|
SIGMA HP UNI A/P 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 11MM 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 8MM LMRL SZ 1
|
Facility
|
OP
|
$13,042.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,912.60 |
| Max. Negotiated Rate |
$12,520.32 |
| Rate for Payer: Aetna Commercial |
$10,042.34
|
| Rate for Payer: Anthem Medicaid |
$4,485.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,172.76
|
| Rate for Payer: Cash Price |
$6,521.00
|
| Rate for Payer: Cigna Commercial |
$10,824.86
|
| Rate for Payer: First Health Commercial |
$12,389.90
|
| Rate for Payer: Humana Commercial |
$11,085.70
|
| Rate for Payer: Humana KY Medicaid |
$4,485.14
|
| Rate for Payer: Kentucky WC Medicaid |
$4,530.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,694.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,625.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,912.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,575.13
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,476.96
|
| Rate for Payer: Ohio Health Group HMO |
$9,781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,433.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,346.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,998.98
|
| Rate for Payer: PHCS Commercial |
$12,520.32
|
| Rate for Payer: United Healthcare All Payer |
$11,476.96
|
|
|
SIGMA HP UNI A/P 8MM LMRL SZ 1
|
Facility
|
IP
|
$13,042.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,912.60 |
| Max. Negotiated Rate |
$12,520.32 |
| Rate for Payer: Aetna Commercial |
$10,042.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,172.76
|
| Rate for Payer: Cash Price |
$6,521.00
|
| Rate for Payer: Cigna Commercial |
$10,824.86
|
| Rate for Payer: First Health Commercial |
$12,389.90
|
| Rate for Payer: Humana Commercial |
$11,085.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,694.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,625.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,912.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,476.96
|
| Rate for Payer: Ohio Health Group HMO |
$9,781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,433.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,346.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,998.98
|
| Rate for Payer: PHCS Commercial |
$12,520.32
|
| Rate for Payer: United Healthcare All Payer |
$11,476.96
|
|
|
SIGMA HP UNI A/P 8MM LMRL SZ 2
|
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 8MM LMRL SZ 2
|
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 8MM LMRL SZ 3
|
Facility
|
IP
|
$13,423.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,027.10 |
| Max. Negotiated Rate |
$12,886.73 |
| Rate for Payer: Aetna Commercial |
$10,336.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,470.47
|
| Rate for Payer: Cash Price |
$6,711.84
|
| Rate for Payer: Cigna Commercial |
$11,141.65
|
| Rate for Payer: First Health Commercial |
$12,752.50
|
| Rate for Payer: Humana Commercial |
$11,410.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,007.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,906.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,027.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,812.84
|
| Rate for Payer: Ohio Health Group HMO |
$10,067.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,738.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,678.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,262.34
|
| Rate for Payer: PHCS Commercial |
$12,886.73
|
| Rate for Payer: United Healthcare All Payer |
$11,812.84
|
|
|
SIGMA HP UNI A/P 8MM LMRL SZ 3
|
Facility
|
OP
|
$13,423.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,027.10 |
| Max. Negotiated Rate |
$12,886.73 |
| Rate for Payer: Aetna Commercial |
$10,336.23
|
| Rate for Payer: Anthem Medicaid |
$4,616.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,470.47
|
| Rate for Payer: Cash Price |
$6,711.84
|
| Rate for Payer: Cigna Commercial |
$11,141.65
|
| Rate for Payer: First Health Commercial |
$12,752.50
|
| Rate for Payer: Humana Commercial |
$11,410.13
|
| Rate for Payer: Humana KY Medicaid |
$4,616.40
|
| Rate for Payer: Kentucky WC Medicaid |
$4,663.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,007.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,906.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,027.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,709.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,812.84
|
| Rate for Payer: Ohio Health Group HMO |
$10,067.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,738.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,678.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,262.34
|
| Rate for Payer: PHCS Commercial |
$12,886.73
|
| Rate for Payer: United Healthcare All Payer |
$11,812.84
|
|
|
SIGMA HP UNI A/P 8MM LMRL SZ 4
|
Facility
|
IP
|
$13,423.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,027.10 |
| Max. Negotiated Rate |
$12,886.73 |
| Rate for Payer: Aetna Commercial |
$10,336.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,470.47
|
| Rate for Payer: Cash Price |
$6,711.84
|
| Rate for Payer: Cigna Commercial |
$11,141.65
|
| Rate for Payer: First Health Commercial |
$12,752.50
|
| Rate for Payer: Humana Commercial |
$11,410.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,007.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,906.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,027.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,812.84
|
| Rate for Payer: Ohio Health Group HMO |
$10,067.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,738.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,678.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,262.34
|
| Rate for Payer: PHCS Commercial |
$12,886.73
|
| Rate for Payer: United Healthcare All Payer |
$11,812.84
|
|
|
SIGMA HP UNI A/P 8MM LMRL SZ 4
|
Facility
|
OP
|
$13,423.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,027.10 |
| Max. Negotiated Rate |
$12,886.73 |
| Rate for Payer: Aetna Commercial |
$10,336.23
|
| Rate for Payer: Anthem Medicaid |
$4,616.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,470.47
|
| Rate for Payer: Cash Price |
$6,711.84
|
| Rate for Payer: Cigna Commercial |
$11,141.65
|
| Rate for Payer: First Health Commercial |
$12,752.50
|
| Rate for Payer: Humana Commercial |
$11,410.13
|
| Rate for Payer: Humana KY Medicaid |
$4,616.40
|
| Rate for Payer: Kentucky WC Medicaid |
$4,663.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,007.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,906.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,027.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,709.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,812.84
|
| Rate for Payer: Ohio Health Group HMO |
$10,067.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,738.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,678.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,262.34
|
| Rate for Payer: PHCS Commercial |
$12,886.73
|
| Rate for Payer: United Healthcare All Payer |
$11,812.84
|
|
|
SIGMA HP UNI A/P 8MM LMRL SZ 6
|
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 8MM LMRL SZ 6
|
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 8MM RMLL SZ 1
|
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 8MM RMLL SZ 1
|
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 8MM RMLL SZ 2
|
Facility
|
IP
|
$12,571.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,771.59 |
| Max. Negotiated Rate |
$12,069.07 |
| Rate for Payer: Aetna Commercial |
$9,680.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,806.12
|
| Rate for Payer: Cash Price |
$6,285.97
|
| Rate for Payer: Cigna Commercial |
$10,434.72
|
| Rate for Payer: First Health Commercial |
$11,943.35
|
| Rate for Payer: Humana Commercial |
$10,686.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,309.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,278.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,771.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,063.32
|
| Rate for Payer: Ohio Health Group HMO |
$9,428.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,057.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,937.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,674.65
|
| Rate for Payer: PHCS Commercial |
$12,069.07
|
| Rate for Payer: United Healthcare All Payer |
$11,063.32
|
|
|
SIGMA HP UNI A/P 8MM RMLL SZ 2
|
Facility
|
OP
|
$12,571.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,771.59 |
| Max. Negotiated Rate |
$12,069.07 |
| Rate for Payer: Aetna Commercial |
$9,680.40
|
| Rate for Payer: Anthem Medicaid |
$4,323.49
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$9,806.12
|
| Rate for Payer: Cash Price |
$6,285.97
|
| Rate for Payer: Cigna Commercial |
$10,434.72
|
| Rate for Payer: First Health Commercial |
$11,943.35
|
| Rate for Payer: Humana Commercial |
$10,686.16
|
| Rate for Payer: Humana KY Medicaid |
$4,323.49
|
| Rate for Payer: Kentucky WC Medicaid |
$4,367.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,309.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,278.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,771.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,410.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,063.32
|
| Rate for Payer: Ohio Health Group HMO |
$9,428.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,057.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,937.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,674.65
|
| Rate for Payer: PHCS Commercial |
$12,069.07
|
| Rate for Payer: United Healthcare All Payer |
$11,063.32
|
|
