|
REMOVAL OF KNEECAP(P
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 27350
|
| Hospital Charge Code |
761P0823
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$509.69 |
| Max. Negotiated Rate |
$1,039.87 |
| Rate for Payer: Aetna Commercial |
$948.74
|
| Rate for Payer: Ambetter Exchange |
$624.98
|
| Rate for Payer: Anthem Medicaid |
$509.69
|
| Rate for Payer: Buckeye Individual/Medicaid |
$624.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$624.98
|
| Rate for Payer: CareSource Just4Me Medicare |
$749.98
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cigna Commercial |
$1,039.87
|
| Rate for Payer: Healthspan PPO |
$859.36
|
| Rate for Payer: Humana Medicaid |
$509.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$804.10
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$624.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$624.98
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$519.88
|
| Rate for Payer: Molina Healthcare Passport |
$509.69
|
| Rate for Payer: Multiplan PHCS |
$984.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$812.47
|
| Rate for Payer: UHCCP Medicaid |
$574.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$514.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$624.98
|
|
|
REMOVAL OF KNEE CARTILAGE
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 27332
|
| Hospital Charge Code |
76102726
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$295.75 |
| Max. Negotiated Rate |
$1,021.04 |
| Rate for Payer: Aetna Commercial |
$933.81
|
| Rate for Payer: Ambetter Exchange |
$617.88
|
| Rate for Payer: Anthem Medicaid |
$541.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$617.88
|
| Rate for Payer: Buckeye Medicare Advantage |
$617.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$741.46
|
| Rate for Payer: Cash Price |
$422.50
|
| Rate for Payer: Cash Price |
$422.50
|
| Rate for Payer: Cigna Commercial |
$1,021.04
|
| Rate for Payer: Healthspan PPO |
$845.83
|
| Rate for Payer: Humana Medicaid |
$541.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$789.46
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$617.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$617.88
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$552.78
|
| Rate for Payer: Molina Healthcare Passport |
$541.94
|
| Rate for Payer: Multiplan PHCS |
$507.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$803.24
|
| Rate for Payer: UHCCP Medicaid |
$295.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$547.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$617.88
|
|
|
REMOVAL OF KNEE PROSTHESIS
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 27488
|
| Hospital Charge Code |
76100854
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$921.03 |
| Max. Negotiated Rate |
$1,929.43 |
| Rate for Payer: Aetna Commercial |
$1,785.75
|
| Rate for Payer: Ambetter Exchange |
$1,140.33
|
| Rate for Payer: Anthem Medicaid |
$921.03
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,140.33
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,140.33
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,368.40
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cigna Commercial |
$1,929.43
|
| Rate for Payer: Healthspan PPO |
$1,617.50
|
| Rate for Payer: Humana Medicaid |
$921.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,504.15
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,140.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,140.33
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$939.45
|
| Rate for Payer: Molina Healthcare Passport |
$921.03
|
| Rate for Payer: Multiplan PHCS |
$1,635.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,482.43
|
| Rate for Payer: UHCCP Medicaid |
$953.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$930.24
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,140.33
|
|
|
REMOVAL OF KNEE PROSTHESIS
|
Facility
|
OP
|
$2,725.00
|
|
|
Service Code
|
HCPCS 27488
|
| Hospital Charge Code |
76100854
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$817.50 |
| Max. Negotiated Rate |
$2,616.00 |
| Rate for Payer: Aetna Commercial |
$2,098.25
|
| Rate for Payer: Anthem Medicaid |
$937.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,125.50
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cigna Commercial |
$2,261.75
|
| Rate for Payer: First Health Commercial |
$2,588.75
|
| Rate for Payer: Humana Commercial |
$2,316.25
|
| Rate for Payer: Humana KY Medicaid |
$937.13
|
| Rate for Payer: Kentucky WC Medicaid |
$946.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,234.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,011.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$817.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$955.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,398.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,043.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,180.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,370.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,880.25
|
| Rate for Payer: PHCS Commercial |
$2,616.00
|
| Rate for Payer: United Healthcare All Payer |
$2,398.00
|
|
|
REMOVAL OF KNEE PROSTHESIS
|
Facility
|
IP
|
$2,725.00
|
|
|
Service Code
|
HCPCS 27488
|
| Hospital Charge Code |
76100854
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$817.50 |
| Max. Negotiated Rate |
$2,616.00 |
| Rate for Payer: Aetna Commercial |
$2,098.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,125.50
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cigna Commercial |
$2,261.75
|
| Rate for Payer: First Health Commercial |
$2,588.75
|
| Rate for Payer: Humana Commercial |
$2,316.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,234.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,011.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$817.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,398.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,043.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,180.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,370.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,880.25
|
| Rate for Payer: PHCS Commercial |
$2,616.00
|
| Rate for Payer: United Healthcare All Payer |
$2,398.00
|
|
|
REMOVAL OF KNEE PROSTHESIS(P
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 27488
|
| Hospital Charge Code |
761P0854
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$921.03 |
| Max. Negotiated Rate |
$1,929.43 |
| Rate for Payer: Aetna Commercial |
$1,785.75
|
| Rate for Payer: Ambetter Exchange |
$1,140.33
|
| Rate for Payer: Anthem Medicaid |
$921.03
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,140.33
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,140.33
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,368.40
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cigna Commercial |
$1,929.43
|
| Rate for Payer: Healthspan PPO |
$1,617.50
|
| Rate for Payer: Humana Medicaid |
$921.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,504.15
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,140.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,140.33
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$939.45
|
| Rate for Payer: Molina Healthcare Passport |
$921.03
|
| Rate for Payer: Multiplan PHCS |
$1,635.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,482.43
|
| Rate for Payer: UHCCP Medicaid |
$953.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$930.24
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,140.33
|
|
|
REMOVAL OF LENS MATERIAL; PHACOFRAGMENTATION TECHNIQUE (MECHANICAL OR ULTRASONIC) (EG, PHACOEMULSIFICATION), WITH ASPIRATION
|
Facility
|
OP
|
$2,950.29
|
|
|
Service Code
|
CPT 66850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,107.35 |
| Max. Negotiated Rate |
$2,950.29 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,107.35
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,950.29
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,844.92
|
| Rate for Payer: Humana Medicare Advantage |
$2,107.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,528.82
|
|
|
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 |
$2,666.93 |
| Rate for Payer: Aetna Commercial |
$2,666.93
|
| Rate for Payer: Ambetter Exchange |
$1,477.69
|
| Rate for Payer: Anthem Medicaid |
$1,146.00
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,477.69
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,477.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,773.23
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,477.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,477.69
|
| 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 |
$1,921.00
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,157.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,477.69
|
|
|
REMOVAL OF LUNG
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32480
|
| Hospital Charge Code |
76101189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,020.00 |
| 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 |
$2,720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,958.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,346.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG
|
Facility
|
OP
|
$3,500.00
|
|
|
Service Code
|
HCPCS 32484
|
| Hospital Charge Code |
76101191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$3,360.00 |
| Rate for Payer: Aetna Commercial |
$2,695.00
|
| Rate for Payer: Anthem Medicaid |
$1,203.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,730.00
|
| Rate for Payer: Cash Price |
$1,750.00
|
| Rate for Payer: Cigna Commercial |
$2,905.00
|
| Rate for Payer: First Health Commercial |
$3,325.00
|
| Rate for Payer: Humana Commercial |
$2,975.00
|
| Rate for Payer: Humana KY Medicaid |
$1,203.65
|
| Rate for Payer: Kentucky WC Medicaid |
$1,215.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,870.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,583.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,050.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,227.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,080.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,625.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,800.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,045.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,415.00
|
| Rate for Payer: PHCS Commercial |
$3,360.00
|
| Rate for Payer: United Healthcare All Payer |
$3,080.00
|
|
|
REMOVAL OF LUNG
|
Facility
|
OP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32440
|
| Hospital Charge Code |
76101188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,020.00 |
| 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 |
$2,720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,958.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,346.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG
|
Facility
|
IP
|
$3,500.00
|
|
|
Service Code
|
HCPCS 32484
|
| Hospital Charge Code |
76101191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$3,360.00 |
| Rate for Payer: Aetna Commercial |
$2,695.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,730.00
|
| Rate for Payer: Cash Price |
$1,750.00
|
| Rate for Payer: Cigna Commercial |
$2,905.00
|
| Rate for Payer: First Health Commercial |
$3,325.00
|
| Rate for Payer: Humana Commercial |
$2,975.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,870.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,583.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,050.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,080.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,625.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,800.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,045.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,415.00
|
| Rate for Payer: PHCS Commercial |
$3,360.00
|
| Rate for Payer: United Healthcare All Payer |
$3,080.00
|
|
|
REMOVAL OF LUNG
|
Professional
|
Both
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32480
|
| Hospital Charge Code |
76101189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,110.19 |
| Max. Negotiated Rate |
$2,517.94 |
| Rate for Payer: Aetna Commercial |
$2,517.94
|
| Rate for Payer: Ambetter Exchange |
$1,393.14
|
| Rate for Payer: Anthem Medicaid |
$1,110.19
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,393.14
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,393.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,671.77
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,393.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,393.14
|
| 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 |
$1,811.08
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,121.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,393.14
|
|
|
REMOVAL OF LUNG
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32440
|
| Hospital Charge Code |
76101188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,020.00 |
| 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 |
$2,720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,958.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,346.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG
|
Professional
|
Both
|
$3,500.00
|
|
|
Service Code
|
HCPCS 32484
|
| Hospital Charge Code |
76101191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,111.27 |
| Max. Negotiated Rate |
$2,417.70 |
| Rate for Payer: Aetna Commercial |
$2,417.70
|
| Rate for Payer: Ambetter Exchange |
$1,351.10
|
| Rate for Payer: Anthem Medicaid |
$1,111.27
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,351.10
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,351.10
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,621.32
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,351.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,351.10
|
| 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 |
$1,756.43
|
| Rate for Payer: UHCCP Medicaid |
$1,225.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,122.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,351.10
|
|
|
REMOVAL OF LUNG
|
Facility
|
OP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32480
|
| Hospital Charge Code |
76101189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,020.00 |
| 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 |
$2,720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,958.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,346.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
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: Ambetter Exchange |
$959.22
|
| Rate for Payer: Anthem Medicaid |
$690.63
|
| Rate for Payer: Buckeye Individual/Medicaid |
$959.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$959.22
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,151.06
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$959.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$959.22
|
| 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 |
$1,246.99
|
| Rate for Payer: UHCCP Medicaid |
$427.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$697.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$959.22
|
|
|
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 |
$366.00 |
| 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 |
$976.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$841.80
|
| Rate for Payer: PHCS Commercial |
$1,171.20
|
| Rate for Payer: United Healthcare All Payer |
$1,073.60
|
|
|
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 |
$366.00 |
| 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 |
$976.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,061.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$841.80
|
| 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: Ambetter Exchange |
$959.22
|
| Rate for Payer: Anthem Medicaid |
$690.63
|
| Rate for Payer: Buckeye Individual/Medicaid |
$959.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$959.22
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,151.06
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$959.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$959.22
|
| 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 |
$1,246.99
|
| Rate for Payer: UHCCP Medicaid |
$427.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$697.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$959.22
|
|
|
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 |
$2,682.66 |
| Rate for Payer: Aetna Commercial |
$2,682.66
|
| Rate for Payer: Ambetter Exchange |
$1,490.51
|
| Rate for Payer: Anthem Medicaid |
$1,082.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,490.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,490.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,788.61
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,490.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,490.51
|
| 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 |
$1,937.66
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,093.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,490.51
|
|
|
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 |
$1,020.00 |
| 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 |
$2,720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,958.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,346.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
REMOVAL OF LUNG - OTHER THAN
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
HCPCS 32482
|
| Hospital Charge Code |
76101190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,020.00 |
| 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 |
$2,720.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,958.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,346.00
|
| Rate for Payer: PHCS Commercial |
$3,264.00
|
| Rate for Payer: United Healthcare All Payer |
$2,992.00
|
|
|
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 |
$2,682.66 |
| Rate for Payer: Aetna Commercial |
$2,682.66
|
| Rate for Payer: Ambetter Exchange |
$1,490.51
|
| Rate for Payer: Anthem Medicaid |
$1,082.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,490.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,490.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,788.61
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,490.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,490.51
|
| 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 |
$1,937.66
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,093.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,490.51
|
|
|
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 |
$2,517.94 |
| Rate for Payer: Aetna Commercial |
$2,517.94
|
| Rate for Payer: Ambetter Exchange |
$1,393.14
|
| Rate for Payer: Anthem Medicaid |
$1,110.19
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,393.14
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,393.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,671.77
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,393.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,393.14
|
| 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 |
$1,811.08
|
| Rate for Payer: UHCCP Medicaid |
$1,190.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,121.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,393.14
|
|
