|
REMOVAL OF LUNG
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32480
|
| Hospital Charge Code |
76101189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$3,264.00 |
| Rate for Payer: Aetna Commercial |
$2,618.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,652.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,822.00
|
| Rate for Payer: First Health Commercial |
$3,230.00
|
| Rate for Payer: Humana Commercial |
$2,890.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,788.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,509.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,020.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,992.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,550.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$442.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,054.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG
|
Professional
|
Both
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32440
|
| Hospital Charge Code |
76101188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,146.00 |
| Max. Negotiated Rate |
$3,400.00 |
| Rate for Payer: Aetna Commercial |
$2,666.93
|
| Rate for Payer: Anthem Medicaid |
$1,146.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,400.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,541.35
|
| Rate for Payer: Healthspan PPO |
$2,082.27
|
| Rate for Payer: Humana Medicaid |
$1,146.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,184.81
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,168.92
|
| Rate for Payer: Molina Healthcare Passport |
$1,146.00
|
| Rate for Payer: Multiplan PHCS |
$2,040.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,380.00
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,157.46
|
|
|
REMOVAL OF LUNG LESION(S)
|
Facility
|
OP
|
$1,220.00
|
|
|
Service Code
|
HCPCS 32150
|
| Hospital Charge Code |
76101179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.60 |
| Max. Negotiated Rate |
$1,171.20 |
| Rate for Payer: Aetna Commercial |
$939.40
|
| Rate for Payer: Anthem Medicaid |
$419.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$951.60
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cigna Commercial |
$1,012.60
|
| Rate for Payer: First Health Commercial |
$1,159.00
|
| Rate for Payer: Humana Commercial |
$1,037.00
|
| Rate for Payer: Humana KY Medicaid |
$419.56
|
| Rate for Payer: Kentucky WC Medicaid |
$423.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,000.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$427.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,073.60
|
| Rate for Payer: Ohio Health Group HMO |
$915.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$244.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$158.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$378.20
|
| Rate for Payer: PHCS Commercial |
$1,171.20
|
| Rate for Payer: United Healthcare All Payer |
$1,073.60
|
|
|
REMOVAL OF LUNG LESION(S)
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 32150
|
| Hospital Charge Code |
76101179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$427.00 |
| Max. Negotiated Rate |
$1,642.72 |
| Rate for Payer: Aetna Commercial |
$1,642.72
|
| Rate for Payer: Anthem Medicaid |
$690.63
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,220.00
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cigna Commercial |
$1,542.03
|
| Rate for Payer: Healthspan PPO |
$1,282.59
|
| Rate for Payer: Humana Medicaid |
$690.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,379.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$704.44
|
| Rate for Payer: Molina Healthcare Passport |
$690.63
|
| Rate for Payer: Multiplan PHCS |
$732.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$854.00
|
| Rate for Payer: UHCCP Medicaid |
$427.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$697.54
|
|
|
REMOVAL OF LUNG LESION(S)
|
Facility
|
IP
|
$1,220.00
|
|
|
Service Code
|
HCPCS 32150
|
| Hospital Charge Code |
76101179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.60 |
| Max. Negotiated Rate |
$1,171.20 |
| Rate for Payer: Aetna Commercial |
$939.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$951.60
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cigna Commercial |
$1,012.60
|
| Rate for Payer: First Health Commercial |
$1,159.00
|
| Rate for Payer: Humana Commercial |
$1,037.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,000.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$900.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$366.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,073.60
|
| Rate for Payer: Ohio Health Group HMO |
$915.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$244.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$158.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$378.20
|
| Rate for Payer: PHCS Commercial |
$1,171.20
|
| Rate for Payer: United Healthcare All Payer |
$1,073.60
|
|
|
REMOVAL OF LUNG LESION(S)(P
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 32150
|
| Hospital Charge Code |
761P1179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$427.00 |
| Max. Negotiated Rate |
$1,642.72 |
| Rate for Payer: Aetna Commercial |
$1,642.72
|
| Rate for Payer: Anthem Medicaid |
$690.63
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,220.00
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cigna Commercial |
$1,542.03
|
| Rate for Payer: Healthspan PPO |
$1,282.59
|
| Rate for Payer: Humana Medicaid |
$690.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,379.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$704.44
|
| Rate for Payer: Molina Healthcare Passport |
$690.63
|
| Rate for Payer: Multiplan PHCS |
$732.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$854.00
|
| Rate for Payer: UHCCP Medicaid |
$427.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$697.54
|
|
|
REMOVAL OF LUNG - OTHER THAN
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32482
|
| Hospital Charge Code |
76101190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$3,264.00 |
| Rate for Payer: Aetna Commercial |
$2,618.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,652.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,822.00
|
| Rate for Payer: First Health Commercial |
$3,230.00
|
| Rate for Payer: Humana Commercial |
$2,890.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,788.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,509.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,020.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,992.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,550.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$442.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,054.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG - OTHER THAN
|
Facility
|
OP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32482
|
| Hospital Charge Code |
76101190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$3,264.00 |
| Rate for Payer: Aetna Commercial |
$2,618.00
|
| Rate for Payer: Anthem Medicaid |
$1,169.26
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,652.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,822.00
|
| Rate for Payer: First Health Commercial |
$3,230.00
|
| Rate for Payer: Humana Commercial |
$2,890.00
|
| Rate for Payer: Humana KY Medicaid |
$1,169.26
|
| Rate for Payer: Kentucky WC Medicaid |
$1,181.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,788.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,509.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,020.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,192.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,992.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,550.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$442.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,054.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG - OTHER THAN
|
Professional
|
Both
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32482
|
| Hospital Charge Code |
76101190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,082.51 |
| Max. Negotiated Rate |
$3,400.00 |
| Rate for Payer: Aetna Commercial |
$2,682.66
|
| Rate for Payer: Anthem Medicaid |
$1,082.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,400.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,548.94
|
| Rate for Payer: Healthspan PPO |
$2,094.55
|
| Rate for Payer: Humana Medicaid |
$1,082.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,209.05
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,104.16
|
| Rate for Payer: Molina Healthcare Passport |
$1,082.51
|
| Rate for Payer: Multiplan PHCS |
$2,040.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,380.00
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,093.34
|
|
|
REMOVAL OF LUNG - OTHER THAN(P
|
Professional
|
Both
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32482
|
| Hospital Charge Code |
761P1190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,082.51 |
| Max. Negotiated Rate |
$3,400.00 |
| Rate for Payer: Aetna Commercial |
$2,682.66
|
| Rate for Payer: Anthem Medicaid |
$1,082.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,400.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,548.94
|
| Rate for Payer: Healthspan PPO |
$2,094.55
|
| Rate for Payer: Humana Medicaid |
$1,082.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,209.05
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,104.16
|
| Rate for Payer: Molina Healthcare Passport |
$1,082.51
|
| Rate for Payer: Multiplan PHCS |
$2,040.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,380.00
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,093.34
|
|
|
REMOVAL OF LUNG(P
|
Professional
|
Both
|
$3,500.00
|
|
|
Service Code
|
HCPCS 32484
|
| Hospital Charge Code |
761P1191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,111.27 |
| Max. Negotiated Rate |
$3,500.00 |
| Rate for Payer: Aetna Commercial |
$2,417.70
|
| Rate for Payer: Anthem Medicaid |
$1,111.27
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,500.00
|
| Rate for Payer: Cash Price |
$1,750.00
|
| Rate for Payer: Cash Price |
$1,750.00
|
| Rate for Payer: Cigna Commercial |
$2,303.54
|
| Rate for Payer: Healthspan PPO |
$1,887.68
|
| Rate for Payer: Humana Medicaid |
$1,111.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,005.12
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,133.50
|
| Rate for Payer: Molina Healthcare Passport |
$1,111.27
|
| Rate for Payer: Multiplan PHCS |
$2,100.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,450.00
|
| Rate for Payer: UHCCP Medicaid |
$1,225.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,122.38
|
|
|
REMOVAL OF LUNG(P
|
Professional
|
Both
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32480
|
| Hospital Charge Code |
761P1189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,110.19 |
| Max. Negotiated Rate |
$3,400.00 |
| Rate for Payer: Aetna Commercial |
$2,517.94
|
| Rate for Payer: Anthem Medicaid |
$1,110.19
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,400.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,396.37
|
| Rate for Payer: Healthspan PPO |
$1,965.94
|
| Rate for Payer: Humana Medicaid |
$1,110.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,067.54
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,132.39
|
| Rate for Payer: Molina Healthcare Passport |
$1,110.19
|
| Rate for Payer: Multiplan PHCS |
$2,040.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,380.00
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,121.29
|
|
|
REMOVAL OF LUNG(P
|
Professional
|
Both
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32440
|
| Hospital Charge Code |
761P1188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,146.00 |
| Max. Negotiated Rate |
$3,400.00 |
| Rate for Payer: Aetna Commercial |
$2,666.93
|
| Rate for Payer: Anthem Medicaid |
$1,146.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,400.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cigna Commercial |
$2,541.35
|
| Rate for Payer: Healthspan PPO |
$2,082.27
|
| Rate for Payer: Humana Medicaid |
$1,146.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,184.81
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,168.92
|
| Rate for Payer: Molina Healthcare Passport |
$1,146.00
|
| Rate for Payer: Multiplan PHCS |
$2,040.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,380.00
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,157.46
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$250.56 |
| Rate for Payer: Aetna Commercial |
$200.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$203.58
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$216.63
|
| Rate for Payer: First Health Commercial |
$247.95
|
| Rate for Payer: Humana Commercial |
$221.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$214.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$192.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$78.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$229.68
|
| Rate for Payer: Ohio Health Group HMO |
$195.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$33.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$80.91
|
| Rate for Payer: PHCS Commercial |
$250.56
|
| Rate for Payer: United Healthcare All Payer |
$229.68
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$250.56 |
| Rate for Payer: Aetna Commercial |
$200.97
|
| Rate for Payer: Anthem Medicaid |
$89.76
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$173.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$203.58
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$242.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$233.71
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$216.63
|
| Rate for Payer: First Health Commercial |
$247.95
|
| Rate for Payer: Humana Commercial |
$221.85
|
| Rate for Payer: Humana KY Medicaid |
$89.76
|
| Rate for Payer: Humana Medicare Advantage |
$173.12
|
| Rate for Payer: Kentucky WC Medicaid |
$90.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$214.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$192.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$207.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$91.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$229.68
|
| Rate for Payer: Ohio Health Group HMO |
$195.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$33.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$80.91
|
| Rate for Payer: PHCS Commercial |
$250.56
|
| Rate for Payer: United Healthcare All Payer |
$229.68
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
IP
|
$411.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.43 |
| Max. Negotiated Rate |
$394.56 |
| Rate for Payer: Aetna Commercial |
$316.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$320.58
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cigna Commercial |
$341.13
|
| Rate for Payer: First Health Commercial |
$390.45
|
| Rate for Payer: Humana Commercial |
$349.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$337.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$303.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$123.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$361.68
|
| Rate for Payer: Ohio Health Group HMO |
$308.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$53.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$127.41
|
| Rate for Payer: PHCS Commercial |
$394.56
|
| Rate for Payer: United Healthcare All Payer |
$361.68
|
|
|
REMOVAL OF NAIL PLATE
|
Facility
|
OP
|
$411.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.43 |
| Max. Negotiated Rate |
$394.56 |
| Rate for Payer: Aetna Commercial |
$316.47
|
| Rate for Payer: Anthem Medicaid |
$141.34
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$173.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$320.58
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$242.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$233.71
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cigna Commercial |
$341.13
|
| Rate for Payer: First Health Commercial |
$390.45
|
| Rate for Payer: Humana Commercial |
$349.35
|
| Rate for Payer: Humana KY Medicaid |
$141.34
|
| Rate for Payer: Humana Medicare Advantage |
$173.12
|
| Rate for Payer: Kentucky WC Medicaid |
$142.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$337.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$303.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$207.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$144.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$361.68
|
| Rate for Payer: Ohio Health Group HMO |
$308.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$82.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$53.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$127.41
|
| Rate for Payer: PHCS Commercial |
$394.56
|
| Rate for Payer: United Healthcare All Payer |
$361.68
|
|
|
REMOVAL OF NAIL PLATE
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$411.00 |
| Rate for Payer: Aetna Commercial |
$90.59
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$27.17
|
| Rate for Payer: Anthem Medicaid |
$40.17
|
| Rate for Payer: Buckeye Medicare Advantage |
$411.00
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cigna Commercial |
$127.59
|
| Rate for Payer: Healthspan PPO |
$111.39
|
| Rate for Payer: Humana Medicaid |
$40.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$65.47
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$40.97
|
| Rate for Payer: Molina Healthcare Passport |
$40.17
|
| Rate for Payer: Multiplan PHCS |
$246.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$287.70
|
| Rate for Payer: UHCCP Medicaid |
$28.53
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$40.57
|
|
|
REMOVAL OF NAIL PLATE(P
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
761P0096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$90.59
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$27.17
|
| Rate for Payer: Anthem Medicaid |
$40.17
|
| Rate for Payer: Buckeye Medicare Advantage |
$150.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cigna Commercial |
$127.59
|
| Rate for Payer: Healthspan PPO |
$111.39
|
| Rate for Payer: Humana Medicaid |
$40.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$65.47
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$40.97
|
| Rate for Payer: Molina Healthcare Passport |
$40.17
|
| Rate for Payer: Multiplan PHCS |
$90.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$105.00
|
| Rate for Payer: UHCCP Medicaid |
$28.53
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$40.57
|
|
|
REMOVAL OF NAIL PLATE(T
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
761T0096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$250.56 |
| Rate for Payer: Aetna Commercial |
$200.97
|
| Rate for Payer: Anthem Medicaid |
$89.76
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$173.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$203.58
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$242.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$233.71
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$216.63
|
| Rate for Payer: First Health Commercial |
$247.95
|
| Rate for Payer: Humana Commercial |
$221.85
|
| Rate for Payer: Humana KY Medicaid |
$89.76
|
| Rate for Payer: Humana Medicare Advantage |
$173.12
|
| Rate for Payer: Kentucky WC Medicaid |
$90.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$214.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$192.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$207.74
|
| Rate for Payer: Molina Healthcare Medicaid |
$91.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$229.68
|
| Rate for Payer: Ohio Health Group HMO |
$195.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$33.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$80.91
|
| Rate for Payer: PHCS Commercial |
$250.56
|
| Rate for Payer: United Healthcare All Payer |
$229.68
|
|
|
REMOVAL OF NAIL PLATE(T
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
761T0096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$250.56 |
| Rate for Payer: Aetna Commercial |
$200.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$203.58
|
| Rate for Payer: Cash Price |
$130.50
|
| Rate for Payer: Cigna Commercial |
$216.63
|
| Rate for Payer: First Health Commercial |
$247.95
|
| Rate for Payer: Humana Commercial |
$221.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$214.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$192.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$78.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$229.68
|
| Rate for Payer: Ohio Health Group HMO |
$195.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$52.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$33.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$80.91
|
| Rate for Payer: PHCS Commercial |
$250.56
|
| Rate for Payer: United Healthcare All Payer |
$229.68
|
|
|
REMOVAL OF NECK WRINKLES
|
Professional
|
Both
|
$11,203.34
|
|
|
Service Code
|
HCPCS 15825
|
| Hospital Charge Code |
76100218
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$11,203.34 |
| Rate for Payer: Aetna Commercial |
$1,766.84
|
| Rate for Payer: Anthem Medicaid |
$735.05
|
| Rate for Payer: Buckeye Medicare Advantage |
$11,203.34
|
| Rate for Payer: Cash Price |
$5,601.67
|
| Rate for Payer: Cash Price |
$5,601.67
|
| Rate for Payer: Cigna Commercial |
$1,663.58
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Humana Medicaid |
$735.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,131.63
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$749.75
|
| Rate for Payer: Molina Healthcare Passport |
$735.05
|
| Rate for Payer: Multiplan PHCS |
$6,722.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$7,842.34
|
| Rate for Payer: UHCCP Medicaid |
$3,921.17
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$742.40
|
|
|
REMOVAL OF NECK WRINKLES
|
Facility
|
IP
|
$11,203.34
|
|
|
Service Code
|
HCPCS 15825
|
| Hospital Charge Code |
76100218
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,456.43 |
| Max. Negotiated Rate |
$10,755.21 |
| Rate for Payer: Aetna Commercial |
$8,626.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,738.61
|
| Rate for Payer: Cash Price |
$5,601.67
|
| Rate for Payer: Cigna Commercial |
$9,298.77
|
| Rate for Payer: First Health Commercial |
$10,643.17
|
| Rate for Payer: Humana Commercial |
$9,522.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,186.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,268.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,361.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,858.94
|
| Rate for Payer: Ohio Health Group HMO |
$8,402.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,240.67
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,456.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,473.04
|
| Rate for Payer: PHCS Commercial |
$10,755.21
|
| Rate for Payer: United Healthcare All Payer |
$9,858.94
|
|
|
REMOVAL OF NECK WRINKLES
|
Facility
|
OP
|
$11,203.34
|
|
|
Service Code
|
HCPCS 15825
|
| Hospital Charge Code |
76100218
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,456.43 |
| Max. Negotiated Rate |
$10,755.21 |
| Rate for Payer: Aetna Commercial |
$8,626.57
|
| Rate for Payer: Anthem Medicaid |
$3,852.83
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,102.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,738.61
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,343.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,188.25
|
| Rate for Payer: Cash Price |
$5,601.67
|
| Rate for Payer: Cash Price |
$5,601.67
|
| Rate for Payer: Cigna Commercial |
$9,298.77
|
| Rate for Payer: First Health Commercial |
$10,643.17
|
| Rate for Payer: Humana Commercial |
$9,522.84
|
| Rate for Payer: Humana KY Medicaid |
$3,852.83
|
| Rate for Payer: Humana Medicare Advantage |
$3,102.41
|
| Rate for Payer: Kentucky WC Medicaid |
$3,892.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,186.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,268.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,722.89
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,930.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,858.94
|
| Rate for Payer: Ohio Health Group HMO |
$8,402.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,240.67
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,456.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,473.04
|
| Rate for Payer: PHCS Commercial |
$10,755.21
|
| Rate for Payer: United Healthcare All Payer |
$9,858.94
|
|
|
REMOVAL OF NECK WRINKLES(P
|
Professional
|
Both
|
$5,000.00
|
|
|
Service Code
|
HCPCS 15825
|
| Hospital Charge Code |
761P0218
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$1,766.84
|
| Rate for Payer: Anthem Medicaid |
$735.05
|
| Rate for Payer: Buckeye Medicare Advantage |
$5,000.00
|
| Rate for Payer: Cash Price |
$2,500.00
|
| Rate for Payer: Cash Price |
$2,500.00
|
| Rate for Payer: Cigna Commercial |
$1,663.58
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Humana Medicaid |
$735.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,131.63
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$749.75
|
| Rate for Payer: Molina Healthcare Passport |
$735.05
|
| Rate for Payer: Multiplan PHCS |
$3,000.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3,500.00
|
| Rate for Payer: UHCCP Medicaid |
$1,750.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$742.40
|
|
