|
PINN MAR +4 10D 32ID*58OD
|
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*60OD
|
Facility
|
OP
|
$7,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$956.18 |
| Max. Negotiated Rate |
$7,060.99 |
| Rate for Payer: Aetna Commercial |
$5,663.50
|
| Rate for Payer: Anthem Medicaid |
$2,529.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,737.06
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cigna Commercial |
$6,104.82
|
| Rate for Payer: First Health Commercial |
$6,987.44
|
| Rate for Payer: Humana Commercial |
$6,251.92
|
| Rate for Payer: Humana KY Medicaid |
$2,529.45
|
| Rate for Payer: Kentucky WC Medicaid |
$2,555.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,031.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,428.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,206.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,580.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,472.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,516.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$956.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,280.11
|
| Rate for Payer: PHCS Commercial |
$7,060.99
|
| Rate for Payer: United Healthcare All Payer |
$6,472.58
|
|
|
PINN MAR +4 10D 32ID*60OD
|
Facility
|
IP
|
$7,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$956.18 |
| Max. Negotiated Rate |
$7,060.99 |
| Rate for Payer: Aetna Commercial |
$5,663.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,737.06
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cigna Commercial |
$6,104.82
|
| Rate for Payer: First Health Commercial |
$6,987.44
|
| Rate for Payer: Humana Commercial |
$6,251.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,031.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,428.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,206.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,472.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,516.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$956.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,280.11
|
| Rate for Payer: PHCS Commercial |
$7,060.99
|
| Rate for Payer: United Healthcare All Payer |
$6,472.58
|
|
|
PINN MAR +4 10D 32ID*62OD
|
Facility
|
IP
|
$7,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$956.18 |
| Max. Negotiated Rate |
$7,060.99 |
| Rate for Payer: Aetna Commercial |
$5,663.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,737.06
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cigna Commercial |
$6,104.82
|
| Rate for Payer: First Health Commercial |
$6,987.44
|
| Rate for Payer: Humana Commercial |
$6,251.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,031.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,428.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,206.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,472.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,516.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$956.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,280.11
|
| Rate for Payer: PHCS Commercial |
$7,060.99
|
| Rate for Payer: United Healthcare All Payer |
$6,472.58
|
|
|
PINN MAR +4 10D 32ID*62OD
|
Facility
|
OP
|
$7,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$956.18 |
| Max. Negotiated Rate |
$7,060.99 |
| Rate for Payer: Aetna Commercial |
$5,663.50
|
| Rate for Payer: Anthem Medicaid |
$2,529.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,737.06
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cigna Commercial |
$6,104.82
|
| Rate for Payer: First Health Commercial |
$6,987.44
|
| Rate for Payer: Humana Commercial |
$6,251.92
|
| Rate for Payer: Humana KY Medicaid |
$2,529.45
|
| Rate for Payer: Kentucky WC Medicaid |
$2,555.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,031.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,428.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,206.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,580.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,472.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,516.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$956.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,280.11
|
| Rate for Payer: PHCS Commercial |
$7,060.99
|
| Rate for Payer: United Healthcare All Payer |
$6,472.58
|
|
|
PINN MAR +4 10D 32ID*66OD
|
Facility
|
OP
|
$7,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$956.18 |
| Max. Negotiated Rate |
$7,060.99 |
| Rate for Payer: Aetna Commercial |
$5,663.50
|
| Rate for Payer: Anthem Medicaid |
$2,529.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,737.06
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cigna Commercial |
$6,104.82
|
| Rate for Payer: First Health Commercial |
$6,987.44
|
| Rate for Payer: Humana Commercial |
$6,251.92
|
| Rate for Payer: Humana KY Medicaid |
$2,529.45
|
| Rate for Payer: Kentucky WC Medicaid |
$2,555.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,031.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,428.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,206.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,580.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,472.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,516.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$956.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,280.11
|
| Rate for Payer: PHCS Commercial |
$7,060.99
|
| Rate for Payer: United Healthcare All Payer |
$6,472.58
|
|
|
PINN MAR +4 10D 32ID*66OD
|
Facility
|
IP
|
$7,355.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$956.18 |
| Max. Negotiated Rate |
$7,060.99 |
| Rate for Payer: Aetna Commercial |
$5,663.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,737.06
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cigna Commercial |
$6,104.82
|
| Rate for Payer: First Health Commercial |
$6,987.44
|
| Rate for Payer: Humana Commercial |
$6,251.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,031.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,428.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,206.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,472.58
|
| Rate for Payer: Ohio Health Group HMO |
$5,516.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,471.04
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$956.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,280.11
|
| Rate for Payer: PHCS Commercial |
$7,060.99
|
| Rate for Payer: United Healthcare All Payer |
$6,472.58
|
|
|
PINN MAR +4 10D 36ID*52OD
|
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 +4 10D 36ID*52OD
|
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 36ID*54OD
|
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 36ID*54OD
|
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 +4 LNR 36ID*52OD
|
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 LNR 36ID*52OD
|
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+4 LNR NEUT 36ID*56OD
|
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+4 LNR NEUT 36ID*56OD
|
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 LNR NEUT 36ID*58OD
|
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+4 LNR NEUT 36ID*58OD
|
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 LNR NEUT 36ID*60OD
|
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+4 LNR NEUT 36ID*60OD
|
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 LNR NEUT 36ID*62OD
|
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+4 LNR NEUT 36ID*62OD
|
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 LNR NEUT 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+4 LNR NEUT 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+4 LNR NEUT 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+4 LNR NEUT 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
|
|
