|
BIOPSY LIVER NEEDLE PERC
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76101945
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$672.00 |
| Rate for Payer: Aetna Commercial |
$539.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$546.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$581.00
|
| Rate for Payer: First Health Commercial |
$665.00
|
| Rate for Payer: Humana Commercial |
$595.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$574.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$516.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$210.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$616.00
|
| Rate for Payer: Ohio Health Group HMO |
$525.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$140.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$91.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$217.00
|
| Rate for Payer: PHCS Commercial |
$672.00
|
| Rate for Payer: United Healthcare All Payer |
$616.00
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Professional
|
Both
|
$2,750.00
|
|
|
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
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Professional
|
Both
|
$700.00
|
|
|
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
|
|
|
BIOPSY LIVER NEEDLE PERC (P
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761P2851
|
|
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
|
|
|
BIOPSY LIVER NEEDLE PERC(P
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761P1945
|
|
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
|
|
|
BIOPSY LIVER NEEDLE PERC (T
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761T2851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$615.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$635.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
BIOPSY LIVER NEEDLE PERC (T
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761T2851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem Medicaid |
$705.00
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,402.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| 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 |
$1,025.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Humana KY Medicaid |
$705.00
|
| Rate for Payer: Humana Medicare Advantage |
$1,402.02
|
| Rate for Payer: Kentucky WC Medicaid |
$712.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,682.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$719.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$635.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
OP
|
$5,969.67
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
76101593
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$776.06 |
| Max. Negotiated Rate |
$5,730.88 |
| Rate for Payer: Aetna Commercial |
$4,596.65
|
| Rate for Payer: Anthem Medicaid |
$2,052.97
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,296.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,656.34
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,614.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,449.88
|
| Rate for Payer: Cash Price |
$2,984.84
|
| Rate for Payer: Cash Price |
$2,984.84
|
| Rate for Payer: Cigna Commercial |
$4,954.83
|
| Rate for Payer: First Health Commercial |
$5,671.19
|
| Rate for Payer: Humana Commercial |
$5,074.22
|
| Rate for Payer: Humana KY Medicaid |
$2,052.97
|
| Rate for Payer: Humana Medicare Advantage |
$3,296.21
|
| Rate for Payer: Kentucky WC Medicaid |
$2,073.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,895.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,405.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,955.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,094.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,253.31
|
| Rate for Payer: Ohio Health Group HMO |
$4,477.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,193.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$776.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,850.60
|
| Rate for Payer: PHCS Commercial |
$5,730.88
|
| Rate for Payer: United Healthcare All Payer |
$5,253.31
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
IP
|
$5,969.67
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
76101593
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$776.06 |
| Max. Negotiated Rate |
$5,730.88 |
| Rate for Payer: Aetna Commercial |
$4,596.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,656.34
|
| Rate for Payer: Cash Price |
$2,984.84
|
| Rate for Payer: Cigna Commercial |
$4,954.83
|
| Rate for Payer: First Health Commercial |
$5,671.19
|
| Rate for Payer: Humana Commercial |
$5,074.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,895.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,405.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,790.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,253.31
|
| Rate for Payer: Ohio Health Group HMO |
$4,477.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,193.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$776.06
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,850.60
|
| Rate for Payer: PHCS Commercial |
$5,730.88
|
| Rate for Payer: United Healthcare All Payer |
$5,253.31
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
IP
|
$4,683.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
45000245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$608.79 |
| Max. Negotiated Rate |
$4,495.68 |
| Rate for Payer: Aetna Commercial |
$3,605.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,652.74
|
| Rate for Payer: Cash Price |
$2,341.50
|
| Rate for Payer: Cigna Commercial |
$3,886.89
|
| Rate for Payer: First Health Commercial |
$4,448.85
|
| Rate for Payer: Humana Commercial |
$3,980.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,840.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,456.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,404.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,121.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,512.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$936.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$608.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,451.73
|
| Rate for Payer: PHCS Commercial |
$4,495.68
|
| Rate for Payer: United Healthcare All Payer |
$4,121.04
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
OP
|
$6,187.64
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
76101597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$804.39 |
| Max. Negotiated Rate |
$5,940.13 |
| Rate for Payer: Aetna Commercial |
$4,764.48
|
| Rate for Payer: Anthem Medicaid |
$2,127.93
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,296.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,826.36
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,614.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,449.88
|
| Rate for Payer: Cash Price |
$3,093.82
|
| Rate for Payer: Cash Price |
$3,093.82
|
| Rate for Payer: Cigna Commercial |
$5,135.74
|
| Rate for Payer: First Health Commercial |
$5,878.26
|
| Rate for Payer: Humana Commercial |
$5,259.49
|
| Rate for Payer: Humana KY Medicaid |
$2,127.93
|
| Rate for Payer: Humana Medicare Advantage |
$3,296.21
|
| Rate for Payer: Kentucky WC Medicaid |
$2,149.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,073.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,566.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,955.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,170.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,445.12
|
| Rate for Payer: Ohio Health Group HMO |
$4,640.73
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,237.53
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$804.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,918.17
|
| Rate for Payer: PHCS Commercial |
$5,940.13
|
| Rate for Payer: United Healthcare All Payer |
$5,445.12
|
|
|
BIOPSY LYMPH NODE
|
Professional
|
Both
|
$5,969.67
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
76101593
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.68 |
| Max. Negotiated Rate |
$5,969.67 |
| Rate for Payer: Aetna Commercial |
$363.27
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$131.68
|
| Rate for Payer: Anthem Medicaid |
$133.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$5,969.67
|
| Rate for Payer: Cash Price |
$2,984.84
|
| Rate for Payer: Cash Price |
$2,984.84
|
| Rate for Payer: Cigna Commercial |
$341.47
|
| Rate for Payer: Healthspan PPO |
$361.51
|
| Rate for Payer: Humana Medicaid |
$133.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$320.97
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$135.88
|
| Rate for Payer: Molina Healthcare Passport |
$133.22
|
| Rate for Payer: Multiplan PHCS |
$3,581.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$4,178.77
|
| Rate for Payer: UHCCP Medicaid |
$138.26
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$134.55
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
OP
|
$4,683.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
45000245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$608.79 |
| Max. Negotiated Rate |
$4,614.69 |
| Rate for Payer: Aetna Commercial |
$3,605.91
|
| Rate for Payer: Anthem Medicaid |
$1,610.48
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,296.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,652.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,614.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,449.88
|
| Rate for Payer: Cash Price |
$2,341.50
|
| Rate for Payer: Cash Price |
$2,341.50
|
| Rate for Payer: Cigna Commercial |
$3,886.89
|
| Rate for Payer: First Health Commercial |
$4,448.85
|
| Rate for Payer: Humana Commercial |
$3,980.55
|
| Rate for Payer: Humana KY Medicaid |
$1,610.48
|
| Rate for Payer: Humana Medicare Advantage |
$3,296.21
|
| Rate for Payer: Kentucky WC Medicaid |
$1,626.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,840.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,456.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,955.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,642.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,121.04
|
| Rate for Payer: Ohio Health Group HMO |
$3,512.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$936.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$608.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,451.73
|
| Rate for Payer: PHCS Commercial |
$4,495.68
|
| Rate for Payer: United Healthcare All Payer |
$4,121.04
|
|
|
BIOPSY LYMPH NODE
|
Professional
|
Both
|
$6,187.64
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
76101597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.58 |
| Max. Negotiated Rate |
$6,187.64 |
| Rate for Payer: Aetna Commercial |
$609.78
|
| Rate for Payer: Anthem Medicaid |
$210.58
|
| Rate for Payer: Buckeye Medicare Advantage |
$6,187.64
|
| Rate for Payer: Cash Price |
$3,093.82
|
| Rate for Payer: Cash Price |
$3,093.82
|
| Rate for Payer: Cigna Commercial |
$566.09
|
| Rate for Payer: Healthspan PPO |
$487.58
|
| Rate for Payer: Humana Medicaid |
$210.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$546.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$214.79
|
| Rate for Payer: Molina Healthcare Passport |
$210.58
|
| Rate for Payer: Multiplan PHCS |
$3,712.58
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$4,331.35
|
| Rate for Payer: UHCCP Medicaid |
$2,165.67
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$212.69
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
IP
|
$6,187.64
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
76101597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$804.39 |
| Max. Negotiated Rate |
$5,940.13 |
| Rate for Payer: Aetna Commercial |
$4,764.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,826.36
|
| Rate for Payer: Cash Price |
$3,093.82
|
| Rate for Payer: Cigna Commercial |
$5,135.74
|
| Rate for Payer: First Health Commercial |
$5,878.26
|
| Rate for Payer: Humana Commercial |
$5,259.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,073.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,566.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,856.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,445.12
|
| Rate for Payer: Ohio Health Group HMO |
$4,640.73
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,237.53
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$804.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,918.17
|
| Rate for Payer: PHCS Commercial |
$5,940.13
|
| Rate for Payer: United Healthcare All Payer |
$5,445.12
|
|
|
BIOPSY LYMPH NODE(P
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
761P1593
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.68 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$363.27
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$131.68
|
| Rate for Payer: Anthem Medicaid |
$133.22
|
| Rate for Payer: Buckeye Medicare Advantage |
$450.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cigna Commercial |
$341.47
|
| Rate for Payer: Healthspan PPO |
$361.51
|
| Rate for Payer: Humana Medicaid |
$133.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$320.97
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$135.88
|
| Rate for Payer: Molina Healthcare Passport |
$133.22
|
| Rate for Payer: Multiplan PHCS |
$270.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$315.00
|
| Rate for Payer: UHCCP Medicaid |
$138.26
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$134.55
|
|
|
BIOPSY LYMPH NODE(P
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
761P1597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.58 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Commercial |
$609.78
|
| Rate for Payer: Anthem Medicaid |
$210.58
|
| Rate for Payer: Buckeye Medicare Advantage |
$650.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cigna Commercial |
$566.09
|
| Rate for Payer: Healthspan PPO |
$487.58
|
| Rate for Payer: Humana Medicaid |
$210.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$546.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$214.79
|
| Rate for Payer: Molina Healthcare Passport |
$210.58
|
| Rate for Payer: Multiplan PHCS |
$390.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$455.00
|
| Rate for Payer: UHCCP Medicaid |
$227.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$212.69
|
|
|
BIOPSY LYMPH NODE(T
|
Facility
|
OP
|
$5,519.67
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
761T1593
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$717.56 |
| Max. Negotiated Rate |
$5,298.88 |
| Rate for Payer: Aetna Commercial |
$4,250.15
|
| Rate for Payer: Anthem Medicaid |
$1,898.21
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,296.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,305.34
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,614.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,449.88
|
| Rate for Payer: Cash Price |
$2,759.84
|
| Rate for Payer: Cash Price |
$2,759.84
|
| Rate for Payer: Cigna Commercial |
$4,581.33
|
| Rate for Payer: First Health Commercial |
$5,243.69
|
| Rate for Payer: Humana Commercial |
$4,691.72
|
| Rate for Payer: Humana KY Medicaid |
$1,898.21
|
| Rate for Payer: Humana Medicare Advantage |
$3,296.21
|
| Rate for Payer: Kentucky WC Medicaid |
$1,917.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,526.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,073.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,955.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,936.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,857.31
|
| Rate for Payer: Ohio Health Group HMO |
$4,139.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,103.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$717.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,711.10
|
| Rate for Payer: PHCS Commercial |
$5,298.88
|
| Rate for Payer: United Healthcare All Payer |
$4,857.31
|
|
|
BIOPSY LYMPH NODE(T
|
Facility
|
IP
|
$5,537.64
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
761T1597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$719.89 |
| Max. Negotiated Rate |
$5,316.13 |
| Rate for Payer: Aetna Commercial |
$4,263.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,319.36
|
| Rate for Payer: Cash Price |
$2,768.82
|
| Rate for Payer: Cigna Commercial |
$4,596.24
|
| Rate for Payer: First Health Commercial |
$5,260.76
|
| Rate for Payer: Humana Commercial |
$4,706.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,540.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,086.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,661.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,873.12
|
| Rate for Payer: Ohio Health Group HMO |
$4,153.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,107.53
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$719.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,716.67
|
| Rate for Payer: PHCS Commercial |
$5,316.13
|
| Rate for Payer: United Healthcare All Payer |
$4,873.12
|
|
|
BIOPSY LYMPH NODE(T
|
Facility
|
OP
|
$5,537.64
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
761T1597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$719.89 |
| Max. Negotiated Rate |
$5,316.13 |
| Rate for Payer: Aetna Commercial |
$4,263.98
|
| Rate for Payer: Anthem Medicaid |
$1,904.39
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,296.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,319.36
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,614.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,449.88
|
| Rate for Payer: Cash Price |
$2,768.82
|
| Rate for Payer: Cash Price |
$2,768.82
|
| Rate for Payer: Cigna Commercial |
$4,596.24
|
| Rate for Payer: First Health Commercial |
$5,260.76
|
| Rate for Payer: Humana Commercial |
$4,706.99
|
| Rate for Payer: Humana KY Medicaid |
$1,904.39
|
| Rate for Payer: Humana Medicare Advantage |
$3,296.21
|
| Rate for Payer: Kentucky WC Medicaid |
$1,923.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,540.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,086.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,955.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,942.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,873.12
|
| Rate for Payer: Ohio Health Group HMO |
$4,153.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,107.53
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$719.89
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,716.67
|
| Rate for Payer: PHCS Commercial |
$5,316.13
|
| Rate for Payer: United Healthcare All Payer |
$4,873.12
|
|
|
BIOPSY LYMPH NODE(T
|
Facility
|
IP
|
$5,519.67
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
761T1593
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$717.56 |
| Max. Negotiated Rate |
$5,298.88 |
| Rate for Payer: Aetna Commercial |
$4,250.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,305.34
|
| Rate for Payer: Cash Price |
$2,759.84
|
| Rate for Payer: Cigna Commercial |
$4,581.33
|
| Rate for Payer: First Health Commercial |
$5,243.69
|
| Rate for Payer: Humana Commercial |
$4,691.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,526.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,073.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,655.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,857.31
|
| Rate for Payer: Ohio Health Group HMO |
$4,139.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,103.93
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$717.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,711.10
|
| Rate for Payer: PHCS Commercial |
$5,298.88
|
| Rate for Payer: United Healthcare All Payer |
$4,857.31
|
|
|
BIOPSY MUSCLE
|
Facility
|
OP
|
$2,366.00
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
76100327
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$307.58 |
| Max. Negotiated Rate |
$2,271.36 |
| Rate for Payer: Aetna Commercial |
$1,821.82
|
| Rate for Payer: Anthem Medicaid |
$813.67
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,402.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,845.48
|
| 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 |
$1,183.00
|
| Rate for Payer: Cash Price |
$1,183.00
|
| Rate for Payer: Cigna Commercial |
$1,963.78
|
| Rate for Payer: First Health Commercial |
$2,247.70
|
| Rate for Payer: Humana Commercial |
$2,011.10
|
| Rate for Payer: Humana KY Medicaid |
$813.67
|
| Rate for Payer: Humana Medicare Advantage |
$1,402.02
|
| Rate for Payer: Kentucky WC Medicaid |
$821.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,940.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,746.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,682.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$829.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,082.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,774.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$473.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$307.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$733.46
|
| Rate for Payer: PHCS Commercial |
$2,271.36
|
| Rate for Payer: United Healthcare All Payer |
$2,082.08
|
|
|
BIOPSY MUSCLE
|
Professional
|
Both
|
$2,366.00
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
76100327
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.91 |
| Max. Negotiated Rate |
$2,366.00 |
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$43.91
|
| Rate for Payer: Anthem Medicaid |
$58.20
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,366.00
|
| Rate for Payer: Cash Price |
$1,183.00
|
| Rate for Payer: Cash Price |
$1,183.00
|
| Rate for Payer: Cigna Commercial |
$101.30
|
| Rate for Payer: Healthspan PPO |
$323.89
|
| Rate for Payer: Humana Medicaid |
$58.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$75.30
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$59.36
|
| Rate for Payer: Molina Healthcare Passport |
$58.20
|
| Rate for Payer: Multiplan PHCS |
$1,419.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,656.20
|
| Rate for Payer: UHCCP Medicaid |
$46.11
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$58.78
|
|
|
BIOPSY MUSCLE
|
Facility
|
IP
|
$2,366.00
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
76100327
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$307.58 |
| Max. Negotiated Rate |
$2,271.36 |
| Rate for Payer: Aetna Commercial |
$1,821.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,845.48
|
| Rate for Payer: Cash Price |
$1,183.00
|
| Rate for Payer: Cigna Commercial |
$1,963.78
|
| Rate for Payer: First Health Commercial |
$2,247.70
|
| Rate for Payer: Humana Commercial |
$2,011.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,940.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,746.11
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$709.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,082.08
|
| Rate for Payer: Ohio Health Group HMO |
$1,774.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$473.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$307.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$733.46
|
| Rate for Payer: PHCS Commercial |
$2,271.36
|
| Rate for Payer: United Healthcare All Payer |
$2,082.08
|
|
|
BIOPSY MUSCLE DEEP
|
Facility
|
OP
|
$6,246.17
|
|
|
Service Code
|
HCPCS 20205
|
| Hospital Charge Code |
76100326
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$812.00 |
| Max. Negotiated Rate |
$5,996.32 |
| Rate for Payer: Aetna Commercial |
$4,809.55
|
| Rate for Payer: Anthem Medicaid |
$2,148.06
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,457.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,872.01
|
| 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 |
$3,123.08
|
| Rate for Payer: Cash Price |
$3,123.08
|
| Rate for Payer: Cigna Commercial |
$5,184.32
|
| Rate for Payer: First Health Commercial |
$5,933.86
|
| Rate for Payer: Humana Commercial |
$5,309.24
|
| Rate for Payer: Humana KY Medicaid |
$2,148.06
|
| Rate for Payer: Humana Medicare Advantage |
$2,457.19
|
| Rate for Payer: Kentucky WC Medicaid |
$2,169.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,121.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,609.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,948.63
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,191.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,496.63
|
| Rate for Payer: Ohio Health Group HMO |
$4,684.63
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,249.23
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$812.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,936.31
|
| Rate for Payer: PHCS Commercial |
$5,996.32
|
| Rate for Payer: United Healthcare All Payer |
$5,496.63
|
|
