|
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
|
|
|
BIOPSY OF UTERUS LINING
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
76102207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.09 |
| Max. Negotiated Rate |
$808.00 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$59.98
|
| Rate for Payer: Anthem Medicaid |
$33.09
|
| Rate for Payer: Buckeye Medicare Advantage |
$808.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cigna Commercial |
$165.93
|
| Rate for Payer: Healthspan PPO |
$160.12
|
| Rate for Payer: Humana Medicaid |
$33.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$114.37
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$33.75
|
| Rate for Payer: Molina Healthcare Passport |
$33.09
|
| Rate for Payer: Multiplan PHCS |
$484.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$565.60
|
| Rate for Payer: UHCCP Medicaid |
$62.98
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$33.42
|
|
|
BIOPSY OF UTERUS LINING(P
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
761P2207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.09 |
| Max. Negotiated Rate |
$425.00 |
| Rate for Payer: Cash Price |
$212.50
|
| Rate for Payer: Cigna Commercial |
$165.93
|
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$59.98
|
| Rate for Payer: Anthem Medicaid |
$33.09
|
| Rate for Payer: Buckeye Medicare Advantage |
$425.00
|
| Rate for Payer: Cash Price |
$212.50
|
| Rate for Payer: Healthspan PPO |
$160.12
|
| Rate for Payer: Humana Medicaid |
$33.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$114.37
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$33.75
|
| Rate for Payer: Molina Healthcare Passport |
$33.09
|
| Rate for Payer: Multiplan PHCS |
$255.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$297.50
|
| Rate for Payer: UHCCP Medicaid |
$62.98
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$33.42
|
|
|
BIOPSY OF UTERUS LINING(T
|
Facility
|
OP
|
$383.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
761T2207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.79 |
| Max. Negotiated Rate |
$367.68 |
| Rate for Payer: Aetna Commercial |
$294.91
|
| Rate for Payer: Anthem Medicaid |
$131.71
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$172.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$298.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$241.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$232.63
|
| Rate for Payer: Cash Price |
$191.50
|
| Rate for Payer: Cash Price |
$191.50
|
| Rate for Payer: Cigna Commercial |
$317.89
|
| Rate for Payer: First Health Commercial |
$363.85
|
| Rate for Payer: Humana Commercial |
$325.55
|
| Rate for Payer: Humana KY Medicaid |
$131.71
|
| Rate for Payer: Humana Medicare Advantage |
$172.32
|
| Rate for Payer: Kentucky WC Medicaid |
$133.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$314.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$282.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$206.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$134.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$337.04
|
| Rate for Payer: Ohio Health Group HMO |
$287.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$76.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$49.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$118.73
|
| Rate for Payer: PHCS Commercial |
$367.68
|
| Rate for Payer: United Healthcare All Payer |
$337.04
|
|
|
BIOPSY OF UTERUS LINING(T
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
761T2207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.79 |
| Max. Negotiated Rate |
$367.68 |
| Rate for Payer: Aetna Commercial |
$294.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$298.74
|
| Rate for Payer: Cash Price |
$191.50
|
| Rate for Payer: Cigna Commercial |
$317.89
|
| Rate for Payer: First Health Commercial |
$363.85
|
| Rate for Payer: Humana Commercial |
$325.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$314.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$282.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$337.04
|
| Rate for Payer: Ohio Health Group HMO |
$287.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$76.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$49.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$118.73
|
| Rate for Payer: PHCS Commercial |
$367.68
|
| Rate for Payer: United Healthcare All Payer |
$337.04
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$2,498.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
76102170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.83 |
| Max. Negotiated Rate |
$2,398.75 |
| Rate for Payer: Aetna Commercial |
$1,924.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,948.99
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cigna Commercial |
$2,073.92
|
| Rate for Payer: First Health Commercial |
$2,373.76
|
| Rate for Payer: Humana Commercial |
$2,123.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,048.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,844.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$749.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,198.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,874.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$499.74
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$324.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$774.60
|
| Rate for Payer: PHCS Commercial |
$2,398.75
|
| Rate for Payer: United Healthcare All Payer |
$2,198.86
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$2,498.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
76102170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.83 |
| Max. Negotiated Rate |
$2,398.75 |
| Rate for Payer: Aetna Commercial |
$1,924.00
|
| Rate for Payer: Anthem Medicaid |
$859.30
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$695.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,948.99
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$973.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$938.51
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cigna Commercial |
$2,073.92
|
| Rate for Payer: First Health Commercial |
$2,373.76
|
| Rate for Payer: Humana Commercial |
$2,123.90
|
| Rate for Payer: Humana KY Medicaid |
$859.30
|
| Rate for Payer: Humana Medicare Advantage |
$695.19
|
| Rate for Payer: Kentucky WC Medicaid |
$868.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,048.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,844.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$834.23
|
| Rate for Payer: Molina Healthcare Medicaid |
$876.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,198.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,874.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$499.74
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$324.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$774.60
|
| Rate for Payer: PHCS Commercial |
$2,398.75
|
| Rate for Payer: United Healthcare All Payer |
$2,198.86
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$5,109.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
76102171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$664.29 |
| Max. Negotiated Rate |
$4,905.53 |
| Rate for Payer: Aetna Commercial |
$3,934.65
|
| Rate for Payer: Anthem Medicaid |
$1,757.30
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,703.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,985.75
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,784.94
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,649.77
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cigna Commercial |
$4,241.24
|
| Rate for Payer: First Health Commercial |
$4,854.43
|
| Rate for Payer: Humana Commercial |
$4,343.44
|
| Rate for Payer: Humana KY Medicaid |
$1,757.30
|
| Rate for Payer: Humana Medicare Advantage |
$2,703.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,775.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,190.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,771.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,244.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,792.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,496.74
|
| Rate for Payer: Ohio Health Group HMO |
$3,832.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,021.99
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$664.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,584.08
|
| Rate for Payer: PHCS Commercial |
$4,905.53
|
| Rate for Payer: United Healthcare All Payer |
$4,496.74
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$5,109.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
76102171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$664.29 |
| Max. Negotiated Rate |
$4,905.53 |
| Rate for Payer: Aetna Commercial |
$3,934.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,985.75
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cigna Commercial |
$4,241.24
|
| Rate for Payer: First Health Commercial |
$4,854.43
|
| Rate for Payer: Humana Commercial |
$4,343.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,190.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,771.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,532.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,496.74
|
| Rate for Payer: Ohio Health Group HMO |
$3,832.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,021.99
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$664.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,584.08
|
| Rate for Payer: PHCS Commercial |
$4,905.53
|
| Rate for Payer: United Healthcare All Payer |
$4,496.74
|
|
|
BIOPSY OF VAGINA
|
Professional
|
Both
|
$5,109.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
76102171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$5,109.93 |
| Rate for Payer: Aetna Commercial |
$186.27
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$92.84
|
| Rate for Payer: Anthem Medicaid |
$98.25
|
| Rate for Payer: Buckeye Medicare Advantage |
$5,109.93
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cigna Commercial |
$184.14
|
| Rate for Payer: Healthspan PPO |
$194.88
|
| Rate for Payer: Humana Medicaid |
$98.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$160.51
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$100.22
|
| Rate for Payer: Molina Healthcare Passport |
$98.25
|
| Rate for Payer: Multiplan PHCS |
$3,065.96
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$3,576.95
|
| Rate for Payer: UHCCP Medicaid |
$97.48
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$99.23
|
|
|
BIOPSY OF VAGINA
|
Professional
|
Both
|
$2,498.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
76102170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$2,498.70 |
| Rate for Payer: Aetna Commercial |
$101.19
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$39.53
|
| Rate for Payer: Anthem Medicaid |
$39.94
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,498.70
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cigna Commercial |
$132.42
|
| Rate for Payer: Healthspan PPO |
$128.03
|
| Rate for Payer: Humana Medicaid |
$39.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$85.62
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$40.74
|
| Rate for Payer: Molina Healthcare Passport |
$39.94
|
| Rate for Payer: Multiplan PHCS |
$1,499.22
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,749.09
|
| Rate for Payer: UHCCP Medicaid |
$41.51
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$40.34
|
|
|
BIOPSY OF VAGINA(P
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
761P2170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$101.19
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$39.53
|
| Rate for Payer: Anthem Medicaid |
$39.94
|
| 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 |
$132.42
|
| Rate for Payer: Healthspan PPO |
$128.03
|
| Rate for Payer: Humana Medicaid |
$39.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$85.62
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$40.74
|
| Rate for Payer: Molina Healthcare Passport |
$39.94
|
| Rate for Payer: Multiplan PHCS |
$120.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$140.00
|
| Rate for Payer: UHCCP Medicaid |
$41.51
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$40.34
|
|
|
BIOPSY OF VAGINA(P
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
761P2171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$505.00 |
| Rate for Payer: Aetna Commercial |
$186.27
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$92.84
|
| Rate for Payer: Anthem Medicaid |
$98.25
|
| Rate for Payer: Buckeye Medicare Advantage |
$505.00
|
| Rate for Payer: Cash Price |
$252.50
|
| Rate for Payer: Cash Price |
$252.50
|
| Rate for Payer: Cigna Commercial |
$184.14
|
| Rate for Payer: Healthspan PPO |
$194.88
|
| Rate for Payer: Humana Medicaid |
$98.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$160.51
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$100.22
|
| Rate for Payer: Molina Healthcare Passport |
$98.25
|
| Rate for Payer: Multiplan PHCS |
$303.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$353.50
|
| Rate for Payer: UHCCP Medicaid |
$97.48
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$99.23
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
IP
|
$4,604.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
761T2171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$598.64 |
| Max. Negotiated Rate |
$4,420.73 |
| Rate for Payer: Aetna Commercial |
$3,545.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,591.85
|
| Rate for Payer: Cash Price |
$2,302.47
|
| Rate for Payer: Cigna Commercial |
$3,822.09
|
| Rate for Payer: First Health Commercial |
$4,374.68
|
| Rate for Payer: Humana Commercial |
$3,914.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,776.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,398.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,381.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,052.34
|
| Rate for Payer: Ohio Health Group HMO |
$3,453.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$920.99
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$598.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,427.53
|
| Rate for Payer: PHCS Commercial |
$4,420.73
|
| Rate for Payer: United Healthcare All Payer |
$4,052.34
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
IP
|
$2,298.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
761T2170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$298.83 |
| Max. Negotiated Rate |
$2,206.75 |
| Rate for Payer: Aetna Commercial |
$1,770.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,792.99
|
| Rate for Payer: Cash Price |
$1,149.35
|
| Rate for Payer: Cigna Commercial |
$1,907.92
|
| Rate for Payer: First Health Commercial |
$2,183.76
|
| Rate for Payer: Humana Commercial |
$1,953.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,884.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,696.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$689.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,022.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,724.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$459.74
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$298.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$712.60
|
| Rate for Payer: PHCS Commercial |
$2,206.75
|
| Rate for Payer: United Healthcare All Payer |
$2,022.86
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
OP
|
$4,604.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
761T2171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$598.64 |
| Max. Negotiated Rate |
$4,420.73 |
| Rate for Payer: Aetna Commercial |
$3,545.80
|
| Rate for Payer: Anthem Medicaid |
$1,583.64
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,703.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,591.85
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,784.94
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,649.77
|
| Rate for Payer: Cash Price |
$2,302.47
|
| Rate for Payer: Cash Price |
$2,302.47
|
| Rate for Payer: Cigna Commercial |
$3,822.09
|
| Rate for Payer: First Health Commercial |
$4,374.68
|
| Rate for Payer: Humana Commercial |
$3,914.19
|
| Rate for Payer: Humana KY Medicaid |
$1,583.64
|
| Rate for Payer: Humana Medicare Advantage |
$2,703.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,599.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,776.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,398.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,244.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,615.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,052.34
|
| Rate for Payer: Ohio Health Group HMO |
$3,453.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$920.99
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$598.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,427.53
|
| Rate for Payer: PHCS Commercial |
$4,420.73
|
| Rate for Payer: United Healthcare All Payer |
$4,052.34
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
OP
|
$2,298.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
761T2170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$298.83 |
| Max. Negotiated Rate |
$2,206.75 |
| Rate for Payer: Aetna Commercial |
$1,770.00
|
| Rate for Payer: Anthem Medicaid |
$790.52
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$695.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,792.99
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$973.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$938.51
|
| Rate for Payer: Cash Price |
$1,149.35
|
| Rate for Payer: Cash Price |
$1,149.35
|
| Rate for Payer: Cigna Commercial |
$1,907.92
|
| Rate for Payer: First Health Commercial |
$2,183.76
|
| Rate for Payer: Humana Commercial |
$1,953.90
|
| Rate for Payer: Humana KY Medicaid |
$790.52
|
| Rate for Payer: Humana Medicare Advantage |
$695.19
|
| Rate for Payer: Kentucky WC Medicaid |
$798.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,884.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,696.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$834.23
|
| Rate for Payer: Molina Healthcare Medicaid |
$806.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,022.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,724.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$459.74
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$298.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$712.60
|
| Rate for Payer: PHCS Commercial |
$2,206.75
|
| Rate for Payer: United Healthcare All Payer |
$2,022.86
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
|
OP
|
$973.27
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$695.19 |
| Max. Negotiated Rate |
$973.27 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$695.19
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$973.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$938.51
|
| Rate for Payer: Humana Medicare Advantage |
$695.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$834.23
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Facility
|
IP
|
$1,042.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
76102161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$135.46 |
| Max. Negotiated Rate |
$1,000.32 |
| Rate for Payer: Aetna Commercial |
$802.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$812.76
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cigna Commercial |
$864.86
|
| Rate for Payer: First Health Commercial |
$989.90
|
| Rate for Payer: Humana Commercial |
$885.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$854.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$769.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$312.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$916.96
|
| Rate for Payer: Ohio Health Group HMO |
$781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$208.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$135.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$323.02
|
| Rate for Payer: PHCS Commercial |
$1,000.32
|
| Rate for Payer: United Healthcare All Payer |
$916.96
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Facility
|
OP
|
$1,042.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
76102161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$135.46 |
| Max. Negotiated Rate |
$1,000.32 |
| Rate for Payer: Aetna Commercial |
$802.34
|
| Rate for Payer: Anthem Medicaid |
$358.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$812.76
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cigna Commercial |
$864.86
|
| Rate for Payer: First Health Commercial |
$989.90
|
| Rate for Payer: Humana Commercial |
$885.70
|
| Rate for Payer: Humana KY Medicaid |
$358.34
|
| Rate for Payer: Kentucky WC Medicaid |
$361.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$854.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$769.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$312.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$365.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$916.96
|
| Rate for Payer: Ohio Health Group HMO |
$781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$208.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$135.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$323.02
|
| Rate for Payer: PHCS Commercial |
$1,000.32
|
| Rate for Payer: United Healthcare All Payer |
$916.96
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Professional
|
Both
|
$1,042.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
76102161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$1,042.00 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$20.24
|
| Rate for Payer: Anthem Medicaid |
$19.26
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,042.00
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cigna Commercial |
$59.78
|
| Rate for Payer: Healthspan PPO |
$56.30
|
| Rate for Payer: Humana Medicaid |
$19.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$38.12
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$19.65
|
| Rate for Payer: Molina Healthcare Passport |
$19.26
|
| Rate for Payer: Multiplan PHCS |
$625.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$729.40
|
| Rate for Payer: UHCCP Medicaid |
$21.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$19.45
|
|
|
BIOPSY OF VULVA/PERINEUM1LE(P
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
761P2160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.31 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$93.63
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$30.31
|
| Rate for Payer: Anthem Medicaid |
$38.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$345.00
|
| Rate for Payer: Cash Price |
$172.50
|
| Rate for Payer: Cash Price |
$172.50
|
| Rate for Payer: Cigna Commercial |
$125.81
|
| Rate for Payer: Healthspan PPO |
$120.71
|
| Rate for Payer: Humana Medicaid |
$38.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$78.97
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$38.76
|
| Rate for Payer: Molina Healthcare Passport |
$38.00
|
| Rate for Payer: Multiplan PHCS |
$207.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$241.50
|
| Rate for Payer: UHCCP Medicaid |
$31.83
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$38.38
|
|
|
BIOPSY OF VULVA/PERINEUM1LES
|
Facility
|
IP
|
$2,247.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
76102160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.11 |
| Max. Negotiated Rate |
$2,157.12 |
| Rate for Payer: Aetna Commercial |
$1,730.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,752.66
|
| Rate for Payer: Cash Price |
$1,123.50
|
| Rate for Payer: Cigna Commercial |
$1,865.01
|
| Rate for Payer: First Health Commercial |
$2,134.65
|
| Rate for Payer: Humana Commercial |
$1,909.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,842.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,658.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$674.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,977.36
|
| Rate for Payer: Ohio Health Group HMO |
$1,685.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$449.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$292.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$696.57
|
| Rate for Payer: PHCS Commercial |
$2,157.12
|
| Rate for Payer: United Healthcare All Payer |
$1,977.36
|
|
|
BIOPSY OF VULVA/PERINEUM1LES
|
Facility
|
OP
|
$2,247.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
76102160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.11 |
| Max. Negotiated Rate |
$2,157.12 |
| Rate for Payer: Aetna Commercial |
$1,730.19
|
| Rate for Payer: Anthem Medicaid |
$772.74
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$695.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,752.66
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$973.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$938.51
|
| Rate for Payer: Cash Price |
$1,123.50
|
| Rate for Payer: Cash Price |
$1,123.50
|
| Rate for Payer: Cigna Commercial |
$1,865.01
|
| Rate for Payer: First Health Commercial |
$2,134.65
|
| Rate for Payer: Humana Commercial |
$1,909.95
|
| Rate for Payer: Humana KY Medicaid |
$772.74
|
| Rate for Payer: Humana Medicare Advantage |
$695.19
|
| Rate for Payer: Kentucky WC Medicaid |
$780.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,842.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,658.29
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$834.23
|
| Rate for Payer: Molina Healthcare Medicaid |
$788.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,977.36
|
| Rate for Payer: Ohio Health Group HMO |
$1,685.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$449.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$292.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$696.57
|
| Rate for Payer: PHCS Commercial |
$2,157.12
|
| Rate for Payer: United Healthcare All Payer |
$1,977.36
|
|
|
BIOPSY OF VULVA/PERINEUM1LES
|
Professional
|
Both
|
$2,247.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
76102160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.31 |
| Max. Negotiated Rate |
$2,247.00 |
| Rate for Payer: Aetna Commercial |
$93.63
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$30.31
|
| Rate for Payer: Anthem Medicaid |
$38.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,247.00
|
| Rate for Payer: Cash Price |
$1,123.50
|
| Rate for Payer: Cash Price |
$1,123.50
|
| Rate for Payer: Cigna Commercial |
$125.81
|
| Rate for Payer: Healthspan PPO |
$120.71
|
| Rate for Payer: Humana Medicaid |
$38.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$78.97
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$38.76
|
| Rate for Payer: Molina Healthcare Passport |
$38.00
|
| Rate for Payer: Multiplan PHCS |
$1,348.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,572.90
|
| Rate for Payer: UHCCP Medicaid |
$31.83
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$38.38
|
|
