|
STENT COTTON-LEUNG BIL 10*5
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 10*5
|
Facility
|
IP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 10*7
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 10*7
|
Facility
|
IP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 10*9
|
Facility
|
IP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 10*9
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 11.5*12
|
Facility
|
IP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*12
|
Facility
|
OP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem Medicaid |
$602.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Humana KY Medicaid |
$602.03
|
| Rate for Payer: Kentucky WC Medicaid |
$608.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*15
|
Facility
|
OP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem Medicaid |
$602.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Humana KY Medicaid |
$602.03
|
| Rate for Payer: Kentucky WC Medicaid |
$608.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*15
|
Facility
|
IP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*5
|
Facility
|
OP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem Medicaid |
$602.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Humana KY Medicaid |
$602.03
|
| Rate for Payer: Kentucky WC Medicaid |
$608.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*5
|
Facility
|
IP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*7
|
Facility
|
IP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*7
|
Facility
|
OP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem Medicaid |
$602.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Humana KY Medicaid |
$602.03
|
| Rate for Payer: Kentucky WC Medicaid |
$608.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*9
|
Facility
|
IP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 11.5*9
|
Facility
|
OP
|
$1,750.61
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.58 |
| Max. Negotiated Rate |
$1,680.59 |
| Rate for Payer: Aetna Commercial |
$1,347.97
|
| Rate for Payer: Anthem Medicaid |
$602.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.48
|
| Rate for Payer: Cash Price |
$875.30
|
| Rate for Payer: Cigna Commercial |
$1,453.01
|
| Rate for Payer: First Health Commercial |
$1,663.08
|
| Rate for Payer: Humana Commercial |
$1,488.02
|
| Rate for Payer: Humana KY Medicaid |
$602.03
|
| Rate for Payer: Kentucky WC Medicaid |
$608.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$614.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.54
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.69
|
| Rate for Payer: PHCS Commercial |
$1,680.59
|
| Rate for Payer: United Healthcare All Payer |
$1,540.54
|
|
|
STENT COTTON-LEUNG BIL 7*12
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 7*12
|
Facility
|
IP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 7*15
|
Facility
|
OP
|
$1,713.44
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.75 |
| Max. Negotiated Rate |
$1,644.90 |
| Rate for Payer: Aetna Commercial |
$1,319.35
|
| Rate for Payer: Anthem Medicaid |
$589.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,336.48
|
| Rate for Payer: Cash Price |
$856.72
|
| Rate for Payer: Cigna Commercial |
$1,422.16
|
| Rate for Payer: First Health Commercial |
$1,627.77
|
| Rate for Payer: Humana Commercial |
$1,456.42
|
| Rate for Payer: Humana KY Medicaid |
$589.25
|
| Rate for Payer: Kentucky WC Medicaid |
$595.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,405.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,264.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$514.03
|
| Rate for Payer: Molina Healthcare Medicaid |
$601.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,507.83
|
| Rate for Payer: Ohio Health Group HMO |
$1,285.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$342.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$222.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$531.17
|
| Rate for Payer: PHCS Commercial |
$1,644.90
|
| Rate for Payer: United Healthcare All Payer |
$1,507.83
|
|
|
STENT COTTON-LEUNG BIL 7*15
|
Facility
|
IP
|
$1,713.44
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.75 |
| Max. Negotiated Rate |
$1,644.90 |
| Rate for Payer: Aetna Commercial |
$1,319.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,336.48
|
| Rate for Payer: Cash Price |
$856.72
|
| Rate for Payer: Cigna Commercial |
$1,422.16
|
| Rate for Payer: First Health Commercial |
$1,627.77
|
| Rate for Payer: Humana Commercial |
$1,456.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,405.02
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,264.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$514.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,507.83
|
| Rate for Payer: Ohio Health Group HMO |
$1,285.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$342.69
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$222.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$531.17
|
| Rate for Payer: PHCS Commercial |
$1,644.90
|
| Rate for Payer: United Healthcare All Payer |
$1,507.83
|
|
|
STENT COTTON-LEUNG BIL 7*5
|
Facility
|
IP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 7*5
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 7*7
|
Facility
|
IP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 7*7
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
|
STENT COTTON-LEUNG BIL 7*9
|
Facility
|
OP
|
$1,766.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.64 |
| Max. Negotiated Rate |
$1,695.84 |
| Rate for Payer: Aetna Commercial |
$1,360.20
|
| Rate for Payer: Anthem Medicaid |
$607.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,377.87
|
| Rate for Payer: Cash Price |
$883.25
|
| Rate for Payer: Cigna Commercial |
$1,466.20
|
| Rate for Payer: First Health Commercial |
$1,678.18
|
| Rate for Payer: Humana Commercial |
$1,501.52
|
| Rate for Payer: Humana KY Medicaid |
$607.50
|
| Rate for Payer: Kentucky WC Medicaid |
$613.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,448.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,303.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$529.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$619.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,554.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,324.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$353.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$229.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$547.62
|
| Rate for Payer: PHCS Commercial |
$1,695.84
|
| Rate for Payer: United Healthcare All Payer |
$1,554.52
|
|
