|
SIGMA HP UNI A/P 10MM LMRL SZ6
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM LMRL SZ6
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ1
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ1
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ2
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ2
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ3
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ3
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ4
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ4
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ5
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ5
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ6
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 10MM RMLL SZ6
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ1
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ1
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ2
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ2
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ3
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ3
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ4
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ4
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ6
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM LMRL SZ6
|
Facility
|
OP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem Medicaid |
$4,146.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Humana KY Medicaid |
$4,146.90
|
| Rate for Payer: Kentucky WC Medicaid |
$4,189.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,230.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
|
SIGMA HP UNI A/P 11MM RMLL SZ1
|
Facility
|
IP
|
$12,058.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,617.53 |
| Max. Negotiated Rate |
$11,576.10 |
| Rate for Payer: Aetna Commercial |
$9,285.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,405.58
|
| Rate for Payer: Cash Price |
$6,029.22
|
| Rate for Payer: Cigna Commercial |
$10,008.51
|
| Rate for Payer: First Health Commercial |
$11,455.52
|
| Rate for Payer: Humana Commercial |
$10,249.67
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,887.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,899.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,617.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$10,611.43
|
| Rate for Payer: Ohio Health Group HMO |
$9,043.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,646.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,490.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,320.32
|
| Rate for Payer: PHCS Commercial |
$11,576.10
|
| Rate for Payer: United Healthcare All Payer |
$10,611.43
|
|
