|
BEARNGS PSN MCVE 18MM 6-7/EF L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 18MM 8-11 EF L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 18MM 8-11 EF L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 18MM 8-11 GH L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 18MM 8-11 GH L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 18MM 8-9/CD L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 18MM 8-9/CD L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 4-5/CD L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 4-5/CD L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 4-5/CD R
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 4-5/CD R
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 6-7/CD L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 6-7/CD L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 6-7/EF L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 6-7/EF L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 20MM 8-11 EF L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 20MM 8-11 EF L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 20MM 8-11 GH L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSNMCVE 20MM 8-11 GH L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 8-9/CD L
|
Facility
|
OP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem Medicaid |
$2,808.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Humana KY Medicaid |
$2,808.12
|
| Rate for Payer: Kentucky WC Medicaid |
$2,836.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,864.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
BEARNGS PSN MCVE 20MM 8-9/CD L
|
Facility
|
IP
|
$8,165.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.52 |
| Max. Negotiated Rate |
$7,838.88 |
| Rate for Payer: Aetna Commercial |
$6,287.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,369.09
|
| Rate for Payer: Cash Price |
$4,082.75
|
| Rate for Payer: Cigna Commercial |
$6,777.36
|
| Rate for Payer: First Health Commercial |
$7,757.22
|
| Rate for Payer: Humana Commercial |
$6,940.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,695.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,026.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,449.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,185.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,124.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,633.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,531.30
|
| Rate for Payer: PHCS Commercial |
$7,838.88
|
| Rate for Payer: United Healthcare All Payer |
$7,185.64
|
|
|
Bebtelovimab inj admn/monitor
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77000075
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$87.49 |
| Max. Negotiated Rate |
$646.08 |
| Rate for Payer: Aetna Commercial |
$518.21
|
| Rate for Payer: Anthem Medicaid |
$231.44
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$318.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$524.94
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$445.35
|
| Rate for Payer: CareSource Just4Me Medicare |
$429.45
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cigna Commercial |
$558.59
|
| Rate for Payer: First Health Commercial |
$639.35
|
| Rate for Payer: Humana Commercial |
$572.05
|
| Rate for Payer: Humana KY Medicaid |
$231.44
|
| Rate for Payer: Humana Medicare Advantage |
$318.11
|
| Rate for Payer: Kentucky WC Medicaid |
$233.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$551.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$496.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$381.73
|
| Rate for Payer: Molina Healthcare Medicaid |
$236.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$592.24
|
| Rate for Payer: Ohio Health Group HMO |
$504.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$134.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$87.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$208.63
|
| Rate for Payer: PHCS Commercial |
$646.08
|
| Rate for Payer: United Healthcare All Payer |
$592.24
|
|
|
Bebtelovimab inj admn/monitor
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77000075
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$87.49 |
| Max. Negotiated Rate |
$646.08 |
| Rate for Payer: Aetna Commercial |
$518.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$524.94
|
| Rate for Payer: Cash Price |
$336.50
|
| Rate for Payer: Cigna Commercial |
$558.59
|
| Rate for Payer: First Health Commercial |
$639.35
|
| Rate for Payer: Humana Commercial |
$572.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$551.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$496.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$201.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$592.24
|
| Rate for Payer: Ohio Health Group HMO |
$504.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$134.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$87.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$208.63
|
| Rate for Payer: PHCS Commercial |
$646.08
|
| Rate for Payer: United Healthcare All Payer |
$592.24
|
|
|
BEDSIDE BRONCHOSCOPY
|
Facility
|
OP
|
$3,009.00
|
|
| Hospital Charge Code |
76102538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.17 |
| Max. Negotiated Rate |
$2,888.64 |
| Rate for Payer: Aetna Commercial |
$2,316.93
|
| Rate for Payer: Anthem Medicaid |
$1,034.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,347.02
|
| Rate for Payer: Cash Price |
$1,504.50
|
| Rate for Payer: Cigna Commercial |
$2,497.47
|
| Rate for Payer: First Health Commercial |
$2,858.55
|
| Rate for Payer: Humana Commercial |
$2,557.65
|
| Rate for Payer: Humana KY Medicaid |
$1,034.80
|
| Rate for Payer: Kentucky WC Medicaid |
$1,045.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,467.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,220.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$902.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,055.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,647.92
|
| Rate for Payer: Ohio Health Group HMO |
$2,256.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$601.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$391.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$932.79
|
| Rate for Payer: PHCS Commercial |
$2,888.64
|
| Rate for Payer: United Healthcare All Payer |
$2,647.92
|
|
|
BEDSIDE BRONCHOSCOPY
|
Facility
|
IP
|
$3,009.00
|
|
| Hospital Charge Code |
76102538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.17 |
| Max. Negotiated Rate |
$2,888.64 |
| Rate for Payer: Aetna Commercial |
$2,316.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,347.02
|
| Rate for Payer: Cash Price |
$1,504.50
|
| Rate for Payer: Cigna Commercial |
$2,497.47
|
| Rate for Payer: First Health Commercial |
$2,858.55
|
| Rate for Payer: Humana Commercial |
$2,557.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,467.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,220.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$902.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,647.92
|
| Rate for Payer: Ohio Health Group HMO |
$2,256.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$601.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$391.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$932.79
|
| Rate for Payer: PHCS Commercial |
$2,888.64
|
| Rate for Payer: United Healthcare All Payer |
$2,647.92
|
|
