|
SIGMA HP UNI A/P 10MM RMLL SZ2
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ3
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ3
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ4
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ4
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ5
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ5
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ6
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ6
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ1
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ1
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ2
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ2
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ3
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ3
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ4
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ4
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ6
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ6
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ1
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ1
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ2
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ2
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ3
|
Facility
|
IP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ3
|
Facility
|
OP
|
$11,811.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,535.53 |
| Max. Negotiated Rate |
$11,339.33 |
| Rate for Payer: Aetna Commercial |
$9,095.09
|
| Rate for Payer: Anthem Medicaid |
$4,062.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,213.20
|
| Rate for Payer: Cash Price |
$5,905.90
|
| Rate for Payer: Cigna Commercial |
$9,803.79
|
| Rate for Payer: First Health Commercial |
$11,221.21
|
| Rate for Payer: Humana Commercial |
$10,040.03
|
| Rate for Payer: Humana KY Medicaid |
$4,062.08
|
| Rate for Payer: Kentucky WC Medicaid |
$4,103.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,685.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,717.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,543.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,143.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,394.38
|
| Rate for Payer: Ohio Health Group HMO |
$8,858.85
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,362.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,535.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,661.66
|
| Rate for Payer: PHCS Commercial |
$11,339.33
|
| Rate for Payer: United Healthcare All Payer |
$10,394.38
|
|
