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Service Code HCPCS J2800
Hospital Charge Code 636T0059
Hospital Revenue Code 636
Min. Negotiated Rate $22.88
Max. Negotiated Rate $168.96
Rate for Payer: Aetna Commercial $135.52
Rate for Payer: Anthem POS/PPO/Traditional $137.28
Rate for Payer: Cash Price $88.00
Rate for Payer: Cigna Commercial $146.08
Rate for Payer: First Health Commercial $167.20
Rate for Payer: Humana Commercial $149.60
Rate for Payer: Medical Mutual Of Ohio HMO $144.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.89
Rate for Payer: Molina Healthcare Benefit Exchange $52.80
Rate for Payer: Ohio Health Choice Commercial $154.88
Rate for Payer: Ohio Health Group HMO $132.00
Rate for Payer: Ohio Health Group PPO Differential $35.20
Rate for Payer: Ohio Health Group PPO No Differential $22.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.56
Rate for Payer: PHCS Commercial $168.96
Rate for Payer: United Healthcare All Payer $154.88
Service Code HCPCS J2800
Hospital Charge Code 636T0059
Hospital Revenue Code 636
Min. Negotiated Rate $22.88
Max. Negotiated Rate $168.96
Rate for Payer: Aetna Commercial $135.52
Rate for Payer: Anthem Medicaid $60.53
Rate for Payer: Anthem POS/PPO/Traditional $137.28
Rate for Payer: Cash Price $88.00
Rate for Payer: Cigna Commercial $146.08
Rate for Payer: First Health Commercial $167.20
Rate for Payer: Humana Commercial $149.60
Rate for Payer: Humana KY Medicaid $60.53
Rate for Payer: Kentucky WC Medicaid $61.14
Rate for Payer: Medical Mutual Of Ohio HMO $144.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.89
Rate for Payer: Molina Healthcare Benefit Exchange $52.80
Rate for Payer: Molina Healthcare Medicaid $61.74
Rate for Payer: Ohio Health Choice Commercial $154.88
Rate for Payer: Ohio Health Group HMO $132.00
Rate for Payer: Ohio Health Group PPO Differential $35.20
Rate for Payer: Ohio Health Group PPO No Differential $22.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.56
Rate for Payer: PHCS Commercial $168.96
Rate for Payer: United Healthcare All Payer $154.88
Service Code HCPCS J2800
Hospital Charge Code 63600059
Hospital Revenue Code 636
Min. Negotiated Rate $22.88
Max. Negotiated Rate $168.96
Rate for Payer: Aetna Commercial $135.52
Rate for Payer: Anthem POS/PPO/Traditional $137.28
Rate for Payer: Cash Price $88.00
Rate for Payer: Cigna Commercial $146.08
Rate for Payer: First Health Commercial $167.20
Rate for Payer: Humana Commercial $149.60
Rate for Payer: Medical Mutual Of Ohio HMO $144.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.89
Rate for Payer: Molina Healthcare Benefit Exchange $52.80
Rate for Payer: Ohio Health Choice Commercial $154.88
Rate for Payer: Ohio Health Group HMO $132.00
Rate for Payer: Ohio Health Group PPO Differential $35.20
Rate for Payer: Ohio Health Group PPO No Differential $22.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.56
Rate for Payer: PHCS Commercial $168.96
Rate for Payer: United Healthcare All Payer $154.88
Service Code HCPCS J2800
Hospital Charge Code 63600059
Hospital Revenue Code 636
Min. Negotiated Rate $9.51
Max. Negotiated Rate $176.00
Rate for Payer: Aetna Commercial $9.51
Rate for Payer: Buckeye Medicare Advantage $176.00
Rate for Payer: Cash Price $88.00
Rate for Payer: Cash Price $88.00
Rate for Payer: Healthspan PPO $13.90
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $10.32
Rate for Payer: Multiplan PHCS $105.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $123.20
Rate for Payer: UHCCP Medicaid $61.60
Service Code HCPCS J2800
Hospital Charge Code 63600059
Hospital Revenue Code 636
Min. Negotiated Rate $22.88
Max. Negotiated Rate $168.96
Rate for Payer: Aetna Commercial $135.52
Rate for Payer: Anthem Medicaid $60.53
Rate for Payer: Anthem POS/PPO/Traditional $137.28
Rate for Payer: Cash Price $88.00
Rate for Payer: Cigna Commercial $146.08
Rate for Payer: First Health Commercial $167.20
Rate for Payer: Humana Commercial $149.60
Rate for Payer: Humana KY Medicaid $60.53
Rate for Payer: Kentucky WC Medicaid $61.14
Rate for Payer: Medical Mutual Of Ohio HMO $144.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.89
Rate for Payer: Molina Healthcare Benefit Exchange $52.80
Rate for Payer: Molina Healthcare Medicaid $61.74
Rate for Payer: Ohio Health Choice Commercial $154.88
Rate for Payer: Ohio Health Group HMO $132.00
Rate for Payer: Ohio Health Group PPO Differential $35.20
Rate for Payer: Ohio Health Group PPO No Differential $22.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.56
Rate for Payer: PHCS Commercial $168.96
Rate for Payer: United Healthcare All Payer $154.88
Service Code HCPCS J2800
Hospital Charge Code 25002355
Hospital Revenue Code 636
Min. Negotiated Rate $15.21
Max. Negotiated Rate $112.32
Rate for Payer: Aetna Commercial $90.09
Rate for Payer: Anthem Medicaid $40.24
Rate for Payer: Anthem POS/PPO/Traditional $91.26
Rate for Payer: Cash Price $58.50
Rate for Payer: Cigna Commercial $97.11
Rate for Payer: First Health Commercial $111.15
Rate for Payer: Humana Commercial $99.45
Rate for Payer: Humana KY Medicaid $40.24
Rate for Payer: Kentucky WC Medicaid $40.65
Rate for Payer: Medical Mutual Of Ohio HMO $95.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $86.35
Rate for Payer: Molina Healthcare Benefit Exchange $35.10
Rate for Payer: Molina Healthcare Medicaid $41.04
Rate for Payer: Ohio Health Choice Commercial $102.96
Rate for Payer: Ohio Health Group HMO $87.75
Rate for Payer: Ohio Health Group PPO Differential $23.40
Rate for Payer: Ohio Health Group PPO No Differential $15.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $36.27
Rate for Payer: PHCS Commercial $112.32
Rate for Payer: United Healthcare All Payer $102.96
Service Code NDC 60687055901
Hospital Charge Code 25001337
Hospital Revenue Code 637
Min. Negotiated Rate $0.58
Max. Negotiated Rate $4.27
Rate for Payer: Aetna Commercial $3.43
Rate for Payer: Anthem Medicaid $1.53
Rate for Payer: Anthem POS/PPO/Traditional $3.47
Rate for Payer: Cash Price $2.22
Rate for Payer: Cigna Commercial $3.69
Rate for Payer: First Health Commercial $4.23
Rate for Payer: Humana Commercial $3.78
Rate for Payer: Humana KY Medicaid $1.53
Rate for Payer: Kentucky WC Medicaid $1.55
Rate for Payer: Medical Mutual Of Ohio HMO $3.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.28
Rate for Payer: Molina Healthcare Benefit Exchange $1.34
Rate for Payer: Molina Healthcare Medicaid $1.56
Rate for Payer: Ohio Health Choice Commercial $3.92
Rate for Payer: Ohio Health Group HMO $3.34
Rate for Payer: Ohio Health Group PPO Differential $0.89
Rate for Payer: Ohio Health Group PPO No Differential $0.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.38
Rate for Payer: PHCS Commercial $4.27
Rate for Payer: United Healthcare All Payer $3.92
Service Code NDC 60687055901
Hospital Charge Code 25001337
Hospital Revenue Code 637
Min. Negotiated Rate $0.58
Max. Negotiated Rate $4.27
Rate for Payer: Aetna Commercial $3.43
Rate for Payer: Anthem POS/PPO/Traditional $3.47
Rate for Payer: Cash Price $2.22
Rate for Payer: Cigna Commercial $3.69
Rate for Payer: First Health Commercial $4.23
Rate for Payer: Humana Commercial $3.78
Rate for Payer: Medical Mutual Of Ohio HMO $3.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.28
Rate for Payer: Molina Healthcare Benefit Exchange $1.34
Rate for Payer: Ohio Health Choice Commercial $3.92
Rate for Payer: Ohio Health Group HMO $3.34
Rate for Payer: Ohio Health Group PPO Differential $0.89
Rate for Payer: Ohio Health Group PPO No Differential $0.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.38
Rate for Payer: PHCS Commercial $4.27
Rate for Payer: United Healthcare All Payer $3.92
Service Code NDC 70010077001
Hospital Charge Code 25001338
Hospital Revenue Code 637
Min. Negotiated Rate $0.55
Max. Negotiated Rate $4.09
Rate for Payer: Aetna Commercial $3.28
Rate for Payer: Anthem POS/PPO/Traditional $3.32
Rate for Payer: Cash Price $2.13
Rate for Payer: Cigna Commercial $3.54
Rate for Payer: First Health Commercial $4.05
Rate for Payer: Humana Commercial $3.62
Rate for Payer: Medical Mutual Of Ohio HMO $3.49
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.14
Rate for Payer: Molina Healthcare Benefit Exchange $1.28
Rate for Payer: Ohio Health Choice Commercial $3.75
Rate for Payer: Ohio Health Group HMO $3.20
Rate for Payer: Ohio Health Group PPO Differential $0.85
Rate for Payer: Ohio Health Group PPO No Differential $0.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.32
Rate for Payer: PHCS Commercial $4.09
Rate for Payer: United Healthcare All Payer $3.75
Service Code NDC 70010077001
Hospital Charge Code 25001338
Hospital Revenue Code 637
Min. Negotiated Rate $0.55
Max. Negotiated Rate $4.09
Rate for Payer: Aetna Commercial $3.28
Rate for Payer: Anthem Medicaid $1.47
Rate for Payer: Anthem POS/PPO/Traditional $3.32
Rate for Payer: Cash Price $2.13
Rate for Payer: Cigna Commercial $3.54
Rate for Payer: First Health Commercial $4.05
Rate for Payer: Humana Commercial $3.62
Rate for Payer: Humana KY Medicaid $1.47
Rate for Payer: Kentucky WC Medicaid $1.48
Rate for Payer: Medical Mutual Of Ohio HMO $3.49
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.14
Rate for Payer: Molina Healthcare Benefit Exchange $1.28
Rate for Payer: Molina Healthcare Medicaid $1.49
Rate for Payer: Ohio Health Choice Commercial $3.75
Rate for Payer: Ohio Health Group HMO $3.20
Rate for Payer: Ohio Health Group PPO Differential $0.85
Rate for Payer: Ohio Health Group PPO No Differential $0.55
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.32
Rate for Payer: PHCS Commercial $4.09
Rate for Payer: United Healthcare All Payer $3.75
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $230.10
Max. Negotiated Rate $1,699.20
Rate for Payer: Aetna Commercial $1,362.90
Rate for Payer: Anthem Medicaid $608.70
Rate for Payer: Anthem POS/PPO/Traditional $1,380.60
Rate for Payer: Cash Price $885.00
Rate for Payer: Cigna Commercial $1,469.10
Rate for Payer: First Health Commercial $1,681.50
Rate for Payer: Humana Commercial $1,504.50
Rate for Payer: Humana KY Medicaid $608.70
Rate for Payer: Kentucky WC Medicaid $614.90
Rate for Payer: Medical Mutual Of Ohio HMO $1,451.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,306.26
Rate for Payer: Molina Healthcare Benefit Exchange $531.00
Rate for Payer: Molina Healthcare Medicaid $620.92
Rate for Payer: Ohio Health Choice Commercial $1,557.60
Rate for Payer: Ohio Health Group HMO $1,327.50
Rate for Payer: Ohio Health Group PPO Differential $354.00
Rate for Payer: Ohio Health Group PPO No Differential $230.10
Rate for Payer: Ohio Health Group PPO SOMC Employees $548.70
Rate for Payer: PHCS Commercial $1,699.20
Rate for Payer: United Healthcare All Payer $1,557.60
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $230.10
Max. Negotiated Rate $1,699.20
Rate for Payer: Aetna Commercial $1,362.90
Rate for Payer: Anthem POS/PPO/Traditional $1,380.60
Rate for Payer: Cash Price $885.00
Rate for Payer: Cigna Commercial $1,469.10
Rate for Payer: First Health Commercial $1,681.50
Rate for Payer: Humana Commercial $1,504.50
Rate for Payer: Medical Mutual Of Ohio HMO $1,451.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,306.26
Rate for Payer: Molina Healthcare Benefit Exchange $531.00
Rate for Payer: Ohio Health Choice Commercial $1,557.60
Rate for Payer: Ohio Health Group HMO $1,327.50
Rate for Payer: Ohio Health Group PPO Differential $354.00
Rate for Payer: Ohio Health Group PPO No Differential $230.10
Rate for Payer: Ohio Health Group PPO SOMC Employees $548.70
Rate for Payer: PHCS Commercial $1,699.20
Rate for Payer: United Healthcare All Payer $1,557.60
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $231.01
Max. Negotiated Rate $1,705.92
Rate for Payer: Aetna Commercial $1,368.29
Rate for Payer: Anthem Medicaid $611.11
Rate for Payer: Anthem POS/PPO/Traditional $1,386.06
Rate for Payer: Cash Price $888.50
Rate for Payer: Cigna Commercial $1,474.91
Rate for Payer: First Health Commercial $1,688.15
Rate for Payer: Humana Commercial $1,510.45
Rate for Payer: Humana KY Medicaid $611.11
Rate for Payer: Kentucky WC Medicaid $617.33
Rate for Payer: Medical Mutual Of Ohio HMO $1,457.14
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,311.43
Rate for Payer: Molina Healthcare Benefit Exchange $533.10
Rate for Payer: Molina Healthcare Medicaid $623.37
Rate for Payer: Ohio Health Choice Commercial $1,563.76
Rate for Payer: Ohio Health Group HMO $1,332.75
Rate for Payer: Ohio Health Group PPO Differential $355.40
Rate for Payer: Ohio Health Group PPO No Differential $231.01
Rate for Payer: Ohio Health Group PPO SOMC Employees $550.87
Rate for Payer: PHCS Commercial $1,705.92
Rate for Payer: United Healthcare All Payer $1,563.76
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $231.01
Max. Negotiated Rate $1,705.92
Rate for Payer: Aetna Commercial $1,368.29
Rate for Payer: Anthem POS/PPO/Traditional $1,386.06
Rate for Payer: Cash Price $888.50
Rate for Payer: Cigna Commercial $1,474.91
Rate for Payer: First Health Commercial $1,688.15
Rate for Payer: Humana Commercial $1,510.45
Rate for Payer: Medical Mutual Of Ohio HMO $1,457.14
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,311.43
Rate for Payer: Molina Healthcare Benefit Exchange $533.10
Rate for Payer: Ohio Health Choice Commercial $1,563.76
Rate for Payer: Ohio Health Group HMO $1,332.75
Rate for Payer: Ohio Health Group PPO Differential $355.40
Rate for Payer: Ohio Health Group PPO No Differential $231.01
Rate for Payer: Ohio Health Group PPO SOMC Employees $550.87
Rate for Payer: PHCS Commercial $1,705.92
Rate for Payer: United Healthcare All Payer $1,563.76
Service Code NDC 23155060601
Hospital Charge Code 25001339
Hospital Revenue Code 637
Min. Negotiated Rate $0.56
Max. Negotiated Rate $4.15
Rate for Payer: Aetna Commercial $3.33
Rate for Payer: Anthem POS/PPO/Traditional $3.37
Rate for Payer: Cash Price $2.16
Rate for Payer: Cigna Commercial $3.59
Rate for Payer: First Health Commercial $4.10
Rate for Payer: Humana Commercial $3.67
Rate for Payer: Medical Mutual Of Ohio HMO $3.54
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.19
Rate for Payer: Molina Healthcare Benefit Exchange $1.30
Rate for Payer: Ohio Health Choice Commercial $3.80
Rate for Payer: Ohio Health Group HMO $3.24
Rate for Payer: Ohio Health Group PPO Differential $0.86
Rate for Payer: Ohio Health Group PPO No Differential $0.56
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.34
Rate for Payer: PHCS Commercial $4.15
Rate for Payer: United Healthcare All Payer $3.80
Service Code NDC 23155060601
Hospital Charge Code 25001339
Hospital Revenue Code 637
Min. Negotiated Rate $0.56
Max. Negotiated Rate $4.15
Rate for Payer: Aetna Commercial $3.33
Rate for Payer: Anthem Medicaid $1.49
Rate for Payer: Anthem POS/PPO/Traditional $3.37
Rate for Payer: Cash Price $2.16
Rate for Payer: Cigna Commercial $3.59
Rate for Payer: First Health Commercial $4.10
Rate for Payer: Humana Commercial $3.67
Rate for Payer: Humana KY Medicaid $1.49
Rate for Payer: Kentucky WC Medicaid $1.50
Rate for Payer: Medical Mutual Of Ohio HMO $3.54
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.19
Rate for Payer: Molina Healthcare Benefit Exchange $1.30
Rate for Payer: Molina Healthcare Medicaid $1.52
Rate for Payer: Ohio Health Choice Commercial $3.80
Rate for Payer: Ohio Health Group HMO $3.24
Rate for Payer: Ohio Health Group PPO Differential $0.86
Rate for Payer: Ohio Health Group PPO No Differential $0.56
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.34
Rate for Payer: PHCS Commercial $4.15
Rate for Payer: United Healthcare All Payer $3.80
Service Code NDC 71288041493
Hospital Charge Code 25003421
Hospital Revenue Code 250
Min. Negotiated Rate $14.59
Max. Negotiated Rate $107.71
Rate for Payer: Aetna Commercial $86.39
Rate for Payer: Anthem Medicaid $38.59
Rate for Payer: Anthem POS/PPO/Traditional $87.52
Rate for Payer: Cash Price $56.10
Rate for Payer: Cigna Commercial $93.13
Rate for Payer: First Health Commercial $106.59
Rate for Payer: Humana Commercial $95.37
Rate for Payer: Humana KY Medicaid $38.59
Rate for Payer: Kentucky WC Medicaid $38.98
Rate for Payer: Medical Mutual Of Ohio HMO $92.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $82.80
Rate for Payer: Molina Healthcare Benefit Exchange $33.66
Rate for Payer: Molina Healthcare Medicaid $39.36
Rate for Payer: Ohio Health Choice Commercial $98.74
Rate for Payer: Ohio Health Group HMO $84.15
Rate for Payer: Ohio Health Group PPO Differential $22.44
Rate for Payer: Ohio Health Group PPO No Differential $14.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $34.78
Rate for Payer: PHCS Commercial $107.71
Rate for Payer: United Healthcare All Payer $98.74
Service Code NDC 71288041493
Hospital Charge Code 25003421
Hospital Revenue Code 250
Min. Negotiated Rate $14.59
Max. Negotiated Rate $107.71
Rate for Payer: Aetna Commercial $86.39
Rate for Payer: Anthem POS/PPO/Traditional $87.52
Rate for Payer: Cash Price $56.10
Rate for Payer: Cigna Commercial $93.13
Rate for Payer: First Health Commercial $106.59
Rate for Payer: Humana Commercial $95.37
Rate for Payer: Medical Mutual Of Ohio HMO $92.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $82.80
Rate for Payer: Molina Healthcare Benefit Exchange $33.66
Rate for Payer: Ohio Health Choice Commercial $98.74
Rate for Payer: Ohio Health Group HMO $84.15
Rate for Payer: Ohio Health Group PPO Differential $22.44
Rate for Payer: Ohio Health Group PPO No Differential $14.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $34.78
Rate for Payer: PHCS Commercial $107.71
Rate for Payer: United Healthcare All Payer $98.74
Service Code NDC 904653720
Hospital Charge Code 25001340
Hospital Revenue Code 637
Min. Negotiated Rate $0.58
Max. Negotiated Rate $4.25
Rate for Payer: Aetna Commercial $3.41
Rate for Payer: Anthem Medicaid $1.52
Rate for Payer: Anthem POS/PPO/Traditional $3.46
Rate for Payer: Cash Price $2.21
Rate for Payer: Cigna Commercial $3.68
Rate for Payer: First Health Commercial $4.21
Rate for Payer: Humana Commercial $3.77
Rate for Payer: Humana KY Medicaid $1.52
Rate for Payer: Kentucky WC Medicaid $1.54
Rate for Payer: Medical Mutual Of Ohio HMO $3.63
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.27
Rate for Payer: Molina Healthcare Benefit Exchange $1.33
Rate for Payer: Molina Healthcare Medicaid $1.55
Rate for Payer: Ohio Health Choice Commercial $3.90
Rate for Payer: Ohio Health Group HMO $3.32
Rate for Payer: Ohio Health Group PPO Differential $0.89
Rate for Payer: Ohio Health Group PPO No Differential $0.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.37
Rate for Payer: PHCS Commercial $4.25
Rate for Payer: United Healthcare All Payer $3.90
Service Code NDC 904653720
Hospital Charge Code 25001340
Hospital Revenue Code 637
Min. Negotiated Rate $0.58
Max. Negotiated Rate $4.25
Rate for Payer: Aetna Commercial $3.41
Rate for Payer: Anthem POS/PPO/Traditional $3.46
Rate for Payer: Cash Price $2.21
Rate for Payer: Cigna Commercial $3.68
Rate for Payer: First Health Commercial $4.21
Rate for Payer: Humana Commercial $3.77
Rate for Payer: Medical Mutual Of Ohio HMO $3.63
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.27
Rate for Payer: Molina Healthcare Benefit Exchange $1.33
Rate for Payer: Ohio Health Choice Commercial $3.90
Rate for Payer: Ohio Health Group HMO $3.32
Rate for Payer: Ohio Health Group PPO Differential $0.89
Rate for Payer: Ohio Health Group PPO No Differential $0.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.37
Rate for Payer: PHCS Commercial $4.25
Rate for Payer: United Healthcare All Payer $3.90
Service Code NDC 24385090434
Hospital Charge Code 25001340
Hospital Revenue Code 637
Min. Negotiated Rate $0.57
Max. Negotiated Rate $4.22
Rate for Payer: Aetna Commercial $3.39
Rate for Payer: Anthem POS/PPO/Traditional $3.43
Rate for Payer: Cash Price $2.20
Rate for Payer: Cigna Commercial $3.65
Rate for Payer: First Health Commercial $4.18
Rate for Payer: Humana Commercial $3.74
Rate for Payer: Medical Mutual Of Ohio HMO $3.61
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.25
Rate for Payer: Molina Healthcare Benefit Exchange $1.32
Rate for Payer: Ohio Health Choice Commercial $3.87
Rate for Payer: Ohio Health Group HMO $3.30
Rate for Payer: Ohio Health Group PPO Differential $0.88
Rate for Payer: Ohio Health Group PPO No Differential $0.57
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.36
Rate for Payer: PHCS Commercial $4.22
Rate for Payer: United Healthcare All Payer $3.87
Service Code NDC 24385090434
Hospital Charge Code 25001340
Hospital Revenue Code 637
Min. Negotiated Rate $0.57
Max. Negotiated Rate $4.22
Rate for Payer: Aetna Commercial $3.39
Rate for Payer: Anthem Medicaid $1.51
Rate for Payer: Anthem POS/PPO/Traditional $3.43
Rate for Payer: Cash Price $2.20
Rate for Payer: Cigna Commercial $3.65
Rate for Payer: First Health Commercial $4.18
Rate for Payer: Humana Commercial $3.74
Rate for Payer: Humana KY Medicaid $1.51
Rate for Payer: Kentucky WC Medicaid $1.53
Rate for Payer: Medical Mutual Of Ohio HMO $3.61
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.25
Rate for Payer: Molina Healthcare Benefit Exchange $1.32
Rate for Payer: Molina Healthcare Medicaid $1.54
Rate for Payer: Ohio Health Choice Commercial $3.87
Rate for Payer: Ohio Health Group HMO $3.30
Rate for Payer: Ohio Health Group PPO Differential $0.88
Rate for Payer: Ohio Health Group PPO No Differential $0.57
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.36
Rate for Payer: PHCS Commercial $4.22
Rate for Payer: United Healthcare All Payer $3.87
Service Code NDC 121127600
Hospital Charge Code 25001341
Hospital Revenue Code 637
Min. Negotiated Rate $1.34
Max. Negotiated Rate $9.90
Rate for Payer: Aetna Commercial $7.94
Rate for Payer: Anthem POS/PPO/Traditional $8.04
Rate for Payer: Cash Price $5.16
Rate for Payer: Cigna Commercial $8.56
Rate for Payer: First Health Commercial $9.79
Rate for Payer: Humana Commercial $8.76
Rate for Payer: Medical Mutual Of Ohio HMO $8.45
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.61
Rate for Payer: Molina Healthcare Benefit Exchange $3.09
Rate for Payer: Ohio Health Choice Commercial $9.07
Rate for Payer: Ohio Health Group HMO $7.73
Rate for Payer: Ohio Health Group PPO Differential $2.06
Rate for Payer: Ohio Health Group PPO No Differential $1.34
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.20
Rate for Payer: PHCS Commercial $9.90
Rate for Payer: United Healthcare All Payer $9.07
Service Code NDC 121127600
Hospital Charge Code 25001341
Hospital Revenue Code 637
Min. Negotiated Rate $1.34
Max. Negotiated Rate $9.90
Rate for Payer: Aetna Commercial $7.94
Rate for Payer: Anthem Medicaid $3.55
Rate for Payer: Anthem POS/PPO/Traditional $8.04
Rate for Payer: Cash Price $5.16
Rate for Payer: Cigna Commercial $8.56
Rate for Payer: First Health Commercial $9.79
Rate for Payer: Humana Commercial $8.76
Rate for Payer: Humana KY Medicaid $3.55
Rate for Payer: Kentucky WC Medicaid $3.58
Rate for Payer: Medical Mutual Of Ohio HMO $8.45
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.61
Rate for Payer: Molina Healthcare Benefit Exchange $3.09
Rate for Payer: Molina Healthcare Medicaid $3.62
Rate for Payer: Ohio Health Choice Commercial $9.07
Rate for Payer: Ohio Health Group HMO $7.73
Rate for Payer: Ohio Health Group PPO Differential $2.06
Rate for Payer: Ohio Health Group PPO No Differential $1.34
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.20
Rate for Payer: PHCS Commercial $9.90
Rate for Payer: United Healthcare All Payer $9.07
Service Code NDC 121148800
Hospital Charge Code 25001343
Hospital Revenue Code 637
Min. Negotiated Rate $0.22
Max. Negotiated Rate $1.62
Rate for Payer: Aetna Commercial $1.30
Rate for Payer: Anthem Medicaid $0.58
Rate for Payer: Anthem POS/PPO/Traditional $1.32
Rate for Payer: Cash Price $0.84
Rate for Payer: Cigna Commercial $1.40
Rate for Payer: First Health Commercial $1.61
Rate for Payer: Humana Commercial $1.44
Rate for Payer: Humana KY Medicaid $0.58
Rate for Payer: Kentucky WC Medicaid $0.59
Rate for Payer: Medical Mutual Of Ohio HMO $1.39
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1.25
Rate for Payer: Molina Healthcare Benefit Exchange $0.51
Rate for Payer: Molina Healthcare Medicaid $0.59
Rate for Payer: Ohio Health Choice Commercial $1.49
Rate for Payer: Ohio Health Group HMO $1.27
Rate for Payer: Ohio Health Group PPO Differential $0.34
Rate for Payer: Ohio Health Group PPO No Differential $0.22
Rate for Payer: Ohio Health Group PPO SOMC Employees $0.52
Rate for Payer: PHCS Commercial $1.62
Rate for Payer: United Healthcare All Payer $1.49