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Service Code HCPCS J0585
Hospital Charge Code 25001901
Hospital Revenue Code 636
Min. Negotiated Rate $256.48
Max. Negotiated Rate $1,893.98
Rate for Payer: Aetna Commercial $1,519.13
Rate for Payer: Anthem POS/PPO/Traditional $1,538.86
Rate for Payer: Cash Price $986.45
Rate for Payer: Cigna Commercial $1,637.51
Rate for Payer: First Health Commercial $1,874.26
Rate for Payer: Humana Commercial $1,676.96
Rate for Payer: Medical Mutual Of Ohio HMO $1,617.78
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,456.00
Rate for Payer: Molina Healthcare Benefit Exchange $591.87
Rate for Payer: Ohio Health Choice Commercial $1,736.15
Rate for Payer: Ohio Health Group HMO $1,479.68
Rate for Payer: Ohio Health Group PPO Differential $394.58
Rate for Payer: Ohio Health Group PPO No Differential $256.48
Rate for Payer: Ohio Health Group PPO SOMC Employees $611.60
Rate for Payer: PHCS Commercial $1,893.98
Rate for Payer: United Healthcare All Payer $1,736.15
Service Code HCPCS J0585
Hospital Charge Code 63600016
Hospital Revenue Code 636
Min. Negotiated Rate $4.44
Max. Negotiated Rate $12.68
Rate for Payer: Aetna Commercial $8.33
Rate for Payer: Buckeye Medicare Advantage $12.68
Rate for Payer: Cash Price $6.34
Rate for Payer: Cash Price $6.34
Rate for Payer: Healthspan PPO $7.10
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $8.59
Rate for Payer: Multiplan PHCS $7.61
Rate for Payer: Ohio Health Choice Preferred Health Choice $8.88
Rate for Payer: UHCCP Medicaid $4.44
Service Code HCPCS J0585
Hospital Charge Code 63600016
Hospital Revenue Code 636
Min. Negotiated Rate $1.65
Max. Negotiated Rate $12.17
Rate for Payer: Aetna Commercial $9.76
Rate for Payer: Anthem Medicaid $4.36
Rate for Payer: Anthem Medicare Advantage/PPO $6.33
Rate for Payer: Anthem POS/PPO/Traditional $9.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $8.86
Rate for Payer: CareSource Just4Me Medicare $8.54
Rate for Payer: Cash Price $6.34
Rate for Payer: Cash Price $6.34
Rate for Payer: Cigna Commercial $10.52
Rate for Payer: First Health Commercial $12.05
Rate for Payer: Humana Commercial $10.78
Rate for Payer: Humana KY Medicaid $4.36
Rate for Payer: Humana Medicare Advantage $6.33
Rate for Payer: Kentucky WC Medicaid $4.41
Rate for Payer: Medical Mutual Of Ohio HMO $10.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9.36
Rate for Payer: Molina Healthcare Benefit Exchange $7.59
Rate for Payer: Molina Healthcare Medicaid $4.45
Rate for Payer: Ohio Health Choice Commercial $11.16
Rate for Payer: Ohio Health Group HMO $9.51
Rate for Payer: Ohio Health Group PPO Differential $2.54
Rate for Payer: Ohio Health Group PPO No Differential $1.65
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.93
Rate for Payer: PHCS Commercial $12.17
Rate for Payer: United Healthcare All Payer $11.16
Service Code HCPCS J0585
Hospital Charge Code 636T0016
Hospital Revenue Code 636
Min. Negotiated Rate $1.65
Max. Negotiated Rate $12.17
Rate for Payer: Aetna Commercial $9.76
Rate for Payer: Anthem POS/PPO/Traditional $9.89
Rate for Payer: Cash Price $6.34
Rate for Payer: Cigna Commercial $10.52
Rate for Payer: First Health Commercial $12.05
Rate for Payer: Humana Commercial $10.78
Rate for Payer: Medical Mutual Of Ohio HMO $10.40
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9.36
Rate for Payer: Molina Healthcare Benefit Exchange $3.80
Rate for Payer: Ohio Health Choice Commercial $11.16
Rate for Payer: Ohio Health Group HMO $9.51
Rate for Payer: Ohio Health Group PPO Differential $2.54
Rate for Payer: Ohio Health Group PPO No Differential $1.65
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.93
Rate for Payer: PHCS Commercial $12.17
Rate for Payer: United Healthcare All Payer $11.16
Service Code HCPCS 44130
Hospital Charge Code 76102610
Hospital Revenue Code 761
Min. Negotiated Rate $202.28
Max. Negotiated Rate $1,493.76
Rate for Payer: Aetna Commercial $1,198.12
Rate for Payer: Anthem POS/PPO/Traditional $1,213.68
Rate for Payer: Cash Price $778.00
Rate for Payer: Cigna Commercial $1,291.48
Rate for Payer: First Health Commercial $1,478.20
Rate for Payer: Humana Commercial $1,322.60
Rate for Payer: Medical Mutual Of Ohio HMO $1,275.92
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,148.33
Rate for Payer: Molina Healthcare Benefit Exchange $466.80
Rate for Payer: Ohio Health Choice Commercial $1,369.28
Rate for Payer: Ohio Health Group HMO $1,167.00
Rate for Payer: Ohio Health Group PPO Differential $311.20
Rate for Payer: Ohio Health Group PPO No Differential $202.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $482.36
Rate for Payer: PHCS Commercial $1,493.76
Rate for Payer: United Healthcare All Payer $1,369.28
Service Code HCPCS 44130
Hospital Charge Code 761P2610
Hospital Revenue Code 761
Min. Negotiated Rate $544.60
Max. Negotiated Rate $1,820.23
Rate for Payer: Aetna Commercial $1,820.23
Rate for Payer: Anthem Medicaid $603.16
Rate for Payer: Buckeye Medicare Advantage $1,556.00
Rate for Payer: Cash Price $778.00
Rate for Payer: Cash Price $778.00
Rate for Payer: Cigna Commercial $1,641.02
Rate for Payer: Healthspan PPO $1,535.03
Rate for Payer: Humana Medicaid $603.16
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,663.70
Rate for Payer: Molina Healthcare CHIP/Medicaid $615.22
Rate for Payer: Molina Healthcare Passport $603.16
Rate for Payer: Multiplan PHCS $933.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,089.20
Rate for Payer: UHCCP Medicaid $544.60
Rate for Payer: Wellcare CHIP/Medicaid $609.19
Service Code HCPCS 44130
Hospital Charge Code 76102610
Hospital Revenue Code 761
Min. Negotiated Rate $544.60
Max. Negotiated Rate $1,820.23
Rate for Payer: Aetna Commercial $1,820.23
Rate for Payer: Anthem Medicaid $603.16
Rate for Payer: Buckeye Medicare Advantage $1,556.00
Rate for Payer: Cash Price $778.00
Rate for Payer: Cash Price $778.00
Rate for Payer: Cigna Commercial $1,641.02
Rate for Payer: Healthspan PPO $1,535.03
Rate for Payer: Humana Medicaid $603.16
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $1,663.70
Rate for Payer: Molina Healthcare CHIP/Medicaid $615.22
Rate for Payer: Molina Healthcare Passport $603.16
Rate for Payer: Multiplan PHCS $933.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,089.20
Rate for Payer: UHCCP Medicaid $544.60
Rate for Payer: Wellcare CHIP/Medicaid $609.19
Service Code HCPCS 44130
Hospital Charge Code 76102610
Hospital Revenue Code 761
Min. Negotiated Rate $202.28
Max. Negotiated Rate $1,493.76
Rate for Payer: Aetna Commercial $1,198.12
Rate for Payer: Anthem Medicaid $535.11
Rate for Payer: Anthem POS/PPO/Traditional $1,213.68
Rate for Payer: Cash Price $778.00
Rate for Payer: Cigna Commercial $1,291.48
Rate for Payer: First Health Commercial $1,478.20
Rate for Payer: Humana Commercial $1,322.60
Rate for Payer: Humana KY Medicaid $535.11
Rate for Payer: Kentucky WC Medicaid $540.55
Rate for Payer: Medical Mutual Of Ohio HMO $1,275.92
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,148.33
Rate for Payer: Molina Healthcare Benefit Exchange $466.80
Rate for Payer: Molina Healthcare Medicaid $545.84
Rate for Payer: Ohio Health Choice Commercial $1,369.28
Rate for Payer: Ohio Health Group HMO $1,167.00
Rate for Payer: Ohio Health Group PPO Differential $311.20
Rate for Payer: Ohio Health Group PPO No Differential $202.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $482.36
Rate for Payer: PHCS Commercial $1,493.76
Rate for Payer: United Healthcare All Payer $1,369.28
Service Code HCPCS 94667
Hospital Charge Code 41000082
Hospital Revenue Code 410
Min. Negotiated Rate $15.97
Max. Negotiated Rate $256.00
Rate for Payer: Aetna Commercial $31.39
Rate for Payer: Anthem Medicaid $15.97
Rate for Payer: Buckeye Medicare Advantage $256.00
Rate for Payer: Cash Price $128.00
Rate for Payer: Cash Price $128.00
Rate for Payer: Cigna Commercial $32.05
Rate for Payer: Healthspan PPO $24.32
Rate for Payer: Humana Medicaid $15.97
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $27.00
Rate for Payer: Molina Healthcare CHIP/Medicaid $16.29
Rate for Payer: Molina Healthcare Passport $15.97
Rate for Payer: Multiplan PHCS $153.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $179.20
Rate for Payer: UHCCP Medicaid $89.60
Rate for Payer: Wellcare CHIP/Medicaid $16.13
Service Code HCPCS 94667
Hospital Charge Code 41000082
Hospital Revenue Code 410
Min. Negotiated Rate $33.28
Max. Negotiated Rate $245.76
Rate for Payer: Aetna Commercial $197.12
Rate for Payer: Anthem Medicaid $88.04
Rate for Payer: Anthem Medicare Advantage/PPO $110.46
Rate for Payer: Anthem POS/PPO/Traditional $199.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $154.64
Rate for Payer: CareSource Just4Me Medicare $149.12
Rate for Payer: Cash Price $128.00
Rate for Payer: Cash Price $128.00
Rate for Payer: Cigna Commercial $212.48
Rate for Payer: First Health Commercial $243.20
Rate for Payer: Humana Commercial $217.60
Rate for Payer: Humana KY Medicaid $88.04
Rate for Payer: Humana Medicare Advantage $110.46
Rate for Payer: Kentucky WC Medicaid $88.93
Rate for Payer: Medical Mutual Of Ohio HMO $209.92
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $188.93
Rate for Payer: Molina Healthcare Benefit Exchange $132.55
Rate for Payer: Molina Healthcare Medicaid $89.80
Rate for Payer: Ohio Health Choice Commercial $225.28
Rate for Payer: Ohio Health Group HMO $192.00
Rate for Payer: Ohio Health Group PPO Differential $51.20
Rate for Payer: Ohio Health Group PPO No Differential $33.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $79.36
Rate for Payer: PHCS Commercial $245.76
Rate for Payer: United Healthcare All Payer $225.28
Service Code HCPCS 94667
Hospital Charge Code 41000082
Hospital Revenue Code 410
Min. Negotiated Rate $33.28
Max. Negotiated Rate $245.76
Rate for Payer: Aetna Commercial $197.12
Rate for Payer: Anthem POS/PPO/Traditional $199.68
Rate for Payer: Cash Price $128.00
Rate for Payer: Cigna Commercial $212.48
Rate for Payer: First Health Commercial $243.20
Rate for Payer: Humana Commercial $217.60
Rate for Payer: Medical Mutual Of Ohio HMO $209.92
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $188.93
Rate for Payer: Molina Healthcare Benefit Exchange $76.80
Rate for Payer: Ohio Health Choice Commercial $225.28
Rate for Payer: Ohio Health Group HMO $192.00
Rate for Payer: Ohio Health Group PPO Differential $51.20
Rate for Payer: Ohio Health Group PPO No Differential $33.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $79.36
Rate for Payer: PHCS Commercial $245.76
Rate for Payer: United Healthcare All Payer $225.28
Service Code HCPCS 94667
Hospital Charge Code 410P0082
Hospital Revenue Code 410
Min. Negotiated Rate $15.97
Max. Negotiated Rate $75.00
Rate for Payer: Aetna Commercial $31.39
Rate for Payer: Anthem Medicaid $15.97
Rate for Payer: Buckeye Medicare Advantage $75.00
Rate for Payer: Cash Price $37.50
Rate for Payer: Cash Price $37.50
Rate for Payer: Cigna Commercial $32.05
Rate for Payer: Healthspan PPO $24.32
Rate for Payer: Humana Medicaid $15.97
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $27.00
Rate for Payer: Molina Healthcare CHIP/Medicaid $16.29
Rate for Payer: Molina Healthcare Passport $15.97
Rate for Payer: Multiplan PHCS $45.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $52.50
Rate for Payer: UHCCP Medicaid $26.25
Rate for Payer: Wellcare CHIP/Medicaid $16.13
Service Code HCPCS 94667
Hospital Charge Code 410T0082
Hospital Revenue Code 410
Min. Negotiated Rate $23.53
Max. Negotiated Rate $173.76
Rate for Payer: Aetna Commercial $139.37
Rate for Payer: Anthem Medicaid $62.25
Rate for Payer: Anthem Medicare Advantage/PPO $110.46
Rate for Payer: Anthem POS/PPO/Traditional $141.18
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $154.64
Rate for Payer: CareSource Just4Me Medicare $149.12
Rate for Payer: Cash Price $90.50
Rate for Payer: Cash Price $90.50
Rate for Payer: Cigna Commercial $150.23
Rate for Payer: First Health Commercial $171.95
Rate for Payer: Humana Commercial $153.85
Rate for Payer: Humana KY Medicaid $62.25
Rate for Payer: Humana Medicare Advantage $110.46
Rate for Payer: Kentucky WC Medicaid $62.88
Rate for Payer: Medical Mutual Of Ohio HMO $148.42
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $133.58
Rate for Payer: Molina Healthcare Benefit Exchange $132.55
Rate for Payer: Molina Healthcare Medicaid $63.49
Rate for Payer: Ohio Health Choice Commercial $159.28
Rate for Payer: Ohio Health Group HMO $135.75
Rate for Payer: Ohio Health Group PPO Differential $36.20
Rate for Payer: Ohio Health Group PPO No Differential $23.53
Rate for Payer: Ohio Health Group PPO SOMC Employees $56.11
Rate for Payer: PHCS Commercial $173.76
Rate for Payer: United Healthcare All Payer $159.28
Service Code HCPCS 94667
Hospital Charge Code 410T0082
Hospital Revenue Code 410
Min. Negotiated Rate $23.53
Max. Negotiated Rate $173.76
Rate for Payer: Aetna Commercial $139.37
Rate for Payer: Anthem POS/PPO/Traditional $141.18
Rate for Payer: Cash Price $90.50
Rate for Payer: Cigna Commercial $150.23
Rate for Payer: First Health Commercial $171.95
Rate for Payer: Humana Commercial $153.85
Rate for Payer: Medical Mutual Of Ohio HMO $148.42
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $133.58
Rate for Payer: Molina Healthcare Benefit Exchange $54.30
Rate for Payer: Ohio Health Choice Commercial $159.28
Rate for Payer: Ohio Health Group HMO $135.75
Rate for Payer: Ohio Health Group PPO Differential $36.20
Rate for Payer: Ohio Health Group PPO No Differential $23.53
Rate for Payer: Ohio Health Group PPO SOMC Employees $56.11
Rate for Payer: PHCS Commercial $173.76
Rate for Payer: United Healthcare All Payer $159.28
Service Code HCPCS 94668
Hospital Charge Code 41000083
Hospital Revenue Code 410
Min. Negotiated Rate $22.88
Max. Negotiated Rate $168.96
Rate for Payer: Aetna Commercial $135.52
Rate for Payer: Anthem Medicaid $60.53
Rate for Payer: Anthem Medicare Advantage/PPO $110.46
Rate for Payer: Anthem POS/PPO/Traditional $137.28
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $154.64
Rate for Payer: CareSource Just4Me Medicare $149.12
Rate for Payer: Cash Price $88.00
Rate for Payer: Cash Price $88.00
Rate for Payer: Cigna Commercial $146.08
Rate for Payer: First Health Commercial $167.20
Rate for Payer: Humana Commercial $149.60
Rate for Payer: Humana KY Medicaid $60.53
Rate for Payer: Humana Medicare Advantage $110.46
Rate for Payer: Kentucky WC Medicaid $61.14
Rate for Payer: Medical Mutual Of Ohio HMO $144.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.89
Rate for Payer: Molina Healthcare Benefit Exchange $132.55
Rate for Payer: Molina Healthcare Medicaid $61.74
Rate for Payer: Ohio Health Choice Commercial $154.88
Rate for Payer: Ohio Health Group HMO $132.00
Rate for Payer: Ohio Health Group PPO Differential $35.20
Rate for Payer: Ohio Health Group PPO No Differential $22.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.56
Rate for Payer: PHCS Commercial $168.96
Rate for Payer: United Healthcare All Payer $154.88
Service Code HCPCS 94668
Hospital Charge Code 41000083
Hospital Revenue Code 410
Min. Negotiated Rate $22.88
Max. Negotiated Rate $168.96
Rate for Payer: Aetna Commercial $135.52
Rate for Payer: Anthem POS/PPO/Traditional $137.28
Rate for Payer: Cash Price $88.00
Rate for Payer: Cigna Commercial $146.08
Rate for Payer: First Health Commercial $167.20
Rate for Payer: Humana Commercial $149.60
Rate for Payer: Medical Mutual Of Ohio HMO $144.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $129.89
Rate for Payer: Molina Healthcare Benefit Exchange $52.80
Rate for Payer: Ohio Health Choice Commercial $154.88
Rate for Payer: Ohio Health Group HMO $132.00
Rate for Payer: Ohio Health Group PPO Differential $35.20
Rate for Payer: Ohio Health Group PPO No Differential $22.88
Rate for Payer: Ohio Health Group PPO SOMC Employees $54.56
Rate for Payer: PHCS Commercial $168.96
Rate for Payer: United Healthcare All Payer $154.88
Hospital Charge Code 22200037
Hospital Revenue Code 222
Min. Negotiated Rate $435.75
Max. Negotiated Rate $1,245.00
Rate for Payer: Buckeye Medicare Advantage $1,245.00
Rate for Payer: Cash Price $622.50
Rate for Payer: Multiplan PHCS $747.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $871.50
Rate for Payer: UHCCP Medicaid $435.75
Hospital Charge Code 22200373
Hospital Revenue Code 222
Min. Negotiated Rate $217.88
Max. Negotiated Rate $622.50
Rate for Payer: Buckeye Medicare Advantage $622.50
Rate for Payer: Cash Price $311.25
Rate for Payer: Multiplan PHCS $373.50
Rate for Payer: Ohio Health Choice Preferred Health Choice $435.75
Rate for Payer: UHCCP Medicaid $217.88
Service Code HCPCS 77317
Hospital Charge Code 33300011
Hospital Revenue Code 333
Min. Negotiated Rate $118.59
Max. Negotiated Rate $1,134.00
Rate for Payer: Anthem Medicaid $183.36
Rate for Payer: Buckeye Medicare Advantage $1,134.00
Rate for Payer: Cash Price $567.00
Rate for Payer: Cash Price $567.00
Rate for Payer: Cigna Commercial $382.91
Rate for Payer: Humana Medicaid $183.36
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $118.59
Rate for Payer: Molina Healthcare CHIP/Medicaid $187.03
Rate for Payer: Molina Healthcare Passport $183.36
Rate for Payer: Multiplan PHCS $680.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $793.80
Rate for Payer: UHCCP Medicaid $396.90
Rate for Payer: Wellcare CHIP/Medicaid $185.19
Service Code HCPCS 77317
Hospital Charge Code 33300011
Hospital Revenue Code 333
Min. Negotiated Rate $147.42
Max. Negotiated Rate $1,088.64
Rate for Payer: Aetna Commercial $873.18
Rate for Payer: Anthem Medicaid $389.98
Rate for Payer: Anthem Medicare Advantage/PPO $319.52
Rate for Payer: Anthem POS/PPO/Traditional $884.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $447.33
Rate for Payer: CareSource Just4Me Medicare $431.35
Rate for Payer: Cash Price $567.00
Rate for Payer: Cash Price $567.00
Rate for Payer: Cigna Commercial $941.22
Rate for Payer: First Health Commercial $1,077.30
Rate for Payer: Humana Commercial $963.90
Rate for Payer: Humana KY Medicaid $389.98
Rate for Payer: Humana Medicare Advantage $319.52
Rate for Payer: Kentucky WC Medicaid $393.95
Rate for Payer: Medical Mutual Of Ohio HMO $929.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $836.89
Rate for Payer: Molina Healthcare Benefit Exchange $383.42
Rate for Payer: Molina Healthcare Medicaid $397.81
Rate for Payer: Ohio Health Choice Commercial $997.92
Rate for Payer: Ohio Health Group HMO $850.50
Rate for Payer: Ohio Health Group PPO Differential $226.80
Rate for Payer: Ohio Health Group PPO No Differential $147.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $351.54
Rate for Payer: PHCS Commercial $1,088.64
Rate for Payer: United Healthcare All Payer $997.92
Service Code HCPCS 77317
Hospital Charge Code 33300011
Hospital Revenue Code 333
Min. Negotiated Rate $147.42
Max. Negotiated Rate $1,088.64
Rate for Payer: Aetna Commercial $873.18
Rate for Payer: Anthem POS/PPO/Traditional $884.52
Rate for Payer: Cash Price $567.00
Rate for Payer: Cigna Commercial $941.22
Rate for Payer: First Health Commercial $1,077.30
Rate for Payer: Humana Commercial $963.90
Rate for Payer: Medical Mutual Of Ohio HMO $929.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $836.89
Rate for Payer: Molina Healthcare Benefit Exchange $340.20
Rate for Payer: Ohio Health Choice Commercial $997.92
Rate for Payer: Ohio Health Group HMO $850.50
Rate for Payer: Ohio Health Group PPO Differential $226.80
Rate for Payer: Ohio Health Group PPO No Differential $147.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $351.54
Rate for Payer: PHCS Commercial $1,088.64
Rate for Payer: United Healthcare All Payer $997.92
Service Code HCPCS 77317
Hospital Charge Code 333P0011
Hospital Revenue Code 333
Min. Negotiated Rate $70.00
Max. Negotiated Rate $382.91
Rate for Payer: Anthem Medicaid $183.36
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 $382.91
Rate for Payer: Humana Medicaid $183.36
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $118.59
Rate for Payer: Molina Healthcare CHIP/Medicaid $187.03
Rate for Payer: Molina Healthcare Passport $183.36
Rate for Payer: Multiplan PHCS $120.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $140.00
Rate for Payer: UHCCP Medicaid $70.00
Rate for Payer: Wellcare CHIP/Medicaid $185.19
Service Code HCPCS 77317
Hospital Charge Code 333T0011
Hospital Revenue Code 333
Min. Negotiated Rate $121.42
Max. Negotiated Rate $896.64
Rate for Payer: Aetna Commercial $719.18
Rate for Payer: Anthem POS/PPO/Traditional $728.52
Rate for Payer: Cash Price $467.00
Rate for Payer: Cigna Commercial $775.22
Rate for Payer: First Health Commercial $887.30
Rate for Payer: Humana Commercial $793.90
Rate for Payer: Medical Mutual Of Ohio HMO $765.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $689.29
Rate for Payer: Molina Healthcare Benefit Exchange $280.20
Rate for Payer: Ohio Health Choice Commercial $821.92
Rate for Payer: Ohio Health Group HMO $700.50
Rate for Payer: Ohio Health Group PPO Differential $186.80
Rate for Payer: Ohio Health Group PPO No Differential $121.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $289.54
Rate for Payer: PHCS Commercial $896.64
Rate for Payer: United Healthcare All Payer $821.92
Service Code HCPCS 77317
Hospital Charge Code 333T0011
Hospital Revenue Code 333
Min. Negotiated Rate $121.42
Max. Negotiated Rate $896.64
Rate for Payer: Aetna Commercial $719.18
Rate for Payer: Anthem Medicaid $321.20
Rate for Payer: Anthem Medicare Advantage/PPO $319.52
Rate for Payer: Anthem POS/PPO/Traditional $728.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $447.33
Rate for Payer: CareSource Just4Me Medicare $431.35
Rate for Payer: Cash Price $467.00
Rate for Payer: Cash Price $467.00
Rate for Payer: Cigna Commercial $775.22
Rate for Payer: First Health Commercial $887.30
Rate for Payer: Humana Commercial $793.90
Rate for Payer: Humana KY Medicaid $321.20
Rate for Payer: Humana Medicare Advantage $319.52
Rate for Payer: Kentucky WC Medicaid $324.47
Rate for Payer: Medical Mutual Of Ohio HMO $765.88
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $689.29
Rate for Payer: Molina Healthcare Benefit Exchange $383.42
Rate for Payer: Molina Healthcare Medicaid $327.65
Rate for Payer: Ohio Health Choice Commercial $821.92
Rate for Payer: Ohio Health Group HMO $700.50
Rate for Payer: Ohio Health Group PPO Differential $186.80
Rate for Payer: Ohio Health Group PPO No Differential $121.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $289.54
Rate for Payer: PHCS Commercial $896.64
Rate for Payer: United Healthcare All Payer $821.92
Service Code HCPCS 77316
Hospital Charge Code 33300010
Hospital Revenue Code 333
Min. Negotiated Rate $135.20
Max. Negotiated Rate $998.40
Rate for Payer: Aetna Commercial $800.80
Rate for Payer: Anthem POS/PPO/Traditional $811.20
Rate for Payer: Cash Price $520.00
Rate for Payer: Cigna Commercial $863.20
Rate for Payer: First Health Commercial $988.00
Rate for Payer: Humana Commercial $884.00
Rate for Payer: Medical Mutual Of Ohio HMO $852.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $767.52
Rate for Payer: Molina Healthcare Benefit Exchange $312.00
Rate for Payer: Ohio Health Choice Commercial $915.20
Rate for Payer: Ohio Health Group HMO $780.00
Rate for Payer: Ohio Health Group PPO Differential $208.00
Rate for Payer: Ohio Health Group PPO No Differential $135.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $322.40
Rate for Payer: PHCS Commercial $998.40
Rate for Payer: United Healthcare All Payer $915.20