|
REPLACE PICVAD CATH
|
Professional
|
Both
|
$5,819.00
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
76101488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$191.06 |
| Max. Negotiated Rate |
$3,491.40 |
| Rate for Payer: Aetna Commercial |
$428.24
|
| Rate for Payer: Ambetter Exchange |
$288.01
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$191.06
|
| Rate for Payer: Anthem Medicaid |
$1,065.26
|
| Rate for Payer: Buckeye Individual/Medicaid |
$288.01
|
| Rate for Payer: Buckeye Medicare Advantage |
$288.01
|
| Rate for Payer: CareSource Just4Me Medicare |
$345.61
|
| Rate for Payer: Cash Price |
$2,909.50
|
| Rate for Payer: Cash Price |
$2,909.50
|
| Rate for Payer: Cigna Commercial |
$409.25
|
| Rate for Payer: Healthspan PPO |
$1,251.39
|
| Rate for Payer: Humana Medicaid |
$1,065.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$362.39
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$288.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$288.01
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,086.57
|
| Rate for Payer: Molina Healthcare Passport |
$1,065.26
|
| Rate for Payer: Multiplan PHCS |
$3,491.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$374.41
|
| Rate for Payer: UHCCP Medicaid |
$200.61
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,075.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$288.01
|
|
|
REPLACE PICVAD CATH
|
Facility
|
OP
|
$5,819.00
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
76101488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,001.15 |
| Max. Negotiated Rate |
$5,586.24 |
| Rate for Payer: Aetna Commercial |
$4,480.63
|
| Rate for Payer: Anthem Medicaid |
$2,001.15
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,538.82
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$2,909.50
|
| Rate for Payer: Cash Price |
$2,909.50
|
| Rate for Payer: Cigna Commercial |
$4,829.77
|
| Rate for Payer: First Health Commercial |
$5,528.05
|
| Rate for Payer: Humana Commercial |
$4,946.15
|
| Rate for Payer: Humana KY Medicaid |
$2,001.15
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,021.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,771.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,294.42
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,041.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,120.72
|
| Rate for Payer: Ohio Health Group HMO |
$4,364.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,655.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,062.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,015.11
|
| Rate for Payer: PHCS Commercial |
$5,586.24
|
| Rate for Payer: United Healthcare All Payer |
$5,120.72
|
|
|
REPLACE PICVAD CATH(P
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
761P1488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$191.06 |
| Max. Negotiated Rate |
$1,251.39 |
| Rate for Payer: Aetna Commercial |
$428.24
|
| Rate for Payer: Ambetter Exchange |
$288.01
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$191.06
|
| Rate for Payer: Anthem Medicaid |
$1,065.26
|
| Rate for Payer: Buckeye Individual/Medicaid |
$288.01
|
| Rate for Payer: Buckeye Medicare Advantage |
$288.01
|
| Rate for Payer: CareSource Just4Me Medicare |
$345.61
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: Cash Price |
$245.00
|
| Rate for Payer: Cigna Commercial |
$409.25
|
| Rate for Payer: Healthspan PPO |
$1,251.39
|
| Rate for Payer: Humana Medicaid |
$1,065.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$362.39
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$288.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$288.01
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,086.57
|
| Rate for Payer: Molina Healthcare Passport |
$1,065.26
|
| Rate for Payer: Multiplan PHCS |
$294.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$374.41
|
| Rate for Payer: UHCCP Medicaid |
$200.61
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,075.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$288.01
|
|
|
REPLACE PICVAD CATH(T
|
Facility
|
OP
|
$5,329.00
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
761T1488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,832.64 |
| Max. Negotiated Rate |
$5,115.84 |
| Rate for Payer: Aetna Commercial |
$4,103.33
|
| Rate for Payer: Anthem Medicaid |
$1,832.64
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,156.62
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$2,664.50
|
| Rate for Payer: Cash Price |
$2,664.50
|
| Rate for Payer: Cigna Commercial |
$4,423.07
|
| Rate for Payer: First Health Commercial |
$5,062.55
|
| Rate for Payer: Humana Commercial |
$4,529.65
|
| Rate for Payer: Humana KY Medicaid |
$1,832.64
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$1,851.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,369.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,932.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,869.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,689.52
|
| Rate for Payer: Ohio Health Group HMO |
$3,996.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,263.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,677.01
|
| Rate for Payer: PHCS Commercial |
$5,115.84
|
| Rate for Payer: United Healthcare All Payer |
$4,689.52
|
|
|
REPLACE PICVAD CATH(T
|
Facility
|
IP
|
$5,329.00
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
761T1488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,598.70 |
| Max. Negotiated Rate |
$5,115.84 |
| Rate for Payer: Aetna Commercial |
$4,103.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,156.62
|
| Rate for Payer: Cash Price |
$2,664.50
|
| Rate for Payer: Cigna Commercial |
$4,423.07
|
| Rate for Payer: First Health Commercial |
$5,062.55
|
| Rate for Payer: Humana Commercial |
$4,529.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,369.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,932.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,598.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,689.52
|
| Rate for Payer: Ohio Health Group HMO |
$3,996.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,263.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,677.01
|
| Rate for Payer: PHCS Commercial |
$5,115.84
|
| Rate for Payer: United Healthcare All Payer |
$4,689.52
|
|
|
REPLACE TISSUE EXPANDER
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 11970
|
| Hospital Charge Code |
76100113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$600.00 |
| Max. Negotiated Rate |
$1,920.00 |
| Rate for Payer: Aetna Commercial |
$1,540.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,660.00
|
| Rate for Payer: First Health Commercial |
$1,900.00
|
| Rate for Payer: Humana Commercial |
$1,700.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,640.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,476.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,760.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,500.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,740.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,380.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
REPLACE TISSUE EXPANDER
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 11970
|
| Hospital Charge Code |
76100113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$687.80 |
| Max. Negotiated Rate |
$9,240.92 |
| Rate for Payer: Aetna Commercial |
$1,540.00
|
| Rate for Payer: Anthem Medicaid |
$687.80
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$6,600.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,560.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$9,240.92
|
| Rate for Payer: CareSource Just4Me Medicare |
$8,910.89
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,660.00
|
| Rate for Payer: First Health Commercial |
$1,900.00
|
| Rate for Payer: Humana Commercial |
$1,700.00
|
| Rate for Payer: Humana KY Medicaid |
$687.80
|
| Rate for Payer: Humana Medicare Advantage |
$6,600.66
|
| Rate for Payer: Kentucky WC Medicaid |
$694.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,640.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,476.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,920.79
|
| Rate for Payer: Molina Healthcare Medicaid |
$701.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,760.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,500.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,740.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,380.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
REPLACE TISSUE EXPANDER
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 11970
|
| Hospital Charge Code |
76100113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$462.51 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$861.40
|
| Rate for Payer: Ambetter Exchange |
$531.49
|
| Rate for Payer: Anthem Medicaid |
$462.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$531.49
|
| Rate for Payer: Buckeye Medicare Advantage |
$531.49
|
| Rate for Payer: CareSource Just4Me Medicare |
$637.79
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$818.24
|
| Rate for Payer: Healthspan PPO |
$688.77
|
| Rate for Payer: Humana Medicaid |
$462.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$760.49
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$531.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$531.49
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$471.76
|
| Rate for Payer: Molina Healthcare Passport |
$462.51
|
| Rate for Payer: Multiplan PHCS |
$1,200.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$690.94
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$467.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$531.49
|
|
|
REPLACE TRICUSPDVALVE CPBYPASS
|
Facility
|
OP
|
$3,650.00
|
|
|
Service Code
|
HCPCS 33465
|
| Hospital Charge Code |
76101294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,095.00 |
| Max. Negotiated Rate |
$3,504.00 |
| Rate for Payer: Aetna Commercial |
$2,810.50
|
| Rate for Payer: Anthem Medicaid |
$1,255.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,847.00
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cigna Commercial |
$3,029.50
|
| Rate for Payer: First Health Commercial |
$3,467.50
|
| Rate for Payer: Humana Commercial |
$3,102.50
|
| Rate for Payer: Humana KY Medicaid |
$1,255.23
|
| Rate for Payer: Kentucky WC Medicaid |
$1,268.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,993.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,693.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,095.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,280.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,212.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,737.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,920.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,175.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,518.50
|
| Rate for Payer: PHCS Commercial |
$3,504.00
|
| Rate for Payer: United Healthcare All Payer |
$3,212.00
|
|
|
REPLACE TRICUSPDVALVE CPBYPASS
|
Professional
|
Both
|
$3,650.00
|
|
|
Service Code
|
HCPCS 33465
|
| Hospital Charge Code |
761P1294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,277.50 |
| Max. Negotiated Rate |
$4,498.59 |
| Rate for Payer: Aetna Commercial |
$4,498.59
|
| Rate for Payer: Ambetter Exchange |
$2,583.23
|
| Rate for Payer: Anthem Medicaid |
$1,800.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$2,583.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,583.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,099.88
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cigna Commercial |
$4,039.03
|
| Rate for Payer: Healthspan PPO |
$4,422.99
|
| Rate for Payer: Humana Medicaid |
$1,800.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$3,877.59
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$2,583.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,583.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,836.52
|
| Rate for Payer: Molina Healthcare Passport |
$1,800.51
|
| Rate for Payer: Multiplan PHCS |
$2,190.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3,358.20
|
| Rate for Payer: UHCCP Medicaid |
$1,277.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,818.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,583.23
|
|
|
REPLACE TRICUSPDVALVE CPBYPASS
|
Professional
|
Both
|
$3,650.00
|
|
|
Service Code
|
HCPCS 33465
|
| Hospital Charge Code |
76101294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,277.50 |
| Max. Negotiated Rate |
$4,498.59 |
| Rate for Payer: Aetna Commercial |
$4,498.59
|
| Rate for Payer: Ambetter Exchange |
$2,583.23
|
| Rate for Payer: Anthem Medicaid |
$1,800.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$2,583.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,583.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,099.88
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cigna Commercial |
$4,039.03
|
| Rate for Payer: Healthspan PPO |
$4,422.99
|
| Rate for Payer: Humana Medicaid |
$1,800.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$3,877.59
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$2,583.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,583.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,836.52
|
| Rate for Payer: Molina Healthcare Passport |
$1,800.51
|
| Rate for Payer: Multiplan PHCS |
$2,190.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3,358.20
|
| Rate for Payer: UHCCP Medicaid |
$1,277.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,818.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,583.23
|
|
|
REPLACE TRICUSPDVALVE CPBYPASS
|
Facility
|
IP
|
$3,650.00
|
|
|
Service Code
|
HCPCS 33465
|
| Hospital Charge Code |
76101294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,095.00 |
| Max. Negotiated Rate |
$3,504.00 |
| Rate for Payer: Aetna Commercial |
$2,810.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,847.00
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cigna Commercial |
$3,029.50
|
| Rate for Payer: First Health Commercial |
$3,467.50
|
| Rate for Payer: Humana Commercial |
$3,102.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,993.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,693.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,095.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,212.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,737.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,920.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,175.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,518.50
|
| Rate for Payer: PHCS Commercial |
$3,504.00
|
| Rate for Payer: United Healthcare All Payer |
$3,212.00
|
|
|
REPLACE TUNNELED CV CATH
|
Facility
|
OP
|
$5,917.00
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
76101485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,034.86 |
| Max. Negotiated Rate |
$5,680.32 |
| Rate for Payer: Aetna Commercial |
$4,556.09
|
| Rate for Payer: Anthem Medicaid |
$2,034.86
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,615.26
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$2,958.50
|
| Rate for Payer: Cash Price |
$2,958.50
|
| Rate for Payer: Cigna Commercial |
$4,911.11
|
| Rate for Payer: First Health Commercial |
$5,621.15
|
| Rate for Payer: Humana Commercial |
$5,029.45
|
| Rate for Payer: Humana KY Medicaid |
$2,034.86
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,055.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,851.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,366.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,075.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,206.96
|
| Rate for Payer: Ohio Health Group HMO |
$4,437.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,733.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,147.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,082.73
|
| Rate for Payer: PHCS Commercial |
$5,680.32
|
| Rate for Payer: United Healthcare All Payer |
$5,206.96
|
|
|
REPLACE TUNNELED CV CATH
|
Professional
|
Both
|
$5,792.29
|
|
|
Service Code
|
HCPCS 36578
|
| Hospital Charge Code |
76101483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.48 |
| Max. Negotiated Rate |
$3,475.37 |
| Rate for Payer: Aetna Commercial |
$329.10
|
| Rate for Payer: Ambetter Exchange |
$188.47
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$103.48
|
| Rate for Payer: Anthem Medicaid |
$387.06
|
| Rate for Payer: Buckeye Individual/Medicaid |
$188.47
|
| Rate for Payer: Buckeye Medicare Advantage |
$188.47
|
| Rate for Payer: CareSource Just4Me Medicare |
$226.16
|
| Rate for Payer: Cash Price |
$2,896.14
|
| Rate for Payer: Cash Price |
$2,896.14
|
| Rate for Payer: Cigna Commercial |
$317.54
|
| Rate for Payer: Healthspan PPO |
$585.40
|
| Rate for Payer: Humana Medicaid |
$387.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$278.37
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$188.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$188.47
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$394.80
|
| Rate for Payer: Molina Healthcare Passport |
$387.06
|
| Rate for Payer: Multiplan PHCS |
$3,475.37
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$245.01
|
| Rate for Payer: UHCCP Medicaid |
$108.65
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$390.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$188.47
|
|
|
REPLACE TUNNELED CV CATH
|
Facility
|
IP
|
$1,435.00
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
76102714
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.50 |
| Max. Negotiated Rate |
$1,377.60 |
| Rate for Payer: Aetna Commercial |
$1,104.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,119.30
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cigna Commercial |
$1,191.05
|
| Rate for Payer: First Health Commercial |
$1,363.25
|
| Rate for Payer: Humana Commercial |
$1,219.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,176.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,059.03
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$430.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,262.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,076.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,148.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,248.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$990.15
|
| Rate for Payer: PHCS Commercial |
$1,377.60
|
| Rate for Payer: United Healthcare All Payer |
$1,262.80
|
|
|
REPLACE TUNNELED CV CATH
|
Professional
|
Both
|
$1,435.00
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
76102714
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.42 |
| Max. Negotiated Rate |
$1,220.81 |
| Rate for Payer: Aetna Commercial |
$456.36
|
| Rate for Payer: Ambetter Exchange |
$311.92
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$216.42
|
| Rate for Payer: Anthem Medicaid |
$503.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$311.92
|
| Rate for Payer: Buckeye Medicare Advantage |
$311.92
|
| Rate for Payer: CareSource Just4Me Medicare |
$374.30
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cigna Commercial |
$440.57
|
| Rate for Payer: Healthspan PPO |
$1,220.81
|
| Rate for Payer: Humana Medicaid |
$503.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$423.50
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$311.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$311.92
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$514.02
|
| Rate for Payer: Molina Healthcare Passport |
$503.94
|
| Rate for Payer: Multiplan PHCS |
$861.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$405.50
|
| Rate for Payer: UHCCP Medicaid |
$227.24
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$508.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$311.92
|
|
|
REPLACE TUNNELED CV CATH
|
Facility
|
OP
|
$1,435.00
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
76102714
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$493.50 |
| Max. Negotiated Rate |
$6,992.66 |
| Rate for Payer: Aetna Commercial |
$1,104.95
|
| Rate for Payer: Anthem Medicaid |
$493.50
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,994.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,119.30
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,992.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,742.93
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cigna Commercial |
$1,191.05
|
| Rate for Payer: First Health Commercial |
$1,363.25
|
| Rate for Payer: Humana Commercial |
$1,219.75
|
| Rate for Payer: Humana KY Medicaid |
$493.50
|
| Rate for Payer: Humana Medicare Advantage |
$4,994.76
|
| Rate for Payer: Kentucky WC Medicaid |
$498.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,176.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,059.03
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,993.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$503.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,262.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,076.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,148.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,248.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$990.15
|
| Rate for Payer: PHCS Commercial |
$1,377.60
|
| Rate for Payer: United Healthcare All Payer |
$1,262.80
|
|
|
REPLACE TUNNELED CV CATH
|
Professional
|
Both
|
$5,917.00
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
76101485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.93 |
| Max. Negotiated Rate |
$3,550.20 |
| Rate for Payer: Aetna Commercial |
$312.26
|
| Rate for Payer: Ambetter Exchange |
$170.71
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$141.93
|
| Rate for Payer: Anthem Medicaid |
$455.48
|
| Rate for Payer: Buckeye Individual/Medicaid |
$170.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$170.71
|
| Rate for Payer: CareSource Just4Me Medicare |
$204.85
|
| Rate for Payer: Cash Price |
$2,958.50
|
| Rate for Payer: Cash Price |
$2,958.50
|
| Rate for Payer: Cigna Commercial |
$294.70
|
| Rate for Payer: Healthspan PPO |
$875.34
|
| Rate for Payer: Humana Medicaid |
$455.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$256.87
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$170.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$170.71
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$464.59
|
| Rate for Payer: Molina Healthcare Passport |
$455.48
|
| Rate for Payer: Multiplan PHCS |
$3,550.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$221.92
|
| Rate for Payer: UHCCP Medicaid |
$149.03
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$460.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$170.71
|
|
|
REPLACE TUNNELED CV CATH
|
Professional
|
Both
|
$1,435.00
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
761P2714
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.42 |
| Max. Negotiated Rate |
$1,220.81 |
| Rate for Payer: Aetna Commercial |
$456.36
|
| Rate for Payer: Ambetter Exchange |
$311.92
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$216.42
|
| Rate for Payer: Anthem Medicaid |
$503.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$311.92
|
| Rate for Payer: Buckeye Medicare Advantage |
$311.92
|
| Rate for Payer: CareSource Just4Me Medicare |
$374.30
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cash Price |
$717.50
|
| Rate for Payer: Cigna Commercial |
$440.57
|
| Rate for Payer: Healthspan PPO |
$1,220.81
|
| Rate for Payer: Humana Medicaid |
$503.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$423.50
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$311.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$311.92
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$514.02
|
| Rate for Payer: Molina Healthcare Passport |
$503.94
|
| Rate for Payer: Multiplan PHCS |
$861.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$405.50
|
| Rate for Payer: UHCCP Medicaid |
$227.24
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$508.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$311.92
|
|
|
REPLACE TUNNELED CV CATH
|
Facility
|
IP
|
$5,792.29
|
|
|
Service Code
|
HCPCS 36578
|
| Hospital Charge Code |
76101483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,737.69 |
| Max. Negotiated Rate |
$5,560.60 |
| Rate for Payer: Aetna Commercial |
$4,460.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,517.99
|
| Rate for Payer: Cash Price |
$2,896.14
|
| Rate for Payer: Cigna Commercial |
$4,807.60
|
| Rate for Payer: First Health Commercial |
$5,502.68
|
| Rate for Payer: Humana Commercial |
$4,923.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,749.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,274.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,737.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,097.22
|
| Rate for Payer: Ohio Health Group HMO |
$4,344.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,633.83
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,039.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,996.68
|
| Rate for Payer: PHCS Commercial |
$5,560.60
|
| Rate for Payer: United Healthcare All Payer |
$5,097.22
|
|
|
REPLACE TUNNELED CV CATH
|
Facility
|
IP
|
$5,917.00
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
76101485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,775.10 |
| Max. Negotiated Rate |
$5,680.32 |
| Rate for Payer: Aetna Commercial |
$4,556.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,615.26
|
| Rate for Payer: Cash Price |
$2,958.50
|
| Rate for Payer: Cigna Commercial |
$4,911.11
|
| Rate for Payer: First Health Commercial |
$5,621.15
|
| Rate for Payer: Humana Commercial |
$5,029.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,851.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,366.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,775.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,206.96
|
| Rate for Payer: Ohio Health Group HMO |
$4,437.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,733.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,147.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,082.73
|
| Rate for Payer: PHCS Commercial |
$5,680.32
|
| Rate for Payer: United Healthcare All Payer |
$5,206.96
|
|
|
REPLACE TUNNELED CV CATH
|
Facility
|
OP
|
$5,792.29
|
|
|
Service Code
|
HCPCS 36578
|
| Hospital Charge Code |
76101483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,991.97 |
| Max. Negotiated Rate |
$5,560.60 |
| Rate for Payer: Aetna Commercial |
$4,460.06
|
| Rate for Payer: Anthem Medicaid |
$1,991.97
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,517.99
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$2,896.14
|
| Rate for Payer: Cash Price |
$2,896.14
|
| Rate for Payer: Cigna Commercial |
$4,807.60
|
| Rate for Payer: First Health Commercial |
$5,502.68
|
| Rate for Payer: Humana Commercial |
$4,923.45
|
| Rate for Payer: Humana KY Medicaid |
$1,991.97
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$2,012.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,749.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,274.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,031.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,097.22
|
| Rate for Payer: Ohio Health Group HMO |
$4,344.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,633.83
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,039.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,996.68
|
| Rate for Payer: PHCS Commercial |
$5,560.60
|
| Rate for Payer: United Healthcare All Payer |
$5,097.22
|
|
|
REPLACE TUNNELED CV CATH(P
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 36578
|
| Hospital Charge Code |
761P1483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.48 |
| Max. Negotiated Rate |
$585.40 |
| Rate for Payer: Aetna Commercial |
$329.10
|
| Rate for Payer: Ambetter Exchange |
$188.47
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$103.48
|
| Rate for Payer: Anthem Medicaid |
$387.06
|
| Rate for Payer: Buckeye Individual/Medicaid |
$188.47
|
| Rate for Payer: Buckeye Medicare Advantage |
$188.47
|
| Rate for Payer: CareSource Just4Me Medicare |
$226.16
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cigna Commercial |
$317.54
|
| Rate for Payer: Healthspan PPO |
$585.40
|
| Rate for Payer: Humana Medicaid |
$387.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$278.37
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$188.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$188.47
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$394.80
|
| Rate for Payer: Molina Healthcare Passport |
$387.06
|
| Rate for Payer: Multiplan PHCS |
$492.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$245.01
|
| Rate for Payer: UHCCP Medicaid |
$108.65
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$390.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$188.47
|
|
|
REPLACE TUNNELED CV CATH(P
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
761P1485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.93 |
| Max. Negotiated Rate |
$875.34 |
| Rate for Payer: Aetna Commercial |
$312.26
|
| Rate for Payer: Ambetter Exchange |
$170.71
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$141.93
|
| Rate for Payer: Anthem Medicaid |
$455.48
|
| Rate for Payer: Buckeye Individual/Medicaid |
$170.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$170.71
|
| Rate for Payer: CareSource Just4Me Medicare |
$204.85
|
| Rate for Payer: Cash Price |
$507.50
|
| Rate for Payer: Cash Price |
$507.50
|
| Rate for Payer: Cigna Commercial |
$294.70
|
| Rate for Payer: Healthspan PPO |
$875.34
|
| Rate for Payer: Humana Medicaid |
$455.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$256.87
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$170.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$170.71
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$464.59
|
| Rate for Payer: Molina Healthcare Passport |
$455.48
|
| Rate for Payer: Multiplan PHCS |
$609.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$221.92
|
| Rate for Payer: UHCCP Medicaid |
$149.03
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$460.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$170.71
|
|
|
REPLACE TUNNELED CV CATH(T
|
Facility
|
OP
|
$4,972.29
|
|
|
Service Code
|
HCPCS 36578
|
| Hospital Charge Code |
761T1483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,709.97 |
| Max. Negotiated Rate |
$4,773.40 |
| Rate for Payer: Aetna Commercial |
$3,828.66
|
| Rate for Payer: Anthem Medicaid |
$1,709.97
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,908.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,878.39
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,071.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,926.11
|
| Rate for Payer: Cash Price |
$2,486.14
|
| Rate for Payer: Cash Price |
$2,486.14
|
| Rate for Payer: Cigna Commercial |
$4,127.00
|
| Rate for Payer: First Health Commercial |
$4,723.68
|
| Rate for Payer: Humana Commercial |
$4,226.45
|
| Rate for Payer: Humana KY Medicaid |
$1,709.97
|
| Rate for Payer: Humana Medicare Advantage |
$2,908.23
|
| Rate for Payer: Kentucky WC Medicaid |
$1,727.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,077.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,669.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,489.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,744.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,375.62
|
| Rate for Payer: Ohio Health Group HMO |
$3,729.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,977.83
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,325.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,430.88
|
| Rate for Payer: PHCS Commercial |
$4,773.40
|
| Rate for Payer: United Healthcare All Payer |
$4,375.62
|
|
