|
SIGMA HP UNI A/P 8MM RMLL SZ 5
|
Facility
|
OP
|
$13,465.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,750.48 |
| Max. Negotiated Rate |
$12,926.64 |
| Rate for Payer: Aetna Commercial |
$10,368.24
|
| Rate for Payer: Anthem Medicaid |
$4,630.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,502.90
|
| Rate for Payer: Cash Price |
$6,732.62
|
| Rate for Payer: Cigna Commercial |
$11,176.16
|
| Rate for Payer: First Health Commercial |
$12,791.99
|
| Rate for Payer: Humana Commercial |
$11,445.46
|
| Rate for Payer: Humana KY Medicaid |
$4,630.70
|
| Rate for Payer: Kentucky WC Medicaid |
$4,677.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,041.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,937.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,039.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,723.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,849.42
|
| Rate for Payer: Ohio Health Group HMO |
$10,098.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,693.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,750.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,174.23
|
| Rate for Payer: PHCS Commercial |
$12,926.64
|
| Rate for Payer: United Healthcare All Payer |
$11,849.42
|
|
|
SIGMA HP UNI A/P 8MM RMLL SZ 6
|
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 8MM RMLL SZ 6
|
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 9MM LMRL SZ 1
|
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 9MM LMRL SZ 1
|
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 9MM LMRL SZ 2
|
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 9MM LMRL SZ 2
|
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 9MM LMRL SZ 3
|
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 9MM LMRL SZ 3
|
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 9MM LMRL SZ 4
|
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 9MM LMRL SZ 4
|
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 9MM LMRL SZ 6
|
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 9MM LMRL SZ 6
|
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 9MM RMLL SZ 1
|
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 9MM RMLL SZ 1
|
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 9MM RMLL SZ 2
|
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 9MM RMLL SZ 2
|
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 9MM RMLL SZ 3
|
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 9MM RMLL SZ 3
|
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 9MM RMLL SZ 4
|
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 9MM RMLL SZ 4
|
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 9MM RMLL SZ 5
|
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 9MM RMLL SZ 5
|
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 9MM RMLL SZ 6
|
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 9MM RMLL SZ 6
|
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
|
|
