|
STEM REDAPT SLVLS HOSZ17 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ18 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ18 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ19 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ19 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ20 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ20 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ21 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ21 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ22 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ22 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ23 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ23 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ24 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ24 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ25 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ25 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ26 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ26 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ27 300MM
|
Facility
|
IP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDAPT SLVLS HOSZ27 300MM
|
Facility
|
OP
|
$36,777.29
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,781.05 |
| Max. Negotiated Rate |
$35,306.20 |
| Rate for Payer: Aetna Commercial |
$28,318.51
|
| Rate for Payer: Anthem Medicaid |
$12,647.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,686.29
|
| Rate for Payer: Cash Price |
$18,388.64
|
| Rate for Payer: Cigna Commercial |
$30,525.15
|
| Rate for Payer: First Health Commercial |
$34,938.43
|
| Rate for Payer: Humana Commercial |
$31,260.70
|
| Rate for Payer: Humana KY Medicaid |
$12,647.71
|
| Rate for Payer: Kentucky WC Medicaid |
$12,776.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,157.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,141.64
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,033.19
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,901.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$32,364.02
|
| Rate for Payer: Ohio Health Group HMO |
$27,582.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,355.46
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,781.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,400.96
|
| Rate for Payer: PHCS Commercial |
$35,306.20
|
| Rate for Payer: United Healthcare All Payer |
$32,364.02
|
|
|
STEM REDPTSLVLSMONO SZ12 300MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
STEM REDPTSLVLSMONO SZ12 300MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
STEM REDPTSLVLSMONO SZ13 300MM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
STEM REDPTSLVLSMONO SZ13 300MM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
