|
PINN LNR CON +4 NEUT 32*66
|
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*68
|
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*68
|
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*70
|
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*70
|
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*72
|
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*72
|
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*74
|
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*74
|
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*76
|
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*76
|
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 40*62
|
Facility
|
OP
|
$30,766.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,999.59 |
| Max. Negotiated Rate |
$29,535.46 |
| Rate for Payer: Aetna Commercial |
$23,689.90
|
| Rate for Payer: Anthem Medicaid |
$10,580.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,997.56
|
| Rate for Payer: Cash Price |
$15,383.05
|
| Rate for Payer: Cigna Commercial |
$25,535.86
|
| Rate for Payer: First Health Commercial |
$29,227.80
|
| Rate for Payer: Humana Commercial |
$26,151.18
|
| Rate for Payer: Humana KY Medicaid |
$10,580.46
|
| Rate for Payer: Kentucky WC Medicaid |
$10,688.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,228.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,705.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,229.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,792.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,074.17
|
| Rate for Payer: Ohio Health Group HMO |
$23,074.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,153.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,999.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,537.49
|
| Rate for Payer: PHCS Commercial |
$29,535.46
|
| Rate for Payer: United Healthcare All Payer |
$27,074.17
|
|
|
PINN LNR CON +4 NEUT 40*62
|
Facility
|
IP
|
$30,766.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,999.59 |
| Max. Negotiated Rate |
$29,535.46 |
| Rate for Payer: Aetna Commercial |
$23,689.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,997.56
|
| Rate for Payer: Cash Price |
$15,383.05
|
| Rate for Payer: Cigna Commercial |
$25,535.86
|
| Rate for Payer: First Health Commercial |
$29,227.80
|
| Rate for Payer: Humana Commercial |
$26,151.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,228.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,705.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,229.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,074.17
|
| Rate for Payer: Ohio Health Group HMO |
$23,074.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,153.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,999.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,537.49
|
| Rate for Payer: PHCS Commercial |
$29,535.46
|
| Rate for Payer: United Healthcare All Payer |
$27,074.17
|
|
|
PINN LNR CON +4 NEUT 40*64
|
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 NEUT 40*64
|
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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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: Cigna Commercial |
$18,513.48
|
| 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: 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
|
|
