|
PARATHYROID IMAGING(T
|
Facility
|
IP
|
$1,401.00
|
|
|
Service Code
|
HCPCS 78070
|
| Hospital Charge Code |
340T0074
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$420.30 |
| Max. Negotiated Rate |
$1,344.96 |
| Rate for Payer: Aetna Commercial |
$1,078.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,092.78
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$1,162.83
|
| Rate for Payer: First Health Commercial |
$1,330.95
|
| Rate for Payer: Humana Commercial |
$1,190.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,148.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,033.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$420.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,232.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,050.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,120.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.69
|
| Rate for Payer: PHCS Commercial |
$1,344.96
|
| Rate for Payer: United Healthcare All Payer |
$1,232.88
|
|
|
PARATHYROID IMAGING(T
|
Facility
|
OP
|
$1,401.00
|
|
|
Service Code
|
HCPCS 78070
|
| Hospital Charge Code |
340T0074
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$371.28 |
| Max. Negotiated Rate |
$1,344.96 |
| Rate for Payer: Aetna Commercial |
$1,078.77
|
| Rate for Payer: Anthem Medicaid |
$481.80
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$371.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,092.78
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$519.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$501.23
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cash Price |
$700.50
|
| Rate for Payer: Cigna Commercial |
$1,162.83
|
| Rate for Payer: First Health Commercial |
$1,330.95
|
| Rate for Payer: Humana Commercial |
$1,190.85
|
| Rate for Payer: Humana KY Medicaid |
$481.80
|
| Rate for Payer: Humana Medicare Advantage |
$371.28
|
| Rate for Payer: Kentucky WC Medicaid |
$486.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,148.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,033.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$445.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$491.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,232.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,050.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,120.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,218.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$966.69
|
| Rate for Payer: PHCS Commercial |
$1,344.96
|
| Rate for Payer: United Healthcare All Payer |
$1,232.88
|
|
|
PARIETEX COMPOSITE15CM RND OPT
|
Facility
|
IP
|
$4,453.14
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,335.94 |
| Max. Negotiated Rate |
$4,275.01 |
| Rate for Payer: Aetna Commercial |
$3,428.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,473.45
|
| Rate for Payer: Cash Price |
$2,226.57
|
| Rate for Payer: Cigna Commercial |
$3,696.11
|
| Rate for Payer: First Health Commercial |
$4,230.48
|
| Rate for Payer: Humana Commercial |
$3,785.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,651.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,286.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,335.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,918.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,339.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,562.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,874.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.67
|
| Rate for Payer: PHCS Commercial |
$4,275.01
|
| Rate for Payer: United Healthcare All Payer |
$3,918.76
|
|
|
PARIETEX COMPOSITE15CM RND OPT
|
Facility
|
OP
|
$4,453.14
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,335.94 |
| Max. Negotiated Rate |
$4,275.01 |
| Rate for Payer: Aetna Commercial |
$3,428.92
|
| Rate for Payer: Anthem Medicaid |
$1,531.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,473.45
|
| Rate for Payer: Cash Price |
$2,226.57
|
| Rate for Payer: Cigna Commercial |
$3,696.11
|
| Rate for Payer: First Health Commercial |
$4,230.48
|
| Rate for Payer: Humana Commercial |
$3,785.17
|
| Rate for Payer: Humana KY Medicaid |
$1,531.43
|
| Rate for Payer: Kentucky WC Medicaid |
$1,547.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,651.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,286.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,335.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,562.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,918.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,339.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,562.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,874.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,072.67
|
| Rate for Payer: PHCS Commercial |
$4,275.01
|
| Rate for Payer: United Healthcare All Payer |
$3,918.76
|
|
|
PARIETEX COMPOSITE 20CM ROUND
|
Facility
|
OP
|
$5,485.55
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,645.66 |
| Max. Negotiated Rate |
$5,266.13 |
| Rate for Payer: Aetna Commercial |
$4,223.87
|
| Rate for Payer: Anthem Medicaid |
$1,886.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,278.73
|
| Rate for Payer: Cash Price |
$2,742.78
|
| Rate for Payer: Cigna Commercial |
$4,553.01
|
| Rate for Payer: First Health Commercial |
$5,211.27
|
| Rate for Payer: Humana Commercial |
$4,662.72
|
| Rate for Payer: Humana KY Medicaid |
$1,886.48
|
| Rate for Payer: Kentucky WC Medicaid |
$1,905.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,498.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,048.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,645.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,924.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,827.28
|
| Rate for Payer: Ohio Health Group HMO |
$4,114.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,388.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,772.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,785.03
|
| Rate for Payer: PHCS Commercial |
$5,266.13
|
| Rate for Payer: United Healthcare All Payer |
$4,827.28
|
|
|
PARIETEX COMPOSITE 20CM ROUND
|
Facility
|
IP
|
$5,485.55
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,645.66 |
| Max. Negotiated Rate |
$5,266.13 |
| Rate for Payer: Aetna Commercial |
$4,223.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,278.73
|
| Rate for Payer: Cash Price |
$2,742.78
|
| Rate for Payer: Cigna Commercial |
$4,553.01
|
| Rate for Payer: First Health Commercial |
$5,211.27
|
| Rate for Payer: Humana Commercial |
$4,662.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,498.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,048.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,645.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,827.28
|
| Rate for Payer: Ohio Health Group HMO |
$4,114.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,388.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,772.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,785.03
|
| Rate for Payer: PHCS Commercial |
$5,266.13
|
| Rate for Payer: United Healthcare All Payer |
$4,827.28
|
|
|
PARIETEX COMPOSITE 25*20 OPT
|
Facility
|
OP
|
$7,447.74
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,234.32 |
| Max. Negotiated Rate |
$7,149.83 |
| Rate for Payer: Aetna Commercial |
$5,734.76
|
| Rate for Payer: Anthem Medicaid |
$2,561.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,809.24
|
| Rate for Payer: Cash Price |
$3,723.87
|
| Rate for Payer: Cigna Commercial |
$6,181.62
|
| Rate for Payer: First Health Commercial |
$7,075.35
|
| Rate for Payer: Humana Commercial |
$6,330.58
|
| Rate for Payer: Humana KY Medicaid |
$2,561.28
|
| Rate for Payer: Kentucky WC Medicaid |
$2,587.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,107.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,496.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,234.32
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,612.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,554.01
|
| Rate for Payer: Ohio Health Group HMO |
$5,585.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,958.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,479.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,138.94
|
| Rate for Payer: PHCS Commercial |
$7,149.83
|
| Rate for Payer: United Healthcare All Payer |
$6,554.01
|
|
|
PARIETEX COMPOSITE 25*20 OPT
|
Facility
|
IP
|
$7,447.74
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,234.32 |
| Max. Negotiated Rate |
$7,149.83 |
| Rate for Payer: Aetna Commercial |
$5,734.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,809.24
|
| Rate for Payer: Cash Price |
$3,723.87
|
| Rate for Payer: Cigna Commercial |
$6,181.62
|
| Rate for Payer: First Health Commercial |
$7,075.35
|
| Rate for Payer: Humana Commercial |
$6,330.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,107.15
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,496.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,234.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,554.01
|
| Rate for Payer: Ohio Health Group HMO |
$5,585.81
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,958.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,479.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,138.94
|
| Rate for Payer: PHCS Commercial |
$7,149.83
|
| Rate for Payer: United Healthcare All Payer |
$6,554.01
|
|
|
PARIETEX COMPOSITE 30*20 RECT
|
Facility
|
IP
|
$9,080.79
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,724.24 |
| Max. Negotiated Rate |
$8,717.56 |
| Rate for Payer: Aetna Commercial |
$6,992.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,083.02
|
| Rate for Payer: Cash Price |
$4,540.40
|
| Rate for Payer: Cigna Commercial |
$7,537.06
|
| Rate for Payer: First Health Commercial |
$8,626.75
|
| Rate for Payer: Humana Commercial |
$7,718.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,446.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,701.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,724.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,991.10
|
| Rate for Payer: Ohio Health Group HMO |
$6,810.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,264.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,900.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,265.75
|
| Rate for Payer: PHCS Commercial |
$8,717.56
|
| Rate for Payer: United Healthcare All Payer |
$7,991.10
|
|
|
PARIETEX COMPOSITE 30*20 RECT
|
Facility
|
OP
|
$9,080.79
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,724.24 |
| Max. Negotiated Rate |
$8,717.56 |
| Rate for Payer: Aetna Commercial |
$6,992.21
|
| Rate for Payer: Anthem Medicaid |
$3,122.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,083.02
|
| Rate for Payer: Cash Price |
$4,540.40
|
| Rate for Payer: Cigna Commercial |
$7,537.06
|
| Rate for Payer: First Health Commercial |
$8,626.75
|
| Rate for Payer: Humana Commercial |
$7,718.67
|
| Rate for Payer: Humana KY Medicaid |
$3,122.88
|
| Rate for Payer: Kentucky WC Medicaid |
$3,154.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,446.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,701.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,724.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,185.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,991.10
|
| Rate for Payer: Ohio Health Group HMO |
$6,810.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,264.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,900.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,265.75
|
| Rate for Payer: PHCS Commercial |
$8,717.56
|
| Rate for Payer: United Healthcare All Payer |
$7,991.10
|
|
|
PARIETEX COMPOSITE 37*28 RECT
|
Facility
|
IP
|
$9,976.76
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,993.03 |
| Max. Negotiated Rate |
$9,577.69 |
| Rate for Payer: Aetna Commercial |
$7,682.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,781.87
|
| Rate for Payer: Cash Price |
$4,988.38
|
| Rate for Payer: Cigna Commercial |
$8,280.71
|
| Rate for Payer: First Health Commercial |
$9,477.92
|
| Rate for Payer: Humana Commercial |
$8,480.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,180.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,362.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,993.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,779.55
|
| Rate for Payer: Ohio Health Group HMO |
$7,482.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,981.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,679.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,883.96
|
| Rate for Payer: PHCS Commercial |
$9,577.69
|
| Rate for Payer: United Healthcare All Payer |
$8,779.55
|
|
|
PARIETEX COMPOSITE 37*28 RECT
|
Facility
|
OP
|
$9,976.76
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,993.03 |
| Max. Negotiated Rate |
$9,577.69 |
| Rate for Payer: Aetna Commercial |
$7,682.11
|
| Rate for Payer: Anthem Medicaid |
$3,431.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,781.87
|
| Rate for Payer: Cash Price |
$4,988.38
|
| Rate for Payer: Cigna Commercial |
$8,280.71
|
| Rate for Payer: First Health Commercial |
$9,477.92
|
| Rate for Payer: Humana Commercial |
$8,480.25
|
| Rate for Payer: Humana KY Medicaid |
$3,431.01
|
| Rate for Payer: Kentucky WC Medicaid |
$3,465.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,180.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,362.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,993.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,499.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,779.55
|
| Rate for Payer: Ohio Health Group HMO |
$7,482.57
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,981.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,679.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,883.96
|
| Rate for Payer: PHCS Commercial |
$9,577.69
|
| Rate for Payer: United Healthcare All Payer |
$8,779.55
|
|
|
PARIETEX COMPOSITE 9CM ROUND
|
Facility
|
IP
|
$3,320.41
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$996.12 |
| Max. Negotiated Rate |
$3,187.59 |
| Rate for Payer: Aetna Commercial |
$2,556.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,589.92
|
| Rate for Payer: Cash Price |
$1,660.21
|
| Rate for Payer: Cigna Commercial |
$2,755.94
|
| Rate for Payer: First Health Commercial |
$3,154.39
|
| Rate for Payer: Humana Commercial |
$2,822.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,722.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,450.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$996.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,921.96
|
| Rate for Payer: Ohio Health Group HMO |
$2,490.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,656.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,888.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,291.08
|
| Rate for Payer: PHCS Commercial |
$3,187.59
|
| Rate for Payer: United Healthcare All Payer |
$2,921.96
|
|
|
PARIETEX COMPOSITE 9CM ROUND
|
Facility
|
OP
|
$3,320.41
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27000073
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$996.12 |
| Max. Negotiated Rate |
$3,187.59 |
| Rate for Payer: Aetna Commercial |
$2,556.72
|
| Rate for Payer: Anthem Medicaid |
$1,141.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,589.92
|
| Rate for Payer: Cash Price |
$1,660.21
|
| Rate for Payer: Cigna Commercial |
$2,755.94
|
| Rate for Payer: First Health Commercial |
$3,154.39
|
| Rate for Payer: Humana Commercial |
$2,822.35
|
| Rate for Payer: Humana KY Medicaid |
$1,141.89
|
| Rate for Payer: Kentucky WC Medicaid |
$1,153.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,722.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,450.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$996.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,164.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,921.96
|
| Rate for Payer: Ohio Health Group HMO |
$2,490.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,656.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,888.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,291.08
|
| Rate for Payer: PHCS Commercial |
$3,187.59
|
| Rate for Payer: United Healthcare All Payer |
$2,921.96
|
|
|
PARING CORN CALLUS
|
Facility
|
OP
|
$365.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
76100032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.52 |
| Max. Negotiated Rate |
$350.40 |
| Rate for Payer: Aetna Commercial |
$281.05
|
| Rate for Payer: Anthem Medicaid |
$125.52
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$183.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$284.70
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$257.03
|
| Rate for Payer: CareSource Just4Me Medicare |
$247.85
|
| Rate for Payer: Cash Price |
$182.50
|
| Rate for Payer: Cash Price |
$182.50
|
| Rate for Payer: Cigna Commercial |
$302.95
|
| Rate for Payer: First Health Commercial |
$346.75
|
| Rate for Payer: Humana Commercial |
$310.25
|
| Rate for Payer: Humana KY Medicaid |
$125.52
|
| Rate for Payer: Humana Medicare Advantage |
$183.59
|
| Rate for Payer: Kentucky WC Medicaid |
$126.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$299.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$269.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$220.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$128.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$321.20
|
| Rate for Payer: Ohio Health Group HMO |
$273.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$292.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$317.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$251.85
|
| Rate for Payer: PHCS Commercial |
$350.40
|
| Rate for Payer: United Healthcare All Payer |
$321.20
|
|
|
PARING CORN CALLUS
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
76100032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$219.00 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: Ambetter Exchange |
$14.68
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$9.82
|
| Rate for Payer: Anthem Medicaid |
$14.74
|
| Rate for Payer: Buckeye Individual/Medicaid |
$14.68
|
| Rate for Payer: Buckeye Medicare Advantage |
$14.68
|
| Rate for Payer: CareSource Just4Me Medicare |
$17.62
|
| Rate for Payer: Cash Price |
$182.50
|
| Rate for Payer: Cash Price |
$182.50
|
| Rate for Payer: Cigna Commercial |
$60.60
|
| Rate for Payer: Healthspan PPO |
$53.94
|
| Rate for Payer: Humana Medicaid |
$14.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$25.48
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$14.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$14.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$15.03
|
| Rate for Payer: Molina Healthcare Passport |
$14.74
|
| Rate for Payer: Multiplan PHCS |
$219.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$19.08
|
| Rate for Payer: UHCCP Medicaid |
$10.31
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$14.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.68
|
|
|
PARING CORN CALLUS
|
Facility
|
IP
|
$365.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
76100032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$350.40 |
| Rate for Payer: Aetna Commercial |
$281.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$284.70
|
| Rate for Payer: Cash Price |
$182.50
|
| Rate for Payer: Cigna Commercial |
$302.95
|
| Rate for Payer: First Health Commercial |
$346.75
|
| Rate for Payer: Humana Commercial |
$310.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$299.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$269.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$109.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$321.20
|
| Rate for Payer: Ohio Health Group HMO |
$273.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$292.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$317.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$251.85
|
| Rate for Payer: PHCS Commercial |
$350.40
|
| Rate for Payer: United Healthcare All Payer |
$321.20
|
|
|
PARING CORN CALLUS(P
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
761P0032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$60.60 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: Ambetter Exchange |
$14.68
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$9.82
|
| Rate for Payer: Anthem Medicaid |
$14.74
|
| Rate for Payer: Buckeye Individual/Medicaid |
$14.68
|
| Rate for Payer: Buckeye Medicare Advantage |
$14.68
|
| Rate for Payer: CareSource Just4Me Medicare |
$17.62
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$60.60
|
| Rate for Payer: Healthspan PPO |
$53.94
|
| Rate for Payer: Humana Medicaid |
$14.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$25.48
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$14.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$14.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$15.03
|
| Rate for Payer: Molina Healthcare Passport |
$14.74
|
| Rate for Payer: Multiplan PHCS |
$45.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$19.08
|
| Rate for Payer: UHCCP Medicaid |
$10.31
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$14.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.68
|
|
|
PARING CORN CALLUS(T
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
761T0032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.73 |
| Max. Negotiated Rate |
$278.40 |
| Rate for Payer: Aetna Commercial |
$223.30
|
| Rate for Payer: Anthem Medicaid |
$99.73
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$183.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$226.20
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$257.03
|
| Rate for Payer: CareSource Just4Me Medicare |
$247.85
|
| Rate for Payer: Cash Price |
$145.00
|
| Rate for Payer: Cash Price |
$145.00
|
| Rate for Payer: Cigna Commercial |
$240.70
|
| Rate for Payer: First Health Commercial |
$275.50
|
| Rate for Payer: Humana Commercial |
$246.50
|
| Rate for Payer: Humana KY Medicaid |
$99.73
|
| Rate for Payer: Humana Medicare Advantage |
$183.59
|
| Rate for Payer: Kentucky WC Medicaid |
$100.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$237.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$214.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$220.31
|
| Rate for Payer: Molina Healthcare Medicaid |
$101.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$255.20
|
| Rate for Payer: Ohio Health Group HMO |
$217.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$232.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$200.10
|
| Rate for Payer: PHCS Commercial |
$278.40
|
| Rate for Payer: United Healthcare All Payer |
$255.20
|
|
|
PARING CORN CALLUS(T
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
761T0032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$278.40 |
| Rate for Payer: Aetna Commercial |
$223.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$226.20
|
| Rate for Payer: Cash Price |
$145.00
|
| Rate for Payer: Cigna Commercial |
$240.70
|
| Rate for Payer: First Health Commercial |
$275.50
|
| Rate for Payer: Humana Commercial |
$246.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$237.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$214.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$87.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$255.20
|
| Rate for Payer: Ohio Health Group HMO |
$217.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$232.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$252.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$200.10
|
| Rate for Payer: PHCS Commercial |
$278.40
|
| Rate for Payer: United Healthcare All Payer |
$255.20
|
|
|
PARLODEL(BROMOCRIPT 2.5MG/1TAB
|
Facility
|
IP
|
$11.31
|
|
|
Service Code
|
NDC 63304096230
|
| Hospital Charge Code |
25001157
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$10.86 |
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8.82
|
| Rate for Payer: Cash Price |
$5.66
|
| Rate for Payer: Cigna Commercial |
$9.39
|
| Rate for Payer: First Health Commercial |
$10.74
|
| Rate for Payer: Humana Commercial |
$9.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$9.95
|
| Rate for Payer: Ohio Health Group HMO |
$8.48
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.80
|
| Rate for Payer: PHCS Commercial |
$10.86
|
| Rate for Payer: United Healthcare All Payer |
$9.95
|
|
|
PARLODEL(BROMOCRIPT 2.5MG/1TAB
|
Facility
|
OP
|
$11.31
|
|
|
Service Code
|
NDC 63304096230
|
| Hospital Charge Code |
25001157
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$10.86 |
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Anthem Medicaid |
$3.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8.82
|
| Rate for Payer: Cash Price |
$5.66
|
| Rate for Payer: Cigna Commercial |
$9.39
|
| Rate for Payer: First Health Commercial |
$10.74
|
| Rate for Payer: Humana Commercial |
$9.61
|
| Rate for Payer: Humana KY Medicaid |
$3.89
|
| Rate for Payer: Kentucky WC Medicaid |
$3.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$3.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$9.95
|
| Rate for Payer: Ohio Health Group HMO |
$8.48
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.80
|
| Rate for Payer: PHCS Commercial |
$10.86
|
| Rate for Payer: United Healthcare All Payer |
$9.95
|
|
|
PARSONNET VASCULAR PROBE 1.5MM
|
Facility
|
OP
|
$1,210.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,161.60 |
| Rate for Payer: Aetna Commercial |
$931.70
|
| Rate for Payer: Anthem Medicaid |
$416.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$943.80
|
| Rate for Payer: Cash Price |
$605.00
|
| Rate for Payer: Cigna Commercial |
$1,004.30
|
| Rate for Payer: First Health Commercial |
$1,149.50
|
| Rate for Payer: Humana Commercial |
$1,028.50
|
| Rate for Payer: Humana KY Medicaid |
$416.12
|
| Rate for Payer: Kentucky WC Medicaid |
$420.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$992.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$892.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$363.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$424.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,064.80
|
| Rate for Payer: Ohio Health Group HMO |
$907.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$968.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,052.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$834.90
|
| Rate for Payer: PHCS Commercial |
$1,161.60
|
| Rate for Payer: United Healthcare All Payer |
$1,064.80
|
|
|
PARSONNET VASCULAR PROBE 1.5MM
|
Facility
|
IP
|
$1,210.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$1,161.60 |
| Rate for Payer: Aetna Commercial |
$931.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$943.80
|
| Rate for Payer: Cash Price |
$605.00
|
| Rate for Payer: Cigna Commercial |
$1,004.30
|
| Rate for Payer: First Health Commercial |
$1,149.50
|
| Rate for Payer: Humana Commercial |
$1,028.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$992.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$892.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$363.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,064.80
|
| Rate for Payer: Ohio Health Group HMO |
$907.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$968.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,052.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$834.90
|
| Rate for Payer: PHCS Commercial |
$1,161.60
|
| Rate for Payer: United Healthcare All Payer |
$1,064.80
|
|
|
PART COLECTOMY LOW PELV ANAS
|
Facility
|
OP
|
$2,650.00
|
|
|
Service Code
|
HCPCS 44145
|
| Hospital Charge Code |
76101818
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$795.00 |
| Max. Negotiated Rate |
$2,544.00 |
| Rate for Payer: Aetna Commercial |
$2,040.50
|
| Rate for Payer: Anthem Medicaid |
$911.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,067.00
|
| Rate for Payer: Cash Price |
$1,325.00
|
| Rate for Payer: Cigna Commercial |
$2,199.50
|
| Rate for Payer: First Health Commercial |
$2,517.50
|
| Rate for Payer: Humana Commercial |
$2,252.50
|
| Rate for Payer: Humana KY Medicaid |
$911.34
|
| Rate for Payer: Kentucky WC Medicaid |
$920.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,173.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,955.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$795.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$929.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,332.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,987.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,120.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,305.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,828.50
|
| Rate for Payer: PHCS Commercial |
$2,544.00
|
| Rate for Payer: United Healthcare All Payer |
$2,332.00
|
|
