|
PINN LNR CON +4 NEUT 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 NEUT 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
|
|
|
PINN LNR CON +4 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 NEUT 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 MAR 10D 36ID*56OD
|
Facility
|
IP
|
$8,187.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,456.24 |
| Max. Negotiated Rate |
$7,859.95 |
| Rate for Payer: Aetna Commercial |
$6,304.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,386.21
|
| Rate for Payer: Cash Price |
$4,093.73
|
| Rate for Payer: Cigna Commercial |
$6,795.58
|
| Rate for Payer: First Health Commercial |
$7,778.08
|
| Rate for Payer: Humana Commercial |
$6,959.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,713.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,042.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,456.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,204.96
|
| Rate for Payer: Ohio Health Group HMO |
$6,140.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,549.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,123.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,649.34
|
| Rate for Payer: PHCS Commercial |
$7,859.95
|
| Rate for Payer: United Healthcare All Payer |
$7,204.96
|
|
|
PINN MAR 10D 36ID*56OD
|
Facility
|
OP
|
$8,187.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,456.24 |
| Max. Negotiated Rate |
$7,859.95 |
| Rate for Payer: Aetna Commercial |
$6,304.34
|
| Rate for Payer: Anthem Medicaid |
$2,815.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,386.21
|
| Rate for Payer: Cash Price |
$4,093.73
|
| Rate for Payer: Cigna Commercial |
$6,795.58
|
| Rate for Payer: First Health Commercial |
$7,778.08
|
| Rate for Payer: Humana Commercial |
$6,959.33
|
| Rate for Payer: Humana KY Medicaid |
$2,815.66
|
| Rate for Payer: Kentucky WC Medicaid |
$2,844.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,713.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,042.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,456.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,872.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,204.96
|
| Rate for Payer: Ohio Health Group HMO |
$6,140.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,549.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,123.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,649.34
|
| Rate for Payer: PHCS Commercial |
$7,859.95
|
| Rate for Payer: United Healthcare All Payer |
$7,204.96
|
|
|
PINN MAR 10D 36ID*58OD
|
Facility
|
IP
|
$7,165.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,149.55 |
| Max. Negotiated Rate |
$6,878.55 |
| Rate for Payer: Aetna Commercial |
$5,517.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,588.82
|
| Rate for Payer: Cash Price |
$3,582.58
|
| Rate for Payer: Cigna Commercial |
$5,947.08
|
| Rate for Payer: First Health Commercial |
$6,806.90
|
| Rate for Payer: Humana Commercial |
$6,090.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,875.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,287.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,149.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,305.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,373.87
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,732.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,233.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,943.96
|
| Rate for Payer: PHCS Commercial |
$6,878.55
|
| Rate for Payer: United Healthcare All Payer |
$6,305.34
|
|
|
PINN MAR 10D 36ID*58OD
|
Facility
|
OP
|
$7,165.16
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,149.55 |
| Max. Negotiated Rate |
$6,878.55 |
| Rate for Payer: Aetna Commercial |
$5,517.17
|
| Rate for Payer: Anthem Medicaid |
$2,464.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,588.82
|
| Rate for Payer: Cash Price |
$3,582.58
|
| Rate for Payer: Cigna Commercial |
$5,947.08
|
| Rate for Payer: First Health Commercial |
$6,806.90
|
| Rate for Payer: Humana Commercial |
$6,090.39
|
| Rate for Payer: Humana KY Medicaid |
$2,464.10
|
| Rate for Payer: Kentucky WC Medicaid |
$2,489.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,875.43
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,287.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,149.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,513.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,305.34
|
| Rate for Payer: Ohio Health Group HMO |
$5,373.87
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,732.13
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,233.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,943.96
|
| Rate for Payer: PHCS Commercial |
$6,878.55
|
| Rate for Payer: United Healthcare All Payer |
$6,305.34
|
|
|
PINN MAR 10D 36ID*60OD
|
Facility
|
IP
|
$11,537.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,461.19 |
| Max. Negotiated Rate |
$11,075.81 |
| Rate for Payer: Aetna Commercial |
$8,883.72
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,999.09
|
| Rate for Payer: Cash Price |
$5,768.65
|
| Rate for Payer: Cigna Commercial |
$9,575.96
|
| Rate for Payer: First Health Commercial |
$10,960.43
|
| Rate for Payer: Humana Commercial |
$9,806.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,460.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,514.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,461.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,152.82
|
| Rate for Payer: Ohio Health Group HMO |
$8,652.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,229.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,037.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,960.74
|
| Rate for Payer: PHCS Commercial |
$11,075.81
|
| Rate for Payer: United Healthcare All Payer |
$10,152.82
|
|
|
PINN MAR 10D 36ID*60OD
|
Facility
|
OP
|
$11,537.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,461.19 |
| Max. Negotiated Rate |
$11,075.81 |
| Rate for Payer: Aetna Commercial |
$8,883.72
|
| Rate for Payer: Anthem Medicaid |
$3,967.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,999.09
|
| Rate for Payer: Cash Price |
$5,768.65
|
| Rate for Payer: Cigna Commercial |
$9,575.96
|
| Rate for Payer: First Health Commercial |
$10,960.43
|
| Rate for Payer: Humana Commercial |
$9,806.70
|
| Rate for Payer: Humana KY Medicaid |
$3,967.68
|
| Rate for Payer: Kentucky WC Medicaid |
$4,008.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,460.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,514.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,461.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,047.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,152.82
|
| Rate for Payer: Ohio Health Group HMO |
$8,652.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,229.84
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,037.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,960.74
|
| Rate for Payer: PHCS Commercial |
$11,075.81
|
| Rate for Payer: United Healthcare All Payer |
$10,152.82
|
|
|
PINN MAR 10D 36ID*62OD
|
Facility
|
IP
|
$7,796.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,338.83 |
| Max. Negotiated Rate |
$7,484.26 |
| Rate for Payer: Aetna Commercial |
$6,003.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,080.96
|
| Rate for Payer: Cash Price |
$3,898.05
|
| Rate for Payer: Cigna Commercial |
$6,470.76
|
| Rate for Payer: First Health Commercial |
$7,406.30
|
| Rate for Payer: Humana Commercial |
$6,626.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,392.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,753.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,338.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,860.57
|
| Rate for Payer: Ohio Health Group HMO |
$5,847.07
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,236.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,782.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,379.31
|
| Rate for Payer: PHCS Commercial |
$7,484.26
|
| Rate for Payer: United Healthcare All Payer |
$6,860.57
|
|
|
PINN MAR 10D 36ID*62OD
|
Facility
|
OP
|
$7,796.10
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,338.83 |
| Max. Negotiated Rate |
$7,484.26 |
| Rate for Payer: Aetna Commercial |
$6,003.00
|
| Rate for Payer: Anthem Medicaid |
$2,681.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,080.96
|
| Rate for Payer: Cash Price |
$3,898.05
|
| Rate for Payer: Cigna Commercial |
$6,470.76
|
| Rate for Payer: First Health Commercial |
$7,406.30
|
| Rate for Payer: Humana Commercial |
$6,626.69
|
| Rate for Payer: Humana KY Medicaid |
$2,681.08
|
| Rate for Payer: Kentucky WC Medicaid |
$2,708.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,392.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,753.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,338.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,734.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,860.57
|
| Rate for Payer: Ohio Health Group HMO |
$5,847.07
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,236.88
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,782.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,379.31
|
| Rate for Payer: PHCS Commercial |
$7,484.26
|
| Rate for Payer: United Healthcare All Payer |
$6,860.57
|
|
|
PINN MAR 10D 36ID*64OD
|
Facility
|
OP
|
$8,604.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,581.26 |
| Max. Negotiated Rate |
$8,260.04 |
| Rate for Payer: Aetna Commercial |
$6,625.24
|
| Rate for Payer: Anthem Medicaid |
$2,958.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,711.28
|
| Rate for Payer: Cash Price |
$4,302.10
|
| Rate for Payer: Cigna Commercial |
$7,141.49
|
| Rate for Payer: First Health Commercial |
$8,174.00
|
| Rate for Payer: Humana Commercial |
$7,313.58
|
| Rate for Payer: Humana KY Medicaid |
$2,958.99
|
| Rate for Payer: Kentucky WC Medicaid |
$2,989.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,055.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,349.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,581.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,018.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,571.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,453.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,883.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,485.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,936.90
|
| Rate for Payer: PHCS Commercial |
$8,260.04
|
| Rate for Payer: United Healthcare All Payer |
$7,571.70
|
|
|
PINN MAR 10D 36ID*64OD
|
Facility
|
IP
|
$8,604.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,581.26 |
| Max. Negotiated Rate |
$8,260.04 |
| Rate for Payer: Aetna Commercial |
$6,625.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,711.28
|
| Rate for Payer: Cash Price |
$4,302.10
|
| Rate for Payer: Cigna Commercial |
$7,141.49
|
| Rate for Payer: First Health Commercial |
$8,174.00
|
| Rate for Payer: Humana Commercial |
$7,313.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,055.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,349.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,581.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,571.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,453.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,883.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,485.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,936.90
|
| Rate for Payer: PHCS Commercial |
$8,260.04
|
| Rate for Payer: United Healthcare All Payer |
$7,571.70
|
|
|
PINN MAR 10D 36ID*66OD
|
Facility
|
IP
|
$8,604.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,581.26 |
| Max. Negotiated Rate |
$8,260.04 |
| Rate for Payer: Aetna Commercial |
$6,625.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,711.28
|
| Rate for Payer: Cash Price |
$4,302.10
|
| Rate for Payer: Cigna Commercial |
$7,141.49
|
| Rate for Payer: First Health Commercial |
$8,174.00
|
| Rate for Payer: Humana Commercial |
$7,313.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,055.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,349.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,581.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,571.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,453.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,883.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,485.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,936.90
|
| Rate for Payer: PHCS Commercial |
$8,260.04
|
| Rate for Payer: United Healthcare All Payer |
$7,571.70
|
|
|
PINN MAR 10D 36ID*66OD
|
Facility
|
OP
|
$8,604.21
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,581.26 |
| Max. Negotiated Rate |
$8,260.04 |
| Rate for Payer: Aetna Commercial |
$6,625.24
|
| Rate for Payer: Anthem Medicaid |
$2,958.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,711.28
|
| Rate for Payer: Cash Price |
$4,302.10
|
| Rate for Payer: Cigna Commercial |
$7,141.49
|
| Rate for Payer: First Health Commercial |
$8,174.00
|
| Rate for Payer: Humana Commercial |
$7,313.58
|
| Rate for Payer: Humana KY Medicaid |
$2,958.99
|
| Rate for Payer: Kentucky WC Medicaid |
$2,989.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,055.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,349.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,581.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,018.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,571.70
|
| Rate for Payer: Ohio Health Group HMO |
$6,453.16
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,883.37
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,485.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,936.90
|
| Rate for Payer: PHCS Commercial |
$8,260.04
|
| Rate for Payer: United Healthcare All Payer |
$7,571.70
|
|
|
PINN MAR +4 10D 32ID*48OD
|
Facility
|
IP
|
$7,119.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,135.82 |
| Max. Negotiated Rate |
$6,834.61 |
| Rate for Payer: Aetna Commercial |
$5,481.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,553.12
|
| Rate for Payer: Cash Price |
$3,559.70
|
| Rate for Payer: Cigna Commercial |
$5,909.09
|
| Rate for Payer: First Health Commercial |
$6,763.42
|
| Rate for Payer: Humana Commercial |
$6,051.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,837.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,254.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,135.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,265.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,339.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,695.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,193.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,912.38
|
| Rate for Payer: PHCS Commercial |
$6,834.61
|
| Rate for Payer: United Healthcare All Payer |
$6,265.06
|
|
|
PINN MAR +4 10D 32ID*48OD
|
Facility
|
OP
|
$7,119.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,135.82 |
| Max. Negotiated Rate |
$6,834.61 |
| Rate for Payer: Aetna Commercial |
$5,481.93
|
| Rate for Payer: Anthem Medicaid |
$2,448.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,553.12
|
| Rate for Payer: Cash Price |
$3,559.70
|
| Rate for Payer: Cigna Commercial |
$5,909.09
|
| Rate for Payer: First Health Commercial |
$6,763.42
|
| Rate for Payer: Humana Commercial |
$6,051.48
|
| Rate for Payer: Humana KY Medicaid |
$2,448.36
|
| Rate for Payer: Kentucky WC Medicaid |
$2,473.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,837.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,254.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,135.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,497.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,265.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,339.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,695.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,193.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,912.38
|
| Rate for Payer: PHCS Commercial |
$6,834.61
|
| Rate for Payer: United Healthcare All Payer |
$6,265.06
|
|
|
PINN MAR +4 10D 32ID*50OD
|
Facility
|
IP
|
$7,119.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,135.82 |
| Max. Negotiated Rate |
$6,834.61 |
| Rate for Payer: Aetna Commercial |
$5,481.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,553.12
|
| Rate for Payer: Cash Price |
$3,559.70
|
| Rate for Payer: Cigna Commercial |
$5,909.09
|
| Rate for Payer: First Health Commercial |
$6,763.42
|
| Rate for Payer: Humana Commercial |
$6,051.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,837.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,254.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,135.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,265.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,339.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,695.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,193.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,912.38
|
| Rate for Payer: PHCS Commercial |
$6,834.61
|
| Rate for Payer: United Healthcare All Payer |
$6,265.06
|
|
|
PINN MAR +4 10D 32ID*50OD
|
Facility
|
OP
|
$7,119.39
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,135.82 |
| Max. Negotiated Rate |
$6,834.61 |
| Rate for Payer: Aetna Commercial |
$5,481.93
|
| Rate for Payer: Anthem Medicaid |
$2,448.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,553.12
|
| Rate for Payer: Cash Price |
$3,559.70
|
| Rate for Payer: Cigna Commercial |
$5,909.09
|
| Rate for Payer: First Health Commercial |
$6,763.42
|
| Rate for Payer: Humana Commercial |
$6,051.48
|
| Rate for Payer: Humana KY Medicaid |
$2,448.36
|
| Rate for Payer: Kentucky WC Medicaid |
$2,473.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,837.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,254.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,135.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,497.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,265.06
|
| Rate for Payer: Ohio Health Group HMO |
$5,339.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,695.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,193.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,912.38
|
| Rate for Payer: PHCS Commercial |
$6,834.61
|
| Rate for Payer: United Healthcare All Payer |
$6,265.06
|
|
