|
PINN LNR CON +4 10^ 32*74
|
Facility
|
IP
|
$8,822.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,146.92 |
| Max. Negotiated Rate |
$8,469.60 |
| Rate for Payer: Aetna Commercial |
$6,793.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,881.55
|
| Rate for Payer: Cash Price |
$4,411.25
|
| Rate for Payer: Cigna Commercial |
$7,322.68
|
| Rate for Payer: First Health Commercial |
$8,381.38
|
| Rate for Payer: Humana Commercial |
$7,499.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,234.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,511.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,646.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,763.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,616.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,764.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,146.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,734.98
|
| Rate for Payer: PHCS Commercial |
$8,469.60
|
| Rate for Payer: United Healthcare All Payer |
$7,763.80
|
|
|
PINN LNR CON +4 10^ 32*76
|
Facility
|
OP
|
$8,822.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,146.92 |
| Max. Negotiated Rate |
$8,469.60 |
| Rate for Payer: Aetna Commercial |
$6,793.32
|
| Rate for Payer: Anthem Medicaid |
$3,034.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,881.55
|
| Rate for Payer: Cash Price |
$4,411.25
|
| Rate for Payer: Cigna Commercial |
$7,322.68
|
| Rate for Payer: First Health Commercial |
$8,381.38
|
| Rate for Payer: Humana Commercial |
$7,499.12
|
| Rate for Payer: Humana KY Medicaid |
$3,034.06
|
| Rate for Payer: Kentucky WC Medicaid |
$3,064.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,234.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,511.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,646.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,094.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,763.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,616.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,764.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,146.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,734.98
|
| Rate for Payer: PHCS Commercial |
$8,469.60
|
| Rate for Payer: United Healthcare All Payer |
$7,763.80
|
|
|
PINN LNR CON +4 10^ 32*76
|
Facility
|
IP
|
$8,822.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,146.92 |
| Max. Negotiated Rate |
$8,469.60 |
| Rate for Payer: Aetna Commercial |
$6,793.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,881.55
|
| Rate for Payer: Cash Price |
$4,411.25
|
| Rate for Payer: Cigna Commercial |
$7,322.68
|
| Rate for Payer: First Health Commercial |
$8,381.38
|
| Rate for Payer: Humana Commercial |
$7,499.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,234.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,511.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,646.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,763.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,616.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,764.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,146.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,734.98
|
| Rate for Payer: PHCS Commercial |
$8,469.60
|
| Rate for Payer: United Healthcare All Payer |
$7,763.80
|
|
|
PINN LNR CON +4 10^ 36*56
|
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^ 36*56
|
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
|
|
|
PINN LNR CON +4 10^ 36*58
|
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
|
|
|
PINN LNR CON +4 10^ 36*58
|
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^ 36*60
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 36*60
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 40*62
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 40*62
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 40*64
|
Facility
|
OP
|
$32,527.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,228.52 |
| Max. Negotiated Rate |
$31,225.96 |
| Rate for Payer: Aetna Commercial |
$25,045.82
|
| Rate for Payer: Anthem Medicaid |
$11,186.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$25,371.09
|
| Rate for Payer: Cash Price |
$16,263.52
|
| Rate for Payer: Cigna Commercial |
$26,997.44
|
| Rate for Payer: First Health Commercial |
$30,900.69
|
| Rate for Payer: Humana Commercial |
$27,647.98
|
| Rate for Payer: Humana KY Medicaid |
$11,186.05
|
| Rate for Payer: Kentucky WC Medicaid |
$11,299.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$26,672.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$24,004.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,758.11
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,410.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$28,623.80
|
| Rate for Payer: Ohio Health Group HMO |
$24,395.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,505.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,228.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,083.38
|
| Rate for Payer: PHCS Commercial |
$31,225.96
|
| Rate for Payer: United Healthcare All Payer |
$28,623.80
|
|
|
PINN LNR CON +4 10^ 40*64
|
Facility
|
IP
|
$32,527.04
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,228.52 |
| Max. Negotiated Rate |
$31,225.96 |
| Rate for Payer: Aetna Commercial |
$25,045.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$25,371.09
|
| Rate for Payer: Cash Price |
$16,263.52
|
| Rate for Payer: Cigna Commercial |
$26,997.44
|
| Rate for Payer: First Health Commercial |
$30,900.69
|
| Rate for Payer: Humana Commercial |
$27,647.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$26,672.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$24,004.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,758.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$28,623.80
|
| Rate for Payer: Ohio Health Group HMO |
$24,395.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,505.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,228.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,083.38
|
| Rate for Payer: PHCS Commercial |
$31,225.96
|
| Rate for Payer: United Healthcare All Payer |
$28,623.80
|
|
|
PINN LNR CON +4 10^ 40*66
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 40*66
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 40*68
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 40*68
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*70
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*70
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*72
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*72
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*74
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*74
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*76
|
Facility
|
OP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem Medicaid |
$7,670.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Humana KY Medicaid |
$7,670.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,824.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
|
PINN LNR CON +4 10^ 44*76
|
Facility
|
IP
|
$22,305.40
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,899.70 |
| Max. Negotiated Rate |
$21,413.18 |
| Rate for Payer: Aetna Commercial |
$17,175.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,398.21
|
| Rate for Payer: Cash Price |
$11,152.70
|
| Rate for Payer: Cigna Commercial |
$18,513.48
|
| Rate for Payer: First Health Commercial |
$21,190.13
|
| Rate for Payer: Humana Commercial |
$18,959.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,290.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,461.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,691.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,628.75
|
| Rate for Payer: Ohio Health Group HMO |
$16,729.05
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,461.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,899.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,914.67
|
| Rate for Payer: PHCS Commercial |
$21,413.18
|
| Rate for Payer: United Healthcare All Payer |
$19,628.75
|
|
