|
PINN LNR CON +4 10^ 32*68
|
Facility
|
IP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*68
|
Facility
|
OP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem Medicaid |
$3,102.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Humana KY Medicaid |
$3,102.84
|
| Rate for Payer: Kentucky WC Medicaid |
$3,134.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,165.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*70
|
Facility
|
OP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem Medicaid |
$3,102.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Humana KY Medicaid |
$3,102.84
|
| Rate for Payer: Kentucky WC Medicaid |
$3,134.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,165.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*70
|
Facility
|
IP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*72
|
Facility
|
OP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem Medicaid |
$3,102.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Humana KY Medicaid |
$3,102.84
|
| Rate for Payer: Kentucky WC Medicaid |
$3,134.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,165.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*72
|
Facility
|
IP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*74
|
Facility
|
IP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*74
|
Facility
|
OP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem Medicaid |
$3,102.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Humana KY Medicaid |
$3,102.84
|
| Rate for Payer: Kentucky WC Medicaid |
$3,134.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,165.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*76
|
Facility
|
IP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 32*76
|
Facility
|
OP
|
$9,022.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,706.75 |
| Max. Negotiated Rate |
$8,661.60 |
| Rate for Payer: Aetna Commercial |
$6,947.32
|
| Rate for Payer: Anthem Medicaid |
$3,102.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,037.55
|
| Rate for Payer: Cash Price |
$4,511.25
|
| Rate for Payer: Cigna Commercial |
$7,488.68
|
| Rate for Payer: First Health Commercial |
$8,571.38
|
| Rate for Payer: Humana Commercial |
$7,669.12
|
| Rate for Payer: Humana KY Medicaid |
$3,102.84
|
| Rate for Payer: Kentucky WC Medicaid |
$3,134.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,398.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,658.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,706.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,165.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,939.80
|
| Rate for Payer: Ohio Health Group HMO |
$6,766.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,218.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,849.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,225.52
|
| Rate for Payer: PHCS Commercial |
$8,661.60
|
| Rate for Payer: United Healthcare All Payer |
$7,939.80
|
|
|
PINN LNR CON +4 10^ 36*56
|
Facility
|
IP
|
$29,601.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,880.34 |
| Max. Negotiated Rate |
$28,417.08 |
| Rate for Payer: Aetna Commercial |
$22,792.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,088.87
|
| Rate for Payer: Cash Price |
$14,800.56
|
| Rate for Payer: Cigna Commercial |
$24,568.93
|
| Rate for Payer: First Health Commercial |
$28,121.06
|
| Rate for Payer: Humana Commercial |
$25,160.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,272.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,845.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,880.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,048.99
|
| Rate for Payer: Ohio Health Group HMO |
$22,200.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23,680.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$25,752.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20,424.77
|
| Rate for Payer: PHCS Commercial |
$28,417.08
|
| Rate for Payer: United Healthcare All Payer |
$26,048.99
|
|
|
PINN LNR CON +4 10^ 36*56
|
Facility
|
OP
|
$29,601.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,880.34 |
| Max. Negotiated Rate |
$28,417.08 |
| Rate for Payer: Aetna Commercial |
$22,792.86
|
| Rate for Payer: Anthem Medicaid |
$10,179.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,088.87
|
| Rate for Payer: Cash Price |
$14,800.56
|
| Rate for Payer: Cigna Commercial |
$24,568.93
|
| Rate for Payer: First Health Commercial |
$28,121.06
|
| Rate for Payer: Humana Commercial |
$25,160.95
|
| Rate for Payer: Humana KY Medicaid |
$10,179.83
|
| Rate for Payer: Kentucky WC Medicaid |
$10,283.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,272.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,845.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,880.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,384.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,048.99
|
| Rate for Payer: Ohio Health Group HMO |
$22,200.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23,680.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$25,752.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20,424.77
|
| Rate for Payer: PHCS Commercial |
$28,417.08
|
| Rate for Payer: United Healthcare All Payer |
$26,048.99
|
|
|
PINN LNR CON +4 10^ 36*58
|
Facility
|
IP
|
$29,601.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,880.34 |
| Max. Negotiated Rate |
$28,417.08 |
| Rate for Payer: Aetna Commercial |
$22,792.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,088.87
|
| Rate for Payer: Cash Price |
$14,800.56
|
| Rate for Payer: Cigna Commercial |
$24,568.93
|
| Rate for Payer: First Health Commercial |
$28,121.06
|
| Rate for Payer: Humana Commercial |
$25,160.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,272.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,845.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,880.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,048.99
|
| Rate for Payer: Ohio Health Group HMO |
$22,200.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23,680.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$25,752.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20,424.77
|
| Rate for Payer: PHCS Commercial |
$28,417.08
|
| Rate for Payer: United Healthcare All Payer |
$26,048.99
|
|
|
PINN LNR CON +4 10^ 36*58
|
Facility
|
OP
|
$29,601.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,880.34 |
| Max. Negotiated Rate |
$28,417.08 |
| Rate for Payer: Aetna Commercial |
$22,792.86
|
| Rate for Payer: Anthem Medicaid |
$10,179.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,088.87
|
| Rate for Payer: Cash Price |
$14,800.56
|
| Rate for Payer: Cigna Commercial |
$24,568.93
|
| Rate for Payer: First Health Commercial |
$28,121.06
|
| Rate for Payer: Humana Commercial |
$25,160.95
|
| Rate for Payer: Humana KY Medicaid |
$10,179.83
|
| Rate for Payer: Kentucky WC Medicaid |
$10,283.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,272.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,845.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,880.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,384.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,048.99
|
| Rate for Payer: Ohio Health Group HMO |
$22,200.84
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23,680.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$25,752.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20,424.77
|
| Rate for Payer: PHCS Commercial |
$28,417.08
|
| Rate for Payer: United Healthcare All Payer |
$26,048.99
|
|
|
PINN LNR CON +4 10^ 36*60
|
Facility
|
IP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 36*60
|
Facility
|
OP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem Medicaid |
$7,904.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Humana KY Medicaid |
$7,904.54
|
| Rate for Payer: Kentucky WC Medicaid |
$7,984.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,063.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 40*62
|
Facility
|
IP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 40*62
|
Facility
|
OP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem Medicaid |
$7,904.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Humana KY Medicaid |
$7,904.54
|
| Rate for Payer: Kentucky WC Medicaid |
$7,984.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,063.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 40*64
|
Facility
|
OP
|
$33,486.69
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,046.01 |
| Max. Negotiated Rate |
$32,147.22 |
| Rate for Payer: Aetna Commercial |
$25,784.75
|
| Rate for Payer: Anthem Medicaid |
$11,516.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$26,119.62
|
| Rate for Payer: Cash Price |
$16,743.34
|
| Rate for Payer: Cigna Commercial |
$27,793.95
|
| Rate for Payer: First Health Commercial |
$31,812.36
|
| Rate for Payer: Humana Commercial |
$28,463.69
|
| Rate for Payer: Humana KY Medicaid |
$11,516.07
|
| Rate for Payer: Kentucky WC Medicaid |
$11,633.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$27,459.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$24,713.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,046.01
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,747.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$29,468.29
|
| Rate for Payer: Ohio Health Group HMO |
$25,115.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$26,789.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$29,133.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$23,105.82
|
| Rate for Payer: PHCS Commercial |
$32,147.22
|
| Rate for Payer: United Healthcare All Payer |
$29,468.29
|
|
|
PINN LNR CON +4 10^ 40*64
|
Facility
|
IP
|
$33,486.69
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,046.01 |
| Max. Negotiated Rate |
$32,147.22 |
| Rate for Payer: Aetna Commercial |
$25,784.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$26,119.62
|
| Rate for Payer: Cash Price |
$16,743.34
|
| Rate for Payer: Cigna Commercial |
$27,793.95
|
| Rate for Payer: First Health Commercial |
$31,812.36
|
| Rate for Payer: Humana Commercial |
$28,463.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$27,459.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$24,713.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,046.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$29,468.29
|
| Rate for Payer: Ohio Health Group HMO |
$25,115.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$26,789.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$29,133.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$23,105.82
|
| Rate for Payer: PHCS Commercial |
$32,147.22
|
| Rate for Payer: United Healthcare All Payer |
$29,468.29
|
|
|
PINN LNR CON +4 10^ 40*66
|
Facility
|
IP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 40*66
|
Facility
|
OP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem Medicaid |
$7,904.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Humana KY Medicaid |
$7,904.54
|
| Rate for Payer: Kentucky WC Medicaid |
$7,984.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,063.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 40*68
|
Facility
|
IP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 40*68
|
Facility
|
OP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem Medicaid |
$7,904.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Humana KY Medicaid |
$7,904.54
|
| Rate for Payer: Kentucky WC Medicaid |
$7,984.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,063.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
|
PINN LNR CON +4 10^ 44*70
|
Facility
|
IP
|
$22,985.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,895.50 |
| Max. Negotiated Rate |
$22,065.60 |
| Rate for Payer: Aetna Commercial |
$17,698.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,928.30
|
| Rate for Payer: Cash Price |
$11,492.50
|
| Rate for Payer: Cigna Commercial |
$19,077.55
|
| Rate for Payer: First Health Commercial |
$21,835.75
|
| Rate for Payer: Humana Commercial |
$19,537.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,847.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,962.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,895.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,226.80
|
| Rate for Payer: Ohio Health Group HMO |
$17,238.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,388.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19,996.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,859.65
|
| Rate for Payer: PHCS Commercial |
$22,065.60
|
| Rate for Payer: United Healthcare All Payer |
$20,226.80
|
|
