|
RECTAL RESECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$18,776.79
|
|
|
Service Code
|
MSDRG 334
|
| Min. Negotiated Rate |
$12,741.39 |
| Max. Negotiated Rate |
$18,776.79 |
| Rate for Payer: Anthem Medicaid |
$12,741.39
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$13,411.99
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$18,776.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$18,106.19
|
| Rate for Payer: Humana KY Medicaid |
$12,741.39
|
| Rate for Payer: Humana Medicare Advantage |
$13,411.99
|
| Rate for Payer: Kentucky WC Medicaid |
$12,868.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$16,094.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,996.22
|
|
|
RECTUM SURGERY PROCEDURE
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
76102612
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$310.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$186.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$217.00
|
| Rate for Payer: UHCCP Medicaid |
$108.50
|
|
|
RECTUM SURGERY PROCEDURE
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
761P2612
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$310.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$186.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$217.00
|
| Rate for Payer: UHCCP Medicaid |
$108.50
|
|
|
RECTUM SURGERY PROCEDURE
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
76102612
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.30 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Aetna Commercial |
$238.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$241.80
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$257.30
|
| Rate for Payer: First Health Commercial |
$294.50
|
| Rate for Payer: Humana Commercial |
$263.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$254.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$228.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$93.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$272.80
|
| Rate for Payer: Ohio Health Group HMO |
$232.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$62.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$40.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$96.10
|
| Rate for Payer: PHCS Commercial |
$297.60
|
| Rate for Payer: United Healthcare All Payer |
$272.80
|
|
|
RECTUM SURGERY PROCEDURE
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
76102612
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.30 |
| Max. Negotiated Rate |
$1,106.49 |
| Rate for Payer: Aetna Commercial |
$238.70
|
| Rate for Payer: Anthem Medicaid |
$106.61
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$790.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$241.80
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,106.49
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,066.97
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$257.30
|
| Rate for Payer: First Health Commercial |
$294.50
|
| Rate for Payer: Humana Commercial |
$263.50
|
| Rate for Payer: Humana KY Medicaid |
$106.61
|
| Rate for Payer: Humana Medicare Advantage |
$790.35
|
| Rate for Payer: Kentucky WC Medicaid |
$107.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$254.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$228.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$948.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$108.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$272.80
|
| Rate for Payer: Ohio Health Group HMO |
$232.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$62.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$40.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$96.10
|
| Rate for Payer: PHCS Commercial |
$297.60
|
| Rate for Payer: United Healthcare All Payer |
$272.80
|
|
|
RED BLOOD CELL DISORDERS WITH MCC
|
Facility
|
IP
|
$16,419.61
|
|
|
Service Code
|
MSDRG 811
|
| Min. Negotiated Rate |
$11,141.88 |
| Max. Negotiated Rate |
$16,419.61 |
| Rate for Payer: Anthem Medicaid |
$11,141.88
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$11,728.29
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$16,419.61
|
| Rate for Payer: CareSource Just4Me Medicare |
$15,833.19
|
| Rate for Payer: Humana KY Medicaid |
$11,141.88
|
| Rate for Payer: Humana Medicare Advantage |
$11,728.29
|
| Rate for Payer: Kentucky WC Medicaid |
$11,253.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$14,073.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,364.71
|
|
|
RED BLOOD CELL DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$10,536.55
|
|
|
Service Code
|
MSDRG 812
|
| Min. Negotiated Rate |
$7,149.80 |
| Max. Negotiated Rate |
$10,536.55 |
| Rate for Payer: Anthem Medicaid |
$7,149.80
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$7,526.11
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$10,536.55
|
| Rate for Payer: CareSource Just4Me Medicare |
$10,160.25
|
| Rate for Payer: Humana KY Medicaid |
$7,149.80
|
| Rate for Payer: Humana Medicare Advantage |
$7,526.11
|
| Rate for Payer: Kentucky WC Medicaid |
$7,221.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,031.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,292.80
|
|
|
RED CELLS LR DEGLYCEROLIZED
|
Facility
|
OP
|
$816.00
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
38000014
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$783.36 |
| Rate for Payer: Aetna Commercial |
$628.32
|
| Rate for Payer: Anthem Medicaid |
$280.62
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$282.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$636.48
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$395.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$381.19
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cigna Commercial |
$677.28
|
| Rate for Payer: First Health Commercial |
$775.20
|
| Rate for Payer: Humana Commercial |
$693.60
|
| Rate for Payer: Humana KY Medicaid |
$280.62
|
| Rate for Payer: Humana Medicare Advantage |
$282.36
|
| Rate for Payer: Kentucky WC Medicaid |
$283.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$669.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$602.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$338.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$286.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$718.08
|
| Rate for Payer: Ohio Health Group HMO |
$612.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$163.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$106.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$252.96
|
| Rate for Payer: PHCS Commercial |
$783.36
|
| Rate for Payer: United Healthcare All Payer |
$718.08
|
|
|
RED CELLS LR DEGLYCEROLIZED
|
Facility
|
IP
|
$816.00
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
38000014
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$783.36 |
| Rate for Payer: Aetna Commercial |
$628.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$636.48
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cigna Commercial |
$677.28
|
| Rate for Payer: First Health Commercial |
$775.20
|
| Rate for Payer: Humana Commercial |
$693.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$669.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$602.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$718.08
|
| Rate for Payer: Ohio Health Group HMO |
$612.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$163.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$106.08
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$252.96
|
| Rate for Payer: PHCS Commercial |
$783.36
|
| Rate for Payer: United Healthcare All Payer |
$718.08
|
|
|
REDDICK SCOOP TP CHOL CATH 50C
|
Facility
|
IP
|
$2,033.59
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$264.37 |
| Max. Negotiated Rate |
$1,952.25 |
| Rate for Payer: Aetna Commercial |
$1,565.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,586.20
|
| Rate for Payer: Cash Price |
$1,016.79
|
| Rate for Payer: Cigna Commercial |
$1,687.88
|
| Rate for Payer: First Health Commercial |
$1,931.91
|
| Rate for Payer: Humana Commercial |
$1,728.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,667.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,500.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$610.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,789.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,525.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$406.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$264.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$630.41
|
| Rate for Payer: PHCS Commercial |
$1,952.25
|
| Rate for Payer: United Healthcare All Payer |
$1,789.56
|
|
|
REDDICK SCOOP TP CHOL CATH 50C
|
Facility
|
OP
|
$2,033.59
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$264.37 |
| Max. Negotiated Rate |
$1,952.25 |
| Rate for Payer: Aetna Commercial |
$1,565.86
|
| Rate for Payer: Anthem Medicaid |
$699.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,586.20
|
| Rate for Payer: Cash Price |
$1,016.79
|
| Rate for Payer: Cigna Commercial |
$1,687.88
|
| Rate for Payer: First Health Commercial |
$1,931.91
|
| Rate for Payer: Humana Commercial |
$1,728.55
|
| Rate for Payer: Humana KY Medicaid |
$699.35
|
| Rate for Payer: Kentucky WC Medicaid |
$706.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,667.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,500.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$610.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$713.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,789.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,525.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$406.72
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$264.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$630.41
|
| Rate for Payer: PHCS Commercial |
$1,952.25
|
| Rate for Payer: United Healthcare All Payer |
$1,789.56
|
|
|
REDO COMPL CARDIAC ANOMALY
|
Facility
|
OP
|
$3,932.93
|
|
|
Service Code
|
HCPCS 33622
|
| Hospital Charge Code |
76101316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$511.28 |
| Max. Negotiated Rate |
$3,775.61 |
| Rate for Payer: Aetna Commercial |
$3,028.36
|
| Rate for Payer: Anthem Medicaid |
$1,352.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,067.69
|
| Rate for Payer: Cash Price |
$1,966.46
|
| Rate for Payer: Cigna Commercial |
$3,264.33
|
| Rate for Payer: First Health Commercial |
$3,736.28
|
| Rate for Payer: Humana Commercial |
$3,342.99
|
| Rate for Payer: Humana KY Medicaid |
$1,352.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,366.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,225.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,902.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,460.98
|
| Rate for Payer: Ohio Health Group HMO |
$2,949.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,219.21
|
| Rate for Payer: PHCS Commercial |
$3,775.61
|
| Rate for Payer: United Healthcare All Payer |
$3,460.98
|
|
|
REDO COMPL CARDIAC ANOMALY
|
Facility
|
IP
|
$3,932.93
|
|
|
Service Code
|
HCPCS 33622
|
| Hospital Charge Code |
76101316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$511.28 |
| Max. Negotiated Rate |
$3,775.61 |
| Rate for Payer: Aetna Commercial |
$3,028.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,067.69
|
| Rate for Payer: Cash Price |
$1,966.46
|
| Rate for Payer: Cigna Commercial |
$3,264.33
|
| Rate for Payer: First Health Commercial |
$3,736.28
|
| Rate for Payer: Humana Commercial |
$3,342.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,225.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,902.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,460.98
|
| Rate for Payer: Ohio Health Group HMO |
$2,949.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.59
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.28
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,219.21
|
| Rate for Payer: PHCS Commercial |
$3,775.61
|
| Rate for Payer: United Healthcare All Payer |
$3,460.98
|
|
|
REDO COMPL CARDIAC ANOMALY
|
Professional
|
Both
|
$3,932.93
|
|
|
Service Code
|
HCPCS 33622
|
| Hospital Charge Code |
76101316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.53 |
| Max. Negotiated Rate |
$6,720.19 |
| Rate for Payer: Aetna Commercial |
$6,434.32
|
| Rate for Payer: Anthem Medicaid |
$3,180.03
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,932.93
|
| Rate for Payer: Cash Price |
$1,966.46
|
| Rate for Payer: Cash Price |
$1,966.46
|
| Rate for Payer: Cigna Commercial |
$6,720.19
|
| Rate for Payer: Healthspan PPO |
$4,743.73
|
| Rate for Payer: Humana Medicaid |
$3,180.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$4,907.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$3,243.63
|
| Rate for Payer: Molina Healthcare Passport |
$3,180.03
|
| Rate for Payer: Multiplan PHCS |
$2,359.76
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,753.05
|
| Rate for Payer: UHCCP Medicaid |
$1,376.53
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$3,211.83
|
|
|
REDO COMPL CARDIAC ANOMALY(P
|
Professional
|
Both
|
$3,932.93
|
|
|
Service Code
|
HCPCS 33622
|
| Hospital Charge Code |
761P1316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.53 |
| Max. Negotiated Rate |
$6,720.19 |
| Rate for Payer: Aetna Commercial |
$6,434.32
|
| Rate for Payer: Anthem Medicaid |
$3,180.03
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,932.93
|
| Rate for Payer: Cash Price |
$1,966.46
|
| Rate for Payer: Cash Price |
$1,966.46
|
| Rate for Payer: Cigna Commercial |
$6,720.19
|
| Rate for Payer: Healthspan PPO |
$4,743.73
|
| Rate for Payer: Humana Medicaid |
$3,180.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$4,907.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$3,243.63
|
| Rate for Payer: Molina Healthcare Passport |
$3,180.03
|
| Rate for Payer: Multiplan PHCS |
$2,359.76
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,753.05
|
| Rate for Payer: UHCCP Medicaid |
$1,376.53
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$3,211.83
|
|
|
REDUC ELBOW,DISLOC/DIS HUMERUS
|
Facility
|
IP
|
$950.00
|
|
|
Service Code
|
HCPCS 24999
|
| Hospital Charge Code |
76102800
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$912.00 |
| Rate for Payer: Aetna Commercial |
$731.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$741.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cigna Commercial |
$788.50
|
| Rate for Payer: First Health Commercial |
$902.50
|
| Rate for Payer: Humana Commercial |
$807.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$779.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$701.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$285.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$836.00
|
| Rate for Payer: Ohio Health Group HMO |
$712.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$190.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$123.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$294.50
|
| Rate for Payer: PHCS Commercial |
$912.00
|
| Rate for Payer: United Healthcare All Payer |
$836.00
|
|
|
REDUC ELBOW,DISLOC/DIS HUMERUS
|
Facility
|
OP
|
$950.00
|
|
|
Service Code
|
HCPCS 24999
|
| Hospital Charge Code |
76102800
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$912.00 |
| Rate for Payer: Aetna Commercial |
$731.50
|
| Rate for Payer: Anthem Medicaid |
$326.70
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$203.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$741.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$285.50
|
| Rate for Payer: CareSource Just4Me Medicare |
$275.31
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cigna Commercial |
$788.50
|
| Rate for Payer: First Health Commercial |
$902.50
|
| Rate for Payer: Humana Commercial |
$807.50
|
| Rate for Payer: Humana KY Medicaid |
$326.70
|
| Rate for Payer: Humana Medicare Advantage |
$203.93
|
| Rate for Payer: Kentucky WC Medicaid |
$330.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$779.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$701.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$244.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$333.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$836.00
|
| Rate for Payer: Ohio Health Group HMO |
$712.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$190.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$123.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$294.50
|
| Rate for Payer: PHCS Commercial |
$912.00
|
| Rate for Payer: United Healthcare All Payer |
$836.00
|
|
|
REDUC ELBOW,DISLOC/DIS HUMERUS
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 24999
|
| Hospital Charge Code |
76102800
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$950.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$950.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$570.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$665.00
|
| Rate for Payer: UHCCP Medicaid |
$332.50
|
|
|
REDUCE TESTIS TORSION
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 54600
|
| Hospital Charge Code |
76102796
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.25 |
| Max. Negotiated Rate |
$732.79 |
| Rate for Payer: Aetna Commercial |
$732.79
|
| Rate for Payer: Anthem Medicaid |
$328.95
|
| Rate for Payer: Buckeye Medicare Advantage |
$475.00
|
| Rate for Payer: Cash Price |
$237.50
|
| Rate for Payer: Cash Price |
$237.50
|
| Rate for Payer: Cigna Commercial |
$647.55
|
| Rate for Payer: Healthspan PPO |
$709.53
|
| Rate for Payer: Humana Medicaid |
$328.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$615.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$335.53
|
| Rate for Payer: Molina Healthcare Passport |
$328.95
|
| Rate for Payer: Multiplan PHCS |
$285.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$332.50
|
| Rate for Payer: UHCCP Medicaid |
$166.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$332.24
|
|
|
REDUCE TESTIS TORSION
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
HCPCS 54600
|
| Hospital Charge Code |
76102796
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.75 |
| Max. Negotiated Rate |
$456.00 |
| Rate for Payer: Aetna Commercial |
$365.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$370.50
|
| Rate for Payer: Cash Price |
$237.50
|
| Rate for Payer: Cigna Commercial |
$394.25
|
| Rate for Payer: First Health Commercial |
$451.25
|
| Rate for Payer: Humana Commercial |
$403.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$389.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$350.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$142.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$418.00
|
| Rate for Payer: Ohio Health Group HMO |
$356.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$95.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$147.25
|
| Rate for Payer: PHCS Commercial |
$456.00
|
| Rate for Payer: United Healthcare All Payer |
$418.00
|
|
|
REDUCE TESTIS TORSION
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
HCPCS 54600
|
| Hospital Charge Code |
76102796
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.75 |
| Max. Negotiated Rate |
$4,220.54 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,014.67
|
| Rate for Payer: Aetna Commercial |
$365.75
|
| Rate for Payer: Anthem Medicaid |
$163.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$370.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,220.54
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,069.80
|
| Rate for Payer: Cash Price |
$237.50
|
| Rate for Payer: Cash Price |
$237.50
|
| Rate for Payer: Cigna Commercial |
$394.25
|
| Rate for Payer: First Health Commercial |
$451.25
|
| Rate for Payer: Humana Commercial |
$403.75
|
| Rate for Payer: Humana KY Medicaid |
$163.35
|
| Rate for Payer: Humana Medicare Advantage |
$3,014.67
|
| Rate for Payer: Kentucky WC Medicaid |
$165.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$389.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$350.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$166.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$418.00
|
| Rate for Payer: Ohio Health Group HMO |
$356.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$95.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$147.25
|
| Rate for Payer: PHCS Commercial |
$456.00
|
| Rate for Payer: United Healthcare All Payer |
$418.00
|
|
|
REDUCTION MAMMOPLASTY
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 19318
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Aetna Commercial |
$2,310.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,340.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,490.00
|
| Rate for Payer: First Health Commercial |
$2,850.00
|
| Rate for Payer: Humana Commercial |
$2,550.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,460.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,214.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$900.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,640.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$390.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$930.00
|
| Rate for Payer: PHCS Commercial |
$2,880.00
|
| Rate for Payer: United Healthcare All Payer |
$2,640.00
|
|
|
REDUCTION MAMMOPLASTY
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 19318
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.00 |
| Max. Negotiated Rate |
$7,894.80 |
| Rate for Payer: Aetna Commercial |
$2,310.00
|
| Rate for Payer: Anthem Medicaid |
$1,031.70
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,639.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,340.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,894.80
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,612.84
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,490.00
|
| Rate for Payer: First Health Commercial |
$2,850.00
|
| Rate for Payer: Humana Commercial |
$2,550.00
|
| Rate for Payer: Humana KY Medicaid |
$1,031.70
|
| Rate for Payer: Humana Medicare Advantage |
$5,639.14
|
| Rate for Payer: Kentucky WC Medicaid |
$1,042.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,460.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,214.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,766.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,052.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,640.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$390.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$930.00
|
| Rate for Payer: PHCS Commercial |
$2,880.00
|
| Rate for Payer: United Healthcare All Payer |
$2,640.00
|
|
|
REDUCTION MAMMOPLASTY
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 19318
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$829.81 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$1,684.69
|
| Rate for Payer: Anthem Medicaid |
$829.81
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,000.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$1,614.17
|
| Rate for Payer: Healthspan PPO |
$1,347.06
|
| Rate for Payer: Humana Medicaid |
$829.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,439.56
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$846.41
|
| Rate for Payer: Molina Healthcare Passport |
$829.81
|
| Rate for Payer: Multiplan PHCS |
$1,800.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,100.00
|
| Rate for Payer: UHCCP Medicaid |
$1,050.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$838.11
|
|
|
REDUCTION MAMMOPLASTY(P
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 19318
|
| Hospital Charge Code |
761P0307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$829.81 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$1,684.69
|
| Rate for Payer: Anthem Medicaid |
$829.81
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,000.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$1,614.17
|
| Rate for Payer: Healthspan PPO |
$1,347.06
|
| Rate for Payer: Humana Medicaid |
$829.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,439.56
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$846.41
|
| Rate for Payer: Molina Healthcare Passport |
$829.81
|
| Rate for Payer: Multiplan PHCS |
$1,800.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,100.00
|
| Rate for Payer: UHCCP Medicaid |
$1,050.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$838.11
|
|
