|
SIGMA HP UNI A/P 8MM RMLL SZ 3
|
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 3
|
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 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 RMLL 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 RMLL SZ 5
|
Facility
|
IP
|
$13,720.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,116.28 |
| Max. Negotiated Rate |
$13,172.11 |
| Rate for Payer: Aetna Commercial |
$10,565.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,702.34
|
| Rate for Payer: Cash Price |
$6,860.48
|
| Rate for Payer: Cigna Commercial |
$11,388.39
|
| Rate for Payer: First Health Commercial |
$13,034.90
|
| Rate for Payer: Humana Commercial |
$11,662.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,251.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,126.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,116.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,074.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,290.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,976.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,937.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,467.46
|
| Rate for Payer: PHCS Commercial |
$13,172.11
|
| Rate for Payer: United Healthcare All Payer |
$12,074.44
|
|
|
SIGMA HP UNI A/P 8MM RMLL SZ 5
|
Facility
|
OP
|
$13,720.95
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,116.28 |
| Max. Negotiated Rate |
$13,172.11 |
| Rate for Payer: Aetna Commercial |
$10,565.13
|
| Rate for Payer: Anthem Medicaid |
$4,718.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,702.34
|
| Rate for Payer: Cash Price |
$6,860.48
|
| Rate for Payer: Cigna Commercial |
$11,388.39
|
| Rate for Payer: First Health Commercial |
$13,034.90
|
| Rate for Payer: Humana Commercial |
$11,662.81
|
| Rate for Payer: Humana KY Medicaid |
$4,718.63
|
| Rate for Payer: Kentucky WC Medicaid |
$4,766.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,251.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,126.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,116.28
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,813.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,074.44
|
| Rate for Payer: Ohio Health Group HMO |
$10,290.71
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,976.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,937.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,467.46
|
| Rate for Payer: PHCS Commercial |
$13,172.11
|
| Rate for Payer: United Healthcare All Payer |
$12,074.44
|
|
|
SIGMA HP UNI A/P 8MM RMLL 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 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 9MM LMRL 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 9MM LMRL 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 9MM 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 9MM 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 9MM LMRL SZ 3
|
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 9MM LMRL SZ 3
|
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 9MM LMRL SZ 4
|
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 9MM LMRL SZ 4
|
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 9MM 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 9MM 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 9MM 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 9MM 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 9MM RMLL 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 9MM RMLL 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 9MM RMLL SZ 3
|
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 9MM RMLL SZ 3
|
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 9MM RMLL SZ 4
|
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
|
|
