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Service Code HCPCS 36247
Hospital Charge Code 761P1453
Hospital Revenue Code 761
Min. Negotiated Rate $210.77
Max. Negotiated Rate $3,010.10
Rate for Payer: Aetna Commercial $567.10
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $210.77
Rate for Payer: Anthem Medicaid $297.78
Rate for Payer: Buckeye Medicare Advantage $2,908.00
Rate for Payer: Cash Price $1,454.00
Rate for Payer: Cash Price $1,454.00
Rate for Payer: Cigna Commercial $522.24
Rate for Payer: Healthspan PPO $3,010.10
Rate for Payer: Humana Medicaid $297.78
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $434.57
Rate for Payer: Molina Healthcare CHIP/Medicaid $303.74
Rate for Payer: Molina Healthcare Passport $297.78
Rate for Payer: Multiplan PHCS $1,744.80
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,035.60
Rate for Payer: UHCCP Medicaid $221.31
Rate for Payer: Wellcare CHIP/Medicaid $300.76
Service Code HCPCS 36247
Hospital Charge Code 76101453
Hospital Revenue Code 761
Min. Negotiated Rate $210.77
Max. Negotiated Rate $4,149.00
Rate for Payer: Aetna Commercial $567.10
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $210.77
Rate for Payer: Anthem Medicaid $297.78
Rate for Payer: Buckeye Medicare Advantage $4,149.00
Rate for Payer: Cash Price $2,074.50
Rate for Payer: Cash Price $2,074.50
Rate for Payer: Cigna Commercial $522.24
Rate for Payer: Healthspan PPO $3,010.10
Rate for Payer: Humana Medicaid $297.78
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $434.57
Rate for Payer: Molina Healthcare CHIP/Medicaid $303.74
Rate for Payer: Molina Healthcare Passport $297.78
Rate for Payer: Multiplan PHCS $2,489.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,904.30
Rate for Payer: UHCCP Medicaid $221.31
Rate for Payer: Wellcare CHIP/Medicaid $300.76
Service Code HCPCS 36012
Hospital Charge Code 761P1433
Hospital Revenue Code 761
Min. Negotiated Rate $131.94
Max. Negotiated Rate $1,345.46
Rate for Payer: Aetna Commercial $311.71
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $131.94
Rate for Payer: Anthem Medicaid $182.68
Rate for Payer: Buckeye Medicare Advantage $1,206.00
Rate for Payer: Cash Price $603.00
Rate for Payer: Cash Price $603.00
Rate for Payer: Cigna Commercial $287.09
Rate for Payer: Healthspan PPO $1,345.46
Rate for Payer: Humana Medicaid $182.68
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $234.61
Rate for Payer: Molina Healthcare CHIP/Medicaid $186.33
Rate for Payer: Molina Healthcare Passport $182.68
Rate for Payer: Multiplan PHCS $723.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $844.20
Rate for Payer: UHCCP Medicaid $138.54
Rate for Payer: Wellcare CHIP/Medicaid $184.51
Service Code HCPCS 36012
Hospital Charge Code 76101433
Hospital Revenue Code 761
Min. Negotiated Rate $485.81
Max. Negotiated Rate $3,587.52
Rate for Payer: Aetna Commercial $2,877.49
Rate for Payer: Anthem Medicaid $1,285.15
Rate for Payer: Anthem POS/PPO/Traditional $2,914.86
Rate for Payer: Cash Price $1,868.50
Rate for Payer: Cigna Commercial $3,101.71
Rate for Payer: First Health Commercial $3,550.15
Rate for Payer: Humana Commercial $3,176.45
Rate for Payer: Humana KY Medicaid $1,285.15
Rate for Payer: Kentucky WC Medicaid $1,298.23
Rate for Payer: Medical Mutual Of Ohio HMO $3,064.34
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,757.91
Rate for Payer: Molina Healthcare Benefit Exchange $1,121.10
Rate for Payer: Molina Healthcare Medicaid $1,310.94
Rate for Payer: Ohio Health Choice Commercial $3,288.56
Rate for Payer: Ohio Health Group HMO $2,802.75
Rate for Payer: Ohio Health Group PPO Differential $747.40
Rate for Payer: Ohio Health Group PPO No Differential $485.81
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,158.47
Rate for Payer: PHCS Commercial $3,587.52
Rate for Payer: United Healthcare All Payer $3,288.56
Service Code HCPCS 36012
Hospital Charge Code 76101433
Hospital Revenue Code 761
Min. Negotiated Rate $485.81
Max. Negotiated Rate $3,587.52
Rate for Payer: Aetna Commercial $2,877.49
Rate for Payer: Anthem POS/PPO/Traditional $2,914.86
Rate for Payer: Cash Price $1,868.50
Rate for Payer: Cigna Commercial $3,101.71
Rate for Payer: First Health Commercial $3,550.15
Rate for Payer: Humana Commercial $3,176.45
Rate for Payer: Medical Mutual Of Ohio HMO $3,064.34
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,757.91
Rate for Payer: Molina Healthcare Benefit Exchange $1,121.10
Rate for Payer: Ohio Health Choice Commercial $3,288.56
Rate for Payer: Ohio Health Group HMO $2,802.75
Rate for Payer: Ohio Health Group PPO Differential $747.40
Rate for Payer: Ohio Health Group PPO No Differential $485.81
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,158.47
Rate for Payer: PHCS Commercial $3,587.52
Rate for Payer: United Healthcare All Payer $3,288.56
Service Code HCPCS 36012
Hospital Charge Code 76101433
Hospital Revenue Code 761
Min. Negotiated Rate $131.94
Max. Negotiated Rate $3,737.00
Rate for Payer: Aetna Commercial $311.71
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $131.94
Rate for Payer: Anthem Medicaid $182.68
Rate for Payer: Buckeye Medicare Advantage $3,737.00
Rate for Payer: Cash Price $1,868.50
Rate for Payer: Cash Price $1,868.50
Rate for Payer: Cigna Commercial $287.09
Rate for Payer: Healthspan PPO $1,345.46
Rate for Payer: Humana Medicaid $182.68
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $234.61
Rate for Payer: Molina Healthcare CHIP/Medicaid $186.33
Rate for Payer: Molina Healthcare Passport $182.68
Rate for Payer: Multiplan PHCS $2,242.20
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,615.90
Rate for Payer: UHCCP Medicaid $138.54
Rate for Payer: Wellcare CHIP/Medicaid $184.51
Service Code HCPCS 36012
Hospital Charge Code 761T1433
Hospital Revenue Code 761
Min. Negotiated Rate $329.03
Max. Negotiated Rate $2,429.76
Rate for Payer: Aetna Commercial $1,948.87
Rate for Payer: Anthem POS/PPO/Traditional $1,974.18
Rate for Payer: Cash Price $1,265.50
Rate for Payer: Cigna Commercial $2,100.73
Rate for Payer: First Health Commercial $2,404.45
Rate for Payer: Humana Commercial $2,151.35
Rate for Payer: Medical Mutual Of Ohio HMO $2,075.42
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,867.88
Rate for Payer: Molina Healthcare Benefit Exchange $759.30
Rate for Payer: Ohio Health Choice Commercial $2,227.28
Rate for Payer: Ohio Health Group HMO $1,898.25
Rate for Payer: Ohio Health Group PPO Differential $506.20
Rate for Payer: Ohio Health Group PPO No Differential $329.03
Rate for Payer: Ohio Health Group PPO SOMC Employees $784.61
Rate for Payer: PHCS Commercial $2,429.76
Rate for Payer: United Healthcare All Payer $2,227.28
Service Code HCPCS 36012
Hospital Charge Code 761T1433
Hospital Revenue Code 761
Min. Negotiated Rate $329.03
Max. Negotiated Rate $2,429.76
Rate for Payer: Aetna Commercial $1,948.87
Rate for Payer: Anthem Medicaid $870.41
Rate for Payer: Anthem POS/PPO/Traditional $1,974.18
Rate for Payer: Cash Price $1,265.50
Rate for Payer: Cigna Commercial $2,100.73
Rate for Payer: First Health Commercial $2,404.45
Rate for Payer: Humana Commercial $2,151.35
Rate for Payer: Humana KY Medicaid $870.41
Rate for Payer: Kentucky WC Medicaid $879.27
Rate for Payer: Medical Mutual Of Ohio HMO $2,075.42
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,867.88
Rate for Payer: Molina Healthcare Benefit Exchange $759.30
Rate for Payer: Molina Healthcare Medicaid $887.87
Rate for Payer: Ohio Health Choice Commercial $2,227.28
Rate for Payer: Ohio Health Group HMO $1,898.25
Rate for Payer: Ohio Health Group PPO Differential $506.20
Rate for Payer: Ohio Health Group PPO No Differential $329.03
Rate for Payer: Ohio Health Group PPO SOMC Employees $784.61
Rate for Payer: PHCS Commercial $2,429.76
Rate for Payer: United Healthcare All Payer $2,227.28
Service Code HCPCS 36011
Hospital Charge Code 76101432
Hospital Revenue Code 761
Min. Negotiated Rate $119.60
Max. Negotiated Rate $3,524.24
Rate for Payer: Aetna Commercial $278.98
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $119.60
Rate for Payer: Anthem Medicaid $148.45
Rate for Payer: Buckeye Medicare Advantage $3,524.24
Rate for Payer: Cash Price $1,762.12
Rate for Payer: Cash Price $1,762.12
Rate for Payer: Cigna Commercial $259.34
Rate for Payer: Healthspan PPO $1,429.24
Rate for Payer: Humana Medicaid $148.45
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $207.01
Rate for Payer: Molina Healthcare CHIP/Medicaid $151.42
Rate for Payer: Molina Healthcare Passport $148.45
Rate for Payer: Multiplan PHCS $2,114.54
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,466.97
Rate for Payer: UHCCP Medicaid $125.58
Rate for Payer: Wellcare CHIP/Medicaid $149.93
Service Code HCPCS 36011
Hospital Charge Code 76101432
Hospital Revenue Code 761
Min. Negotiated Rate $458.15
Max. Negotiated Rate $3,383.27
Rate for Payer: Aetna Commercial $2,713.66
Rate for Payer: Anthem Medicaid $1,211.99
Rate for Payer: Anthem POS/PPO/Traditional $2,748.91
Rate for Payer: Cash Price $1,762.12
Rate for Payer: Cigna Commercial $2,925.12
Rate for Payer: First Health Commercial $3,348.03
Rate for Payer: Humana Commercial $2,995.60
Rate for Payer: Humana KY Medicaid $1,211.99
Rate for Payer: Kentucky WC Medicaid $1,224.32
Rate for Payer: Medical Mutual Of Ohio HMO $2,889.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,600.89
Rate for Payer: Molina Healthcare Benefit Exchange $1,057.27
Rate for Payer: Molina Healthcare Medicaid $1,236.30
Rate for Payer: Ohio Health Choice Commercial $3,101.33
Rate for Payer: Ohio Health Group HMO $2,643.18
Rate for Payer: Ohio Health Group PPO Differential $704.85
Rate for Payer: Ohio Health Group PPO No Differential $458.15
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,092.51
Rate for Payer: PHCS Commercial $3,383.27
Rate for Payer: United Healthcare All Payer $3,101.33
Service Code HCPCS 36011
Hospital Charge Code 76101432
Hospital Revenue Code 761
Min. Negotiated Rate $458.15
Max. Negotiated Rate $3,383.27
Rate for Payer: Aetna Commercial $2,713.66
Rate for Payer: Anthem POS/PPO/Traditional $2,748.91
Rate for Payer: Cash Price $1,762.12
Rate for Payer: Cigna Commercial $2,925.12
Rate for Payer: First Health Commercial $3,348.03
Rate for Payer: Humana Commercial $2,995.60
Rate for Payer: Medical Mutual Of Ohio HMO $2,889.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,600.89
Rate for Payer: Molina Healthcare Benefit Exchange $1,057.27
Rate for Payer: Ohio Health Choice Commercial $3,101.33
Rate for Payer: Ohio Health Group HMO $2,643.18
Rate for Payer: Ohio Health Group PPO Differential $704.85
Rate for Payer: Ohio Health Group PPO No Differential $458.15
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,092.51
Rate for Payer: PHCS Commercial $3,383.27
Rate for Payer: United Healthcare All Payer $3,101.33
Service Code HCPCS 36011
Hospital Charge Code 761P1432
Hospital Revenue Code 761
Min. Negotiated Rate $119.60
Max. Negotiated Rate $1,535.00
Rate for Payer: Aetna Commercial $278.98
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $119.60
Rate for Payer: Anthem Medicaid $148.45
Rate for Payer: Buckeye Medicare Advantage $1,535.00
Rate for Payer: Cash Price $767.50
Rate for Payer: Cash Price $767.50
Rate for Payer: Cigna Commercial $259.34
Rate for Payer: Healthspan PPO $1,429.24
Rate for Payer: Humana Medicaid $148.45
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $207.01
Rate for Payer: Molina Healthcare CHIP/Medicaid $151.42
Rate for Payer: Molina Healthcare Passport $148.45
Rate for Payer: Multiplan PHCS $921.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,074.50
Rate for Payer: UHCCP Medicaid $125.58
Rate for Payer: Wellcare CHIP/Medicaid $149.93
Service Code HCPCS 36011
Hospital Charge Code 761T1432
Hospital Revenue Code 761
Min. Negotiated Rate $258.60
Max. Negotiated Rate $1,909.67
Rate for Payer: Aetna Commercial $1,531.71
Rate for Payer: Anthem POS/PPO/Traditional $1,551.61
Rate for Payer: Cash Price $994.62
Rate for Payer: Cigna Commercial $1,651.07
Rate for Payer: First Health Commercial $1,889.78
Rate for Payer: Humana Commercial $1,690.85
Rate for Payer: Medical Mutual Of Ohio HMO $1,631.18
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,468.06
Rate for Payer: Molina Healthcare Benefit Exchange $596.77
Rate for Payer: Ohio Health Choice Commercial $1,750.53
Rate for Payer: Ohio Health Group HMO $1,491.93
Rate for Payer: Ohio Health Group PPO Differential $397.85
Rate for Payer: Ohio Health Group PPO No Differential $258.60
Rate for Payer: Ohio Health Group PPO SOMC Employees $616.66
Rate for Payer: PHCS Commercial $1,909.67
Rate for Payer: United Healthcare All Payer $1,750.53
Service Code HCPCS 36011
Hospital Charge Code 761T1432
Hospital Revenue Code 761
Min. Negotiated Rate $258.60
Max. Negotiated Rate $1,909.67
Rate for Payer: Aetna Commercial $1,531.71
Rate for Payer: Anthem Medicaid $684.10
Rate for Payer: Anthem POS/PPO/Traditional $1,551.61
Rate for Payer: Cash Price $994.62
Rate for Payer: Cigna Commercial $1,651.07
Rate for Payer: First Health Commercial $1,889.78
Rate for Payer: Humana Commercial $1,690.85
Rate for Payer: Humana KY Medicaid $684.10
Rate for Payer: Kentucky WC Medicaid $691.06
Rate for Payer: Medical Mutual Of Ohio HMO $1,631.18
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,468.06
Rate for Payer: Molina Healthcare Benefit Exchange $596.77
Rate for Payer: Molina Healthcare Medicaid $697.83
Rate for Payer: Ohio Health Choice Commercial $1,750.53
Rate for Payer: Ohio Health Group HMO $1,491.93
Rate for Payer: Ohio Health Group PPO Differential $397.85
Rate for Payer: Ohio Health Group PPO No Differential $258.60
Rate for Payer: Ohio Health Group PPO SOMC Employees $616.66
Rate for Payer: PHCS Commercial $1,909.67
Rate for Payer: United Healthcare All Payer $1,750.53
Service Code HCPCS 36013
Hospital Charge Code 76101434
Hospital Revenue Code 761
Min. Negotiated Rate $374.27
Max. Negotiated Rate $2,763.84
Rate for Payer: Aetna Commercial $2,216.83
Rate for Payer: Anthem Medicaid $990.09
Rate for Payer: Anthem POS/PPO/Traditional $2,245.62
Rate for Payer: Cash Price $1,439.50
Rate for Payer: Cigna Commercial $2,389.57
Rate for Payer: First Health Commercial $2,735.05
Rate for Payer: Humana Commercial $2,447.15
Rate for Payer: Humana KY Medicaid $990.09
Rate for Payer: Kentucky WC Medicaid $1,000.16
Rate for Payer: Medical Mutual Of Ohio HMO $2,360.78
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,124.70
Rate for Payer: Molina Healthcare Benefit Exchange $863.70
Rate for Payer: Molina Healthcare Medicaid $1,009.95
Rate for Payer: Ohio Health Choice Commercial $2,533.52
Rate for Payer: Ohio Health Group HMO $2,159.25
Rate for Payer: Ohio Health Group PPO Differential $575.80
Rate for Payer: Ohio Health Group PPO No Differential $374.27
Rate for Payer: Ohio Health Group PPO SOMC Employees $892.49
Rate for Payer: PHCS Commercial $2,763.84
Rate for Payer: United Healthcare All Payer $2,533.52
Service Code HCPCS 36013
Hospital Charge Code 76101434
Hospital Revenue Code 761
Min. Negotiated Rate $374.27
Max. Negotiated Rate $2,763.84
Rate for Payer: Aetna Commercial $2,216.83
Rate for Payer: Anthem POS/PPO/Traditional $2,245.62
Rate for Payer: Cash Price $1,439.50
Rate for Payer: Cigna Commercial $2,389.57
Rate for Payer: First Health Commercial $2,735.05
Rate for Payer: Humana Commercial $2,447.15
Rate for Payer: Medical Mutual Of Ohio HMO $2,360.78
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,124.70
Rate for Payer: Molina Healthcare Benefit Exchange $863.70
Rate for Payer: Ohio Health Choice Commercial $2,533.52
Rate for Payer: Ohio Health Group HMO $2,159.25
Rate for Payer: Ohio Health Group PPO Differential $575.80
Rate for Payer: Ohio Health Group PPO No Differential $374.27
Rate for Payer: Ohio Health Group PPO SOMC Employees $892.49
Rate for Payer: PHCS Commercial $2,763.84
Rate for Payer: United Healthcare All Payer $2,533.52
Service Code HCPCS 36013
Hospital Charge Code 76101434
Hospital Revenue Code 761
Min. Negotiated Rate $94.53
Max. Negotiated Rate $2,879.00
Rate for Payer: Aetna Commercial $227.23
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $94.53
Rate for Payer: Anthem Medicaid $138.07
Rate for Payer: Buckeye Medicare Advantage $2,879.00
Rate for Payer: Cash Price $1,439.50
Rate for Payer: Cash Price $1,439.50
Rate for Payer: Cigna Commercial $206.62
Rate for Payer: Healthspan PPO $1,241.37
Rate for Payer: Humana Medicaid $138.07
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $171.46
Rate for Payer: Molina Healthcare CHIP/Medicaid $140.83
Rate for Payer: Molina Healthcare Passport $138.07
Rate for Payer: Multiplan PHCS $1,727.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,015.30
Rate for Payer: UHCCP Medicaid $99.26
Rate for Payer: Wellcare CHIP/Medicaid $139.45
Service Code HCPCS 36013
Hospital Charge Code 761P1434
Hospital Revenue Code 761
Min. Negotiated Rate $94.53
Max. Negotiated Rate $1,246.00
Rate for Payer: Aetna Commercial $227.23
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $94.53
Rate for Payer: Anthem Medicaid $138.07
Rate for Payer: Buckeye Medicare Advantage $1,246.00
Rate for Payer: Cash Price $623.00
Rate for Payer: Cash Price $623.00
Rate for Payer: Cigna Commercial $206.62
Rate for Payer: Healthspan PPO $1,241.37
Rate for Payer: Humana Medicaid $138.07
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $171.46
Rate for Payer: Molina Healthcare CHIP/Medicaid $140.83
Rate for Payer: Molina Healthcare Passport $138.07
Rate for Payer: Multiplan PHCS $747.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $872.20
Rate for Payer: UHCCP Medicaid $99.26
Rate for Payer: Wellcare CHIP/Medicaid $139.45
Service Code HCPCS 36013
Hospital Charge Code 761T1434
Hospital Revenue Code 761
Min. Negotiated Rate $212.29
Max. Negotiated Rate $1,567.68
Rate for Payer: Aetna Commercial $1,257.41
Rate for Payer: Anthem Medicaid $561.59
Rate for Payer: Anthem POS/PPO/Traditional $1,273.74
Rate for Payer: Cash Price $816.50
Rate for Payer: Cigna Commercial $1,355.39
Rate for Payer: First Health Commercial $1,551.35
Rate for Payer: Humana Commercial $1,388.05
Rate for Payer: Humana KY Medicaid $561.59
Rate for Payer: Kentucky WC Medicaid $567.30
Rate for Payer: Medical Mutual Of Ohio HMO $1,339.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,205.15
Rate for Payer: Molina Healthcare Benefit Exchange $489.90
Rate for Payer: Molina Healthcare Medicaid $572.86
Rate for Payer: Ohio Health Choice Commercial $1,437.04
Rate for Payer: Ohio Health Group HMO $1,224.75
Rate for Payer: Ohio Health Group PPO Differential $326.60
Rate for Payer: Ohio Health Group PPO No Differential $212.29
Rate for Payer: Ohio Health Group PPO SOMC Employees $506.23
Rate for Payer: PHCS Commercial $1,567.68
Rate for Payer: United Healthcare All Payer $1,437.04
Service Code HCPCS 36013
Hospital Charge Code 761T1434
Hospital Revenue Code 761
Min. Negotiated Rate $212.29
Max. Negotiated Rate $1,567.68
Rate for Payer: Aetna Commercial $1,257.41
Rate for Payer: Anthem POS/PPO/Traditional $1,273.74
Rate for Payer: Cash Price $816.50
Rate for Payer: Cigna Commercial $1,355.39
Rate for Payer: First Health Commercial $1,551.35
Rate for Payer: Humana Commercial $1,388.05
Rate for Payer: Medical Mutual Of Ohio HMO $1,339.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,205.15
Rate for Payer: Molina Healthcare Benefit Exchange $489.90
Rate for Payer: Ohio Health Choice Commercial $1,437.04
Rate for Payer: Ohio Health Group HMO $1,224.75
Rate for Payer: Ohio Health Group PPO Differential $326.60
Rate for Payer: Ohio Health Group PPO No Differential $212.29
Rate for Payer: Ohio Health Group PPO SOMC Employees $506.23
Rate for Payer: PHCS Commercial $1,567.68
Rate for Payer: United Healthcare All Payer $1,437.04
Service Code HCPCS C1887
Hospital Charge Code 27000243
Hospital Revenue Code 272
Min. Negotiated Rate $248.76
Max. Negotiated Rate $1,836.96
Rate for Payer: Aetna Commercial $1,473.40
Rate for Payer: Anthem POS/PPO/Traditional $1,492.53
Rate for Payer: Cash Price $956.75
Rate for Payer: Cigna Commercial $1,588.20
Rate for Payer: First Health Commercial $1,817.82
Rate for Payer: Humana Commercial $1,626.48
Rate for Payer: Medical Mutual Of Ohio HMO $1,569.07
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,412.16
Rate for Payer: Molina Healthcare Benefit Exchange $574.05
Rate for Payer: Ohio Health Choice Commercial $1,683.88
Rate for Payer: Ohio Health Group HMO $1,435.12
Rate for Payer: Ohio Health Group PPO Differential $382.70
Rate for Payer: Ohio Health Group PPO No Differential $248.76
Rate for Payer: Ohio Health Group PPO SOMC Employees $593.18
Rate for Payer: PHCS Commercial $1,836.96
Rate for Payer: United Healthcare All Payer $1,683.88
Service Code HCPCS C1887
Hospital Charge Code 27000243
Hospital Revenue Code 272
Min. Negotiated Rate $248.76
Max. Negotiated Rate $1,836.96
Rate for Payer: Aetna Commercial $1,473.40
Rate for Payer: Anthem Medicaid $658.05
Rate for Payer: Anthem POS/PPO/Traditional $1,492.53
Rate for Payer: Cash Price $956.75
Rate for Payer: Cigna Commercial $1,588.20
Rate for Payer: First Health Commercial $1,817.82
Rate for Payer: Humana Commercial $1,626.48
Rate for Payer: Humana KY Medicaid $658.05
Rate for Payer: Kentucky WC Medicaid $664.75
Rate for Payer: Medical Mutual Of Ohio HMO $1,569.07
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,412.16
Rate for Payer: Molina Healthcare Benefit Exchange $574.05
Rate for Payer: Molina Healthcare Medicaid $671.26
Rate for Payer: Ohio Health Choice Commercial $1,683.88
Rate for Payer: Ohio Health Group HMO $1,435.12
Rate for Payer: Ohio Health Group PPO Differential $382.70
Rate for Payer: Ohio Health Group PPO No Differential $248.76
Rate for Payer: Ohio Health Group PPO SOMC Employees $593.18
Rate for Payer: PHCS Commercial $1,836.96
Rate for Payer: United Healthcare All Payer $1,683.88
Service Code HCPCS C1887
Hospital Charge Code 27000243
Hospital Revenue Code 272
Min. Negotiated Rate $255.12
Max. Negotiated Rate $1,884.00
Rate for Payer: Aetna Commercial $1,511.12
Rate for Payer: Anthem POS/PPO/Traditional $1,530.75
Rate for Payer: Cash Price $981.25
Rate for Payer: Cigna Commercial $1,628.88
Rate for Payer: First Health Commercial $1,864.38
Rate for Payer: Humana Commercial $1,668.12
Rate for Payer: Medical Mutual Of Ohio HMO $1,609.25
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,448.32
Rate for Payer: Molina Healthcare Benefit Exchange $588.75
Rate for Payer: Ohio Health Choice Commercial $1,727.00
Rate for Payer: Ohio Health Group HMO $1,471.88
Rate for Payer: Ohio Health Group PPO Differential $392.50
Rate for Payer: Ohio Health Group PPO No Differential $255.12
Rate for Payer: Ohio Health Group PPO SOMC Employees $608.38
Rate for Payer: PHCS Commercial $1,884.00
Rate for Payer: United Healthcare All Payer $1,727.00
Service Code HCPCS C1887
Hospital Charge Code 27000243
Hospital Revenue Code 272
Min. Negotiated Rate $255.12
Max. Negotiated Rate $1,884.00
Rate for Payer: Aetna Commercial $1,511.12
Rate for Payer: Anthem Medicaid $674.90
Rate for Payer: Anthem POS/PPO/Traditional $1,530.75
Rate for Payer: Cash Price $981.25
Rate for Payer: Cigna Commercial $1,628.88
Rate for Payer: First Health Commercial $1,864.38
Rate for Payer: Humana Commercial $1,668.12
Rate for Payer: Humana KY Medicaid $674.90
Rate for Payer: Kentucky WC Medicaid $681.77
Rate for Payer: Medical Mutual Of Ohio HMO $1,609.25
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,448.32
Rate for Payer: Molina Healthcare Benefit Exchange $588.75
Rate for Payer: Molina Healthcare Medicaid $688.44
Rate for Payer: Ohio Health Choice Commercial $1,727.00
Rate for Payer: Ohio Health Group HMO $1,471.88
Rate for Payer: Ohio Health Group PPO Differential $392.50
Rate for Payer: Ohio Health Group PPO No Differential $255.12
Rate for Payer: Ohio Health Group PPO SOMC Employees $608.38
Rate for Payer: PHCS Commercial $1,884.00
Rate for Payer: United Healthcare All Payer $1,727.00
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $3,031.61
Max. Negotiated Rate $22,387.30
Rate for Payer: Aetna Commercial $17,956.48
Rate for Payer: Anthem Medicaid $8,019.78
Rate for Payer: Anthem POS/PPO/Traditional $18,189.68
Rate for Payer: Cash Price $11,660.05
Rate for Payer: Cigna Commercial $19,355.68
Rate for Payer: First Health Commercial $22,154.10
Rate for Payer: Humana Commercial $19,822.08
Rate for Payer: Humana KY Medicaid $8,019.78
Rate for Payer: Kentucky WC Medicaid $8,101.40
Rate for Payer: Medical Mutual Of Ohio HMO $19,122.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $17,210.23
Rate for Payer: Molina Healthcare Benefit Exchange $6,996.03
Rate for Payer: Molina Healthcare Medicaid $8,180.69
Rate for Payer: Ohio Health Choice Commercial $20,521.69
Rate for Payer: Ohio Health Group HMO $17,490.08
Rate for Payer: Ohio Health Group PPO Differential $4,664.02
Rate for Payer: Ohio Health Group PPO No Differential $3,031.61
Rate for Payer: Ohio Health Group PPO SOMC Employees $7,229.23
Rate for Payer: PHCS Commercial $22,387.30
Rate for Payer: United Healthcare All Payer $20,521.69