|
PATH CONS INTRAOP 1 BLOC (T
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
300T2036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$158.33 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$231.00
|
| Rate for Payer: Anthem Medicaid |
$158.33
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$158.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$240.90
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$221.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$158.33
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$249.00
|
| Rate for Payer: First Health Commercial |
$285.00
|
| Rate for Payer: Humana Commercial |
$255.00
|
| Rate for Payer: Humana KY Medicaid |
$158.33
|
| Rate for Payer: Humana Medicare Advantage |
$158.33
|
| Rate for Payer: Kentucky WC Medicaid |
$159.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$246.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$221.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$190.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$161.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$264.00
|
| Rate for Payer: Ohio Health Group HMO |
$225.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$240.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$261.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$207.00
|
| Rate for Payer: PHCS Commercial |
$288.00
|
| Rate for Payer: United Healthcare All Payer |
$264.00
|
|
|
PATH CONS INTRAOP ADDl
|
Facility
|
IP
|
$307.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30002037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$92.10 |
| Max. Negotiated Rate |
$294.72 |
| Rate for Payer: Aetna Commercial |
$236.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$246.52
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$254.81
|
| Rate for Payer: First Health Commercial |
$291.65
|
| Rate for Payer: Humana Commercial |
$260.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$251.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$226.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$92.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$270.16
|
| Rate for Payer: Ohio Health Group HMO |
$230.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$245.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$267.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$211.83
|
| Rate for Payer: PHCS Commercial |
$294.72
|
| Rate for Payer: United Healthcare All Payer |
$270.16
|
|
|
PATH CONS INTRAOP ADDl
|
Facility
|
OP
|
$307.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30002037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$92.10 |
| Max. Negotiated Rate |
$294.72 |
| Rate for Payer: Aetna Commercial |
$236.39
|
| Rate for Payer: Anthem Medicaid |
$105.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$246.52
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$254.81
|
| Rate for Payer: First Health Commercial |
$291.65
|
| Rate for Payer: Humana Commercial |
$260.95
|
| Rate for Payer: Humana KY Medicaid |
$105.58
|
| Rate for Payer: Kentucky WC Medicaid |
$106.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$251.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$226.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$92.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$107.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$270.16
|
| Rate for Payer: Ohio Health Group HMO |
$230.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$245.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$267.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$211.83
|
| Rate for Payer: PHCS Commercial |
$294.72
|
| Rate for Payer: United Healthcare All Payer |
$270.16
|
|
|
PATH CONS INTRAOP ADDl
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30002037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$184.20 |
| Rate for Payer: Aetna Commercial |
$62.06
|
| Rate for Payer: Ambetter Exchange |
$50.10
|
| Rate for Payer: Buckeye Individual/Medicaid |
$50.10
|
| Rate for Payer: Buckeye Medicare Advantage |
$50.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$60.12
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cash Price |
$153.50
|
| Rate for Payer: Cigna Commercial |
$25.61
|
| Rate for Payer: Healthspan PPO |
$58.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.60
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$50.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$50.10
|
| Rate for Payer: Multiplan PHCS |
$184.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$65.13
|
| Rate for Payer: UHCCP Medicaid |
$107.45
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$18.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$50.10
|
|
|
PATH CONS INTRAOP ADDl (P
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
300P2037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$65.13 |
| Rate for Payer: Aetna Commercial |
$62.06
|
| Rate for Payer: Ambetter Exchange |
$50.10
|
| Rate for Payer: Buckeye Individual/Medicaid |
$50.10
|
| Rate for Payer: Buckeye Medicare Advantage |
$50.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$60.12
|
| Rate for Payer: Cash Price |
$27.50
|
| Rate for Payer: Cash Price |
$27.50
|
| Rate for Payer: Cigna Commercial |
$25.61
|
| Rate for Payer: Healthspan PPO |
$58.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.60
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$50.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$50.10
|
| Rate for Payer: Multiplan PHCS |
$33.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$65.13
|
| Rate for Payer: UHCCP Medicaid |
$19.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$18.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$50.10
|
|
|
PATH CONS INTRAOP ADDl (T
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
300T2037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$241.92 |
| Rate for Payer: Aetna Commercial |
$194.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$202.36
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$209.16
|
| Rate for Payer: First Health Commercial |
$239.40
|
| Rate for Payer: Humana Commercial |
$214.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$206.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$185.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$75.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$221.76
|
| Rate for Payer: Ohio Health Group HMO |
$189.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$201.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$173.88
|
| Rate for Payer: PHCS Commercial |
$241.92
|
| Rate for Payer: United Healthcare All Payer |
$221.76
|
|
|
PATH CONS INTRAOP ADDl (T
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
300T2037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$241.92 |
| Rate for Payer: Aetna Commercial |
$194.04
|
| Rate for Payer: Anthem Medicaid |
$86.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$202.36
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$209.16
|
| Rate for Payer: First Health Commercial |
$239.40
|
| Rate for Payer: Humana Commercial |
$214.20
|
| Rate for Payer: Humana KY Medicaid |
$86.66
|
| Rate for Payer: Kentucky WC Medicaid |
$87.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$206.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$185.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$75.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$88.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$221.76
|
| Rate for Payer: Ohio Health Group HMO |
$189.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$201.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$219.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$173.88
|
| Rate for Payer: PHCS Commercial |
$241.92
|
| Rate for Payer: United Healthcare All Payer |
$221.76
|
|
|
PATH CONSULT INTRAOP 1 BLOC
|
Facility
|
IP
|
$289.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30001521
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$86.70 |
| Max. Negotiated Rate |
$277.44 |
| Rate for Payer: Aetna Commercial |
$222.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$232.07
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$239.87
|
| Rate for Payer: First Health Commercial |
$274.55
|
| Rate for Payer: Humana Commercial |
$245.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$236.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$213.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$86.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$254.32
|
| Rate for Payer: Ohio Health Group HMO |
$216.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$231.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$251.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$199.41
|
| Rate for Payer: PHCS Commercial |
$277.44
|
| Rate for Payer: United Healthcare All Payer |
$254.32
|
|
|
PATH CONSULT INTRAOP 1 BLOC
|
Facility
|
OP
|
$289.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30001521
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$158.33 |
| Max. Negotiated Rate |
$277.44 |
| Rate for Payer: Aetna Commercial |
$222.53
|
| Rate for Payer: Anthem Medicaid |
$158.33
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$158.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$232.07
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$221.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$158.33
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$239.87
|
| Rate for Payer: First Health Commercial |
$274.55
|
| Rate for Payer: Humana Commercial |
$245.65
|
| Rate for Payer: Humana KY Medicaid |
$158.33
|
| Rate for Payer: Humana Medicare Advantage |
$158.33
|
| Rate for Payer: Kentucky WC Medicaid |
$159.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$236.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$213.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$190.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$161.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$254.32
|
| Rate for Payer: Ohio Health Group HMO |
$216.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$231.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$251.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$199.41
|
| Rate for Payer: PHCS Commercial |
$277.44
|
| Rate for Payer: United Healthcare All Payer |
$254.32
|
|
|
PATH CONSULT INTRAOP 1 BLOC
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 88331
|
| Hospital Charge Code |
30001521
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$173.40 |
| Rate for Payer: Aetna Commercial |
$138.09
|
| Rate for Payer: Ambetter Exchange |
$92.54
|
| Rate for Payer: Buckeye Individual/Medicaid |
$92.54
|
| Rate for Payer: Buckeye Medicare Advantage |
$92.54
|
| Rate for Payer: CareSource Just4Me Medicare |
$111.05
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cash Price |
$144.50
|
| Rate for Payer: Cigna Commercial |
$56.76
|
| Rate for Payer: Healthspan PPO |
$131.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$31.68
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$92.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$92.54
|
| Rate for Payer: Multiplan PHCS |
$173.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$120.30
|
| Rate for Payer: UHCCP Medicaid |
$101.15
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$39.55
|
| Rate for Payer: Wellcare Medicare Advantage |
$92.54
|
|
|
PATH CONSULT INTRAOP ADDL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30001522
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem Medicaid |
$84.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Humana KY Medicaid |
$84.26
|
| Rate for Payer: Kentucky WC Medicaid |
$85.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$85.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$213.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$169.05
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATH CONSULT INTRAOP ADDL
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30001522
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Aetna Commercial |
$62.06
|
| Rate for Payer: Ambetter Exchange |
$50.10
|
| Rate for Payer: Buckeye Individual/Medicaid |
$50.10
|
| Rate for Payer: Buckeye Medicare Advantage |
$50.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$60.12
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$25.61
|
| Rate for Payer: Healthspan PPO |
$58.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.60
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$50.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$50.10
|
| Rate for Payer: Multiplan PHCS |
$147.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$65.13
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$18.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$50.10
|
|
|
PATH CONSULT INTRAOP ADDL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 88332
|
| Hospital Charge Code |
30001522
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$213.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$169.05
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATHOLOGY CONSULT INTROP
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 88329
|
| Hospital Charge Code |
30001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Aetna Commercial |
$52.41
|
| Rate for Payer: Ambetter Exchange |
$32.44
|
| Rate for Payer: Buckeye Individual/Medicaid |
$32.44
|
| Rate for Payer: Buckeye Medicare Advantage |
$32.44
|
| Rate for Payer: CareSource Just4Me Medicare |
$38.93
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$22.37
|
| Rate for Payer: Healthspan PPO |
$71.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$18.44
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$32.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$32.44
|
| Rate for Payer: Multiplan PHCS |
$147.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$42.17
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$17.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$32.44
|
|
|
PATHOLOGY CONSULT INTROP
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 88329
|
| Hospital Charge Code |
30001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.88 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem Medicaid |
$54.88
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$54.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$76.83
|
| Rate for Payer: CareSource Just4Me Medicare |
$54.88
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Humana KY Medicaid |
$54.88
|
| Rate for Payer: Humana Medicare Advantage |
$54.88
|
| Rate for Payer: Kentucky WC Medicaid |
$55.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$65.86
|
| Rate for Payer: Molina Healthcare Medicaid |
$55.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$213.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$169.05
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATHOLOGY CONSULT INTROP
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 88329
|
| Hospital Charge Code |
30001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$213.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$169.05
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
PATIENT EVAL/DEMO RESP DEVICES
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
HCPCS 94664
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$90.45 |
| Max. Negotiated Rate |
$263.10 |
| Rate for Payer: Aetna Commercial |
$202.51
|
| Rate for Payer: Anthem Medicaid |
$90.45
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$187.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$205.14
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$263.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$253.71
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cigna Commercial |
$218.29
|
| Rate for Payer: First Health Commercial |
$249.85
|
| Rate for Payer: Humana Commercial |
$223.55
|
| Rate for Payer: Humana KY Medicaid |
$90.45
|
| Rate for Payer: Humana Medicare Advantage |
$187.93
|
| Rate for Payer: Kentucky WC Medicaid |
$91.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$215.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$194.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$92.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$231.44
|
| Rate for Payer: Ohio Health Group HMO |
$197.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$228.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$181.47
|
| Rate for Payer: PHCS Commercial |
$252.48
|
| Rate for Payer: United Healthcare All Payer |
$231.44
|
|
|
PATIENT EVAL/DEMO RESP DEVICES
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
HCPCS 94664
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$78.90 |
| Max. Negotiated Rate |
$252.48 |
| Rate for Payer: Aetna Commercial |
$202.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$205.14
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cigna Commercial |
$218.29
|
| Rate for Payer: First Health Commercial |
$249.85
|
| Rate for Payer: Humana Commercial |
$223.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$215.66
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$194.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$78.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$231.44
|
| Rate for Payer: Ohio Health Group HMO |
$197.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$210.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$228.81
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$181.47
|
| Rate for Payer: PHCS Commercial |
$252.48
|
| Rate for Payer: United Healthcare All Payer |
$231.44
|
|
|
PATIENT EXCISION THYROID
|
Facility
|
IP
|
$1,106.00
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
76102271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$331.80 |
| Max. Negotiated Rate |
$1,061.76 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$331.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
PATIENT EXCISION THYROID
|
Facility
|
OP
|
$1,106.00
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
76102271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$380.35 |
| Max. Negotiated Rate |
$7,547.16 |
| Rate for Payer: Aetna Commercial |
$851.62
|
| Rate for Payer: Anthem Medicaid |
$380.35
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,390.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$862.68
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,547.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,277.62
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$917.98
|
| Rate for Payer: First Health Commercial |
$1,050.70
|
| Rate for Payer: Humana Commercial |
$940.10
|
| Rate for Payer: Humana KY Medicaid |
$380.35
|
| Rate for Payer: Humana Medicare Advantage |
$5,390.83
|
| Rate for Payer: Kentucky WC Medicaid |
$384.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$906.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$816.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,469.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$387.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$973.28
|
| Rate for Payer: Ohio Health Group HMO |
$829.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$884.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$962.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$763.14
|
| Rate for Payer: PHCS Commercial |
$1,061.76
|
| Rate for Payer: United Healthcare All Payer |
$973.28
|
|
|
PATIENT EXCISION THYROID
|
Professional
|
Both
|
$1,106.00
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
76102271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.10 |
| Max. Negotiated Rate |
$1,025.08 |
| Rate for Payer: Aetna Commercial |
$1,025.08
|
| Rate for Payer: Ambetter Exchange |
$674.00
|
| Rate for Payer: Anthem Medicaid |
$581.31
|
| Rate for Payer: Buckeye Individual/Medicaid |
$674.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$674.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$808.80
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$964.60
|
| Rate for Payer: Healthspan PPO |
$864.47
|
| Rate for Payer: Humana Medicaid |
$581.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$906.58
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$674.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$674.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$592.94
|
| Rate for Payer: Molina Healthcare Passport |
$581.31
|
| Rate for Payer: Multiplan PHCS |
$663.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$876.20
|
| Rate for Payer: UHCCP Medicaid |
$387.10
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$587.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$674.00
|
|
|
PATIENT EXCISION THYROID(P
|
Professional
|
Both
|
$1,106.00
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
761P2271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.10 |
| Max. Negotiated Rate |
$1,025.08 |
| Rate for Payer: Aetna Commercial |
$1,025.08
|
| Rate for Payer: Ambetter Exchange |
$674.00
|
| Rate for Payer: Anthem Medicaid |
$581.31
|
| Rate for Payer: Buckeye Individual/Medicaid |
$674.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$674.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$808.80
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cash Price |
$553.00
|
| Rate for Payer: Cigna Commercial |
$964.60
|
| Rate for Payer: Healthspan PPO |
$864.47
|
| Rate for Payer: Humana Medicaid |
$581.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$906.58
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$674.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$674.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$592.94
|
| Rate for Payer: Molina Healthcare Passport |
$581.31
|
| Rate for Payer: Multiplan PHCS |
$663.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$876.20
|
| Rate for Payer: UHCCP Medicaid |
$387.10
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$587.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$674.00
|
|
|
PATIENT PROGRAMMER
|
Facility
|
OP
|
$10,117.50
|
|
|
Service Code
|
HCPCS C1787
|
| Hospital Charge Code |
27000083
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,035.25 |
| Max. Negotiated Rate |
$9,712.80 |
| Rate for Payer: Aetna Commercial |
$7,790.48
|
| Rate for Payer: Anthem Medicaid |
$3,479.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,891.65
|
| Rate for Payer: Cash Price |
$5,058.75
|
| Rate for Payer: Cigna Commercial |
$8,397.52
|
| Rate for Payer: First Health Commercial |
$9,611.62
|
| Rate for Payer: Humana Commercial |
$8,599.88
|
| Rate for Payer: Humana KY Medicaid |
$3,479.41
|
| Rate for Payer: Kentucky WC Medicaid |
$3,514.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,296.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,466.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,035.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,549.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,903.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,588.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,094.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,802.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,981.07
|
| Rate for Payer: PHCS Commercial |
$9,712.80
|
| Rate for Payer: United Healthcare All Payer |
$8,903.40
|
|
|
PATIENT PROGRAMMER
|
Facility
|
IP
|
$10,117.50
|
|
|
Service Code
|
HCPCS C1787
|
| Hospital Charge Code |
27000083
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,035.25 |
| Max. Negotiated Rate |
$9,712.80 |
| Rate for Payer: Aetna Commercial |
$7,790.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,891.65
|
| Rate for Payer: Cash Price |
$5,058.75
|
| Rate for Payer: Cigna Commercial |
$8,397.52
|
| Rate for Payer: First Health Commercial |
$9,611.62
|
| Rate for Payer: Humana Commercial |
$8,599.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,296.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,466.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,035.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,903.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,588.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,094.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,802.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,981.07
|
| Rate for Payer: PHCS Commercial |
$9,712.80
|
| Rate for Payer: United Healthcare All Payer |
$8,903.40
|
|
|
PATIENT PROGRAMMER 3037
|
Facility
|
IP
|
$10,117.50
|
|
|
Service Code
|
HCPCS C1787
|
| Hospital Charge Code |
27000083
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,035.25 |
| Max. Negotiated Rate |
$9,712.80 |
| Rate for Payer: Aetna Commercial |
$7,790.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,891.65
|
| Rate for Payer: Cash Price |
$5,058.75
|
| Rate for Payer: Cigna Commercial |
$8,397.52
|
| Rate for Payer: First Health Commercial |
$9,611.62
|
| Rate for Payer: Humana Commercial |
$8,599.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,296.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,466.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,035.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,903.40
|
| Rate for Payer: Ohio Health Group HMO |
$7,588.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,094.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,802.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,981.07
|
| Rate for Payer: PHCS Commercial |
$9,712.80
|
| Rate for Payer: United Healthcare All Payer |
$8,903.40
|
|
