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Service Code HCPCS 26110
Hospital Charge Code 76100665
Hospital Revenue Code 761
Min. Negotiated Rate $182.00
Max. Negotiated Rate $520.00
Rate for Payer: Aetna Commercial $444.52
Rate for Payer: Anthem Medicaid $190.51
Rate for Payer: Buckeye Medicare Advantage $520.00
Rate for Payer: Cash Price $260.00
Rate for Payer: Cash Price $260.00
Rate for Payer: Cigna Commercial $493.79
Rate for Payer: Healthspan PPO $402.64
Rate for Payer: Humana Medicaid $190.51
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $387.38
Rate for Payer: Molina Healthcare CHIP/Medicaid $194.32
Rate for Payer: Molina Healthcare Passport $190.51
Rate for Payer: Multiplan PHCS $312.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $364.00
Rate for Payer: UHCCP Medicaid $182.00
Rate for Payer: Wellcare CHIP/Medicaid $192.42
Service Code HCPCS 26110
Hospital Charge Code 76100665
Hospital Revenue Code 761
Min. Negotiated Rate $67.60
Max. Negotiated Rate $1,945.78
Rate for Payer: Aetna Commercial $400.40
Rate for Payer: Anthem Medicaid $178.83
Rate for Payer: Anthem Medicare Advantage/PPO $1,389.84
Rate for Payer: Anthem POS/PPO/Traditional $405.60
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,945.78
Rate for Payer: CareSource Just4Me Medicare $1,876.28
Rate for Payer: Cash Price $260.00
Rate for Payer: Cash Price $260.00
Rate for Payer: Cigna Commercial $431.60
Rate for Payer: First Health Commercial $494.00
Rate for Payer: Humana Commercial $442.00
Rate for Payer: Humana KY Medicaid $178.83
Rate for Payer: Humana Medicare Advantage $1,389.84
Rate for Payer: Kentucky WC Medicaid $180.65
Rate for Payer: Medical Mutual Of Ohio HMO $426.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $383.76
Rate for Payer: Molina Healthcare Benefit Exchange $1,667.81
Rate for Payer: Molina Healthcare Medicaid $182.42
Rate for Payer: Ohio Health Choice Commercial $457.60
Rate for Payer: Ohio Health Group HMO $390.00
Rate for Payer: Ohio Health Group PPO Differential $104.00
Rate for Payer: Ohio Health Group PPO No Differential $67.60
Rate for Payer: Ohio Health Group PPO SOMC Employees $161.20
Rate for Payer: PHCS Commercial $499.20
Rate for Payer: United Healthcare All Payer $457.60
Service Code HCPCS 26105
Hospital Charge Code 761P0664
Hospital Revenue Code 761
Min. Negotiated Rate $233.18
Max. Negotiated Rate $1,060.00
Rate for Payer: Aetna Commercial $464.54
Rate for Payer: Anthem Medicaid $233.18
Rate for Payer: Buckeye Medicare Advantage $1,060.00
Rate for Payer: Cash Price $530.00
Rate for Payer: Cash Price $530.00
Rate for Payer: Cigna Commercial $518.91
Rate for Payer: Healthspan PPO $420.78
Rate for Payer: Humana Medicaid $233.18
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $405.64
Rate for Payer: Molina Healthcare CHIP/Medicaid $237.84
Rate for Payer: Molina Healthcare Passport $233.18
Rate for Payer: Multiplan PHCS $636.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $742.00
Rate for Payer: UHCCP Medicaid $371.00
Rate for Payer: Wellcare CHIP/Medicaid $235.51
Service Code HCPCS 26110
Hospital Charge Code 761P0665
Hospital Revenue Code 761
Min. Negotiated Rate $182.00
Max. Negotiated Rate $520.00
Rate for Payer: Aetna Commercial $444.52
Rate for Payer: Anthem Medicaid $190.51
Rate for Payer: Buckeye Medicare Advantage $520.00
Rate for Payer: Cash Price $260.00
Rate for Payer: Cash Price $260.00
Rate for Payer: Cigna Commercial $493.79
Rate for Payer: Healthspan PPO $402.64
Rate for Payer: Humana Medicaid $190.51
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $387.38
Rate for Payer: Molina Healthcare CHIP/Medicaid $194.32
Rate for Payer: Molina Healthcare Passport $190.51
Rate for Payer: Multiplan PHCS $312.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $364.00
Rate for Payer: UHCCP Medicaid $182.00
Rate for Payer: Wellcare CHIP/Medicaid $192.42
Service Code HCPCS 41108
Hospital Charge Code 76101653
Hospital Revenue Code 761
Min. Negotiated Rate $304.75
Max. Negotiated Rate $2,250.45
Rate for Payer: Aetna Commercial $1,805.05
Rate for Payer: Anthem POS/PPO/Traditional $1,828.49
Rate for Payer: Cash Price $1,172.11
Rate for Payer: Cigna Commercial $1,945.70
Rate for Payer: First Health Commercial $2,227.01
Rate for Payer: Humana Commercial $1,992.59
Rate for Payer: Medical Mutual Of Ohio HMO $1,922.26
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,730.03
Rate for Payer: Molina Healthcare Benefit Exchange $703.27
Rate for Payer: Ohio Health Choice Commercial $2,062.91
Rate for Payer: Ohio Health Group HMO $1,758.16
Rate for Payer: Ohio Health Group PPO Differential $468.84
Rate for Payer: Ohio Health Group PPO No Differential $304.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $726.71
Rate for Payer: PHCS Commercial $2,250.45
Rate for Payer: United Healthcare All Payer $2,062.91
Service Code HCPCS 41108
Hospital Charge Code 76101653
Hospital Revenue Code 761
Min. Negotiated Rate $304.75
Max. Negotiated Rate $2,250.45
Rate for Payer: Aetna Commercial $1,805.05
Rate for Payer: Anthem Medicaid $806.18
Rate for Payer: Anthem Medicare Advantage/PPO $1,402.02
Rate for Payer: Anthem POS/PPO/Traditional $1,828.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,962.83
Rate for Payer: CareSource Just4Me Medicare $1,892.73
Rate for Payer: Cash Price $1,172.11
Rate for Payer: Cash Price $1,172.11
Rate for Payer: Cigna Commercial $1,945.70
Rate for Payer: First Health Commercial $2,227.01
Rate for Payer: Humana Commercial $1,992.59
Rate for Payer: Humana KY Medicaid $806.18
Rate for Payer: Humana Medicare Advantage $1,402.02
Rate for Payer: Kentucky WC Medicaid $814.38
Rate for Payer: Medical Mutual Of Ohio HMO $1,922.26
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,730.03
Rate for Payer: Molina Healthcare Benefit Exchange $1,682.42
Rate for Payer: Molina Healthcare Medicaid $822.35
Rate for Payer: Ohio Health Choice Commercial $2,062.91
Rate for Payer: Ohio Health Group HMO $1,758.16
Rate for Payer: Ohio Health Group PPO Differential $468.84
Rate for Payer: Ohio Health Group PPO No Differential $304.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $726.71
Rate for Payer: PHCS Commercial $2,250.45
Rate for Payer: United Healthcare All Payer $2,062.91
Service Code HCPCS 41108
Hospital Charge Code 76101653
Hospital Revenue Code 761
Min. Negotiated Rate $42.93
Max. Negotiated Rate $2,344.22
Rate for Payer: Aetna Commercial $127.76
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $59.83
Rate for Payer: Anthem Medicaid $42.93
Rate for Payer: Buckeye Medicare Advantage $2,344.22
Rate for Payer: Cash Price $1,172.11
Rate for Payer: Cash Price $1,172.11
Rate for Payer: Cigna Commercial $185.62
Rate for Payer: Healthspan PPO $165.97
Rate for Payer: Humana Medicaid $42.93
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $115.16
Rate for Payer: Molina Healthcare CHIP/Medicaid $43.79
Rate for Payer: Molina Healthcare Passport $42.93
Rate for Payer: Multiplan PHCS $1,406.53
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,640.95
Rate for Payer: UHCCP Medicaid $62.82
Rate for Payer: Wellcare CHIP/Medicaid $43.36
Service Code HCPCS 41108
Hospital Charge Code 761P1653
Hospital Revenue Code 761
Min. Negotiated Rate $42.93
Max. Negotiated Rate $200.00
Rate for Payer: Aetna Commercial $127.76
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $59.83
Rate for Payer: Anthem Medicaid $42.93
Rate for Payer: Buckeye Medicare Advantage $200.00
Rate for Payer: Cash Price $100.00
Rate for Payer: Cash Price $100.00
Rate for Payer: Cigna Commercial $185.62
Rate for Payer: Healthspan PPO $165.97
Rate for Payer: Humana Medicaid $42.93
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $115.16
Rate for Payer: Molina Healthcare CHIP/Medicaid $43.79
Rate for Payer: Molina Healthcare Passport $42.93
Rate for Payer: Multiplan PHCS $120.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $140.00
Rate for Payer: UHCCP Medicaid $62.82
Rate for Payer: Wellcare CHIP/Medicaid $43.36
Service Code HCPCS 41108
Hospital Charge Code 761T1653
Hospital Revenue Code 761
Min. Negotiated Rate $278.75
Max. Negotiated Rate $2,058.45
Rate for Payer: Aetna Commercial $1,651.05
Rate for Payer: Anthem Medicaid $737.40
Rate for Payer: Anthem Medicare Advantage/PPO $1,402.02
Rate for Payer: Anthem POS/PPO/Traditional $1,672.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,962.83
Rate for Payer: CareSource Just4Me Medicare $1,892.73
Rate for Payer: Cash Price $1,072.11
Rate for Payer: Cash Price $1,072.11
Rate for Payer: Cigna Commercial $1,779.70
Rate for Payer: First Health Commercial $2,037.01
Rate for Payer: Humana Commercial $1,822.59
Rate for Payer: Humana KY Medicaid $737.40
Rate for Payer: Humana Medicare Advantage $1,402.02
Rate for Payer: Kentucky WC Medicaid $744.90
Rate for Payer: Medical Mutual Of Ohio HMO $1,758.26
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,582.43
Rate for Payer: Molina Healthcare Benefit Exchange $1,682.42
Rate for Payer: Molina Healthcare Medicaid $752.19
Rate for Payer: Ohio Health Choice Commercial $1,886.91
Rate for Payer: Ohio Health Group HMO $1,608.16
Rate for Payer: Ohio Health Group PPO Differential $428.84
Rate for Payer: Ohio Health Group PPO No Differential $278.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $664.71
Rate for Payer: PHCS Commercial $2,058.45
Rate for Payer: United Healthcare All Payer $1,886.91
Service Code HCPCS 41108
Hospital Charge Code 761T1653
Hospital Revenue Code 761
Min. Negotiated Rate $278.75
Max. Negotiated Rate $2,058.45
Rate for Payer: Aetna Commercial $1,651.05
Rate for Payer: Anthem POS/PPO/Traditional $1,672.49
Rate for Payer: Cash Price $1,072.11
Rate for Payer: Cigna Commercial $1,779.70
Rate for Payer: First Health Commercial $2,037.01
Rate for Payer: Humana Commercial $1,822.59
Rate for Payer: Medical Mutual Of Ohio HMO $1,758.26
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,582.43
Rate for Payer: Molina Healthcare Benefit Exchange $643.27
Rate for Payer: Ohio Health Choice Commercial $1,886.91
Rate for Payer: Ohio Health Group HMO $1,608.16
Rate for Payer: Ohio Health Group PPO Differential $428.84
Rate for Payer: Ohio Health Group PPO No Differential $278.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $664.71
Rate for Payer: PHCS Commercial $2,058.45
Rate for Payer: United Healthcare All Payer $1,886.91
Service Code HCPCS 25066
Hospital Charge Code 76100572
Hospital Revenue Code 761
Min. Negotiated Rate $107.25
Max. Negotiated Rate $792.00
Rate for Payer: Aetna Commercial $635.25
Rate for Payer: Anthem POS/PPO/Traditional $643.50
Rate for Payer: Cash Price $412.50
Rate for Payer: Cigna Commercial $684.75
Rate for Payer: First Health Commercial $783.75
Rate for Payer: Humana Commercial $701.25
Rate for Payer: Medical Mutual Of Ohio HMO $676.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $608.85
Rate for Payer: Molina Healthcare Benefit Exchange $247.50
Rate for Payer: Ohio Health Choice Commercial $726.00
Rate for Payer: Ohio Health Group HMO $618.75
Rate for Payer: Ohio Health Group PPO Differential $165.00
Rate for Payer: Ohio Health Group PPO No Differential $107.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $255.75
Rate for Payer: PHCS Commercial $792.00
Rate for Payer: United Healthcare All Payer $726.00
Service Code HCPCS 25066
Hospital Charge Code 76100572
Hospital Revenue Code 761
Min. Negotiated Rate $160.21
Max. Negotiated Rate $825.00
Rate for Payer: Aetna Commercial $537.35
Rate for Payer: Anthem Medicaid $160.21
Rate for Payer: Buckeye Medicare Advantage $825.00
Rate for Payer: Cash Price $412.50
Rate for Payer: Cash Price $412.50
Rate for Payer: Cigna Commercial $707.10
Rate for Payer: Healthspan PPO $486.72
Rate for Payer: Humana Medicaid $160.21
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $450.53
Rate for Payer: Molina Healthcare CHIP/Medicaid $163.41
Rate for Payer: Molina Healthcare Passport $160.21
Rate for Payer: Multiplan PHCS $495.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $577.50
Rate for Payer: UHCCP Medicaid $288.75
Rate for Payer: Wellcare CHIP/Medicaid $161.81
Service Code HCPCS 25065
Hospital Charge Code 76100571
Hospital Revenue Code 761
Min. Negotiated Rate $98.80
Max. Negotiated Rate $729.60
Rate for Payer: Aetna Commercial $585.20
Rate for Payer: Anthem POS/PPO/Traditional $592.80
Rate for Payer: Cash Price $380.00
Rate for Payer: Cigna Commercial $630.80
Rate for Payer: First Health Commercial $722.00
Rate for Payer: Humana Commercial $646.00
Rate for Payer: Medical Mutual Of Ohio HMO $623.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $560.88
Rate for Payer: Molina Healthcare Benefit Exchange $228.00
Rate for Payer: Ohio Health Choice Commercial $668.80
Rate for Payer: Ohio Health Group HMO $570.00
Rate for Payer: Ohio Health Group PPO Differential $152.00
Rate for Payer: Ohio Health Group PPO No Differential $98.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $235.60
Rate for Payer: PHCS Commercial $729.60
Rate for Payer: United Healthcare All Payer $668.80
Service Code HCPCS 25065
Hospital Charge Code 76100571
Hospital Revenue Code 761
Min. Negotiated Rate $82.38
Max. Negotiated Rate $760.00
Rate for Payer: Aetna Commercial $231.08
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $89.47
Rate for Payer: Anthem Medicaid $82.38
Rate for Payer: Buckeye Medicare Advantage $760.00
Rate for Payer: Cash Price $380.00
Rate for Payer: Cash Price $380.00
Rate for Payer: Cigna Commercial $250.10
Rate for Payer: Healthspan PPO $307.24
Rate for Payer: Humana Medicaid $82.38
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $204.76
Rate for Payer: Molina Healthcare CHIP/Medicaid $84.03
Rate for Payer: Molina Healthcare Passport $82.38
Rate for Payer: Multiplan PHCS $456.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $532.00
Rate for Payer: UHCCP Medicaid $93.94
Rate for Payer: Wellcare CHIP/Medicaid $83.20
Service Code HCPCS 25065
Hospital Charge Code 76100571
Hospital Revenue Code 761
Min. Negotiated Rate $98.80
Max. Negotiated Rate $1,962.83
Rate for Payer: Aetna Commercial $585.20
Rate for Payer: Anthem Medicaid $261.36
Rate for Payer: Anthem Medicare Advantage/PPO $1,402.02
Rate for Payer: Anthem POS/PPO/Traditional $592.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,962.83
Rate for Payer: CareSource Just4Me Medicare $1,892.73
Rate for Payer: Cash Price $380.00
Rate for Payer: Cash Price $380.00
Rate for Payer: Cigna Commercial $630.80
Rate for Payer: First Health Commercial $722.00
Rate for Payer: Humana Commercial $646.00
Rate for Payer: Humana KY Medicaid $261.36
Rate for Payer: Humana Medicare Advantage $1,402.02
Rate for Payer: Kentucky WC Medicaid $264.02
Rate for Payer: Medical Mutual Of Ohio HMO $623.20
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $560.88
Rate for Payer: Molina Healthcare Benefit Exchange $1,682.42
Rate for Payer: Molina Healthcare Medicaid $266.61
Rate for Payer: Ohio Health Choice Commercial $668.80
Rate for Payer: Ohio Health Group HMO $570.00
Rate for Payer: Ohio Health Group PPO Differential $152.00
Rate for Payer: Ohio Health Group PPO No Differential $98.80
Rate for Payer: Ohio Health Group PPO SOMC Employees $235.60
Rate for Payer: PHCS Commercial $729.60
Rate for Payer: United Healthcare All Payer $668.80
Service Code HCPCS 25066
Hospital Charge Code 76100572
Hospital Revenue Code 761
Min. Negotiated Rate $107.25
Max. Negotiated Rate $3,440.07
Rate for Payer: Aetna Commercial $635.25
Rate for Payer: Anthem Medicaid $283.72
Rate for Payer: Anthem Medicare Advantage/PPO $2,457.19
Rate for Payer: Anthem POS/PPO/Traditional $643.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $3,440.07
Rate for Payer: CareSource Just4Me Medicare $3,317.21
Rate for Payer: Cash Price $412.50
Rate for Payer: Cash Price $412.50
Rate for Payer: Cigna Commercial $684.75
Rate for Payer: First Health Commercial $783.75
Rate for Payer: Humana Commercial $701.25
Rate for Payer: Humana KY Medicaid $283.72
Rate for Payer: Humana Medicare Advantage $2,457.19
Rate for Payer: Kentucky WC Medicaid $286.60
Rate for Payer: Medical Mutual Of Ohio HMO $676.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $608.85
Rate for Payer: Molina Healthcare Benefit Exchange $2,948.63
Rate for Payer: Molina Healthcare Medicaid $289.41
Rate for Payer: Ohio Health Choice Commercial $726.00
Rate for Payer: Ohio Health Group HMO $618.75
Rate for Payer: Ohio Health Group PPO Differential $165.00
Rate for Payer: Ohio Health Group PPO No Differential $107.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $255.75
Rate for Payer: PHCS Commercial $792.00
Rate for Payer: United Healthcare All Payer $726.00
Service Code HCPCS 25065
Hospital Charge Code 761P0571
Hospital Revenue Code 761
Min. Negotiated Rate $82.38
Max. Negotiated Rate $760.00
Rate for Payer: Aetna Commercial $231.08
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $89.47
Rate for Payer: Anthem Medicaid $82.38
Rate for Payer: Buckeye Medicare Advantage $760.00
Rate for Payer: Cash Price $380.00
Rate for Payer: Cash Price $380.00
Rate for Payer: Cigna Commercial $250.10
Rate for Payer: Healthspan PPO $307.24
Rate for Payer: Humana Medicaid $82.38
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $204.76
Rate for Payer: Molina Healthcare CHIP/Medicaid $84.03
Rate for Payer: Molina Healthcare Passport $82.38
Rate for Payer: Multiplan PHCS $456.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $532.00
Rate for Payer: UHCCP Medicaid $93.94
Rate for Payer: Wellcare CHIP/Medicaid $83.20
Service Code HCPCS 25066
Hospital Charge Code 761P0572
Hospital Revenue Code 761
Min. Negotiated Rate $160.21
Max. Negotiated Rate $825.00
Rate for Payer: Aetna Commercial $537.35
Rate for Payer: Anthem Medicaid $160.21
Rate for Payer: Buckeye Medicare Advantage $825.00
Rate for Payer: Cash Price $412.50
Rate for Payer: Cash Price $412.50
Rate for Payer: Cigna Commercial $707.10
Rate for Payer: Healthspan PPO $486.72
Rate for Payer: Humana Medicaid $160.21
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $450.53
Rate for Payer: Molina Healthcare CHIP/Medicaid $163.41
Rate for Payer: Molina Healthcare Passport $160.21
Rate for Payer: Multiplan PHCS $495.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $577.50
Rate for Payer: UHCCP Medicaid $288.75
Rate for Payer: Wellcare CHIP/Medicaid $161.81
Service Code HCPCS 30100
Hospital Charge Code 76101119
Hospital Revenue Code 761
Min. Negotiated Rate $38.78
Max. Negotiated Rate $175.00
Rate for Payer: Aetna Commercial $101.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $48.53
Rate for Payer: Anthem Medicaid $38.78
Rate for Payer: Buckeye Medicare Advantage $175.00
Rate for Payer: Cash Price $87.50
Rate for Payer: Cash Price $87.50
Rate for Payer: Cigna Commercial $173.24
Rate for Payer: Healthspan PPO $158.29
Rate for Payer: Humana Medicaid $38.78
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $87.88
Rate for Payer: Molina Healthcare CHIP/Medicaid $39.56
Rate for Payer: Molina Healthcare Passport $38.78
Rate for Payer: Multiplan PHCS $105.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $122.50
Rate for Payer: UHCCP Medicaid $50.96
Rate for Payer: Wellcare CHIP/Medicaid $39.17
Service Code HCPCS 30100
Hospital Charge Code 76101119
Hospital Revenue Code 761
Min. Negotiated Rate $22.75
Max. Negotiated Rate $168.00
Rate for Payer: Aetna Commercial $134.75
Rate for Payer: Anthem POS/PPO/Traditional $136.50
Rate for Payer: Cash Price $87.50
Rate for Payer: Cigna Commercial $145.25
Rate for Payer: First Health Commercial $166.25
Rate for Payer: Humana Commercial $148.75
Rate for Payer: Medical Mutual Of Ohio HMO $143.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.15
Rate for Payer: Molina Healthcare Benefit Exchange $52.50
Rate for Payer: Ohio Health Choice Commercial $154.00
Rate for Payer: Ohio Health Group HMO $131.25
Rate for Payer: Ohio Health Group PPO Differential $35.00
Rate for Payer: Ohio Health Group PPO No Differential $22.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.25
Rate for Payer: PHCS Commercial $168.00
Rate for Payer: United Healthcare All Payer $154.00
Service Code HCPCS 30100
Hospital Charge Code 76101119
Hospital Revenue Code 761
Min. Negotiated Rate $22.75
Max. Negotiated Rate $1,846.31
Rate for Payer: Aetna Commercial $134.75
Rate for Payer: Anthem Medicaid $60.18
Rate for Payer: Anthem Medicare Advantage/PPO $1,318.79
Rate for Payer: Anthem POS/PPO/Traditional $136.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,846.31
Rate for Payer: CareSource Just4Me Medicare $1,780.37
Rate for Payer: Cash Price $87.50
Rate for Payer: Cash Price $87.50
Rate for Payer: Cigna Commercial $145.25
Rate for Payer: First Health Commercial $166.25
Rate for Payer: Humana Commercial $148.75
Rate for Payer: Humana KY Medicaid $60.18
Rate for Payer: Humana Medicare Advantage $1,318.79
Rate for Payer: Kentucky WC Medicaid $60.80
Rate for Payer: Medical Mutual Of Ohio HMO $143.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.15
Rate for Payer: Molina Healthcare Benefit Exchange $1,582.55
Rate for Payer: Molina Healthcare Medicaid $61.39
Rate for Payer: Ohio Health Choice Commercial $154.00
Rate for Payer: Ohio Health Group HMO $131.25
Rate for Payer: Ohio Health Group PPO Differential $35.00
Rate for Payer: Ohio Health Group PPO No Differential $22.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.25
Rate for Payer: PHCS Commercial $168.00
Rate for Payer: United Healthcare All Payer $154.00
Service Code HCPCS 30100
Hospital Charge Code 761P1119
Hospital Revenue Code 761
Min. Negotiated Rate $38.78
Max. Negotiated Rate $175.00
Rate for Payer: Aetna Commercial $101.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $48.53
Rate for Payer: Anthem Medicaid $38.78
Rate for Payer: Buckeye Medicare Advantage $175.00
Rate for Payer: Cash Price $87.50
Rate for Payer: Cash Price $87.50
Rate for Payer: Cigna Commercial $173.24
Rate for Payer: Healthspan PPO $158.29
Rate for Payer: Humana Medicaid $38.78
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $87.88
Rate for Payer: Molina Healthcare CHIP/Medicaid $39.56
Rate for Payer: Molina Healthcare Passport $38.78
Rate for Payer: Multiplan PHCS $105.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $122.50
Rate for Payer: UHCCP Medicaid $50.96
Rate for Payer: Wellcare CHIP/Medicaid $39.17
Service Code HCPCS 47000
Hospital Charge Code 76102851
Hospital Revenue Code 761
Min. Negotiated Rate $88.25
Max. Negotiated Rate $2,750.00
Rate for Payer: Aetna Commercial $157.31
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $88.25
Rate for Payer: Anthem Medicaid $96.46
Rate for Payer: Buckeye Medicare Advantage $2,750.00
Rate for Payer: Cash Price $1,375.00
Rate for Payer: Cash Price $1,375.00
Rate for Payer: Cigna Commercial $141.95
Rate for Payer: Healthspan PPO $392.19
Rate for Payer: Humana Medicaid $96.46
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $126.81
Rate for Payer: Molina Healthcare CHIP/Medicaid $98.39
Rate for Payer: Molina Healthcare Passport $96.46
Rate for Payer: Multiplan PHCS $1,650.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,925.00
Rate for Payer: UHCCP Medicaid $92.66
Rate for Payer: Wellcare CHIP/Medicaid $97.42
Service Code HCPCS 47000
Hospital Charge Code 76102851
Hospital Revenue Code 761
Min. Negotiated Rate $357.50
Max. Negotiated Rate $2,640.00
Rate for Payer: Aetna Commercial $2,117.50
Rate for Payer: Anthem Medicaid $945.72
Rate for Payer: Anthem Medicare Advantage/PPO $1,402.02
Rate for Payer: Anthem POS/PPO/Traditional $2,145.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,962.83
Rate for Payer: CareSource Just4Me Medicare $1,892.73
Rate for Payer: Cash Price $1,375.00
Rate for Payer: Cash Price $1,375.00
Rate for Payer: Cigna Commercial $2,282.50
Rate for Payer: First Health Commercial $2,612.50
Rate for Payer: Humana Commercial $2,337.50
Rate for Payer: Humana KY Medicaid $945.72
Rate for Payer: Humana Medicare Advantage $1,402.02
Rate for Payer: Kentucky WC Medicaid $955.35
Rate for Payer: Medical Mutual Of Ohio HMO $2,255.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,029.50
Rate for Payer: Molina Healthcare Benefit Exchange $1,682.42
Rate for Payer: Molina Healthcare Medicaid $964.70
Rate for Payer: Ohio Health Choice Commercial $2,420.00
Rate for Payer: Ohio Health Group HMO $2,062.50
Rate for Payer: Ohio Health Group PPO Differential $550.00
Rate for Payer: Ohio Health Group PPO No Differential $357.50
Rate for Payer: Ohio Health Group PPO SOMC Employees $852.50
Rate for Payer: PHCS Commercial $2,640.00
Rate for Payer: United Healthcare All Payer $2,420.00
Service Code HCPCS 47000
Hospital Charge Code 76101945
Hospital Revenue Code 761
Min. Negotiated Rate $88.25
Max. Negotiated Rate $700.00
Rate for Payer: Aetna Commercial $157.31
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $88.25
Rate for Payer: Anthem Medicaid $96.46
Rate for Payer: Buckeye Medicare Advantage $700.00
Rate for Payer: Cash Price $350.00
Rate for Payer: Cash Price $350.00
Rate for Payer: Cigna Commercial $141.95
Rate for Payer: Healthspan PPO $392.19
Rate for Payer: Humana Medicaid $96.46
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $126.81
Rate for Payer: Molina Healthcare CHIP/Medicaid $98.39
Rate for Payer: Molina Healthcare Passport $96.46
Rate for Payer: Multiplan PHCS $420.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $490.00
Rate for Payer: UHCCP Medicaid $92.66
Rate for Payer: Wellcare CHIP/Medicaid $97.42