.55
|
| Rate for Payer: Cigna Commercial |
$23,858.43
|
| Rate for Payer: First Health Commercial |
$27,307.84
|
| Rate for Payer: Humana Commercial |
$24,433.34
|
| Rate for Payer: Humana KY Medicaid |
$9,885.44
|
| Rate for Payer: Kentucky WC Medicaid |
$9,986.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,570.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,213.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,623.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,083.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,295.69
|
| Rate for Payer: Ohio Health Group HMO |
$21,558.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,749.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,736.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,910.98
|
| Rate for Payer: PHCS Commercial |
$27,595.30
|
| Rate for Payer: United Healthcare All Payer |
$25,295.69
|
|
