|
PINNACLE MTL INS NEUT 28 * 60
|
Facility
|
OP
|
$12,491.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,747.45 |
| Max. Negotiated Rate |
$11,991.84 |
| Rate for Payer: Aetna Commercial |
$9,618.45
|
| Rate for Payer: Anthem Medicaid |
$4,295.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,743.37
|
| Rate for Payer: Cash Price |
$6,245.75
|
| Rate for Payer: Cigna Commercial |
$10,367.94
|
| Rate for Payer: First Health Commercial |
$11,866.92
|
| Rate for Payer: Humana Commercial |
$10,617.77
|
| Rate for Payer: Humana KY Medicaid |
$4,295.83
|
| Rate for Payer: Kentucky WC Medicaid |
$4,339.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,243.03
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,218.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,747.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,382.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,992.52
|
| Rate for Payer: Ohio Health Group HMO |
$9,368.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,993.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,867.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,619.14
|
| Rate for Payer: PHCS Commercial |
$11,991.84
|
| Rate for Payer: United Healthcare All Payer |
$10,992.52
|
|
|
PINNACLE MTL INS NEUT 36 * 50
|
Facility
|
OP
|
$13,944.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,183.45 |
| Max. Negotiated Rate |
$13,387.03 |
| Rate for Payer: Aetna Commercial |
$10,737.51
|
| Rate for Payer: Anthem Medicaid |
$4,795.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,876.96
|
| Rate for Payer: Cash Price |
$6,972.41
|
| Rate for Payer: Cigna Commercial |
$11,574.20
|
| Rate for Payer: First Health Commercial |
$13,247.58
|
| Rate for Payer: Humana Commercial |
$11,853.10
|
| Rate for Payer: Humana KY Medicaid |
$4,795.62
|
| Rate for Payer: Kentucky WC Medicaid |
$4,844.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,434.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,291.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,183.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,891.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,271.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,458.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,155.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,131.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,621.93
|
| Rate for Payer: PHCS Commercial |
$13,387.03
|
| Rate for Payer: United Healthcare All Payer |
$12,271.44
|
|
|
PINNACLE MTL INS NEUT 36 * 50
|
Facility
|
IP
|
$13,944.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,183.45 |
| Max. Negotiated Rate |
$13,387.03 |
| Rate for Payer: Aetna Commercial |
$10,737.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,876.96
|
| Rate for Payer: Cash Price |
$6,972.41
|
| Rate for Payer: Cigna Commercial |
$11,574.20
|
| Rate for Payer: First Health Commercial |
$13,247.58
|
| Rate for Payer: Humana Commercial |
$11,853.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,434.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,291.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,183.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,271.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,458.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,155.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,131.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,621.93
|
| Rate for Payer: PHCS Commercial |
$13,387.03
|
| Rate for Payer: United Healthcare All Payer |
$12,271.44
|
|
|
PINNACLE MTL INS NEUT 36 * 52
|
Facility
|
OP
|
$13,944.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,183.45 |
| Max. Negotiated Rate |
$13,387.03 |
| Rate for Payer: Aetna Commercial |
$10,737.51
|
| Rate for Payer: Anthem Medicaid |
$4,795.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,876.96
|
| Rate for Payer: Cash Price |
$6,972.41
|
| Rate for Payer: Cigna Commercial |
$11,574.20
|
| Rate for Payer: First Health Commercial |
$13,247.58
|
| Rate for Payer: Humana Commercial |
$11,853.10
|
| Rate for Payer: Humana KY Medicaid |
$4,795.62
|
| Rate for Payer: Kentucky WC Medicaid |
$4,844.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,434.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,291.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,183.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,891.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,271.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,458.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,155.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,131.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,621.93
|
| Rate for Payer: PHCS Commercial |
$13,387.03
|
| Rate for Payer: United Healthcare All Payer |
$12,271.44
|
|
|
PINNACLE MTL INS NEUT 36 * 52
|
Facility
|
IP
|
$13,944.82
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,183.45 |
| Max. Negotiated Rate |
$13,387.03 |
| Rate for Payer: Aetna Commercial |
$10,737.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,876.96
|
| Rate for Payer: Cash Price |
$6,972.41
|
| Rate for Payer: Cigna Commercial |
$11,574.20
|
| Rate for Payer: First Health Commercial |
$13,247.58
|
| Rate for Payer: Humana Commercial |
$11,853.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,434.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,291.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,183.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,271.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,458.61
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,155.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,131.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,621.93
|
| Rate for Payer: PHCS Commercial |
$13,387.03
|
| Rate for Payer: United Healthcare All Payer |
$12,271.44
|
|
|
PINNACLE MTL INS NEUT 36 * 54
|
Facility
|
OP
|
$14,467.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,340.12 |
| Max. Negotiated Rate |
$13,888.38 |
| Rate for Payer: Aetna Commercial |
$11,139.64
|
| Rate for Payer: Anthem Medicaid |
$4,975.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,284.31
|
| Rate for Payer: Cash Price |
$7,233.53
|
| Rate for Payer: Cigna Commercial |
$12,007.66
|
| Rate for Payer: First Health Commercial |
$13,743.71
|
| Rate for Payer: Humana Commercial |
$12,297.00
|
| Rate for Payer: Humana KY Medicaid |
$4,975.22
|
| Rate for Payer: Kentucky WC Medicaid |
$5,025.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,862.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,676.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,340.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,075.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,731.01
|
| Rate for Payer: Ohio Health Group HMO |
$10,850.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,573.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,586.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,982.27
|
| Rate for Payer: PHCS Commercial |
$13,888.38
|
| Rate for Payer: United Healthcare All Payer |
$12,731.01
|
|
|
PINNACLE MTL INS NEUT 36 * 54
|
Facility
|
IP
|
$14,467.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,340.12 |
| Max. Negotiated Rate |
$13,888.38 |
| Rate for Payer: Aetna Commercial |
$11,139.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,284.31
|
| Rate for Payer: Cash Price |
$7,233.53
|
| Rate for Payer: Cigna Commercial |
$12,007.66
|
| Rate for Payer: First Health Commercial |
$13,743.71
|
| Rate for Payer: Humana Commercial |
$12,297.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,862.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,676.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,340.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,731.01
|
| Rate for Payer: Ohio Health Group HMO |
$10,850.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,573.65
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,586.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,982.27
|
| Rate for Payer: PHCS Commercial |
$13,888.38
|
| Rate for Payer: United Healthcare All Payer |
$12,731.01
|
|
|
PINNACLE MTL INS NEUT 36 * 56
|
Facility
|
IP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 56
|
Facility
|
OP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem Medicaid |
$4,623.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Humana KY Medicaid |
$4,623.98
|
| Rate for Payer: Kentucky WC Medicaid |
$4,671.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,716.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 58
|
Facility
|
IP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 58
|
Facility
|
OP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem Medicaid |
$4,623.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Humana KY Medicaid |
$4,623.98
|
| Rate for Payer: Kentucky WC Medicaid |
$4,671.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,716.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 60
|
Facility
|
IP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 60
|
Facility
|
OP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem Medicaid |
$4,623.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Humana KY Medicaid |
$4,623.98
|
| Rate for Payer: Kentucky WC Medicaid |
$4,671.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,716.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 62
|
Facility
|
OP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem Medicaid |
$4,623.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Humana KY Medicaid |
$4,623.98
|
| Rate for Payer: Kentucky WC Medicaid |
$4,671.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,716.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 62
|
Facility
|
IP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 64
|
Facility
|
IP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 64
|
Facility
|
OP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem Medicaid |
$4,623.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Humana KY Medicaid |
$4,623.98
|
| Rate for Payer: Kentucky WC Medicaid |
$4,671.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,716.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 66
|
Facility
|
IP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 36 * 66
|
Facility
|
OP
|
$13,445.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,033.71 |
| Max. Negotiated Rate |
$12,907.87 |
| Rate for Payer: Aetna Commercial |
$10,353.19
|
| Rate for Payer: Anthem Medicaid |
$4,623.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,487.65
|
| Rate for Payer: Cash Price |
$6,722.85
|
| Rate for Payer: Cigna Commercial |
$11,159.93
|
| Rate for Payer: First Health Commercial |
$12,773.42
|
| Rate for Payer: Humana Commercial |
$11,428.84
|
| Rate for Payer: Humana KY Medicaid |
$4,623.98
|
| Rate for Payer: Kentucky WC Medicaid |
$4,671.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,025.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,922.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,033.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,716.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,832.22
|
| Rate for Payer: Ohio Health Group HMO |
$10,084.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,756.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,697.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,277.53
|
| Rate for Payer: PHCS Commercial |
$12,907.87
|
| Rate for Payer: United Healthcare All Payer |
$11,832.22
|
|
|
PINNACLE MTL INS NEUT 40 * 56
|
Facility
|
OP
|
$21,027.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,308.25 |
| Max. Negotiated Rate |
$20,186.40 |
| Rate for Payer: Aetna Commercial |
$16,191.17
|
| Rate for Payer: Anthem Medicaid |
$7,231.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,401.45
|
| Rate for Payer: Cash Price |
$10,513.75
|
| Rate for Payer: Cigna Commercial |
$17,452.83
|
| Rate for Payer: First Health Commercial |
$19,976.12
|
| Rate for Payer: Humana Commercial |
$17,873.38
|
| Rate for Payer: Humana KY Medicaid |
$7,231.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,304.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,242.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,518.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,308.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,376.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,504.20
|
| Rate for Payer: Ohio Health Group HMO |
$15,770.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,822.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,293.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,508.98
|
| Rate for Payer: PHCS Commercial |
$20,186.40
|
| Rate for Payer: United Healthcare All Payer |
$18,504.20
|
|
|
PINNACLE MTL INS NEUT 40 * 56
|
Facility
|
IP
|
$21,027.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,308.25 |
| Max. Negotiated Rate |
$20,186.40 |
| Rate for Payer: Aetna Commercial |
$16,191.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,401.45
|
| Rate for Payer: Cash Price |
$10,513.75
|
| Rate for Payer: Cigna Commercial |
$17,452.83
|
| Rate for Payer: First Health Commercial |
$19,976.12
|
| Rate for Payer: Humana Commercial |
$17,873.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,242.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,518.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,308.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,504.20
|
| Rate for Payer: Ohio Health Group HMO |
$15,770.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,822.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,293.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,508.98
|
| Rate for Payer: PHCS Commercial |
$20,186.40
|
| Rate for Payer: United Healthcare All Payer |
$18,504.20
|
|
|
PINNACLE MTL INS NEUT 40 * 58
|
Facility
|
OP
|
$21,027.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,308.25 |
| Max. Negotiated Rate |
$20,186.40 |
| Rate for Payer: Aetna Commercial |
$16,191.17
|
| Rate for Payer: Anthem Medicaid |
$7,231.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,401.45
|
| Rate for Payer: Cash Price |
$10,513.75
|
| Rate for Payer: Cigna Commercial |
$17,452.83
|
| Rate for Payer: First Health Commercial |
$19,976.12
|
| Rate for Payer: Humana Commercial |
$17,873.38
|
| Rate for Payer: Humana KY Medicaid |
$7,231.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,304.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,242.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,518.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,308.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,376.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,504.20
|
| Rate for Payer: Ohio Health Group HMO |
$15,770.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,822.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,293.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,508.98
|
| Rate for Payer: PHCS Commercial |
$20,186.40
|
| Rate for Payer: United Healthcare All Payer |
$18,504.20
|
|
|
PINNACLE MTL INS NEUT 40 * 58
|
Facility
|
IP
|
$21,027.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,308.25 |
| Max. Negotiated Rate |
$20,186.40 |
| Rate for Payer: Aetna Commercial |
$16,191.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,401.45
|
| Rate for Payer: Cash Price |
$10,513.75
|
| Rate for Payer: Cigna Commercial |
$17,452.83
|
| Rate for Payer: First Health Commercial |
$19,976.12
|
| Rate for Payer: Humana Commercial |
$17,873.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,242.55
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,518.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,308.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,504.20
|
| Rate for Payer: Ohio Health Group HMO |
$15,770.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,822.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,293.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,508.98
|
| Rate for Payer: PHCS Commercial |
$20,186.40
|
| Rate for Payer: United Healthcare All Payer |
$18,504.20
|
|
|
PINNACLE MTL INS NEUT 40 * 60
|
Facility
|
OP
|
$22,309.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,692.91 |
| Max. Negotiated Rate |
$21,417.31 |
| Rate for Payer: Aetna Commercial |
$17,178.47
|
| Rate for Payer: Anthem Medicaid |
$7,672.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,401.57
|
| Rate for Payer: Cash Price |
$11,154.85
|
| Rate for Payer: Cigna Commercial |
$18,517.05
|
| Rate for Payer: First Health Commercial |
$21,194.22
|
| Rate for Payer: Humana Commercial |
$18,963.24
|
| Rate for Payer: Humana KY Medicaid |
$7,672.31
|
| Rate for Payer: Kentucky WC Medicaid |
$7,750.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,293.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,464.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,692.91
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,826.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,632.54
|
| Rate for Payer: Ohio Health Group HMO |
$16,732.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,847.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,409.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,393.69
|
| Rate for Payer: PHCS Commercial |
$21,417.31
|
| Rate for Payer: United Healthcare All Payer |
$19,632.54
|
|
|
PINNACLE MTL INS NEUT 40 * 60
|
Facility
|
IP
|
$22,309.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,692.91 |
| Max. Negotiated Rate |
$21,417.31 |
| Rate for Payer: Aetna Commercial |
$17,178.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,401.57
|
| Rate for Payer: Cash Price |
$11,154.85
|
| Rate for Payer: Cigna Commercial |
$18,517.05
|
| Rate for Payer: First Health Commercial |
$21,194.22
|
| Rate for Payer: Humana Commercial |
$18,963.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,293.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,464.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,692.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,632.54
|
| Rate for Payer: Ohio Health Group HMO |
$16,732.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,847.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,409.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,393.69
|
| Rate for Payer: PHCS Commercial |
$21,417.31
|
| Rate for Payer: United Healthcare All Payer |
$19,632.54
|
|
