|
BIOPSY OF SALIVARY GLAND(P
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 42400
|
| Hospital Charge Code |
761P1684
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.91 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$85.16
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$47.88
|
| Rate for Payer: Anthem Medicaid |
$35.91
|
| Rate for Payer: Buckeye Medicare Advantage |
$200.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cigna Commercial |
$142.65
|
| Rate for Payer: Healthspan PPO |
$126.43
|
| Rate for Payer: Humana Medicaid |
$35.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$72.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$36.63
|
| Rate for Payer: Molina Healthcare Passport |
$35.91
|
| Rate for Payer: Multiplan PHCS |
$120.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$140.00
|
| Rate for Payer: UHCCP Medicaid |
$50.27
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$36.27
|
|
|
BIOPSY OF SALIVARY GLAND(P
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 42405
|
| Hospital Charge Code |
761P1685
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.34 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$333.05
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$144.22
|
| Rate for Payer: Anthem Medicaid |
$120.34
|
| Rate for Payer: Buckeye Medicare Advantage |
$450.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cigna Commercial |
$419.74
|
| Rate for Payer: Healthspan PPO |
$358.51
|
| Rate for Payer: Humana Medicaid |
$120.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$291.40
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$122.75
|
| Rate for Payer: Molina Healthcare Passport |
$120.34
|
| Rate for Payer: Multiplan PHCS |
$270.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$315.00
|
| Rate for Payer: UHCCP Medicaid |
$151.43
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$121.54
|
|
|
BIOPSY OF SALIVARY GLAND(T
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
HCPCS 42400
|
| Hospital Charge Code |
761T1684
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$851.79 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Anthem Medicaid |
$300.57
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$608.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$681.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$851.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$821.37
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$725.42
|
| Rate for Payer: First Health Commercial |
$830.30
|
| Rate for Payer: Humana Commercial |
$742.90
|
| Rate for Payer: Humana KY Medicaid |
$300.57
|
| Rate for Payer: Humana Medicare Advantage |
$608.42
|
| Rate for Payer: Kentucky WC Medicaid |
$303.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$716.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$645.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$730.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$306.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$769.12
|
| Rate for Payer: Ohio Health Group HMO |
$655.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$174.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$113.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$270.94
|
| Rate for Payer: PHCS Commercial |
$839.04
|
| Rate for Payer: United Healthcare All Payer |
$769.12
|
|
|
BIOPSY OF SALIVARY GLAND(T
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
HCPCS 42400
|
| Hospital Charge Code |
761T1684
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$839.04 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$681.72
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$725.42
|
| Rate for Payer: First Health Commercial |
$830.30
|
| Rate for Payer: Humana Commercial |
$742.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$716.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$645.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$262.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$769.12
|
| Rate for Payer: Ohio Health Group HMO |
$655.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$174.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$113.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$270.94
|
| Rate for Payer: PHCS Commercial |
$839.04
|
| Rate for Payer: United Healthcare All Payer |
$769.12
|
|
|
BIOPSY OF SALIVARY GLAND(T
|
Facility
|
IP
|
$4,585.50
|
|
|
Service Code
|
HCPCS 42405
|
| Hospital Charge Code |
761T1685
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$596.12 |
| Max. Negotiated Rate |
$4,402.08 |
| Rate for Payer: Aetna Commercial |
$3,530.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,576.69
|
| Rate for Payer: Cash Price |
$2,292.75
|
| Rate for Payer: Cigna Commercial |
$3,805.96
|
| Rate for Payer: First Health Commercial |
$4,356.22
|
| Rate for Payer: Humana Commercial |
$3,897.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,760.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,384.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,375.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,035.24
|
| Rate for Payer: Ohio Health Group HMO |
$3,439.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$917.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$596.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,421.50
|
| Rate for Payer: PHCS Commercial |
$4,402.08
|
| Rate for Payer: United Healthcare All Payer |
$4,035.24
|
|
|
BIOPSY OF SALIVARY GLAND(T
|
Facility
|
OP
|
$4,585.50
|
|
|
Service Code
|
HCPCS 42405
|
| Hospital Charge Code |
761T1685
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$596.12 |
| Max. Negotiated Rate |
$4,402.08 |
| Rate for Payer: Aetna Commercial |
$3,530.84
|
| Rate for Payer: Anthem Medicaid |
$1,576.95
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,318.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,576.69
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,846.31
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,780.37
|
| Rate for Payer: Cash Price |
$2,292.75
|
| Rate for Payer: Cash Price |
$2,292.75
|
| Rate for Payer: Cigna Commercial |
$3,805.96
|
| Rate for Payer: First Health Commercial |
$4,356.22
|
| Rate for Payer: Humana Commercial |
$3,897.68
|
| Rate for Payer: Humana KY Medicaid |
$1,576.95
|
| Rate for Payer: Humana Medicare Advantage |
$1,318.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,593.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,760.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,384.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,582.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,608.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,035.24
|
| Rate for Payer: Ohio Health Group HMO |
$3,439.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$917.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$596.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,421.50
|
| Rate for Payer: PHCS Commercial |
$4,402.08
|
| Rate for Payer: United Healthcare All Payer |
$4,035.24
|
|
|
BIOPSY OF SPLEEN
|
Facility
|
IP
|
$5,409.50
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
76102725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.24 |
| Max. Negotiated Rate |
$5,193.12 |
| Rate for Payer: Aetna Commercial |
$4,165.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,219.41
|
| Rate for Payer: Cash Price |
$2,704.75
|
| Rate for Payer: Cigna Commercial |
$4,489.88
|
| Rate for Payer: First Health Commercial |
$5,139.02
|
| Rate for Payer: Humana Commercial |
$4,598.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,435.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,992.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,622.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,760.36
|
| Rate for Payer: Ohio Health Group HMO |
$4,057.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,081.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$703.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,676.94
|
| Rate for Payer: PHCS Commercial |
$5,193.12
|
| Rate for Payer: United Healthcare All Payer |
$4,760.36
|
|
|
BIOPSY OF SPLEEN
|
Facility
|
OP
|
$5,409.50
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
76102725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.39 |
| Max. Negotiated Rate |
$5,193.12 |
| Rate for Payer: Aetna Commercial |
$4,165.32
|
| Rate for Payer: Anthem Medicaid |
$1,860.33
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$375.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,219.41
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$525.55
|
| Rate for Payer: CareSource Just4Me Medicare |
$506.78
|
| Rate for Payer: Cash Price |
$2,704.75
|
| Rate for Payer: Cash Price |
$2,704.75
|
| Rate for Payer: Cigna Commercial |
$4,489.88
|
| Rate for Payer: First Health Commercial |
$5,139.02
|
| Rate for Payer: Humana Commercial |
$4,598.08
|
| Rate for Payer: Humana KY Medicaid |
$1,860.33
|
| Rate for Payer: Humana Medicare Advantage |
$375.39
|
| Rate for Payer: Kentucky WC Medicaid |
$1,879.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,435.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,992.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$450.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,897.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,760.36
|
| Rate for Payer: Ohio Health Group HMO |
$4,057.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,081.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$703.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,676.94
|
| Rate for Payer: PHCS Commercial |
$5,193.12
|
| Rate for Payer: United Healthcare All Payer |
$4,760.36
|
|
|
BIOPSY OF SPLEEN
|
Professional
|
Both
|
$5,409.50
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
76102725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$5,409.50 |
| Rate for Payer: Buckeye Medicare Advantage |
$5,409.50
|
| Rate for Payer: Cash Price |
$2,704.75
|
| Rate for Payer: Cash Price |
$2,704.75
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$3,245.70
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3,786.65
|
| Rate for Payer: UHCCP Medicaid |
$1,893.32
|
|
|
BIOPSY OF SPLEEN (P
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
761P2725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$650.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$390.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$455.00
|
| Rate for Payer: UHCCP Medicaid |
$227.50
|
|
|
BIOPSY OF SPLEEN (T
|
Facility
|
OP
|
$4,759.50
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
761T2725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.39 |
| Max. Negotiated Rate |
$4,569.12 |
| Rate for Payer: Aetna Commercial |
$3,664.82
|
| Rate for Payer: Anthem Medicaid |
$1,636.79
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$375.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,712.41
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$525.55
|
| Rate for Payer: CareSource Just4Me Medicare |
$506.78
|
| Rate for Payer: Cash Price |
$2,379.75
|
| Rate for Payer: Cash Price |
$2,379.75
|
| Rate for Payer: Cigna Commercial |
$3,950.38
|
| Rate for Payer: First Health Commercial |
$4,521.52
|
| Rate for Payer: Humana Commercial |
$4,045.58
|
| Rate for Payer: Humana KY Medicaid |
$1,636.79
|
| Rate for Payer: Humana Medicare Advantage |
$375.39
|
| Rate for Payer: Kentucky WC Medicaid |
$1,653.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,902.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,512.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$450.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,669.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,188.36
|
| Rate for Payer: Ohio Health Group HMO |
$3,569.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$951.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$618.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,475.44
|
| Rate for Payer: PHCS Commercial |
$4,569.12
|
| Rate for Payer: United Healthcare All Payer |
$4,188.36
|
|
|
BIOPSY OF SPLEEN (T
|
Facility
|
IP
|
$4,759.50
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
761T2725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.74 |
| Max. Negotiated Rate |
$4,569.12 |
| Rate for Payer: Aetna Commercial |
$3,664.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,712.41
|
| Rate for Payer: Cash Price |
$2,379.75
|
| Rate for Payer: Cigna Commercial |
$3,950.38
|
| Rate for Payer: First Health Commercial |
$4,521.52
|
| Rate for Payer: Humana Commercial |
$4,045.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,902.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,512.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,427.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,188.36
|
| Rate for Payer: Ohio Health Group HMO |
$3,569.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$951.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$618.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,475.44
|
| Rate for Payer: PHCS Commercial |
$4,569.12
|
| Rate for Payer: United Healthcare All Payer |
$4,188.36
|
|
|
BIOPSY OF THYROID
|
Facility
|
OP
|
$1,124.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
76102269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.12 |
| Max. Negotiated Rate |
$1,079.04 |
| Rate for Payer: Aetna Commercial |
$865.48
|
| Rate for Payer: Anthem Medicaid |
$386.54
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$608.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$876.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$851.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$821.37
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cigna Commercial |
$932.92
|
| Rate for Payer: First Health Commercial |
$1,067.80
|
| Rate for Payer: Humana Commercial |
$955.40
|
| Rate for Payer: Humana KY Medicaid |
$386.54
|
| Rate for Payer: Humana Medicare Advantage |
$608.42
|
| Rate for Payer: Kentucky WC Medicaid |
$390.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$921.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$829.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$730.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$394.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$989.12
|
| Rate for Payer: Ohio Health Group HMO |
$843.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$224.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$348.44
|
| Rate for Payer: PHCS Commercial |
$1,079.04
|
| Rate for Payer: United Healthcare All Payer |
$989.12
|
|
|
BIOPSY OF THYROID
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
76102269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$1,124.00 |
| Rate for Payer: Aetna Commercial |
$127.15
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$45.12
|
| Rate for Payer: Anthem Medicaid |
$45.46
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,124.00
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cigna Commercial |
$162.76
|
| Rate for Payer: Healthspan PPO |
$143.79
|
| Rate for Payer: Humana Medicaid |
$45.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$103.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$46.37
|
| Rate for Payer: Molina Healthcare Passport |
$45.46
|
| Rate for Payer: Multiplan PHCS |
$674.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$786.80
|
| Rate for Payer: UHCCP Medicaid |
$47.38
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$45.91
|
|
|
BIOPSY OF THYROID
|
Facility
|
IP
|
$1,124.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
76102269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.12 |
| Max. Negotiated Rate |
$1,079.04 |
| Rate for Payer: Aetna Commercial |
$865.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$876.72
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cigna Commercial |
$932.92
|
| Rate for Payer: First Health Commercial |
$1,067.80
|
| Rate for Payer: Humana Commercial |
$955.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$921.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$829.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$337.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$989.12
|
| Rate for Payer: Ohio Health Group HMO |
$843.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$224.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.12
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$348.44
|
| Rate for Payer: PHCS Commercial |
$1,079.04
|
| Rate for Payer: United Healthcare All Payer |
$989.12
|
|
|
BIOPSY OF THYROID(P
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
761P2269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna Commercial |
$127.15
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$45.12
|
| Rate for Payer: Anthem Medicaid |
$45.46
|
| Rate for Payer: Buckeye Medicare Advantage |
$250.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cigna Commercial |
$162.76
|
| Rate for Payer: Healthspan PPO |
$143.79
|
| Rate for Payer: Humana Medicaid |
$45.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$103.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$46.37
|
| Rate for Payer: Molina Healthcare Passport |
$45.46
|
| Rate for Payer: Multiplan PHCS |
$150.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$175.00
|
| Rate for Payer: UHCCP Medicaid |
$47.38
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$45.91
|
|
|
BIOPSY OF THYROID(T
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
761T2269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$851.79 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Anthem Medicaid |
$300.57
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$608.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$681.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$851.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$821.37
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$725.42
|
| Rate for Payer: First Health Commercial |
$830.30
|
| Rate for Payer: Humana Commercial |
$742.90
|
| Rate for Payer: Humana KY Medicaid |
$300.57
|
| Rate for Payer: Humana Medicare Advantage |
$608.42
|
| Rate for Payer: Kentucky WC Medicaid |
$303.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$716.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$645.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$730.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$306.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$769.12
|
| Rate for Payer: Ohio Health Group HMO |
$655.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$174.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$113.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$270.94
|
| Rate for Payer: PHCS Commercial |
$839.04
|
| Rate for Payer: United Healthcare All Payer |
$769.12
|
|
|
BIOPSY OF THYROID(T
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
761T2269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$839.04 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$681.72
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$725.42
|
| Rate for Payer: First Health Commercial |
$830.30
|
| Rate for Payer: Humana Commercial |
$742.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$716.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$645.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$262.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$769.12
|
| Rate for Payer: Ohio Health Group HMO |
$655.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$174.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$113.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$270.94
|
| Rate for Payer: PHCS Commercial |
$839.04
|
| Rate for Payer: United Healthcare All Payer |
$769.12
|
|
|
BIOPSY OF TONGUE
|
Facility
|
IP
|
$4,052.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
76101652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$526.76 |
| Max. Negotiated Rate |
$3,889.92 |
| Rate for Payer: Aetna Commercial |
$3,120.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,160.56
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cigna Commercial |
$3,363.16
|
| Rate for Payer: First Health Commercial |
$3,849.40
|
| Rate for Payer: Humana Commercial |
$3,444.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,322.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,990.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,215.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,565.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,039.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$526.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,256.12
|
| Rate for Payer: PHCS Commercial |
$3,889.92
|
| Rate for Payer: United Healthcare All Payer |
$3,565.76
|
|
|
BIOPSY OF TONGUE
|
Professional
|
Both
|
$4,052.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
76101652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$56.93 |
| Max. Negotiated Rate |
$4,052.00 |
| Rate for Payer: Aetna Commercial |
$159.28
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$75.25
|
| Rate for Payer: Anthem Medicaid |
$56.93
|
| Rate for Payer: Buckeye Medicare Advantage |
$4,052.00
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cigna Commercial |
$220.40
|
| Rate for Payer: Healthspan PPO |
$194.36
|
| Rate for Payer: Humana Medicaid |
$56.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$143.17
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$58.07
|
| Rate for Payer: Molina Healthcare Passport |
$56.93
|
| Rate for Payer: Multiplan PHCS |
$2,431.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,836.40
|
| Rate for Payer: UHCCP Medicaid |
$79.01
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$57.50
|
|
|
BIOPSY OF TONGUE
|
Facility
|
OP
|
$4,052.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
76101652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$526.76 |
| Max. Negotiated Rate |
$3,897.84 |
| Rate for Payer: Aetna Commercial |
$3,120.04
|
| Rate for Payer: Anthem Medicaid |
$1,393.48
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,784.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,160.56
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,897.84
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,758.63
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cigna Commercial |
$3,363.16
|
| Rate for Payer: First Health Commercial |
$3,849.40
|
| Rate for Payer: Humana Commercial |
$3,444.20
|
| Rate for Payer: Humana KY Medicaid |
$1,393.48
|
| Rate for Payer: Humana Medicare Advantage |
$2,784.17
|
| Rate for Payer: Kentucky WC Medicaid |
$1,407.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,322.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,990.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,341.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,421.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,565.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,039.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$810.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$526.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,256.12
|
| Rate for Payer: PHCS Commercial |
$3,889.92
|
| Rate for Payer: United Healthcare All Payer |
$3,565.76
|
|
|
BIOPSY OF TONGUE(P
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
761P1652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$56.93 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$159.28
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$75.25
|
| Rate for Payer: Anthem Medicaid |
$56.93
|
| Rate for Payer: Buckeye Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$220.40
|
| Rate for Payer: Healthspan PPO |
$194.36
|
| Rate for Payer: Humana Medicaid |
$56.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$143.17
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$58.07
|
| Rate for Payer: Molina Healthcare Passport |
$56.93
|
| Rate for Payer: Multiplan PHCS |
$180.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$210.00
|
| Rate for Payer: UHCCP Medicaid |
$79.01
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$57.50
|
|
|
BIOPSY OF TONGUE(T
|
Facility
|
IP
|
$3,752.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
761T1652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$487.76 |
| Max. Negotiated Rate |
$3,601.92 |
| Rate for Payer: Aetna Commercial |
$2,889.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,926.56
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cigna Commercial |
$3,114.16
|
| Rate for Payer: First Health Commercial |
$3,564.40
|
| Rate for Payer: Humana Commercial |
$3,189.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,076.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,768.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,125.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,301.76
|
| Rate for Payer: Ohio Health Group HMO |
$2,814.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$750.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,163.12
|
| Rate for Payer: PHCS Commercial |
$3,601.92
|
| Rate for Payer: United Healthcare All Payer |
$3,301.76
|
|
|
BIOPSY OF TONGUE(T
|
Facility
|
OP
|
$3,752.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
761T1652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$487.76 |
| Max. Negotiated Rate |
$3,897.84 |
| Rate for Payer: Aetna Commercial |
$2,889.04
|
| Rate for Payer: Anthem Medicaid |
$1,290.31
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,784.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,926.56
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,897.84
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,758.63
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cigna Commercial |
$3,114.16
|
| Rate for Payer: First Health Commercial |
$3,564.40
|
| Rate for Payer: Humana Commercial |
$3,189.20
|
| Rate for Payer: Humana KY Medicaid |
$1,290.31
|
| Rate for Payer: Humana Medicare Advantage |
$2,784.17
|
| Rate for Payer: Kentucky WC Medicaid |
$1,303.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,076.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,768.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,341.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,316.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,301.76
|
| Rate for Payer: Ohio Health Group HMO |
$2,814.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$750.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$487.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,163.12
|
| Rate for Payer: PHCS Commercial |
$3,601.92
|
| Rate for Payer: United Healthcare All Payer |
$3,301.76
|
|
|
BIOPSY OF UTERUS LINING
|
Facility
|
IP
|
$808.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
76102207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.04 |
| Max. Negotiated Rate |
$775.68 |
| Rate for Payer: Aetna Commercial |
$622.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$630.24
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cigna Commercial |
$670.64
|
| Rate for Payer: First Health Commercial |
$767.60
|
| Rate for Payer: Humana Commercial |
$686.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$662.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$596.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$242.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$711.04
|
| Rate for Payer: Ohio Health Group HMO |
$606.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$161.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$105.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$250.48
|
| Rate for Payer: PHCS Commercial |
$775.68
|
| Rate for Payer: United Healthcare All Payer |
$711.04
|
|
