|
PINN LNR CON +4 NEUT 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
|
|
|
PINN LNR CON +4 NEUT 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 MAR 10D 36ID*56OD
|
Facility
|
IP
|
$7,987.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,038.37 |
| Max. Negotiated Rate |
$7,667.95 |
| Rate for Payer: Aetna Commercial |
$6,150.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,230.21
|
| Rate for Payer: Cash Price |
$3,993.73
|
| Rate for Payer: Cigna Commercial |
$6,629.58
|
| Rate for Payer: First Health Commercial |
$7,588.08
|
| Rate for Payer: Humana Commercial |
$6,789.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,549.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,894.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,396.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,028.96
|
| Rate for Payer: Ohio Health Group HMO |
$5,990.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,597.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,038.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,476.11
|
| Rate for Payer: PHCS Commercial |
$7,667.95
|
| Rate for Payer: United Healthcare All Payer |
$7,028.96
|
|
|
PINN MAR 10D 36ID*56OD
|
Facility
|
OP
|
$7,987.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,038.37 |
| Max. Negotiated Rate |
$7,667.95 |
| Rate for Payer: Aetna Commercial |
$6,150.34
|
| Rate for Payer: Anthem Medicaid |
$2,746.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,230.21
|
| Rate for Payer: Cash Price |
$3,993.73
|
| Rate for Payer: Cigna Commercial |
$6,629.58
|
| Rate for Payer: First Health Commercial |
$7,588.08
|
| Rate for Payer: Humana Commercial |
$6,789.33
|
| Rate for Payer: Humana KY Medicaid |
$2,746.88
|
| Rate for Payer: Kentucky WC Medicaid |
$2,774.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,549.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,894.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,396.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,802.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,028.96
|
| Rate for Payer: Ohio Health Group HMO |
$5,990.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,597.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,038.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,476.11
|
| Rate for Payer: PHCS Commercial |
$7,667.95
|
| Rate for Payer: United Healthcare All Payer |
$7,028.96
|
|
|
PINN MAR 10D 36ID*58OD
|
Facility
|
OP
|
$6,965.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$905.47 |
| Max. Negotiated Rate |
$6,686.55 |
| Rate for Payer: Aetna Commercial |
$5,363.17
|
| Rate for Payer: Anthem Medicaid |
$2,395.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,432.82
|
| Rate for Payer: Cash Price |
$3,482.58
|
| Rate for Payer: Cigna Commercial |
$5,781.08
|
| Rate for Payer: First Health Commercial |
$6,616.90
|
| Rate for Payer: Humana Commercial |
$5,920.39
|
| Rate for Payer: Humana KY Medicaid |
$2,395.32
|
| Rate for Payer: Kentucky WC Medicaid |
$2,419.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,711.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,140.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,089.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,443.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,129.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,223.87
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,393.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$905.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,159.20
|
| Rate for Payer: PHCS Commercial |
$6,686.55
|
| Rate for Payer: United Healthcare All Payer |
$6,129.34
|
|
|
PINN MAR 10D 36ID*58OD
|
Facility
|
IP
|
$6,965.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$905.47 |
| Max. Negotiated Rate |
$6,686.55 |
| Rate for Payer: Aetna Commercial |
$5,363.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,432.82
|
| Rate for Payer: Cash Price |
$3,482.58
|
| Rate for Payer: Cigna Commercial |
$5,781.08
|
| Rate for Payer: First Health Commercial |
$6,616.90
|
| Rate for Payer: Humana Commercial |
$5,920.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,711.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,140.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,089.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,129.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,223.87
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,393.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$905.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,159.20
|
| Rate for Payer: PHCS Commercial |
$6,686.55
|
| Rate for Payer: United Healthcare All Payer |
$6,129.34
|
|
|
PINN MAR 10D 36ID*60OD
|
Facility
|
OP
|
$11,293.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,468.16 |
| Max. Negotiated Rate |
$10,841.76 |
| Rate for Payer: Aetna Commercial |
$8,696.00
|
| Rate for Payer: Anthem Medicaid |
$3,883.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,808.93
|
| Rate for Payer: Cash Price |
$5,646.75
|
| Rate for Payer: Cigna Commercial |
$9,373.60
|
| Rate for Payer: First Health Commercial |
$10,728.82
|
| Rate for Payer: Humana Commercial |
$9,599.48
|
| Rate for Payer: Humana KY Medicaid |
$3,883.83
|
| Rate for Payer: Kentucky WC Medicaid |
$3,923.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,260.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,334.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,388.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,961.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,938.28
|
| Rate for Payer: Ohio Health Group HMO |
$8,470.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,258.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,468.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,500.98
|
| Rate for Payer: PHCS Commercial |
$10,841.76
|
| Rate for Payer: United Healthcare All Payer |
$9,938.28
|
|
|
PINN MAR 10D 36ID*60OD
|
Facility
|
IP
|
$11,293.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,468.16 |
| Max. Negotiated Rate |
$10,841.76 |
| Rate for Payer: Aetna Commercial |
$8,696.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,808.93
|
| Rate for Payer: Cash Price |
$5,646.75
|
| Rate for Payer: Cigna Commercial |
$9,373.60
|
| Rate for Payer: First Health Commercial |
$10,728.82
|
| Rate for Payer: Humana Commercial |
$9,599.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,260.67
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,334.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,388.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,938.28
|
| Rate for Payer: Ohio Health Group HMO |
$8,470.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,258.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,468.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,500.98
|
| Rate for Payer: PHCS Commercial |
$10,841.76
|
| Rate for Payer: United Healthcare All Payer |
$9,938.28
|
|
|
PINN MAR 10D 36ID*62OD
|
Facility
|
OP
|
$7,596.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$987.49 |
| Max. Negotiated Rate |
$7,292.26 |
| Rate for Payer: Aetna Commercial |
$5,849.00
|
| Rate for Payer: Anthem Medicaid |
$2,612.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,924.96
|
| Rate for Payer: Cash Price |
$3,798.05
|
| Rate for Payer: Cigna Commercial |
$6,304.76
|
| Rate for Payer: First Health Commercial |
$7,216.30
|
| Rate for Payer: Humana Commercial |
$6,456.68
|
| Rate for Payer: Humana KY Medicaid |
$2,612.30
|
| Rate for Payer: Kentucky WC Medicaid |
$2,638.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,228.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,605.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,278.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,664.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,684.57
|
| Rate for Payer: Ohio Health Group HMO |
$5,697.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,519.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$987.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,354.79
|
| Rate for Payer: PHCS Commercial |
$7,292.26
|
| Rate for Payer: United Healthcare All Payer |
$6,684.57
|
|
|
PINN MAR 10D 36ID*62OD
|
Facility
|
IP
|
$7,596.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$987.49 |
| Max. Negotiated Rate |
$7,292.26 |
| Rate for Payer: Aetna Commercial |
$5,849.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,924.96
|
| Rate for Payer: Cash Price |
$3,798.05
|
| Rate for Payer: Cigna Commercial |
$6,304.76
|
| Rate for Payer: First Health Commercial |
$7,216.30
|
| Rate for Payer: Humana Commercial |
$6,456.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,228.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,605.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,278.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,684.57
|
| Rate for Payer: Ohio Health Group HMO |
$5,697.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,519.22
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$987.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,354.79
|
| Rate for Payer: PHCS Commercial |
$7,292.26
|
| Rate for Payer: United Healthcare All Payer |
$6,684.57
|
|
|
PINN MAR 10D 36ID*64OD
|
Facility
|
OP
|
$8,404.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,092.55 |
| Max. Negotiated Rate |
$8,068.04 |
| Rate for Payer: Aetna Commercial |
$6,471.24
|
| Rate for Payer: Anthem Medicaid |
$2,890.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,555.28
|
| Rate for Payer: Cash Price |
$4,202.10
|
| Rate for Payer: Cigna Commercial |
$6,975.49
|
| Rate for Payer: First Health Commercial |
$7,984.00
|
| Rate for Payer: Humana Commercial |
$7,143.58
|
| Rate for Payer: Humana KY Medicaid |
$2,890.21
|
| Rate for Payer: Kentucky WC Medicaid |
$2,919.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,891.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,202.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,521.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,948.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,395.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,303.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,680.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,092.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,605.31
|
| Rate for Payer: PHCS Commercial |
$8,068.04
|
| Rate for Payer: United Healthcare All Payer |
$7,395.70
|
|
|
PINN MAR 10D 36ID*64OD
|
Facility
|
IP
|
$8,404.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,092.55 |
| Max. Negotiated Rate |
$8,068.04 |
| Rate for Payer: Aetna Commercial |
$6,471.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,555.28
|
| Rate for Payer: Cash Price |
$4,202.10
|
| Rate for Payer: Cigna Commercial |
$6,975.49
|
| Rate for Payer: First Health Commercial |
$7,984.00
|
| Rate for Payer: Humana Commercial |
$7,143.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,891.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,202.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,521.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,395.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,303.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,680.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,092.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,605.31
|
| Rate for Payer: PHCS Commercial |
$8,068.04
|
| Rate for Payer: United Healthcare All Payer |
$7,395.70
|
|
|
PINN MAR 10D 36ID*66OD
|
Facility
|
IP
|
$8,404.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,092.55 |
| Max. Negotiated Rate |
$8,068.04 |
| Rate for Payer: Aetna Commercial |
$6,471.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,555.28
|
| Rate for Payer: Cash Price |
$4,202.10
|
| Rate for Payer: Cigna Commercial |
$6,975.49
|
| Rate for Payer: First Health Commercial |
$7,984.00
|
| Rate for Payer: Humana Commercial |
$7,143.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,891.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,202.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,521.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,395.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,303.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,680.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,092.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,605.31
|
| Rate for Payer: PHCS Commercial |
$8,068.04
|
| Rate for Payer: United Healthcare All Payer |
$7,395.70
|
|
|
PINN MAR 10D 36ID*66OD
|
Facility
|
OP
|
$8,404.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,092.55 |
| Max. Negotiated Rate |
$8,068.04 |
| Rate for Payer: Aetna Commercial |
$6,471.24
|
| Rate for Payer: Anthem Medicaid |
$2,890.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,555.28
|
| Rate for Payer: Cash Price |
$4,202.10
|
| Rate for Payer: Cigna Commercial |
$6,975.49
|
| Rate for Payer: First Health Commercial |
$7,984.00
|
| Rate for Payer: Humana Commercial |
$7,143.58
|
| Rate for Payer: Humana KY Medicaid |
$2,890.21
|
| Rate for Payer: Kentucky WC Medicaid |
$2,919.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,891.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,202.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,521.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,948.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,395.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,303.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,680.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,092.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,605.31
|
| Rate for Payer: PHCS Commercial |
$8,068.04
|
| Rate for Payer: United Healthcare All Payer |
$7,395.70
|
|
|
PINN MAR +4 10D 32ID*48OD
|
Facility
|
IP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*48OD
|
Facility
|
OP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem Medicaid |
$2,379.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Humana KY Medicaid |
$2,379.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,403.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,427.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*50OD
|
Facility
|
OP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem Medicaid |
$2,379.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Humana KY Medicaid |
$2,379.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,403.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,427.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*50OD
|
Facility
|
IP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*52OD
|
Facility
|
OP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem Medicaid |
$2,379.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Humana KY Medicaid |
$2,379.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,403.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,427.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*52OD
|
Facility
|
IP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*54OD
|
Facility
|
OP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem Medicaid |
$2,379.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Humana KY Medicaid |
$2,379.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,403.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,427.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*54OD
|
Facility
|
IP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*56OD
|
Facility
|
OP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem Medicaid |
$2,379.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Humana KY Medicaid |
$2,379.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,403.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,427.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*56OD
|
Facility
|
IP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
|
PINN MAR +4 10D 32ID*58OD
|
Facility
|
OP
|
$6,919.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$899.52 |
| Max. Negotiated Rate |
$6,642.61 |
| Rate for Payer: Aetna Commercial |
$5,327.93
|
| Rate for Payer: Anthem Medicaid |
$2,379.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,397.12
|
| Rate for Payer: Cash Price |
$3,459.70
|
| Rate for Payer: Cigna Commercial |
$5,743.09
|
| Rate for Payer: First Health Commercial |
$6,573.42
|
| Rate for Payer: Humana Commercial |
$5,881.48
|
| Rate for Payer: Humana KY Medicaid |
$2,379.58
|
| Rate for Payer: Kentucky WC Medicaid |
$2,403.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,673.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,106.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,075.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,427.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,089.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,189.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,383.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$899.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,145.01
|
| Rate for Payer: PHCS Commercial |
$6,642.61
|
| Rate for Payer: United Healthcare All Payer |
$6,089.06
|
|
