|
PINN LNR CON +4 10^ 44*70
|
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*72
|
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*72
|
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^ 44*74
|
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^ 44*74
|
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*76
|
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*76
|
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 36*56
|
Facility
|
OP
|
$36,230.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,869.00 |
| Max. Negotiated Rate |
$34,780.80 |
| Rate for Payer: Aetna Commercial |
$27,897.10
|
| Rate for Payer: Anthem Medicaid |
$12,459.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,259.40
|
| Rate for Payer: Cash Price |
$18,115.00
|
| Rate for Payer: Cigna Commercial |
$30,070.90
|
| Rate for Payer: First Health Commercial |
$34,418.50
|
| Rate for Payer: Humana Commercial |
$30,795.50
|
| Rate for Payer: Humana KY Medicaid |
$12,459.50
|
| Rate for Payer: Kentucky WC Medicaid |
$12,586.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,708.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,737.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,869.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,709.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,882.40
|
| Rate for Payer: Ohio Health Group HMO |
$27,172.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,984.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,520.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,998.70
|
| Rate for Payer: PHCS Commercial |
$34,780.80
|
| Rate for Payer: United Healthcare All Payer |
$31,882.40
|
|
|
PINN LNR CON +4 36*56
|
Facility
|
IP
|
$36,230.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,869.00 |
| Max. Negotiated Rate |
$34,780.80 |
| Rate for Payer: Aetna Commercial |
$27,897.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,259.40
|
| Rate for Payer: Cash Price |
$18,115.00
|
| Rate for Payer: Cigna Commercial |
$30,070.90
|
| Rate for Payer: First Health Commercial |
$34,418.50
|
| Rate for Payer: Humana Commercial |
$30,795.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,708.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,737.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,869.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,882.40
|
| Rate for Payer: Ohio Health Group HMO |
$27,172.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,984.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,520.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,998.70
|
| Rate for Payer: PHCS Commercial |
$34,780.80
|
| Rate for Payer: United Healthcare All Payer |
$31,882.40
|
|
|
PINN LNR CON +4 36*58
|
Facility
|
IP
|
$31,545.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,463.65 |
| Max. Negotiated Rate |
$30,283.68 |
| Rate for Payer: Aetna Commercial |
$24,290.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,605.49
|
| Rate for Payer: Cash Price |
$15,772.75
|
| Rate for Payer: Cigna Commercial |
$26,182.76
|
| Rate for Payer: First Health Commercial |
$29,968.22
|
| Rate for Payer: Humana Commercial |
$26,813.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,867.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,280.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,463.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,760.04
|
| Rate for Payer: Ohio Health Group HMO |
$23,659.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,236.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,444.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,766.40
|
| Rate for Payer: PHCS Commercial |
$30,283.68
|
| Rate for Payer: United Healthcare All Payer |
$27,760.04
|
|
|
PINN LNR CON +4 36*58
|
Facility
|
OP
|
$31,545.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,463.65 |
| Max. Negotiated Rate |
$30,283.68 |
| Rate for Payer: Aetna Commercial |
$24,290.03
|
| Rate for Payer: Anthem Medicaid |
$10,848.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,605.49
|
| Rate for Payer: Cash Price |
$15,772.75
|
| Rate for Payer: Cigna Commercial |
$26,182.76
|
| Rate for Payer: First Health Commercial |
$29,968.22
|
| Rate for Payer: Humana Commercial |
$26,813.67
|
| Rate for Payer: Humana KY Medicaid |
$10,848.50
|
| Rate for Payer: Kentucky WC Medicaid |
$10,958.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,867.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,280.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,463.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,066.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,760.04
|
| Rate for Payer: Ohio Health Group HMO |
$23,659.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,236.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,444.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,766.40
|
| Rate for Payer: PHCS Commercial |
$30,283.68
|
| Rate for Payer: United Healthcare All Payer |
$27,760.04
|
|
|
PINN LNR CON +4 36*60
|
Facility
|
OP
|
$34,741.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,422.38 |
| Max. Negotiated Rate |
$33,351.60 |
| Rate for Payer: Aetna Commercial |
$26,750.76
|
| Rate for Payer: Anthem Medicaid |
$11,947.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,098.17
|
| Rate for Payer: Cash Price |
$17,370.62
|
| Rate for Payer: Cigna Commercial |
$28,835.24
|
| Rate for Payer: First Health Commercial |
$33,004.19
|
| Rate for Payer: Humana Commercial |
$29,530.06
|
| Rate for Payer: Humana KY Medicaid |
$11,947.52
|
| Rate for Payer: Kentucky WC Medicaid |
$12,069.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,487.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,639.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,422.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,187.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,572.30
|
| Rate for Payer: Ohio Health Group HMO |
$26,055.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,793.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,224.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$23,971.46
|
| Rate for Payer: PHCS Commercial |
$33,351.60
|
| Rate for Payer: United Healthcare All Payer |
$30,572.30
|
|
|
PINN LNR CON +4 36*60
|
Facility
|
IP
|
$34,741.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,422.38 |
| Max. Negotiated Rate |
$33,351.60 |
| Rate for Payer: Aetna Commercial |
$26,750.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,098.17
|
| Rate for Payer: Cash Price |
$17,370.62
|
| Rate for Payer: Cigna Commercial |
$28,835.24
|
| Rate for Payer: First Health Commercial |
$33,004.19
|
| Rate for Payer: Humana Commercial |
$29,530.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,487.83
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,639.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,422.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,572.30
|
| Rate for Payer: Ohio Health Group HMO |
$26,055.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,793.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,224.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$23,971.46
|
| Rate for Payer: PHCS Commercial |
$33,351.60
|
| Rate for Payer: United Healthcare All Payer |
$30,572.30
|
|
|
PINN LNR CON +4 NEUT 28*48
|
Facility
|
IP
|
$21,758.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,527.62 |
| Max. Negotiated Rate |
$20,888.40 |
| Rate for Payer: Aetna Commercial |
$16,754.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,971.83
|
| Rate for Payer: Cash Price |
$10,879.38
|
| Rate for Payer: Cigna Commercial |
$18,059.76
|
| Rate for Payer: First Health Commercial |
$20,670.81
|
| Rate for Payer: Humana Commercial |
$18,494.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,842.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,057.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,527.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,147.70
|
| Rate for Payer: Ohio Health Group HMO |
$16,319.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,407.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,930.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,013.54
|
| Rate for Payer: PHCS Commercial |
$20,888.40
|
| Rate for Payer: United Healthcare All Payer |
$19,147.70
|
|
|
PINN LNR CON +4 NEUT 28*48
|
Facility
|
OP
|
$21,758.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,527.62 |
| Max. Negotiated Rate |
$20,888.40 |
| Rate for Payer: Aetna Commercial |
$16,754.24
|
| Rate for Payer: Anthem Medicaid |
$7,482.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,971.83
|
| Rate for Payer: Cash Price |
$10,879.38
|
| Rate for Payer: Cigna Commercial |
$18,059.76
|
| Rate for Payer: First Health Commercial |
$20,670.81
|
| Rate for Payer: Humana Commercial |
$18,494.94
|
| Rate for Payer: Humana KY Medicaid |
$7,482.83
|
| Rate for Payer: Kentucky WC Medicaid |
$7,558.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,842.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,057.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,527.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,632.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,147.70
|
| Rate for Payer: Ohio Health Group HMO |
$16,319.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$17,407.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,930.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,013.54
|
| Rate for Payer: PHCS Commercial |
$20,888.40
|
| Rate for Payer: United Healthcare All Payer |
$19,147.70
|
|
|
PINN LNR CON +4 NEUT 28*50
|
Facility
|
OP
|
$36,230.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,869.00 |
| Max. Negotiated Rate |
$34,780.80 |
| Rate for Payer: Aetna Commercial |
$27,897.10
|
| Rate for Payer: Anthem Medicaid |
$12,459.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,259.40
|
| Rate for Payer: Cash Price |
$18,115.00
|
| Rate for Payer: Cigna Commercial |
$30,070.90
|
| Rate for Payer: First Health Commercial |
$34,418.50
|
| Rate for Payer: Humana Commercial |
$30,795.50
|
| Rate for Payer: Humana KY Medicaid |
$12,459.50
|
| Rate for Payer: Kentucky WC Medicaid |
$12,586.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,708.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,737.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,869.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,709.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,882.40
|
| Rate for Payer: Ohio Health Group HMO |
$27,172.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,984.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,520.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,998.70
|
| Rate for Payer: PHCS Commercial |
$34,780.80
|
| Rate for Payer: United Healthcare All Payer |
$31,882.40
|
|
|
PINN LNR CON +4 NEUT 28*50
|
Facility
|
IP
|
$36,230.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,869.00 |
| Max. Negotiated Rate |
$34,780.80 |
| Rate for Payer: Aetna Commercial |
$27,897.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,259.40
|
| Rate for Payer: Cash Price |
$18,115.00
|
| Rate for Payer: Cigna Commercial |
$30,070.90
|
| Rate for Payer: First Health Commercial |
$34,418.50
|
| Rate for Payer: Humana Commercial |
$30,795.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,708.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,737.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,869.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,882.40
|
| Rate for Payer: Ohio Health Group HMO |
$27,172.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,984.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,520.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,998.70
|
| Rate for Payer: PHCS Commercial |
$34,780.80
|
| Rate for Payer: United Healthcare All Payer |
$31,882.40
|
|
|
PINN LNR CON +4 NEUT 32*52
|
Facility
|
IP
|
$36,623.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,986.96 |
| Max. Negotiated Rate |
$35,158.26 |
| Rate for Payer: Aetna Commercial |
$28,199.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,566.09
|
| Rate for Payer: Cash Price |
$18,311.59
|
| Rate for Payer: Cigna Commercial |
$30,397.25
|
| Rate for Payer: First Health Commercial |
$34,792.03
|
| Rate for Payer: Humana Commercial |
$31,129.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,031.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,027.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,986.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,228.41
|
| Rate for Payer: Ohio Health Group HMO |
$27,467.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29,298.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,862.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,270.00
|
| Rate for Payer: PHCS Commercial |
$35,158.26
|
| Rate for Payer: United Healthcare All Payer |
$32,228.41
|
|
|
PINN LNR CON +4 NEUT 32*52
|
Facility
|
OP
|
$36,623.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,986.96 |
| Max. Negotiated Rate |
$35,158.26 |
| Rate for Payer: Aetna Commercial |
$28,199.86
|
| Rate for Payer: Anthem Medicaid |
$12,594.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,566.09
|
| Rate for Payer: Cash Price |
$18,311.59
|
| Rate for Payer: Cigna Commercial |
$30,397.25
|
| Rate for Payer: First Health Commercial |
$34,792.03
|
| Rate for Payer: Humana Commercial |
$31,129.71
|
| Rate for Payer: Humana KY Medicaid |
$12,594.72
|
| Rate for Payer: Kentucky WC Medicaid |
$12,722.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,031.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,027.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,986.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,847.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,228.41
|
| Rate for Payer: Ohio Health Group HMO |
$27,467.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29,298.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,862.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,270.00
|
| Rate for Payer: PHCS Commercial |
$35,158.26
|
| Rate for Payer: United Healthcare All Payer |
$32,228.41
|
|
|
PINN LNR CON +4 NEUT 32*54
|
Facility
|
IP
|
$36,623.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,986.96 |
| Max. Negotiated Rate |
$35,158.26 |
| Rate for Payer: Aetna Commercial |
$28,199.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,566.09
|
| Rate for Payer: Cash Price |
$18,311.59
|
| Rate for Payer: Cigna Commercial |
$30,397.25
|
| Rate for Payer: First Health Commercial |
$34,792.03
|
| Rate for Payer: Humana Commercial |
$31,129.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,031.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,027.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,986.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,228.41
|
| Rate for Payer: Ohio Health Group HMO |
$27,467.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29,298.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,862.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,270.00
|
| Rate for Payer: PHCS Commercial |
$35,158.26
|
| Rate for Payer: United Healthcare All Payer |
$32,228.41
|
|
|
PINN LNR CON +4 NEUT 32*54
|
Facility
|
OP
|
$36,623.19
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,986.96 |
| Max. Negotiated Rate |
$35,158.26 |
| Rate for Payer: Aetna Commercial |
$28,199.86
|
| Rate for Payer: Anthem Medicaid |
$12,594.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,566.09
|
| Rate for Payer: Cash Price |
$18,311.59
|
| Rate for Payer: Cigna Commercial |
$30,397.25
|
| Rate for Payer: First Health Commercial |
$34,792.03
|
| Rate for Payer: Humana Commercial |
$31,129.71
|
| Rate for Payer: Humana KY Medicaid |
$12,594.72
|
| Rate for Payer: Kentucky WC Medicaid |
$12,722.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,031.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,027.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,986.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,847.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,228.41
|
| Rate for Payer: Ohio Health Group HMO |
$27,467.39
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29,298.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,862.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,270.00
|
| Rate for Payer: PHCS Commercial |
$35,158.26
|
| Rate for Payer: United Healthcare All Payer |
$32,228.41
|
|
|
PINN LNR CON +4 NEUT 32*56
|
Facility
|
OP
|
$9,570.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,871.00 |
| Max. Negotiated Rate |
$9,187.20 |
| Rate for Payer: Aetna Commercial |
$7,368.90
|
| Rate for Payer: Anthem Medicaid |
$3,291.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,464.60
|
| Rate for Payer: Cash Price |
$4,785.00
|
| Rate for Payer: Cigna Commercial |
$7,943.10
|
| Rate for Payer: First Health Commercial |
$9,091.50
|
| Rate for Payer: Humana Commercial |
$8,134.50
|
| Rate for Payer: Humana KY Medicaid |
$3,291.12
|
| Rate for Payer: Kentucky WC Medicaid |
$3,324.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,847.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,062.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,871.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,357.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,421.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,177.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,656.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,325.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,603.30
|
| Rate for Payer: PHCS Commercial |
$9,187.20
|
| Rate for Payer: United Healthcare All Payer |
$8,421.60
|
|
|
PINN LNR CON +4 NEUT 32*56
|
Facility
|
IP
|
$9,570.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,871.00 |
| Max. Negotiated Rate |
$9,187.20 |
| Rate for Payer: Aetna Commercial |
$7,368.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,464.60
|
| Rate for Payer: Cash Price |
$4,785.00
|
| Rate for Payer: Cigna Commercial |
$7,943.10
|
| Rate for Payer: First Health Commercial |
$9,091.50
|
| Rate for Payer: Humana Commercial |
$8,134.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,847.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,062.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,871.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,421.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,177.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,656.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,325.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,603.30
|
| Rate for Payer: PHCS Commercial |
$9,187.20
|
| Rate for Payer: United Healthcare All Payer |
$8,421.60
|
|
|
PINN LNR CON +4 NEUT 32*58
|
Facility
|
IP
|
$9,570.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,871.00 |
| Max. Negotiated Rate |
$9,187.20 |
| Rate for Payer: Aetna Commercial |
$7,368.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,464.60
|
| Rate for Payer: Cash Price |
$4,785.00
|
| Rate for Payer: Cigna Commercial |
$7,943.10
|
| Rate for Payer: First Health Commercial |
$9,091.50
|
| Rate for Payer: Humana Commercial |
$8,134.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,847.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,062.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,871.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,421.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,177.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,656.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,325.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,603.30
|
| Rate for Payer: PHCS Commercial |
$9,187.20
|
| Rate for Payer: United Healthcare All Payer |
$8,421.60
|
|
|
PINN LNR CON +4 NEUT 32*58
|
Facility
|
OP
|
$9,570.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,871.00 |
| Max. Negotiated Rate |
$9,187.20 |
| Rate for Payer: Aetna Commercial |
$7,368.90
|
| Rate for Payer: Anthem Medicaid |
$3,291.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,464.60
|
| Rate for Payer: Cash Price |
$4,785.00
|
| Rate for Payer: Cigna Commercial |
$7,943.10
|
| Rate for Payer: First Health Commercial |
$9,091.50
|
| Rate for Payer: Humana Commercial |
$8,134.50
|
| Rate for Payer: Humana KY Medicaid |
$3,291.12
|
| Rate for Payer: Kentucky WC Medicaid |
$3,324.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,847.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,062.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,871.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,357.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,421.60
|
| Rate for Payer: Ohio Health Group HMO |
$7,177.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,656.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,325.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,603.30
|
| Rate for Payer: PHCS Commercial |
$9,187.20
|
| Rate for Payer: United Healthcare All Payer |
$8,421.60
|
|
