|
PINN LNR CON +4 36*56
|
Facility
|
IP
|
$35,197.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,575.64 |
| Max. Negotiated Rate |
$33,789.31 |
| Rate for Payer: Aetna Commercial |
$27,101.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,453.82
|
| Rate for Payer: Cash Price |
$17,598.60
|
| Rate for Payer: Cigna Commercial |
$29,213.68
|
| Rate for Payer: First Health Commercial |
$33,437.34
|
| Rate for Payer: Humana Commercial |
$29,917.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,861.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,975.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,559.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,973.54
|
| Rate for Payer: Ohio Health Group HMO |
$26,397.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,039.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,575.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,911.13
|
| Rate for Payer: PHCS Commercial |
$33,789.31
|
| Rate for Payer: United Healthcare All Payer |
$30,973.54
|
|
|
PINN LNR CON +4 36*56
|
Facility
|
OP
|
$35,197.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,575.64 |
| Max. Negotiated Rate |
$33,789.31 |
| Rate for Payer: Aetna Commercial |
$27,101.84
|
| Rate for Payer: Anthem Medicaid |
$12,104.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,453.82
|
| Rate for Payer: Cash Price |
$17,598.60
|
| Rate for Payer: Cigna Commercial |
$29,213.68
|
| Rate for Payer: First Health Commercial |
$33,437.34
|
| Rate for Payer: Humana Commercial |
$29,917.62
|
| Rate for Payer: Humana KY Medicaid |
$12,104.32
|
| Rate for Payer: Kentucky WC Medicaid |
$12,227.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,861.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,975.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,559.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,347.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,973.54
|
| Rate for Payer: Ohio Health Group HMO |
$26,397.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,039.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,575.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,911.13
|
| Rate for Payer: PHCS Commercial |
$33,789.31
|
| Rate for Payer: United Healthcare All Payer |
$30,973.54
|
|
|
PINN LNR CON +4 36*58
|
Facility
|
OP
|
$30,637.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,982.89 |
| Max. Negotiated Rate |
$29,412.12 |
| Rate for Payer: Aetna Commercial |
$23,590.97
|
| Rate for Payer: Anthem Medicaid |
$10,536.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,897.34
|
| Rate for Payer: Cash Price |
$15,318.81
|
| Rate for Payer: Cigna Commercial |
$25,429.22
|
| Rate for Payer: First Health Commercial |
$29,105.74
|
| Rate for Payer: Humana Commercial |
$26,041.98
|
| Rate for Payer: Humana KY Medicaid |
$10,536.28
|
| Rate for Payer: Kentucky WC Medicaid |
$10,643.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,122.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,610.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,191.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,747.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,961.11
|
| Rate for Payer: Ohio Health Group HMO |
$22,978.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,127.52
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,982.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,497.66
|
| Rate for Payer: PHCS Commercial |
$29,412.12
|
| Rate for Payer: United Healthcare All Payer |
$26,961.11
|
|
|
PINN LNR CON +4 36*58
|
Facility
|
IP
|
$30,637.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,982.89 |
| Max. Negotiated Rate |
$29,412.12 |
| Rate for Payer: Aetna Commercial |
$23,590.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,897.34
|
| Rate for Payer: Cash Price |
$15,318.81
|
| Rate for Payer: Cigna Commercial |
$25,429.22
|
| Rate for Payer: First Health Commercial |
$29,105.74
|
| Rate for Payer: Humana Commercial |
$26,041.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,122.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,610.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,191.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,961.11
|
| Rate for Payer: Ohio Health Group HMO |
$22,978.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,127.52
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,982.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,497.66
|
| Rate for Payer: PHCS Commercial |
$29,412.12
|
| Rate for Payer: United Healthcare All Payer |
$26,961.11
|
|
|
PINN LNR CON +4 36*60
|
Facility
|
OP
|
$33,748.15
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,387.26 |
| Max. Negotiated Rate |
$32,398.22 |
| Rate for Payer: Aetna Commercial |
$25,986.08
|
| Rate for Payer: Anthem Medicaid |
$11,605.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$26,323.56
|
| Rate for Payer: Cash Price |
$16,874.08
|
| Rate for Payer: Cigna Commercial |
$28,010.96
|
| Rate for Payer: First Health Commercial |
$32,060.74
|
| Rate for Payer: Humana Commercial |
$28,685.93
|
| Rate for Payer: Humana KY Medicaid |
$11,605.99
|
| Rate for Payer: Kentucky WC Medicaid |
$11,724.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$27,673.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$24,906.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,124.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,838.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$29,698.37
|
| Rate for Payer: Ohio Health Group HMO |
$25,311.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,749.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,387.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,461.93
|
| Rate for Payer: PHCS Commercial |
$32,398.22
|
| Rate for Payer: United Healthcare All Payer |
$29,698.37
|
|
|
PINN LNR CON +4 36*60
|
Facility
|
IP
|
$33,748.15
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,387.26 |
| Max. Negotiated Rate |
$32,398.22 |
| Rate for Payer: Aetna Commercial |
$25,986.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$26,323.56
|
| Rate for Payer: Cash Price |
$16,874.08
|
| Rate for Payer: Cigna Commercial |
$28,010.96
|
| Rate for Payer: First Health Commercial |
$32,060.74
|
| Rate for Payer: Humana Commercial |
$28,685.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$27,673.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$24,906.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,124.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$29,698.37
|
| Rate for Payer: Ohio Health Group HMO |
$25,311.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,749.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,387.26
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,461.93
|
| Rate for Payer: PHCS Commercial |
$32,398.22
|
| Rate for Payer: United Healthcare All Payer |
$29,698.37
|
|
|
PINN LNR CON +4 NEUT 28*48
|
Facility
|
OP
|
$21,111.85
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,744.54 |
| Max. Negotiated Rate |
$20,267.38 |
| Rate for Payer: Aetna Commercial |
$16,256.12
|
| Rate for Payer: Anthem Medicaid |
$7,260.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,467.24
|
| Rate for Payer: Cash Price |
$10,555.92
|
| Rate for Payer: Cigna Commercial |
$17,522.84
|
| Rate for Payer: First Health Commercial |
$20,056.26
|
| Rate for Payer: Humana Commercial |
$17,945.07
|
| Rate for Payer: Humana KY Medicaid |
$7,260.37
|
| Rate for Payer: Kentucky WC Medicaid |
$7,334.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,311.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,580.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,333.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,406.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,578.43
|
| Rate for Payer: Ohio Health Group HMO |
$15,833.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,222.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,744.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,544.67
|
| Rate for Payer: PHCS Commercial |
$20,267.38
|
| Rate for Payer: United Healthcare All Payer |
$18,578.43
|
|
|
PINN LNR CON +4 NEUT 28*48
|
Facility
|
IP
|
$21,111.85
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,744.54 |
| Max. Negotiated Rate |
$20,267.38 |
| Rate for Payer: Aetna Commercial |
$16,256.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,467.24
|
| Rate for Payer: Cash Price |
$10,555.92
|
| Rate for Payer: Cigna Commercial |
$17,522.84
|
| Rate for Payer: First Health Commercial |
$20,056.26
|
| Rate for Payer: Humana Commercial |
$17,945.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,311.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,580.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,333.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,578.43
|
| Rate for Payer: Ohio Health Group HMO |
$15,833.89
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,222.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,744.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,544.67
|
| Rate for Payer: PHCS Commercial |
$20,267.38
|
| Rate for Payer: United Healthcare All Payer |
$18,578.43
|
|
|
PINN LNR CON +4 NEUT 28*50
|
Facility
|
OP
|
$35,197.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,575.64 |
| Max. Negotiated Rate |
$33,789.31 |
| Rate for Payer: Aetna Commercial |
$27,101.84
|
| Rate for Payer: Anthem Medicaid |
$12,104.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,453.82
|
| Rate for Payer: Cash Price |
$17,598.60
|
| Rate for Payer: Cigna Commercial |
$29,213.68
|
| Rate for Payer: First Health Commercial |
$33,437.34
|
| Rate for Payer: Humana Commercial |
$29,917.62
|
| Rate for Payer: Humana KY Medicaid |
$12,104.32
|
| Rate for Payer: Kentucky WC Medicaid |
$12,227.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,861.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,975.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,559.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,347.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,973.54
|
| Rate for Payer: Ohio Health Group HMO |
$26,397.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,039.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,575.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,911.13
|
| Rate for Payer: PHCS Commercial |
$33,789.31
|
| Rate for Payer: United Healthcare All Payer |
$30,973.54
|
|
|
PINN LNR CON +4 NEUT 28*50
|
Facility
|
IP
|
$35,197.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,575.64 |
| Max. Negotiated Rate |
$33,789.31 |
| Rate for Payer: Aetna Commercial |
$27,101.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,453.82
|
| Rate for Payer: Cash Price |
$17,598.60
|
| Rate for Payer: Cigna Commercial |
$29,213.68
|
| Rate for Payer: First Health Commercial |
$33,437.34
|
| Rate for Payer: Humana Commercial |
$29,917.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,861.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,975.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,559.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,973.54
|
| Rate for Payer: Ohio Health Group HMO |
$26,397.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,039.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,575.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,911.13
|
| Rate for Payer: PHCS Commercial |
$33,789.31
|
| Rate for Payer: United Healthcare All Payer |
$30,973.54
|
|
|
PINN LNR CON +4 NEUT 32*52
|
Facility
|
OP
|
$35,579.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,625.39 |
| Max. Negotiated Rate |
$34,156.70 |
| Rate for Payer: Aetna Commercial |
$27,396.52
|
| Rate for Payer: Anthem Medicaid |
$12,235.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,752.32
|
| Rate for Payer: Cash Price |
$17,789.95
|
| Rate for Payer: Cigna Commercial |
$29,531.32
|
| Rate for Payer: First Health Commercial |
$33,800.90
|
| Rate for Payer: Humana Commercial |
$30,242.92
|
| Rate for Payer: Humana KY Medicaid |
$12,235.93
|
| Rate for Payer: Kentucky WC Medicaid |
$12,360.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,175.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,257.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,673.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,481.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,310.31
|
| Rate for Payer: Ohio Health Group HMO |
$26,684.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,115.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,625.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,029.77
|
| Rate for Payer: PHCS Commercial |
$34,156.70
|
| Rate for Payer: United Healthcare All Payer |
$31,310.31
|
|
|
PINN LNR CON +4 NEUT 32*52
|
Facility
|
IP
|
$35,579.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,625.39 |
| Max. Negotiated Rate |
$34,156.70 |
| Rate for Payer: Aetna Commercial |
$27,396.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,752.32
|
| Rate for Payer: Cash Price |
$17,789.95
|
| Rate for Payer: Cigna Commercial |
$29,531.32
|
| Rate for Payer: First Health Commercial |
$33,800.90
|
| Rate for Payer: Humana Commercial |
$30,242.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,175.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,257.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,673.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,310.31
|
| Rate for Payer: Ohio Health Group HMO |
$26,684.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,115.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,625.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,029.77
|
| Rate for Payer: PHCS Commercial |
$34,156.70
|
| Rate for Payer: United Healthcare All Payer |
$31,310.31
|
|
|
PINN LNR CON +4 NEUT 32*54
|
Facility
|
OP
|
$35,579.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,625.39 |
| Max. Negotiated Rate |
$34,156.70 |
| Rate for Payer: Aetna Commercial |
$27,396.52
|
| Rate for Payer: Anthem Medicaid |
$12,235.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,752.32
|
| Rate for Payer: Cash Price |
$17,789.95
|
| Rate for Payer: Cigna Commercial |
$29,531.32
|
| Rate for Payer: First Health Commercial |
$33,800.90
|
| Rate for Payer: Humana Commercial |
$30,242.92
|
| Rate for Payer: Humana KY Medicaid |
$12,235.93
|
| Rate for Payer: Kentucky WC Medicaid |
$12,360.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,175.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,257.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,673.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,481.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,310.31
|
| Rate for Payer: Ohio Health Group HMO |
$26,684.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,115.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,625.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,029.77
|
| Rate for Payer: PHCS Commercial |
$34,156.70
|
| Rate for Payer: United Healthcare All Payer |
$31,310.31
|
|
|
PINN LNR CON +4 NEUT 32*54
|
Facility
|
IP
|
$35,579.90
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,625.39 |
| Max. Negotiated Rate |
$34,156.70 |
| Rate for Payer: Aetna Commercial |
$27,396.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,752.32
|
| Rate for Payer: Cash Price |
$17,789.95
|
| Rate for Payer: Cigna Commercial |
$29,531.32
|
| Rate for Payer: First Health Commercial |
$33,800.90
|
| Rate for Payer: Humana Commercial |
$30,242.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,175.52
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,257.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,673.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,310.31
|
| Rate for Payer: Ohio Health Group HMO |
$26,684.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,115.98
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,625.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,029.77
|
| Rate for Payer: PHCS Commercial |
$34,156.70
|
| Rate for Payer: United Healthcare All Payer |
$31,310.31
|
|
|
PINN LNR CON +4 NEUT 32*56
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*56
|
Facility
|
OP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem Medicaid |
$3,222.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Humana KY Medicaid |
$3,222.34
|
| Rate for Payer: Kentucky WC Medicaid |
$3,255.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,287.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*58
|
Facility
|
OP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem Medicaid |
$3,222.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Humana KY Medicaid |
$3,222.34
|
| Rate for Payer: Kentucky WC Medicaid |
$3,255.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,287.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*58
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*60
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*60
|
Facility
|
OP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem Medicaid |
$3,222.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Humana KY Medicaid |
$3,222.34
|
| Rate for Payer: Kentucky WC Medicaid |
$3,255.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,287.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*62
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*62
|
Facility
|
OP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem Medicaid |
$3,222.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Humana KY Medicaid |
$3,222.34
|
| Rate for Payer: Kentucky WC Medicaid |
$3,255.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,287.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*64
|
Facility
|
OP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem Medicaid |
$3,222.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Humana KY Medicaid |
$3,222.34
|
| Rate for Payer: Kentucky WC Medicaid |
$3,255.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,287.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*64
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
|
PINN LNR CON +4 NEUT 32*66
|
Facility
|
IP
|
$9,370.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.10 |
| Max. Negotiated Rate |
$8,995.20 |
| Rate for Payer: Aetna Commercial |
$7,214.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,308.60
|
| Rate for Payer: Cash Price |
$4,685.00
|
| Rate for Payer: Cigna Commercial |
$7,777.10
|
| Rate for Payer: First Health Commercial |
$8,901.50
|
| Rate for Payer: Humana Commercial |
$7,964.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,683.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,915.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,811.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,245.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,027.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,874.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,904.70
|
| Rate for Payer: PHCS Commercial |
$8,995.20
|
| Rate for Payer: United Healthcare All Payer |
$8,245.60
|
|
