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Service Code HCPCS 15935
Hospital Charge Code 761T0233
Hospital Revenue Code 761
Min. Negotiated Rate $554.32
Max. Negotiated Rate $4,093.44
Rate for Payer: Aetna Commercial $3,283.28
Rate for Payer: Anthem POS/PPO/Traditional $3,325.92
Rate for Payer: Cash Price $2,132.00
Rate for Payer: Cigna Commercial $3,539.12
Rate for Payer: First Health Commercial $4,050.80
Rate for Payer: Humana Commercial $3,624.40
Rate for Payer: Medical Mutual Of Ohio HMO $3,496.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,146.83
Rate for Payer: Molina Healthcare Benefit Exchange $1,279.20
Rate for Payer: Ohio Health Choice Commercial $3,752.32
Rate for Payer: Ohio Health Group HMO $3,198.00
Rate for Payer: Ohio Health Group PPO Differential $852.80
Rate for Payer: Ohio Health Group PPO No Differential $554.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,321.84
Rate for Payer: PHCS Commercial $4,093.44
Rate for Payer: United Healthcare All Payer $3,752.32
Service Code HCPCS 15934
Hospital Charge Code 761T0232
Hospital Revenue Code 761
Min. Negotiated Rate $934.70
Max. Negotiated Rate $6,902.40
Rate for Payer: Aetna Commercial $5,536.30
Rate for Payer: Anthem POS/PPO/Traditional $5,608.20
Rate for Payer: Cash Price $3,595.00
Rate for Payer: Cigna Commercial $5,967.70
Rate for Payer: First Health Commercial $6,830.50
Rate for Payer: Humana Commercial $6,111.50
Rate for Payer: Medical Mutual Of Ohio HMO $5,895.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $5,306.22
Rate for Payer: Molina Healthcare Benefit Exchange $2,157.00
Rate for Payer: Ohio Health Choice Commercial $6,327.20
Rate for Payer: Ohio Health Group HMO $5,392.50
Rate for Payer: Ohio Health Group PPO Differential $1,438.00
Rate for Payer: Ohio Health Group PPO No Differential $934.70
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,228.90
Rate for Payer: PHCS Commercial $6,902.40
Rate for Payer: United Healthcare All Payer $6,327.20
Service Code HCPCS 15931
Hospital Charge Code 761T0231
Hospital Revenue Code 761
Min. Negotiated Rate $682.74
Max. Negotiated Rate $5,041.80
Rate for Payer: Aetna Commercial $4,043.94
Rate for Payer: Anthem POS/PPO/Traditional $4,096.46
Rate for Payer: Cash Price $2,625.94
Rate for Payer: Cigna Commercial $4,359.05
Rate for Payer: First Health Commercial $4,989.28
Rate for Payer: Humana Commercial $4,464.09
Rate for Payer: Medical Mutual Of Ohio HMO $4,306.53
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,875.88
Rate for Payer: Molina Healthcare Benefit Exchange $1,575.56
Rate for Payer: Ohio Health Choice Commercial $4,621.65
Rate for Payer: Ohio Health Group HMO $3,938.90
Rate for Payer: Ohio Health Group PPO Differential $1,050.37
Rate for Payer: Ohio Health Group PPO No Differential $682.74
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,628.08
Rate for Payer: PHCS Commercial $5,041.80
Rate for Payer: United Healthcare All Payer $4,621.65
Service Code HCPCS 54415
Hospital Charge Code 76102824
Hospital Revenue Code 761
Min. Negotiated Rate $68.90
Max. Negotiated Rate $4,220.54
Rate for Payer: Aetna Commercial $408.10
Rate for Payer: Anthem Medicaid $182.27
Rate for Payer: Anthem Medicare Advantage/PPO $3,014.67
Rate for Payer: Anthem POS/PPO/Traditional $413.40
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 $265.00
Rate for Payer: Cash Price $265.00
Rate for Payer: Cigna Commercial $439.90
Rate for Payer: First Health Commercial $503.50
Rate for Payer: Humana Commercial $450.50
Rate for Payer: Humana KY Medicaid $182.27
Rate for Payer: Humana Medicare Advantage $3,014.67
Rate for Payer: Kentucky WC Medicaid $184.12
Rate for Payer: Medical Mutual Of Ohio HMO $434.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $391.14
Rate for Payer: Molina Healthcare Benefit Exchange $3,617.60
Rate for Payer: Molina Healthcare Medicaid $185.92
Rate for Payer: Ohio Health Choice Commercial $466.40
Rate for Payer: Ohio Health Group HMO $397.50
Rate for Payer: Ohio Health Group PPO Differential $106.00
Rate for Payer: Ohio Health Group PPO No Differential $68.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $164.30
Rate for Payer: PHCS Commercial $508.80
Rate for Payer: United Healthcare All Payer $466.40
Service Code HCPCS 54415
Hospital Charge Code 76102824
Hospital Revenue Code 761
Min. Negotiated Rate $185.50
Max. Negotiated Rate $853.65
Rate for Payer: Aetna Commercial $853.65
Rate for Payer: Anthem Medicaid $387.83
Rate for Payer: Buckeye Medicare Advantage $530.00
Rate for Payer: Cash Price $265.00
Rate for Payer: Cash Price $265.00
Rate for Payer: Cigna Commercial $755.03
Rate for Payer: Healthspan PPO $826.55
Rate for Payer: Humana Medicaid $387.83
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $717.86
Rate for Payer: Molina Healthcare CHIP/Medicaid $395.59
Rate for Payer: Molina Healthcare Passport $387.83
Rate for Payer: Multiplan PHCS $318.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $371.00
Rate for Payer: UHCCP Medicaid $185.50
Rate for Payer: Wellcare CHIP/Medicaid $391.71
Service Code HCPCS 54415
Hospital Charge Code 76102824
Hospital Revenue Code 761
Min. Negotiated Rate $68.90
Max. Negotiated Rate $508.80
Rate for Payer: Aetna Commercial $408.10
Rate for Payer: Anthem POS/PPO/Traditional $413.40
Rate for Payer: Cash Price $265.00
Rate for Payer: Cigna Commercial $439.90
Rate for Payer: First Health Commercial $503.50
Rate for Payer: Humana Commercial $450.50
Rate for Payer: Medical Mutual Of Ohio HMO $434.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $391.14
Rate for Payer: Molina Healthcare Benefit Exchange $159.00
Rate for Payer: Ohio Health Choice Commercial $466.40
Rate for Payer: Ohio Health Group HMO $397.50
Rate for Payer: Ohio Health Group PPO Differential $106.00
Rate for Payer: Ohio Health Group PPO No Differential $68.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $164.30
Rate for Payer: PHCS Commercial $508.80
Rate for Payer: United Healthcare All Payer $466.40
Service Code HCPCS 23130
Hospital Charge Code 76100447
Hospital Revenue Code 761
Min. Negotiated Rate $150.67
Max. Negotiated Rate $1,112.64
Rate for Payer: Aetna Commercial $892.43
Rate for Payer: Anthem POS/PPO/Traditional $904.02
Rate for Payer: Cash Price $579.50
Rate for Payer: Cigna Commercial $961.97
Rate for Payer: First Health Commercial $1,101.05
Rate for Payer: Humana Commercial $985.15
Rate for Payer: Medical Mutual Of Ohio HMO $950.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $855.34
Rate for Payer: Molina Healthcare Benefit Exchange $347.70
Rate for Payer: Ohio Health Choice Commercial $1,019.92
Rate for Payer: Ohio Health Group HMO $869.25
Rate for Payer: Ohio Health Group PPO Differential $231.80
Rate for Payer: Ohio Health Group PPO No Differential $150.67
Rate for Payer: Ohio Health Group PPO SOMC Employees $359.29
Rate for Payer: PHCS Commercial $1,112.64
Rate for Payer: United Healthcare All Payer $1,019.92
Service Code HCPCS 23130
Hospital Charge Code 76100447
Hospital Revenue Code 761
Min. Negotiated Rate $150.67
Max. Negotiated Rate $3,918.70
Rate for Payer: Aetna Commercial $892.43
Rate for Payer: Anthem Medicaid $398.58
Rate for Payer: Anthem Medicare Advantage/PPO $2,799.07
Rate for Payer: Anthem POS/PPO/Traditional $904.02
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3,918.70
Rate for Payer: CareSource Just4Me Medicare $3,778.74
Rate for Payer: Cash Price $579.50
Rate for Payer: Cash Price $579.50
Rate for Payer: Cigna Commercial $961.97
Rate for Payer: First Health Commercial $1,101.05
Rate for Payer: Humana Commercial $985.15
Rate for Payer: Humana KY Medicaid $398.58
Rate for Payer: Humana Medicare Advantage $2,799.07
Rate for Payer: Kentucky WC Medicaid $402.64
Rate for Payer: Medical Mutual Of Ohio HMO $950.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $855.34
Rate for Payer: Molina Healthcare Benefit Exchange $3,358.88
Rate for Payer: Molina Healthcare Medicaid $406.58
Rate for Payer: Ohio Health Choice Commercial $1,019.92
Rate for Payer: Ohio Health Group HMO $869.25
Rate for Payer: Ohio Health Group PPO Differential $231.80
Rate for Payer: Ohio Health Group PPO No Differential $150.67
Rate for Payer: Ohio Health Group PPO SOMC Employees $359.29
Rate for Payer: PHCS Commercial $1,112.64
Rate for Payer: United Healthcare All Payer $1,019.92
Service Code HCPCS 23130
Hospital Charge Code 76100447
Hospital Revenue Code 761
Min. Negotiated Rate $405.65
Max. Negotiated Rate $1,159.00
Rate for Payer: Aetna Commercial $878.21
Rate for Payer: Anthem Medicaid $425.13
Rate for Payer: Buckeye Medicare Advantage $1,159.00
Rate for Payer: Cash Price $579.50
Rate for Payer: Cash Price $579.50
Rate for Payer: Cigna Commercial $970.00
Rate for Payer: Healthspan PPO $795.47
Rate for Payer: Humana Medicaid $425.13
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $747.30
Rate for Payer: Molina Healthcare CHIP/Medicaid $433.63
Rate for Payer: Molina Healthcare Passport $425.13
Rate for Payer: Multiplan PHCS $695.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $811.30
Rate for Payer: UHCCP Medicaid $405.65
Rate for Payer: Wellcare CHIP/Medicaid $429.38
Service Code HCPCS 23130
Hospital Charge Code 761P0447
Hospital Revenue Code 761
Min. Negotiated Rate $405.65
Max. Negotiated Rate $1,159.00
Rate for Payer: Aetna Commercial $878.21
Rate for Payer: Anthem Medicaid $425.13
Rate for Payer: Buckeye Medicare Advantage $1,159.00
Rate for Payer: Cash Price $579.50
Rate for Payer: Cash Price $579.50
Rate for Payer: Cigna Commercial $970.00
Rate for Payer: Healthspan PPO $795.47
Rate for Payer: Humana Medicaid $425.13
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $747.30
Rate for Payer: Molina Healthcare CHIP/Medicaid $433.63
Rate for Payer: Molina Healthcare Passport $425.13
Rate for Payer: Multiplan PHCS $695.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $811.30
Rate for Payer: UHCCP Medicaid $405.65
Rate for Payer: Wellcare CHIP/Medicaid $429.38
Service Code HCPCS 23333
Hospital Charge Code 76100452
Hospital Revenue Code 761
Min. Negotiated Rate $85.80
Max. Negotiated Rate $633.60
Rate for Payer: Aetna Commercial $508.20
Rate for Payer: Anthem POS/PPO/Traditional $514.80
Rate for Payer: Cash Price $330.00
Rate for Payer: Cigna Commercial $547.80
Rate for Payer: First Health Commercial $627.00
Rate for Payer: Humana Commercial $561.00
Rate for Payer: Medical Mutual Of Ohio HMO $541.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $487.08
Rate for Payer: Molina Healthcare Benefit Exchange $198.00
Rate for Payer: Ohio Health Choice Commercial $580.80
Rate for Payer: Ohio Health Group HMO $495.00
Rate for Payer: Ohio Health Group PPO Differential $132.00
Rate for Payer: Ohio Health Group PPO No Differential $85.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $204.60
Rate for Payer: PHCS Commercial $633.60
Rate for Payer: United Healthcare All Payer $580.80
Service Code HCPCS 23333
Hospital Charge Code 76100452
Hospital Revenue Code 761
Min. Negotiated Rate $85.80
Max. Negotiated Rate $3,440.07
Rate for Payer: Aetna Commercial $508.20
Rate for Payer: Anthem Medicaid $226.97
Rate for Payer: Anthem Medicare Advantage/PPO $2,457.19
Rate for Payer: Anthem POS/PPO/Traditional $514.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3,440.07
Rate for Payer: CareSource Just4Me Medicare $3,317.21
Rate for Payer: Cash Price $330.00
Rate for Payer: Cash Price $330.00
Rate for Payer: Cigna Commercial $547.80
Rate for Payer: First Health Commercial $627.00
Rate for Payer: Humana Commercial $561.00
Rate for Payer: Humana KY Medicaid $226.97
Rate for Payer: Humana Medicare Advantage $2,457.19
Rate for Payer: Kentucky WC Medicaid $229.28
Rate for Payer: Medical Mutual Of Ohio HMO $541.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $487.08
Rate for Payer: Molina Healthcare Benefit Exchange $2,948.63
Rate for Payer: Molina Healthcare Medicaid $231.53
Rate for Payer: Ohio Health Choice Commercial $580.80
Rate for Payer: Ohio Health Group HMO $495.00
Rate for Payer: Ohio Health Group PPO Differential $132.00
Rate for Payer: Ohio Health Group PPO No Differential $85.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $204.60
Rate for Payer: PHCS Commercial $633.60
Rate for Payer: United Healthcare All Payer $580.80
Service Code HCPCS 23333
Hospital Charge Code 76100452
Hospital Revenue Code 761
Min. Negotiated Rate $231.00
Max. Negotiated Rate $842.01
Rate for Payer: Anthem Medicaid $356.13
Rate for Payer: Buckeye Medicare Advantage $660.00
Rate for Payer: Cash Price $330.00
Rate for Payer: Cash Price $330.00
Rate for Payer: Cigna Commercial $842.01
Rate for Payer: Healthspan PPO $659.03
Rate for Payer: Humana Medicaid $356.13
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $580.07
Rate for Payer: Molina Healthcare CHIP/Medicaid $363.25
Rate for Payer: Molina Healthcare Passport $356.13
Rate for Payer: Multiplan PHCS $396.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $462.00
Rate for Payer: UHCCP Medicaid $231.00
Rate for Payer: Wellcare CHIP/Medicaid $359.69
Service Code HCPCS 23333
Hospital Charge Code 761P0452
Hospital Revenue Code 761
Min. Negotiated Rate $231.00
Max. Negotiated Rate $842.01
Rate for Payer: Anthem Medicaid $356.13
Rate for Payer: Buckeye Medicare Advantage $660.00
Rate for Payer: Cash Price $330.00
Rate for Payer: Cash Price $330.00
Rate for Payer: Cigna Commercial $842.01
Rate for Payer: Healthspan PPO $659.03
Rate for Payer: Humana Medicaid $356.13
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $580.07
Rate for Payer: Molina Healthcare CHIP/Medicaid $363.25
Rate for Payer: Molina Healthcare Passport $356.13
Rate for Payer: Multiplan PHCS $396.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $462.00
Rate for Payer: UHCCP Medicaid $231.00
Rate for Payer: Wellcare CHIP/Medicaid $359.69
Service Code HCPCS 23105
Hospital Charge Code 76100442
Hospital Revenue Code 761
Min. Negotiated Rate $525.00
Max. Negotiated Rate $1,500.00
Rate for Payer: Aetna Commercial $931.56
Rate for Payer: Anthem Medicaid $534.96
Rate for Payer: Buckeye Medicare Advantage $1,500.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cigna Commercial $1,021.73
Rate for Payer: Healthspan PPO $843.80
Rate for Payer: Humana Medicaid $534.96
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $786.34
Rate for Payer: Molina Healthcare CHIP/Medicaid $545.66
Rate for Payer: Molina Healthcare Passport $534.96
Rate for Payer: Multiplan PHCS $900.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,050.00
Rate for Payer: UHCCP Medicaid $525.00
Rate for Payer: Wellcare CHIP/Medicaid $540.31
Service Code HCPCS 23105
Hospital Charge Code 76100442
Hospital Revenue Code 761
Min. Negotiated Rate $195.00
Max. Negotiated Rate $1,440.00
Rate for Payer: Aetna Commercial $1,155.00
Rate for Payer: Anthem POS/PPO/Traditional $1,170.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cigna Commercial $1,245.00
Rate for Payer: First Health Commercial $1,425.00
Rate for Payer: Humana Commercial $1,275.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,230.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,107.00
Rate for Payer: Molina Healthcare Benefit Exchange $450.00
Rate for Payer: Ohio Health Choice Commercial $1,320.00
Rate for Payer: Ohio Health Group HMO $1,125.00
Rate for Payer: Ohio Health Group PPO Differential $300.00
Rate for Payer: Ohio Health Group PPO No Differential $195.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $465.00
Rate for Payer: PHCS Commercial $1,440.00
Rate for Payer: United Healthcare All Payer $1,320.00
Service Code HCPCS 23105
Hospital Charge Code 76100442
Hospital Revenue Code 761
Min. Negotiated Rate $195.00
Max. Negotiated Rate $8,661.10
Rate for Payer: Aetna Commercial $1,155.00
Rate for Payer: Anthem Medicaid $515.85
Rate for Payer: Anthem Medicare Advantage/PPO $6,186.50
Rate for Payer: Anthem POS/PPO/Traditional $1,170.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $8,661.10
Rate for Payer: CareSource Just4Me Medicare $8,351.78
Rate for Payer: Cash Price $750.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cigna Commercial $1,245.00
Rate for Payer: First Health Commercial $1,425.00
Rate for Payer: Humana Commercial $1,275.00
Rate for Payer: Humana KY Medicaid $515.85
Rate for Payer: Humana Medicare Advantage $6,186.50
Rate for Payer: Kentucky WC Medicaid $521.10
Rate for Payer: Medical Mutual Of Ohio HMO $1,230.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,107.00
Rate for Payer: Molina Healthcare Benefit Exchange $7,423.80
Rate for Payer: Molina Healthcare Medicaid $526.20
Rate for Payer: Ohio Health Choice Commercial $1,320.00
Rate for Payer: Ohio Health Group HMO $1,125.00
Rate for Payer: Ohio Health Group PPO Differential $300.00
Rate for Payer: Ohio Health Group PPO No Differential $195.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $465.00
Rate for Payer: PHCS Commercial $1,440.00
Rate for Payer: United Healthcare All Payer $1,320.00
Service Code HCPCS 23105
Hospital Charge Code 761P0442
Hospital Revenue Code 761
Min. Negotiated Rate $525.00
Max. Negotiated Rate $1,500.00
Rate for Payer: Aetna Commercial $931.56
Rate for Payer: Anthem Medicaid $534.96
Rate for Payer: Buckeye Medicare Advantage $1,500.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cash Price $750.00
Rate for Payer: Cigna Commercial $1,021.73
Rate for Payer: Healthspan PPO $843.80
Rate for Payer: Humana Medicaid $534.96
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $786.34
Rate for Payer: Molina Healthcare CHIP/Medicaid $545.66
Rate for Payer: Molina Healthcare Passport $534.96
Rate for Payer: Multiplan PHCS $900.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,050.00
Rate for Payer: UHCCP Medicaid $525.00
Rate for Payer: Wellcare CHIP/Medicaid $540.31
Service Code HCPCS 64774
Hospital Charge Code 76102368
Hospital Revenue Code 761
Min. Negotiated Rate $120.25
Max. Negotiated Rate $2,337.51
Rate for Payer: Aetna Commercial $712.25
Rate for Payer: Anthem Medicaid $318.11
Rate for Payer: Anthem Medicare Advantage/PPO $1,669.65
Rate for Payer: Anthem POS/PPO/Traditional $721.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,337.51
Rate for Payer: CareSource Just4Me Medicare $2,254.03
Rate for Payer: Cash Price $462.50
Rate for Payer: Cash Price $462.50
Rate for Payer: Cigna Commercial $767.75
Rate for Payer: First Health Commercial $878.75
Rate for Payer: Humana Commercial $786.25
Rate for Payer: Humana KY Medicaid $318.11
Rate for Payer: Humana Medicare Advantage $1,669.65
Rate for Payer: Kentucky WC Medicaid $321.34
Rate for Payer: Medical Mutual Of Ohio HMO $758.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $682.65
Rate for Payer: Molina Healthcare Benefit Exchange $2,003.58
Rate for Payer: Molina Healthcare Medicaid $324.49
Rate for Payer: Ohio Health Choice Commercial $814.00
Rate for Payer: Ohio Health Group HMO $693.75
Rate for Payer: Ohio Health Group PPO Differential $185.00
Rate for Payer: Ohio Health Group PPO No Differential $120.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $286.75
Rate for Payer: PHCS Commercial $888.00
Rate for Payer: United Healthcare All Payer $814.00
Service Code HCPCS 64774
Hospital Charge Code 76102368
Hospital Revenue Code 761
Min. Negotiated Rate $227.04
Max. Negotiated Rate $925.00
Rate for Payer: Aetna Commercial $642.40
Rate for Payer: Anthem Medicaid $227.04
Rate for Payer: Buckeye Medicare Advantage $925.00
Rate for Payer: Cash Price $462.50
Rate for Payer: Cash Price $462.50
Rate for Payer: Cigna Commercial $582.48
Rate for Payer: Healthspan PPO $501.57
Rate for Payer: Humana Medicaid $227.04
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $526.28
Rate for Payer: Molina Healthcare CHIP/Medicaid $231.58
Rate for Payer: Molina Healthcare Passport $227.04
Rate for Payer: Multiplan PHCS $555.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $647.50
Rate for Payer: UHCCP Medicaid $323.75
Rate for Payer: Wellcare CHIP/Medicaid $229.31
Service Code HCPCS 64774
Hospital Charge Code 76102368
Hospital Revenue Code 761
Min. Negotiated Rate $120.25
Max. Negotiated Rate $888.00
Rate for Payer: Aetna Commercial $712.25
Rate for Payer: Anthem POS/PPO/Traditional $721.50
Rate for Payer: Cash Price $462.50
Rate for Payer: Cigna Commercial $767.75
Rate for Payer: First Health Commercial $878.75
Rate for Payer: Humana Commercial $786.25
Rate for Payer: Medical Mutual Of Ohio HMO $758.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $682.65
Rate for Payer: Molina Healthcare Benefit Exchange $277.50
Rate for Payer: Ohio Health Choice Commercial $814.00
Rate for Payer: Ohio Health Group HMO $693.75
Rate for Payer: Ohio Health Group PPO Differential $185.00
Rate for Payer: Ohio Health Group PPO No Differential $120.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $286.75
Rate for Payer: PHCS Commercial $888.00
Rate for Payer: United Healthcare All Payer $814.00
Service Code HCPCS 64774
Hospital Charge Code 761P2368
Hospital Revenue Code 761
Min. Negotiated Rate $227.04
Max. Negotiated Rate $925.00
Rate for Payer: Aetna Commercial $642.40
Rate for Payer: Anthem Medicaid $227.04
Rate for Payer: Buckeye Medicare Advantage $925.00
Rate for Payer: Cash Price $462.50
Rate for Payer: Cash Price $462.50
Rate for Payer: Cigna Commercial $582.48
Rate for Payer: Healthspan PPO $501.57
Rate for Payer: Humana Medicaid $227.04
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $526.28
Rate for Payer: Molina Healthcare CHIP/Medicaid $231.58
Rate for Payer: Molina Healthcare Passport $227.04
Rate for Payer: Multiplan PHCS $555.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $647.50
Rate for Payer: UHCCP Medicaid $323.75
Rate for Payer: Wellcare CHIP/Medicaid $229.31
Service Code HCPCS 63661
Hospital Charge Code 761P2306
Hospital Revenue Code 761
Min. Negotiated Rate $167.67
Max. Negotiated Rate $1,400.00
Rate for Payer: Aetna Commercial $500.01
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $167.67
Rate for Payer: Anthem Medicaid $227.64
Rate for Payer: Buckeye Medicare Advantage $1,400.00
Rate for Payer: Cash Price $700.00
Rate for Payer: Cash Price $700.00
Rate for Payer: Cigna Commercial $873.41
Rate for Payer: Healthspan PPO $539.49
Rate for Payer: Humana Medicaid $227.64
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $421.92
Rate for Payer: Molina Healthcare CHIP/Medicaid $232.19
Rate for Payer: Molina Healthcare Passport $227.64
Rate for Payer: Multiplan PHCS $840.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $980.00
Rate for Payer: UHCCP Medicaid $176.05
Rate for Payer: Wellcare CHIP/Medicaid $229.92
Service Code HCPCS 63661
Hospital Charge Code 76102306
Hospital Revenue Code 761
Min. Negotiated Rate $182.00
Max. Negotiated Rate $2,337.51
Rate for Payer: Aetna Commercial $1,078.00
Rate for Payer: Anthem Medicaid $481.46
Rate for Payer: Anthem Medicare Advantage/PPO $1,669.65
Rate for Payer: Anthem POS/PPO/Traditional $1,092.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,337.51
Rate for Payer: CareSource Just4Me Medicare $2,254.03
Rate for Payer: Cash Price $700.00
Rate for Payer: Cash Price $700.00
Rate for Payer: Cigna Commercial $1,162.00
Rate for Payer: First Health Commercial $1,330.00
Rate for Payer: Humana Commercial $1,190.00
Rate for Payer: Humana KY Medicaid $481.46
Rate for Payer: Humana Medicare Advantage $1,669.65
Rate for Payer: Kentucky WC Medicaid $486.36
Rate for Payer: Medical Mutual Of Ohio HMO $1,148.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,033.20
Rate for Payer: Molina Healthcare Benefit Exchange $2,003.58
Rate for Payer: Molina Healthcare Medicaid $491.12
Rate for Payer: Ohio Health Choice Commercial $1,232.00
Rate for Payer: Ohio Health Group HMO $1,050.00
Rate for Payer: Ohio Health Group PPO Differential $280.00
Rate for Payer: Ohio Health Group PPO No Differential $182.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $434.00
Rate for Payer: PHCS Commercial $1,344.00
Rate for Payer: United Healthcare All Payer $1,232.00
Service Code HCPCS 63661
Hospital Charge Code 76102306
Hospital Revenue Code 761
Min. Negotiated Rate $167.67
Max. Negotiated Rate $1,400.00
Rate for Payer: Aetna Commercial $500.01
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $167.67
Rate for Payer: Anthem Medicaid $227.64
Rate for Payer: Buckeye Medicare Advantage $1,400.00
Rate for Payer: Cash Price $700.00
Rate for Payer: Cash Price $700.00
Rate for Payer: Cigna Commercial $873.41
Rate for Payer: Healthspan PPO $539.49
Rate for Payer: Humana Medicaid $227.64
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $421.92
Rate for Payer: Molina Healthcare CHIP/Medicaid $232.19
Rate for Payer: Molina Healthcare Passport $227.64
Rate for Payer: Multiplan PHCS $840.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $980.00
Rate for Payer: UHCCP Medicaid $176.05
Rate for Payer: Wellcare CHIP/Medicaid $229.92