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Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $866.97
Max. Negotiated Rate $6,402.24
Rate for Payer: Aetna Commercial $5,135.13
Rate for Payer: Anthem Medicaid $2,293.47
Rate for Payer: Anthem POS/PPO/Traditional $5,201.82
Rate for Payer: Cash Price $3,334.50
Rate for Payer: Cigna Commercial $5,535.27
Rate for Payer: First Health Commercial $6,335.55
Rate for Payer: Humana Commercial $5,668.65
Rate for Payer: Humana KY Medicaid $2,293.47
Rate for Payer: Kentucky WC Medicaid $2,316.81
Rate for Payer: Medical Mutual Of Ohio HMO $5,468.58
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,921.72
Rate for Payer: Molina Healthcare Benefit Exchange $2,000.70
Rate for Payer: Molina Healthcare Medicaid $2,339.49
Rate for Payer: Ohio Health Choice Commercial $5,868.72
Rate for Payer: Ohio Health Group HMO $5,001.75
Rate for Payer: Ohio Health Group PPO Differential $1,333.80
Rate for Payer: Ohio Health Group PPO No Differential $866.97
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,067.39
Rate for Payer: PHCS Commercial $6,402.24
Rate for Payer: United Healthcare All Payer $5,868.72
Service Code HCPCS 49442
Hospital Charge Code 76102006
Hospital Revenue Code 761
Min. Negotiated Rate $561.21
Max. Negotiated Rate $4,144.32
Rate for Payer: Aetna Commercial $3,324.09
Rate for Payer: Anthem Medicaid $1,484.62
Rate for Payer: Anthem Medicare Advantage/PPO $1,020.47
Rate for Payer: Anthem POS/PPO/Traditional $3,367.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,428.66
Rate for Payer: CareSource Just4Me Medicare $1,377.63
Rate for Payer: Cash Price $2,158.50
Rate for Payer: Cash Price $2,158.50
Rate for Payer: Cigna Commercial $3,583.11
Rate for Payer: First Health Commercial $4,101.15
Rate for Payer: Humana Commercial $3,669.45
Rate for Payer: Humana KY Medicaid $1,484.62
Rate for Payer: Humana Medicare Advantage $1,020.47
Rate for Payer: Kentucky WC Medicaid $1,499.73
Rate for Payer: Medical Mutual Of Ohio HMO $3,539.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,185.95
Rate for Payer: Molina Healthcare Benefit Exchange $1,224.56
Rate for Payer: Molina Healthcare Medicaid $1,514.40
Rate for Payer: Ohio Health Choice Commercial $3,798.96
Rate for Payer: Ohio Health Group HMO $3,237.75
Rate for Payer: Ohio Health Group PPO Differential $863.40
Rate for Payer: Ohio Health Group PPO No Differential $561.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,338.27
Rate for Payer: PHCS Commercial $4,144.32
Rate for Payer: United Healthcare All Payer $3,798.96
Service Code HCPCS 49442
Hospital Charge Code 76102006
Hospital Revenue Code 761
Min. Negotiated Rate $561.21
Max. Negotiated Rate $4,144.32
Rate for Payer: Aetna Commercial $3,324.09
Rate for Payer: Anthem POS/PPO/Traditional $3,367.26
Rate for Payer: Cash Price $2,158.50
Rate for Payer: Cigna Commercial $3,583.11
Rate for Payer: First Health Commercial $4,101.15
Rate for Payer: Humana Commercial $3,669.45
Rate for Payer: Medical Mutual Of Ohio HMO $3,539.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,185.95
Rate for Payer: Molina Healthcare Benefit Exchange $1,295.10
Rate for Payer: Ohio Health Choice Commercial $3,798.96
Rate for Payer: Ohio Health Group HMO $3,237.75
Rate for Payer: Ohio Health Group PPO Differential $863.40
Rate for Payer: Ohio Health Group PPO No Differential $561.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,338.27
Rate for Payer: PHCS Commercial $4,144.32
Rate for Payer: United Healthcare All Payer $3,798.96
Service Code HCPCS 49442
Hospital Charge Code 76102006
Hospital Revenue Code 761
Min. Negotiated Rate $174.16
Max. Negotiated Rate $4,317.00
Rate for Payer: Aetna Commercial $338.46
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $190.29
Rate for Payer: Anthem Medicaid $174.16
Rate for Payer: Buckeye Medicare Advantage $4,317.00
Rate for Payer: Cash Price $2,158.50
Rate for Payer: Cash Price $2,158.50
Rate for Payer: Cigna Commercial $311.30
Rate for Payer: Healthspan PPO $1,291.96
Rate for Payer: Humana Medicaid $174.16
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $278.20
Rate for Payer: Molina Healthcare CHIP/Medicaid $177.64
Rate for Payer: Molina Healthcare Passport $174.16
Rate for Payer: Multiplan PHCS $2,590.20
Rate for Payer: Ohio Health Choice Preferred Health Choice $3,021.90
Rate for Payer: UHCCP Medicaid $199.80
Rate for Payer: Wellcare CHIP/Medicaid $175.90
Service Code HCPCS 49442
Hospital Charge Code 761P2006
Hospital Revenue Code 761
Min. Negotiated Rate $174.16
Max. Negotiated Rate $1,500.00
Rate for Payer: Aetna Commercial $338.46
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $190.29
Rate for Payer: Anthem Medicaid $174.16
Rate for Payer: Buckeye Medicare Advantage $1,500.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cigna Commercial $311.30
Rate for Payer: Healthspan PPO $1,291.96
Rate for Payer: Humana Medicaid $174.16
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $278.20
Rate for Payer: Molina Healthcare CHIP/Medicaid $177.64
Rate for Payer: Molina Healthcare Passport $174.16
Rate for Payer: Multiplan PHCS $900.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,050.00
Rate for Payer: UHCCP Medicaid $199.80
Rate for Payer: Wellcare CHIP/Medicaid $175.90
Service Code HCPCS 49442
Hospital Charge Code 761T2006
Hospital Revenue Code 761
Min. Negotiated Rate $366.21
Max. Negotiated Rate $2,704.32
Rate for Payer: Aetna Commercial $2,169.09
Rate for Payer: Anthem Medicaid $968.77
Rate for Payer: Anthem Medicare Advantage/PPO $1,020.47
Rate for Payer: Anthem POS/PPO/Traditional $2,197.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,428.66
Rate for Payer: CareSource Just4Me Medicare $1,377.63
Rate for Payer: Cash Price $1,408.50
Rate for Payer: Cash Price $1,408.50
Rate for Payer: Cigna Commercial $2,338.11
Rate for Payer: First Health Commercial $2,676.15
Rate for Payer: Humana Commercial $2,394.45
Rate for Payer: Humana KY Medicaid $968.77
Rate for Payer: Humana Medicare Advantage $1,020.47
Rate for Payer: Kentucky WC Medicaid $978.63
Rate for Payer: Medical Mutual Of Ohio HMO $2,309.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,078.95
Rate for Payer: Molina Healthcare Benefit Exchange $1,224.56
Rate for Payer: Molina Healthcare Medicaid $988.20
Rate for Payer: Ohio Health Choice Commercial $2,478.96
Rate for Payer: Ohio Health Group HMO $2,112.75
Rate for Payer: Ohio Health Group PPO Differential $563.40
Rate for Payer: Ohio Health Group PPO No Differential $366.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $873.27
Rate for Payer: PHCS Commercial $2,704.32
Rate for Payer: United Healthcare All Payer $2,478.96
Service Code HCPCS 49442
Hospital Charge Code 761T2006
Hospital Revenue Code 761
Min. Negotiated Rate $366.21
Max. Negotiated Rate $2,704.32
Rate for Payer: Aetna Commercial $2,169.09
Rate for Payer: Anthem POS/PPO/Traditional $2,197.26
Rate for Payer: Cash Price $1,408.50
Rate for Payer: Cigna Commercial $2,338.11
Rate for Payer: First Health Commercial $2,676.15
Rate for Payer: Humana Commercial $2,394.45
Rate for Payer: Medical Mutual Of Ohio HMO $2,309.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,078.95
Rate for Payer: Molina Healthcare Benefit Exchange $845.10
Rate for Payer: Ohio Health Choice Commercial $2,478.96
Rate for Payer: Ohio Health Group HMO $2,112.75
Rate for Payer: Ohio Health Group PPO Differential $563.40
Rate for Payer: Ohio Health Group PPO No Differential $366.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $873.27
Rate for Payer: PHCS Commercial $2,704.32
Rate for Payer: United Healthcare All Payer $2,478.96
Service Code HCPCS 49441
Hospital Charge Code 76102005
Hospital Revenue Code 761
Min. Negotiated Rate $209.77
Max. Negotiated Rate $3,406.24
Rate for Payer: Aetna Commercial $409.49
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $240.51
Rate for Payer: Anthem Medicaid $209.77
Rate for Payer: Buckeye Medicare Advantage $3,406.24
Rate for Payer: Cash Price $1,703.12
Rate for Payer: Cash Price $1,703.12
Rate for Payer: Cigna Commercial $375.25
Rate for Payer: Healthspan PPO $1,443.03
Rate for Payer: Humana Medicaid $209.77
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $337.32
Rate for Payer: Molina Healthcare CHIP/Medicaid $213.97
Rate for Payer: Molina Healthcare Passport $209.77
Rate for Payer: Multiplan PHCS $2,043.74
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,384.37
Rate for Payer: UHCCP Medicaid $252.54
Rate for Payer: Wellcare CHIP/Medicaid $211.87
Service Code HCPCS 49441
Hospital Charge Code 76102005
Hospital Revenue Code 761
Min. Negotiated Rate $442.81
Max. Negotiated Rate $3,269.99
Rate for Payer: Aetna Commercial $2,622.80
Rate for Payer: Anthem POS/PPO/Traditional $2,656.87
Rate for Payer: Cash Price $1,703.12
Rate for Payer: Cigna Commercial $2,827.18
Rate for Payer: First Health Commercial $3,235.93
Rate for Payer: Humana Commercial $2,895.30
Rate for Payer: Medical Mutual Of Ohio HMO $2,793.12
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,513.81
Rate for Payer: Molina Healthcare Benefit Exchange $1,021.87
Rate for Payer: Ohio Health Choice Commercial $2,997.49
Rate for Payer: Ohio Health Group HMO $2,554.68
Rate for Payer: Ohio Health Group PPO Differential $681.25
Rate for Payer: Ohio Health Group PPO No Differential $442.81
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,055.93
Rate for Payer: PHCS Commercial $3,269.99
Rate for Payer: United Healthcare All Payer $2,997.49
Service Code HCPCS 49441
Hospital Charge Code 76102005
Hospital Revenue Code 761
Min. Negotiated Rate $442.81
Max. Negotiated Rate $3,269.99
Rate for Payer: Aetna Commercial $2,622.80
Rate for Payer: Anthem Medicaid $1,171.41
Rate for Payer: Anthem Medicare Advantage/PPO $1,645.47
Rate for Payer: Anthem POS/PPO/Traditional $2,656.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,303.66
Rate for Payer: CareSource Just4Me Medicare $2,221.38
Rate for Payer: Cash Price $1,703.12
Rate for Payer: Cash Price $1,703.12
Rate for Payer: Cigna Commercial $2,827.18
Rate for Payer: First Health Commercial $3,235.93
Rate for Payer: Humana Commercial $2,895.30
Rate for Payer: Humana KY Medicaid $1,171.41
Rate for Payer: Humana Medicare Advantage $1,645.47
Rate for Payer: Kentucky WC Medicaid $1,183.33
Rate for Payer: Medical Mutual Of Ohio HMO $2,793.12
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,513.81
Rate for Payer: Molina Healthcare Benefit Exchange $1,974.56
Rate for Payer: Molina Healthcare Medicaid $1,194.91
Rate for Payer: Ohio Health Choice Commercial $2,997.49
Rate for Payer: Ohio Health Group HMO $2,554.68
Rate for Payer: Ohio Health Group PPO Differential $681.25
Rate for Payer: Ohio Health Group PPO No Differential $442.81
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,055.93
Rate for Payer: PHCS Commercial $3,269.99
Rate for Payer: United Healthcare All Payer $2,997.49
Service Code HCPCS 49441
Hospital Charge Code 761P2005
Hospital Revenue Code 761
Min. Negotiated Rate $209.77
Max. Negotiated Rate $1,443.03
Rate for Payer: Aetna Commercial $409.49
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $240.51
Rate for Payer: Anthem Medicaid $209.77
Rate for Payer: Buckeye Medicare Advantage $445.00
Rate for Payer: Cash Price $222.50
Rate for Payer: Cash Price $222.50
Rate for Payer: Cigna Commercial $375.25
Rate for Payer: Healthspan PPO $1,443.03
Rate for Payer: Humana Medicaid $209.77
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $337.32
Rate for Payer: Molina Healthcare CHIP/Medicaid $213.97
Rate for Payer: Molina Healthcare Passport $209.77
Rate for Payer: Multiplan PHCS $267.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $311.50
Rate for Payer: UHCCP Medicaid $252.54
Rate for Payer: Wellcare CHIP/Medicaid $211.87