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Service Code HCPCS C1880
Hospital Charge Code 27000050
Hospital Revenue Code 278
Min. Negotiated Rate $957.12
Max. Negotiated Rate $7,068.00
Rate for Payer: Aetna Commercial $5,669.12
Rate for Payer: Anthem Medicaid $2,531.96
Rate for Payer: Anthem POS/PPO/Traditional $5,742.75
Rate for Payer: Cash Price $3,681.25
Rate for Payer: Cigna Commercial $6,110.88
Rate for Payer: First Health Commercial $6,994.38
Rate for Payer: Humana Commercial $6,258.12
Rate for Payer: Humana KY Medicaid $2,531.96
Rate for Payer: Kentucky WC Medicaid $2,557.73
Rate for Payer: Medical Mutual Of Ohio HMO $6,037.25
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $5,433.52
Rate for Payer: Molina Healthcare Benefit Exchange $2,208.75
Rate for Payer: Molina Healthcare Medicaid $2,582.76
Rate for Payer: Ohio Health Choice Commercial $6,479.00
Rate for Payer: Ohio Health Group HMO $5,521.88
Rate for Payer: Ohio Health Group PPO Differential $1,472.50
Rate for Payer: Ohio Health Group PPO No Differential $957.12
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,282.38
Rate for Payer: PHCS Commercial $7,068.00
Rate for Payer: United Healthcare All Payer $6,479.00
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,286.90
Max. Negotiated Rate $9,503.28
Rate for Payer: Aetna Commercial $7,622.42
Rate for Payer: Anthem Medicaid $3,404.35
Rate for Payer: Anthem POS/PPO/Traditional $7,721.42
Rate for Payer: Cash Price $4,949.62
Rate for Payer: Cigna Commercial $8,216.38
Rate for Payer: First Health Commercial $9,404.29
Rate for Payer: Humana Commercial $8,414.36
Rate for Payer: Humana KY Medicaid $3,404.35
Rate for Payer: Kentucky WC Medicaid $3,439.00
Rate for Payer: Medical Mutual Of Ohio HMO $8,117.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7,305.65
Rate for Payer: Molina Healthcare Benefit Exchange $2,969.78
Rate for Payer: Molina Healthcare Medicaid $3,472.66
Rate for Payer: Ohio Health Choice Commercial $8,711.34
Rate for Payer: Ohio Health Group HMO $7,424.44
Rate for Payer: Ohio Health Group PPO Differential $1,979.85
Rate for Payer: Ohio Health Group PPO No Differential $1,286.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $3,068.77
Rate for Payer: PHCS Commercial $9,503.28
Rate for Payer: United Healthcare All Payer $8,711.34
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,286.90
Max. Negotiated Rate $9,503.28
Rate for Payer: Aetna Commercial $7,622.42
Rate for Payer: Anthem POS/PPO/Traditional $7,721.42
Rate for Payer: Cash Price $4,949.62
Rate for Payer: Cigna Commercial $8,216.38
Rate for Payer: First Health Commercial $9,404.29
Rate for Payer: Humana Commercial $8,414.36
Rate for Payer: Medical Mutual Of Ohio HMO $8,117.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7,305.65
Rate for Payer: Molina Healthcare Benefit Exchange $2,969.78
Rate for Payer: Ohio Health Choice Commercial $8,711.34
Rate for Payer: Ohio Health Group HMO $7,424.44
Rate for Payer: Ohio Health Group PPO Differential $1,979.85
Rate for Payer: Ohio Health Group PPO No Differential $1,286.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $3,068.77
Rate for Payer: PHCS Commercial $9,503.28
Rate for Payer: United Healthcare All Payer $8,711.34
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $611.32
Max. Negotiated Rate $4,514.40
Rate for Payer: Aetna Commercial $3,620.92
Rate for Payer: Anthem POS/PPO/Traditional $3,667.95
Rate for Payer: Cash Price $2,351.25
Rate for Payer: Cigna Commercial $3,903.08
Rate for Payer: First Health Commercial $4,467.38
Rate for Payer: Humana Commercial $3,997.12
Rate for Payer: Medical Mutual Of Ohio HMO $3,856.05
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,470.44
Rate for Payer: Molina Healthcare Benefit Exchange $1,410.75
Rate for Payer: Ohio Health Choice Commercial $4,138.20
Rate for Payer: Ohio Health Group HMO $3,526.88
Rate for Payer: Ohio Health Group PPO Differential $940.50
Rate for Payer: Ohio Health Group PPO No Differential $611.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,457.78
Rate for Payer: PHCS Commercial $4,514.40
Rate for Payer: United Healthcare All Payer $4,138.20
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $611.32
Max. Negotiated Rate $4,514.40
Rate for Payer: Aetna Commercial $3,620.92
Rate for Payer: Anthem Medicaid $1,617.19
Rate for Payer: Anthem POS/PPO/Traditional $3,667.95
Rate for Payer: Cash Price $2,351.25
Rate for Payer: Cigna Commercial $3,903.08
Rate for Payer: First Health Commercial $4,467.38
Rate for Payer: Humana Commercial $3,997.12
Rate for Payer: Humana KY Medicaid $1,617.19
Rate for Payer: Kentucky WC Medicaid $1,633.65
Rate for Payer: Medical Mutual Of Ohio HMO $3,856.05
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,470.44
Rate for Payer: Molina Healthcare Benefit Exchange $1,410.75
Rate for Payer: Molina Healthcare Medicaid $1,649.64
Rate for Payer: Ohio Health Choice Commercial $4,138.20
Rate for Payer: Ohio Health Group HMO $3,526.88
Rate for Payer: Ohio Health Group PPO Differential $940.50
Rate for Payer: Ohio Health Group PPO No Differential $611.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,457.78
Rate for Payer: PHCS Commercial $4,514.40
Rate for Payer: United Healthcare All Payer $4,138.20
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $686.40
Max. Negotiated Rate $5,068.80
Rate for Payer: Aetna Commercial $4,065.60
Rate for Payer: Anthem POS/PPO/Traditional $4,118.40
Rate for Payer: Cash Price $2,640.00
Rate for Payer: Cigna Commercial $4,382.40
Rate for Payer: First Health Commercial $5,016.00
Rate for Payer: Humana Commercial $4,488.00
Rate for Payer: Medical Mutual Of Ohio HMO $4,329.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,896.64
Rate for Payer: Molina Healthcare Benefit Exchange $1,584.00
Rate for Payer: Ohio Health Choice Commercial $4,646.40
Rate for Payer: Ohio Health Group HMO $3,960.00
Rate for Payer: Ohio Health Group PPO Differential $1,056.00
Rate for Payer: Ohio Health Group PPO No Differential $686.40
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,636.80
Rate for Payer: PHCS Commercial $5,068.80
Rate for Payer: United Healthcare All Payer $4,646.40
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $686.40
Max. Negotiated Rate $5,068.80
Rate for Payer: Aetna Commercial $4,065.60
Rate for Payer: Anthem Medicaid $1,815.79
Rate for Payer: Anthem POS/PPO/Traditional $4,118.40
Rate for Payer: Cash Price $2,640.00
Rate for Payer: Cigna Commercial $4,382.40
Rate for Payer: First Health Commercial $5,016.00
Rate for Payer: Humana Commercial $4,488.00
Rate for Payer: Humana KY Medicaid $1,815.79
Rate for Payer: Kentucky WC Medicaid $1,834.27
Rate for Payer: Medical Mutual Of Ohio HMO $4,329.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,896.64
Rate for Payer: Molina Healthcare Benefit Exchange $1,584.00
Rate for Payer: Molina Healthcare Medicaid $1,852.22
Rate for Payer: Ohio Health Choice Commercial $4,646.40
Rate for Payer: Ohio Health Group HMO $3,960.00
Rate for Payer: Ohio Health Group PPO Differential $1,056.00
Rate for Payer: Ohio Health Group PPO No Differential $686.40
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,636.80
Rate for Payer: PHCS Commercial $5,068.80
Rate for Payer: United Healthcare All Payer $4,646.40
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $611.32
Max. Negotiated Rate $4,514.40
Rate for Payer: Aetna Commercial $3,620.92
Rate for Payer: Anthem Medicaid $1,617.19
Rate for Payer: Anthem POS/PPO/Traditional $3,667.95
Rate for Payer: Cash Price $2,351.25
Rate for Payer: Cigna Commercial $3,903.08
Rate for Payer: First Health Commercial $4,467.38
Rate for Payer: Humana Commercial $3,997.12
Rate for Payer: Humana KY Medicaid $1,617.19
Rate for Payer: Kentucky WC Medicaid $1,633.65
Rate for Payer: Medical Mutual Of Ohio HMO $3,856.05
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,470.44
Rate for Payer: Molina Healthcare Benefit Exchange $1,410.75
Rate for Payer: Molina Healthcare Medicaid $1,649.64
Rate for Payer: Ohio Health Choice Commercial $4,138.20
Rate for Payer: Ohio Health Group HMO $3,526.88
Rate for Payer: Ohio Health Group PPO Differential $940.50
Rate for Payer: Ohio Health Group PPO No Differential $611.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,457.78
Rate for Payer: PHCS Commercial $4,514.40
Rate for Payer: United Healthcare All Payer $4,138.20
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $611.32
Max. Negotiated Rate $4,514.40
Rate for Payer: Aetna Commercial $3,620.92
Rate for Payer: Anthem POS/PPO/Traditional $3,667.95
Rate for Payer: Cash Price $2,351.25
Rate for Payer: Cigna Commercial $3,903.08
Rate for Payer: First Health Commercial $4,467.38
Rate for Payer: Humana Commercial $3,997.12
Rate for Payer: Medical Mutual Of Ohio HMO $3,856.05
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,470.44
Rate for Payer: Molina Healthcare Benefit Exchange $1,410.75
Rate for Payer: Ohio Health Choice Commercial $4,138.20
Rate for Payer: Ohio Health Group HMO $3,526.88
Rate for Payer: Ohio Health Group PPO Differential $940.50
Rate for Payer: Ohio Health Group PPO No Differential $611.32
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,457.78
Rate for Payer: PHCS Commercial $4,514.40
Rate for Payer: United Healthcare All Payer $4,138.20
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem Medicaid $3,071.71
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Humana KY Medicaid $3,071.71
Rate for Payer: Kentucky WC Medicaid $3,102.98
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Molina Healthcare Medicaid $3,133.35
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem Medicaid $3,071.71
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Humana KY Medicaid $3,071.71
Rate for Payer: Kentucky WC Medicaid $3,102.98
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Molina Healthcare Medicaid $3,133.35
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1757
Hospital Charge Code 27000008
Hospital Revenue Code 272
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem Medicaid $3,071.71
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Humana KY Medicaid $3,071.71
Rate for Payer: Kentucky WC Medicaid $3,102.98
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Molina Healthcare Medicaid $3,133.35
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code MSDRG 549
Min. Negotiated Rate $9,574.89
Max. Negotiated Rate $14,110.36
Rate for Payer: Anthem Medicaid $9,574.89
Rate for Payer: Anthem Medicare Advantage/PPO $10,078.83
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $14,110.36
Rate for Payer: CareSource Just4Me Medicare $13,606.42
Rate for Payer: Humana KY Medicaid $9,574.89
Rate for Payer: Humana Medicare Advantage $10,078.83
Rate for Payer: Kentucky WC Medicaid $9,670.64
Rate for Payer: Molina Healthcare Benefit Exchange $12,094.60
Rate for Payer: Molina Healthcare Medicaid $9,766.39
Service Code MSDRG 548
Min. Negotiated Rate $15,477.64
Max. Negotiated Rate $22,809.15
Rate for Payer: Anthem Medicaid $15,477.64
Rate for Payer: Anthem Medicare Advantage/PPO $16,292.25
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $22,809.15
Rate for Payer: CareSource Just4Me Medicare $21,994.54
Rate for Payer: Humana KY Medicaid $15,477.64
Rate for Payer: Humana Medicare Advantage $16,292.25
Rate for Payer: Kentucky WC Medicaid $15,632.41
Rate for Payer: Molina Healthcare Benefit Exchange $19,550.70
Rate for Payer: Molina Healthcare Medicaid $15,787.19
Service Code MSDRG 550
Min. Negotiated Rate $7,489.56
Max. Negotiated Rate $11,037.25
Rate for Payer: Anthem Medicaid $7,489.56
Rate for Payer: Anthem Medicare Advantage/PPO $7,883.75
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $11,037.25
Rate for Payer: CareSource Just4Me Medicare $10,643.06
Rate for Payer: Humana KY Medicaid $7,489.56
Rate for Payer: Humana Medicare Advantage $7,883.75
Rate for Payer: Kentucky WC Medicaid $7,564.46
Rate for Payer: Molina Healthcare Benefit Exchange $9,460.50
Rate for Payer: Molina Healthcare Medicaid $7,639.35
Service Code MSDRG 870
Min. Negotiated Rate $55,287.84
Max. Negotiated Rate $81,476.82
Rate for Payer: Anthem Medicaid $55,287.84
Rate for Payer: Anthem Medicare Advantage/PPO $58,197.73
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $81,476.82
Rate for Payer: CareSource Just4Me Medicare $78,566.94
Rate for Payer: Humana KY Medicaid $55,287.84
Rate for Payer: Humana Medicare Advantage $58,197.73
Rate for Payer: Kentucky WC Medicaid $55,840.72
Rate for Payer: Molina Healthcare Benefit Exchange $69,837.28
Rate for Payer: Molina Healthcare Medicaid $56,393.60
Service Code MSDRG 871
Min. Negotiated Rate $15,738.02
Max. Negotiated Rate $23,192.88
Rate for Payer: Anthem Medicaid $15,738.02
Rate for Payer: Anthem Medicare Advantage/PPO $16,566.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $23,192.88
Rate for Payer: CareSource Just4Me Medicare $22,364.56
Rate for Payer: Humana KY Medicaid $15,738.02
Rate for Payer: Humana Medicare Advantage $16,566.34
Rate for Payer: Kentucky WC Medicaid $15,895.40
Rate for Payer: Molina Healthcare Benefit Exchange $19,879.61
Rate for Payer: Molina Healthcare Medicaid $16,052.78
Service Code MSDRG 872
Min. Negotiated Rate $8,175.42
Max. Negotiated Rate $12,047.98
Rate for Payer: Anthem Medicaid $8,175.42
Rate for Payer: Anthem Medicare Advantage/PPO $8,605.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $12,047.98
Rate for Payer: CareSource Just4Me Medicare $11,617.70
Rate for Payer: Humana KY Medicaid $8,175.42
Rate for Payer: Humana Medicare Advantage $8,605.70
Rate for Payer: Kentucky WC Medicaid $8,257.17
Rate for Payer: Molina Healthcare Benefit Exchange $10,326.84
Rate for Payer: Molina Healthcare Medicaid $8,338.92
Service Code HCPCS 30520
Hospital Charge Code 76101132
Hospital Revenue Code 761
Min. Negotiated Rate $234.00
Max. Negotiated Rate $1,728.00
Rate for Payer: Aetna Commercial $1,386.00
Rate for Payer: Anthem POS/PPO/Traditional $1,404.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $1,494.00
Rate for Payer: First Health Commercial $1,710.00
Rate for Payer: Humana Commercial $1,530.00
Rate for Payer: Medical Mutual Of Ohio HMO $1,476.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,328.40
Rate for Payer: Molina Healthcare Benefit Exchange $540.00
Rate for Payer: Ohio Health Choice Commercial $1,584.00
Rate for Payer: Ohio Health Group HMO $1,350.00
Rate for Payer: Ohio Health Group PPO Differential $360.00
Rate for Payer: Ohio Health Group PPO No Differential $234.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $558.00
Rate for Payer: PHCS Commercial $1,728.00
Rate for Payer: United Healthcare All Payer $1,584.00
Service Code HCPCS 30520
Hospital Charge Code 76101132
Hospital Revenue Code 761
Min. Negotiated Rate $234.00
Max. Negotiated Rate $3,897.84
Rate for Payer: Aetna Commercial $1,386.00
Rate for Payer: Anthem Medicaid $619.02
Rate for Payer: Anthem Medicare Advantage/PPO $2,784.17
Rate for Payer: Anthem POS/PPO/Traditional $1,404.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3,897.84
Rate for Payer: CareSource Just4Me Medicare $3,758.63
Rate for Payer: Cash Price $900.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $1,494.00
Rate for Payer: First Health Commercial $1,710.00
Rate for Payer: Humana Commercial $1,530.00
Rate for Payer: Humana KY Medicaid $619.02
Rate for Payer: Humana Medicare Advantage $2,784.17
Rate for Payer: Kentucky WC Medicaid $625.32
Rate for Payer: Medical Mutual Of Ohio HMO $1,476.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,328.40
Rate for Payer: Molina Healthcare Benefit Exchange $3,341.00
Rate for Payer: Molina Healthcare Medicaid $631.44
Rate for Payer: Ohio Health Choice Commercial $1,584.00
Rate for Payer: Ohio Health Group HMO $1,350.00
Rate for Payer: Ohio Health Group PPO Differential $360.00
Rate for Payer: Ohio Health Group PPO No Differential $234.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $558.00
Rate for Payer: PHCS Commercial $1,728.00
Rate for Payer: United Healthcare All Payer $1,584.00
Service Code HCPCS 30520
Hospital Charge Code 76101132
Hospital Revenue Code 761
Min. Negotiated Rate $376.62
Max. Negotiated Rate $1,800.00
Rate for Payer: Aetna Commercial $841.39
Rate for Payer: Anthem Medicaid $376.62
Rate for Payer: Buckeye Medicare Advantage $1,800.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cash Price $900.00
Rate for Payer: Cigna Commercial $787.50
Rate for Payer: Healthspan PPO $709.56
Rate for Payer: Humana Medicaid $376.62
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $777.45
Rate for Payer: Molina Healthcare CHIP/Medicaid $384.15
Rate for Payer: Molina Healthcare Passport $376.62
Rate for Payer: Multiplan PHCS $1,080.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,260.00
Rate for Payer: UHCCP Medicaid $630.00
Rate for Payer: Wellcare CHIP/Medicaid $380.39
Service Code CPT 30520
Hospital Revenue Code 360
Min. Negotiated Rate $2,784.17
Max. Negotiated Rate $3,897.84
Rate for Payer: Anthem Medicare Advantage/PPO $2,784.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3,897.84
Rate for Payer: CareSource Just4Me Medicare $3,758.63
Rate for Payer: Humana Medicare Advantage $2,784.17
Rate for Payer: Molina Healthcare Benefit Exchange $3,341.00