|
PINN MAR+4 LNR NEUT 36ID*60OD
|
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+4 LNR NEUT 36ID*62OD
|
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+4 LNR NEUT 36ID*62OD
|
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 LNR NEUT 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+4 LNR NEUT 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+4 LNR NEUT 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+4 LNR NEUT 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 LIP LNR 28ID*48OD+4
|
Facility
|
OP
|
$11,001.48
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,300.44 |
| Max. Negotiated Rate |
$10,561.42 |
| Rate for Payer: Aetna Commercial |
$8,471.14
|
| Rate for Payer: Anthem Medicaid |
$3,783.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,581.15
|
| Rate for Payer: Cash Price |
$5,500.74
|
| Rate for Payer: Cigna Commercial |
$9,131.23
|
| Rate for Payer: First Health Commercial |
$10,451.41
|
| Rate for Payer: Humana Commercial |
$9,351.26
|
| Rate for Payer: Humana KY Medicaid |
$3,783.41
|
| Rate for Payer: Kentucky WC Medicaid |
$3,821.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,021.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,119.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,300.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,859.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,681.30
|
| Rate for Payer: Ohio Health Group HMO |
$8,251.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,801.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,571.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,591.02
|
| Rate for Payer: PHCS Commercial |
$10,561.42
|
| Rate for Payer: United Healthcare All Payer |
$9,681.30
|
|
|
PINN MAR LIP LNR 28ID*48OD+4
|
Facility
|
IP
|
$11,001.48
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,300.44 |
| Max. Negotiated Rate |
$10,561.42 |
| Rate for Payer: Aetna Commercial |
$8,471.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,581.15
|
| Rate for Payer: Cash Price |
$5,500.74
|
| Rate for Payer: Cigna Commercial |
$9,131.23
|
| Rate for Payer: First Health Commercial |
$10,451.41
|
| Rate for Payer: Humana Commercial |
$9,351.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,021.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,119.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,300.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,681.30
|
| Rate for Payer: Ohio Health Group HMO |
$8,251.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$8,801.18
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,571.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,591.02
|
| Rate for Payer: PHCS Commercial |
$10,561.42
|
| Rate for Payer: United Healthcare All Payer |
$9,681.30
|
|
|
PINN MAR LIP LNR 28ID*52OD
|
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 LIP LNR 28ID*52OD
|
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 LIP LNR 32ID*52OD
|
Facility
|
OP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem Medicaid |
$2,466.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Humana KY Medicaid |
$2,466.43
|
| Rate for Payer: Kentucky WC Medicaid |
$2,491.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,515.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*52OD
|
Facility
|
IP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*54OD
|
Facility
|
OP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem Medicaid |
$2,466.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Humana KY Medicaid |
$2,466.43
|
| Rate for Payer: Kentucky WC Medicaid |
$2,491.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,515.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*54OD
|
Facility
|
IP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*56OD
|
Facility
|
OP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem Medicaid |
$2,466.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Humana KY Medicaid |
$2,466.43
|
| Rate for Payer: Kentucky WC Medicaid |
$2,491.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,515.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*56OD
|
Facility
|
IP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*58OD
|
Facility
|
OP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem Medicaid |
$2,466.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Humana KY Medicaid |
$2,466.43
|
| Rate for Payer: Kentucky WC Medicaid |
$2,491.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,515.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*58OD
|
Facility
|
IP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*60OD
|
Facility
|
OP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem Medicaid |
$2,466.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Humana KY Medicaid |
$2,466.43
|
| Rate for Payer: Kentucky WC Medicaid |
$2,491.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,515.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*60OD
|
Facility
|
IP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*62OD
|
Facility
|
OP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem Medicaid |
$2,466.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Humana KY Medicaid |
$2,466.43
|
| Rate for Payer: Kentucky WC Medicaid |
$2,491.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,515.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*62OD
|
Facility
|
IP
|
$7,171.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.59 |
| Max. Negotiated Rate |
$6,885.07 |
| Rate for Payer: Aetna Commercial |
$5,522.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,594.12
|
| Rate for Payer: Cash Price |
$3,585.98
|
| Rate for Payer: Cigna Commercial |
$5,952.72
|
| Rate for Payer: First Health Commercial |
$6,813.35
|
| Rate for Payer: Humana Commercial |
$6,096.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,881.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,292.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,151.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,311.32
|
| Rate for Payer: Ohio Health Group HMO |
$5,378.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,737.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$6,239.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,948.65
|
| Rate for Payer: PHCS Commercial |
$6,885.07
|
| Rate for Payer: United Healthcare All Payer |
$6,311.32
|
|
|
PINN MAR LIP LNR 32ID*64OD
|
Facility
|
OP
|
$5,189.15
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,556.74 |
| Max. Negotiated Rate |
$4,981.58 |
| Rate for Payer: Aetna Commercial |
$3,995.65
|
| Rate for Payer: Anthem Medicaid |
$1,784.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,047.54
|
| Rate for Payer: Cash Price |
$2,594.57
|
| Rate for Payer: Cigna Commercial |
$4,306.99
|
| Rate for Payer: First Health Commercial |
$4,929.69
|
| Rate for Payer: Humana Commercial |
$4,410.78
|
| Rate for Payer: Humana KY Medicaid |
$1,784.55
|
| Rate for Payer: Kentucky WC Medicaid |
$1,802.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,255.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,829.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,556.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,820.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,566.45
|
| Rate for Payer: Ohio Health Group HMO |
$3,891.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,151.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,514.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,580.51
|
| Rate for Payer: PHCS Commercial |
$4,981.58
|
| Rate for Payer: United Healthcare All Payer |
$4,566.45
|
|
|
PINN MAR LIP LNR 32ID*64OD
|
Facility
|
IP
|
$5,189.15
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,556.74 |
| Max. Negotiated Rate |
$4,981.58 |
| Rate for Payer: Aetna Commercial |
$3,995.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,047.54
|
| Rate for Payer: Cash Price |
$2,594.57
|
| Rate for Payer: Cigna Commercial |
$4,306.99
|
| Rate for Payer: First Health Commercial |
$4,929.69
|
| Rate for Payer: Humana Commercial |
$4,410.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,255.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,829.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,556.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,566.45
|
| Rate for Payer: Ohio Health Group HMO |
$3,891.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,151.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,514.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,580.51
|
| Rate for Payer: PHCS Commercial |
$4,981.58
|
| Rate for Payer: United Healthcare All Payer |
$4,566.45
|
|
